An original account of willful ignorance and how this principle relates to modern probability and statistical methods

Through a series of colorful stories about great thinkers and the problems they chose to solve, the author traces the historical evolution of probability and explains how statistical methods have helped to propel scientific research. However, the past success of statistics has depended on vast, deliberate simplifications amounting to willful ignorance, and this very success now threatens future advances in medicine, the social sciences, and other fields. Limitations of existing methods result in frequent reversals of scientific findings and recommendations, to the consternation of both scientists and the lay public.

"Willful Ignorance" "The Mismeasure of Uncertainty" exposes the fallacy of regarding probability as the full measure of our uncertainty. The book explains how statistical methodology, though enormously productive and influential over the past century, is approaching a crisis. The deep and troubling divide between qualitative and quantitative modes of research, and between research and practice, are reflections of this underlying problem. The author outlines a path toward the re-engineering of data analysis to help close these gaps and accelerate scientific discovery.

"Willful Ignorance: The Mismeasure of Uncertainty "presents essential information and novel ideas that should be of interest to anyone concerned about the future of scientific research. The book is especially pertinent for professionals in statistics and related fields, including practicing and research clinicians, biomedical and social science researchers, business leaders, and policy-makers.

The Oxford American Handbook of Clinical Medicine Second Edition covers all areas of internal medicine and surgery, offering up-to-date advice on examination, diagnostic testing, common procedures, and in-patient care. Students, residents, nurses, and clinicians will find the handbook to be a succinct, comprehensive, and affordable introduction to clinical medicine in the popular format of the Oxford American Handbooks in Medicine series. The second edition includes a thorough updating of diagnostic and therapeutic guidelines, updated information on key clinical trials, numerous new images, and new information on palliative care. This handbook has everything you need for on-the-spot access to evidence-based clinical management guidelines.

Over the past decade, radiological imaging tests - including CT scanning, MRI, PET, X-rays, ultrasound, fluoroscopy and other modalities - have become essential to the routine diagnostic process. While these modern advanced medical images and their striking anatomic detail have discovered underlying issues, they have also contributed to a false impression of infallibility. Unlike other straightforward diagnostic tests, such as the EKG or blood chemistry panel, radiological imaging tests are highly variable and complex, often yielding uncertain results, as well as frequent false-negatives and false-positives. The experts who interpret the images (the diagnostic radiologists) sometimes make mistakes: the practice of diagnostic radiology is a fallible, human endeavour, one involving complex perceptual, neuro-physiological and cognitive processes employed under a wide range of circumstances, and with a great deal of variability. Error and Uncertainty in Diagnostic Radiology opens the 'black box,' of medical imaging, exposing the remarkable inner workings of the process of diagnostic radiology-including how and why it can sometimes go tragically wrong. The occurrence of radiological error is shown to be fundamentally intertwined with the underlying high level of uncertainty known to be present in the diagnostic process. As a foremost expert on radiology quality and safety, Dr. Bruno provides insight into the various types of radiologist error, along with a conceptual framework for understanding error and uncertainty in radiology, leading to practical strategies for error prevention and for reducing the risk of harm to patients when errors inevitably occur. This book is essential for radiologists, members of the Society to Improve Diagnosis in Medicine, emergency physicians, medical educators, medical and hospice administrators, especially quality and safety officers, as well as malpractice insurance carriers.

Computational and Evolutionary Analysis of HIV Molecular Sequences is for all researchers interested in HIV research, even those who only have a nodding acquaintance with computational biology (or those who are familiar with some, but not all, aspects of the field). HIV research is unusual in that it brings together scientists from a wide range of disciplines: clinicians, pathologists, immunologists, epidemiologists, virologists, computational biologists, structural biologists, evolutionary biologists, statisticians and mathematicians. This book seeks to bridge the gap between these groups, in both subject matter and terminology. Focused largely on HIV genetic variation, Computational and Evolutionary Analysis of HIV Molecular Sequences covers such issues as sampling and processing sequences, population genetics, phylogenetics and drug targets.

The chapters of this book report cutting-edge research on molecular events in adiposity and type 2 diabetes, thus opening the way for innovative drug-based therapeutic strategies. It addresses all those who wish to keep in touch with recent developments in the field.

The recent sequencing of mycoplasma genomes has marked a turning point in the molecular genetic analysis of these microorganisms. Transcriptome and proteome analyses promise to provide the first definition of the total protein complement of a cell. The mycoplasma group includes the smallest known self-replicating organisms carrying the smallest number of genes. No wonder, therefore, that mycoplasmas have a special appeal to those interested in deciphering the minimal set of genes essential for life. Mycoplasma genomics facilitated better understanding of mycoplasma pathogenesis. Most impressive are the findings concerning the interaction of mycoplasmas with the immune system, macrophage activation, cytokine induction, mycoplasma cell components acting as superantigens, and autoimmune manifestations. The molecular definition of mycoplasmal adhesins responsible for mycoplasma attachment to host cells and evasion of the host immune system by antigenic variation of mycoplasmal surface components are other 'hot' subjects of research.Demonstration of the ability of mycoplasmas to enter host cells, cause fusogenic, apoptotic and oncogenic effects, as well as the possible association of mycoplasmas with arthritis, had their share in intensifying research on mycoplasma pathogenesis, bringing more researchers into the circle of those interested in this group of organisms. The present book is a comprehensive, up-to-date, multi-authored treatise.

In this new volume, Dr. Gregory Fanelli, of the Geisinger Medical Center and a reknowned expert on knee injuries, provides orthopaedic surgeons with an unprecedented review of the most recent and advanced knowledge needed to successfully diagnosis and treat PCL injuries. This comprehensive and practical volume covers everything from biomechanics and anatomy, evaluation and non-operative treatment to the latest surgical treatments of PCL injuries using arthroscopy, grafts and synthetic ligament substitutes. In addition, contributions from such well-known specialists as Drs. M. Malek, Roger Larson and Fred Flandery make this an essential text for every orthopaedic surgeon.

Legal action involving doctors, either as defendants or expert witnesses, has greatly increased over the past decade and few can now remain aloof from this aspect of their profession. Written by doctors (including five Council Members of the Medical Defence Union of Great Britain) and lawyers, this practical guide offers clear and comprehensive advice to all concerned. Part I discusses how to write medical reports, especially when consent is required or confidential information is involved. Part II covers contentious issues in various clinical specialties which repeatedly arise in litigation; well-known examples are cases involving whiplash injuries or perinatal brain damage. In Part III lawyers discuss the medico-legal problems of the solicitor's role, court testimony and medical negligence. This book is a valuable reference to all members of the medical profession. Lawyers, officials and others outside the medical profession who come into contact with medical litigation but have limited medical knowledge will find much helpful information.

also occurs. New outbreaks of yellow fever have occurred in Colombia and Trinidad and new outbreaks of rift valley fever have occurred in Egypt. Chapter 6, Arenaviruses: The biochemical and physical properties have now been clar ified, and they show a remarkable uniformity in the various viruses constituting the group. The possibility that prenatal infection with LCM may result in hydrocephalus and chorioretinitis has been raised. Serologic surveys have suggested the existence of Lassa virus infection in Guinea, Central African Empire, Mali, Senegal, Cameroon, and Benin, in addition to earlier identification in Nigeria, Liberia, and Sierra Leone. Chapter 7, Coronaviruses: New studies have confirmed the important role of these viruses in common respiratory illnesses of children and adults. The viruses are now known to contain a single positive strand of RNA. About 50% of corona virus infections result in clinical illness. About 5% of common colds are caused by strain DC 43 in winter. Chapter 8, Cytomegalovirus: Sections on pathogenesis of CMV in relation to organ transplantation and mononucleosis, as well as sections on the risk and features of con genital infection and disease, have been expanded. There are encouraging preliminary results with a live CMV vaccine, but the questions of viral persistence and oncogenicity require further evaluation."

Essentials of Palliative Care is a to-the-point, clinically oriented resource for all members of the multidisciplinary palliative care team and trainees. It covers practical clinical topics, including assessment of the patient and pain and symptom management, and practical non-medical topics central to providing effective palliative care, including psychological management, guidance on how to help patients and their families through the many healthcare decision points they face, and sensitivity to the goals and culture of the patient. Review questions, with detailed answers, provide a convenient way for readers to test their knowledge.

Features:

. Concise, comprehensive, clinically focused

. Multiple choice review questions, with detailed answers

. Expert contributors from leading institutions

. Coordination of care by palliative care team a major focus

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Consumer interest in diet and nutritional supplements is increasing dramatically. Patients and members of the public are seeking advice from health professionals, nutritionists and food scientists. This book is designed to meet the needs of those professionals who are called upon to advise patients and the general public. It provides also a valuable text for those who are researchers or decision makers in the food and pharmaceutical industries. The text presents a thorough account of this topical subject and enables the reader to appreciate the functions of nutrients in health and common disease states, to understand the current debates over the roles of nutrients and supplements in the diet, and to answer those questions frequently asked by patients and consumers.

The Boron '97 meeting was a great success in summarising all recent developments in basic and applied research on boron's function, especially in plants. New techniques have since been developed and new insight has been gained into the role of boron in plant and animal metabolism. Nevertheless, there were still lots of open questions. The aim of the present workshop held in Bonn as a satellite meeting to the International Plant Nutrition Colloquium was thus to gather all actual information which has been gained since the Boron '97 meeting and to compile knowledge, both from animal and plant sciences. Furthermore, applied aspects had to be addressed too, as there is an increasing awareness of boron deficiencies even in crops such as wheat, which have formerly not been considered as responsive to boron application. Genetic differences in boron demand and efficiency within one species are a further important topic which has gained importance since the 1997 meeting. More in-depth knowledge on the mechanisms of boron efficiency are required as an increased efficiency will be one major possibility to maintain and improve crop yields for resource-poor farmers. Nevertheless, it has also clearly been shown that an adequate supply of boron is needed to obtain high yields of crops with a high quality, and that a sustainable agriculture has to provide an adequate boron supply to compensate for inevitable losses through leaching (especially in the humid tropics and temperate regions) and for the boron removal by the crop.

The availability of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) sold over-the-counter (OTC) to the public without prescription has become an issue of major concern in recent years. The problem has been highlighted in the UK, USA and other countries because of the continuing high rates of cases of poisoning and the influence of switching from prescription-only status for many NSAIDs to OTC sale brought about, in a large part, by governments and health maintenance organisations (especially in the USA) anxious to save on costs of these drugs. Concern in the UK about poisoning from paracetamol and the appreciable morbidity and mortality from aspirin was such that a major review was initiated in 1996 by the UK government's Medicines Control Agency (MCA). Doubtless, many other governments have also undertaken reviews of the safety issues concerning OTC analgesics and NSAIDs. In the UK the situation has culminated in the decision announced in August 1997, as this book was going to press, that the number of tablets/capsules of the solid dosage forms of paracetamol and aspirin would be limited for sale OTe. This decision was essentially based on the need to limit the unit quantity of these drugs so as to reduce the likelihood of poisoning with paracetamol and the development of gastrointestinal and other more serious side-effects from aspirin. Time. will tell whether these new regulations will influence the occurrence of these adverse events.

Every cell and organism faces the problem of spaces, made up of the two leaflets of the lipid generating a confined space in which metabolic bilayer. The importance of traffic and signaling across membranes is reflected by the estimate and anabolic reactions take place and at the same time allowing entry and exit of metabo that 20% of all genes in the human genome encode membrane proteins. A failure of any of lites, ions, proteins, and signals across its bor der. Evolution has solved the problem by these proteins may have dramatic con se generating lipid membranes that contain trans quences for ceH function. In recent years much porters, ion channels, and receptors. In eukary attention has been paid to diseases resulting otic cells, this problem is exacerbated by the from nonfunctional ion channels ("chan presence of multiple organelles, which are con nelopathies"). Not surprisingly, many of these fined spaces in their own right. Even the lipid diseases affect the excitability of cells. membrane consists of two relatively separate Transporter diseases (perhaps coined "carrier vi PREFACE diseases") are more related to metabolic dis Each chapter is concluded by a summary, and eases, Transporters are frequently found at the most chapters also contain an overview of the beginning or the end of metabolic pathways clinical features of a particular transporter and as a result can have similar effects to disease. a missing enzyme."

The administration of intravenous fluids is one of the most common and important therapeutic practices in the treatment of surgical, medical and critically ill patients. The international literature accordingly contains a vast number of works on fluid management, yet there is still confusion as to the best options in the various situations encountered in clinical practice. The purpose of this volume is to help the decision-making process by comparing different solution properties describing their indications, mechanisms of action and side-effects according to physiologic body water distribution, electrolytic and acid-base balance, and to clarify which products available on the market represent the best choice in different circumstances. The book opens by discussing in detail the concepts central to a sound understanding of abnormalities in fluid and electrolyte homeostasis and the effect of intravenous fluid administration. In the second part of the monograph, these concepts are used to explain the advantages and disadvantages of solutions available on the market in different clinical settings. Body Fluid Management: From Physiology to Therapy will serve as an invaluable decision-making guide, including for those who are not experts in the subject.

One of the most important developments in diagnostic imaging over the last decade has been magnetic resonance imaging (MRI). Its ability to differentiate between tissues and give patholog ical information about diseases has led to earlier treatment, thus increasing the likelihood of recovery. The images produced using this technique give superb anatomical detail in any plane and are obtained without the use of ionising radiation. The increased use of MRI has presented radiographers with a number of challenges, and because we are no longer dealing with ionising radiation understanding the subject can some times be confusing. We hope that this text will help radiographers and student radiographers to further their knowledge and unravel the mysteries of MRI. Philip T. English Christine Moore Contents 1 Basic Principles . . . . . . . . . 1 History ..... . 1 Atomic Theory . . 1 Magnetic Theory . 2 Resonance 4 Relaxation. . . . . 5 2 Instrumentation........ 9 The Magnet .. 9 Shim Coils ........... . 12 Gradient Coils ......... . 13 RF Transmitter/Receiver Coils. 14 The Computer . . . . . . . . . 18 3 Pulse Sequences. . . . . . . . . 19 Saturation Recovery (Partial Saturation) 19 Spin Echo (SE) . . . . . . . . . . . . . 20 Multiple Spin Echo. . . . . . . . . . . 22 Fast Spin Echo (FSE) or Turbo Spin Echo (TSE). 23 Inversion Recovery (IR) . . . . . . . . . . . . . 26 Gradient Echo .................. . 28 Magnetisation Transfer Contrast Imaging (MTC) 34 4 Image Production. . . . . . . .