'Second-Stage' Iorwerth: Textual Change and Development in Medieval Welsh Legal Manuscripts

This thesis explores a set of legal manuscripts from medieval Wales, known as the Iorwerth recension. These manuscripts are placed in their historical and material settings, and a view of the development of the text is given. From an original thirteenth-century core, a story is told of the recension’s development across a range of further rearrangements and uses across the Middle Ages. The use of the Iorwerth text is analysed for what it might reveal of the intentions and mindset of the copyist. In the second half of the thesis, a more traditional textual account is given of the Iorwerth recension. Volume II contains tables and editions to accompany the arguments in the first volume

Prospective evaluation of voice outcome during the first two years in male patients treated by radiotherapy or laser surgery for T1a glottic carcinoma

In this prospective cohort study, we assessed voice outcome in patients before and up to 2 years after treatment for early glottic cancer either by radiotherapy or by laser surgery; 106 male patients, treated for T1aN0M0 glottic cancer either by endoscopic laser surgery (n = 67) or by radiotherapy (n = 39), participated in the study. Patients’ voices were recorded and analysed pre-treatment and 3, 6, 12 and 24 months post-treatment at their routine visit at the outpatient clinic. Average fundamental frequency (F0), percent jitter, percent shimmer and normalized noise energy (NNE) were determined. After 2 years, local control rate was 95% in the radiotherapy group and 97% in the laser surgery group. Larynx preservation rate was 95% after radiotherapy and 100% after laser surgery. Voice outcome recovers more quickly in patients treated with laser surgery in comparison to radiotherapy: 3 months after laser surgery there is no longer a difference with regard to normal voices except for the fundamental frequency, which remains higher pitched, even in the longer term. For patients treated with radiotherapy it takes longer for jitter, shimmer and NNE to become normal, where jitter remains significantly different from normal voices even after 2 years. According to these results, we believe that laser surgery is the first treatment of choice in the treatment of selected cases of T1a glottic carcinomas with good functional and oncological results

Recent advances in pediatric anesthesia

Writing about advances in a field of medicine normally includes some pride about progress which one was witness to or even a participant in. The younger one is, the more enthusiastically every advance is lauded and welcomed. This is human nature and nothing to be complained about. However, when anesthesiologists, having worked and struggled in the field of pediatric anesthesia for about 40 years, look back to past advances, a more realistic, even painful picture comes to mind. There was a price which a considerable number of patients had to pay for progress, ruined health or even death. This experience of decades of practice is rarely presented in the literature but should not be forgotten when we proudly remember advances in pediatric anesthesia

Evidence‐based review of treatment options for patients with glottic cancer

Evidence‐based medicine integrates the best available data in decision making, with the goal of minimizing physicians' and patients' subjectivity. In 2006, the American Society of Clinical Oncology edited clinical practice guidelines for the use of larynx preservation strategies. The objective of this review was to evaluate the current levels of evidence for glottic squamous cell carcinoma. Current guidelines for early stage glottic cancer are based on low‐level evidence. Conservation surgery (open or transoral) and radiation therapy are all valid options for T1 and selected T2 lesions. For advanced lesions, surgery and combined chemotherapy and radiation are options. High‐level evidence favors combined chemotherapy and radiation therapy or altered fractionation radiation therapy as nonsurgical strategies for organ preservation, compared with radiation therapy alone. The optimal combination of chemotherapy, targeted therapy, and radiation therapy remains to be demonstrated, however, and for high‐volume tumors, total laryngectomy may still be warranted. © 2011 Wiley Periodicals, Inc. Head Neck, 2011Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87151/1/21528_ftp.pd

An Emergence Framework of Carcinogenesis

Experimental paradigms provide the framework for the understanding of cancer, and drive research and treatment, but are rarely considered by clinicians. The somatic mutation theory (SMT), in which cancer is considered a genetic disease, has been the predominant traditional model of cancer for over 50 years. More recently, alternative theories have been proposed, such as tissue organization field theory (TOFT), evolutionary models, and inflammatory models. Key concepts within the various models have led to them being difficult to reconcile. Progressively, it has been recognized that biological systems cannot be fully explained by the physicochemical properties of their constituent parts. There is an increasing call for a ‘systems’ approach. Incorporating the concepts of ‘emergence’, ‘systems’, ‘thermodynamics’, and ‘chaos’, a single integrated framework for carcinogenesis has been developed, enabling existing theories to become compatible as alternative mechanisms, facilitating the integration of bioinformatics and providing a structure in which translational research can flow from both ‘benchtop to bedside’ and ‘bedside to benchtop’. In this review, a basic understanding of the key concepts of ‘emergence’, ‘systems’, ‘system levels’, ‘complexity’, ‘thermodynamics’, ‘entropy’, ‘chaos’, and ‘fractals’ is provided. Non-linear mathematical equations are included where possible to demonstrate compatibility with bioinformatics. Twelve principles that define the ‘emergence framework of carcinogenesis’ are developed, with principles 1–10 encapsulating the key concepts upon which the framework is built and their application to carcinogenesis. Principle 11 relates the framework to cancer progression. Principle 12 relates to the application of the framework to translational research. The ‘emergence framework of carcinogenesis’ collates current paradigms, concepts, and evidence around carcinogenesis into a single framework that incorporates previously incompatible viewpoints and ideas. Any researcher, scientist, or clinician involved in research, treatment, or prevention of cancer can employ this framework

Young schoolboys of Kasompe Township school doing physical training in front of their school building.

210 x 160 mm. Showing a group of boys standing in lines in front of the school building. Crown Copyright Photograph

African mine workers collecting rations from the Mine Compound Ration store at Chingola

220 x 170 mm. Showing five men standing in a line. The men are carrying small baskets. Crown Copyright Photograph

A Kasompe shoe repairer at work, 1951

210 x 160 mm. Showing a man sitting on a small wooden bench. The man is hammering the heel of a shoe. Crown Copyright Photograph

Entrance to the main shaft at Nchanga Mine, Northern Rhodesia, 1950

210 x 150 mm. Showing the entrance to the main shaft and also a large notice board containing the heading 'N.C.C.M. SAFETY FIRST. LOST TIME CASUALTIES FOR CURRENT MONTH'. Crown Copyright Photograph