Immunologic tumor microenvironment modulators for turning ”cold“ tumors to ”hot“ tumors

Download Immunologic tumor microenvironment modulators for turning ”cold“ tumors to ”hot“ tumors PDF Online Free

Author :
Publisher : Frontiers Media SA
ISBN 13 : 2832549373
Total Pages : 195 pages
Book Rating : 4.8/5 (325 download)

DOWNLOAD NOW!


Book Synopsis Immunologic tumor microenvironment modulators for turning ”cold“ tumors to ”hot“ tumors by : Xin He

Download or read book Immunologic tumor microenvironment modulators for turning ”cold“ tumors to ”hot“ tumors written by Xin He and published by Frontiers Media SA. This book was released on 2024-05-24 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer immunotherapy is based on using the immune system components to fight tumors, without destroying normal cells. Several immunotherapeutic strategies have been investigated and proposed for the treatment of cancers, including cancer vaccines containing tumor antigens that are used to induce immune responses against tumors, monoclonal antibodies against tumor antigens, and immune checkpoint inhibitors. However, many clinical trials have shown that the use of these methods as monotherapy is ineffective in many cases. Many tumors can resist immunotherapy due to the absence or insufficient infiltration of tumors with CD8+ T cells and hence, are called “cold” or non-inflammatory tumors. Cold tumors are characterized by a lack of infiltrating CD8+ T cells, the presence of anti-inflammatory myeloid cells, tumor-associated M2 macrophages, and regulatory T cells. A combination of other cancer therapeutic approaches, such as chemotherapy or immunotherapy with cancer vaccines, could dramatically enhance the efficacy and, eventually, the outcome of the treatment. Despite some success of the immunotherapy of oncological diseases, cold tumors represent one of the main therapeutic challenges for modern immunotherapy. It can be expected that in the near future, treatment algorithms will be developed to adapt the therapeutic strategies to the immune context of the tumor since treatment with checkpoint inhibitors or vaccines alone is not enough for cold tumors. Therefore, using other therapeutic approaches alongside the existing treatment methods can be more reasonable for cold tumors that do not strongly stimulate the immune system or resist against it. To apply targeted treatments such as the use of small molecules, small peptides, hybrid small molecules, biologically active peptides, non-protein isolates of food products or by-products, and every material that is capable of the disturbing immunosuppressive tumor microenvironment (TME) as an adjuvant therapy can reduce the resistance of cold tumors to immunotherapy which is so-called turning them into “warm” tumors. This research topic aims to cover all outstanding advances in immunology, medical chemistry and biochemistry, pharmacology, food engineering and molecular biology of contemporary molecular drug targets involved in cancer treatment and encompasses the following subjects: • Definition and explanation of cold tumors and challenges ahead toward their treatment • Designing and application of small peptides, small molecules, and other similar materials to overcome suppressive TME and break tumors resistance • Extraction and preparation of bioactive peptides or other components derived from natural resources to make cold tumor barriers fragile • Modifications and alterations leading to overcoming cold tumor resistance against cancer vaccines and ICP inhibitors Manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by robust and relevant validation (clinical cohort or biological validation in vitro or in vivo) are out of scope for this topic.

Radioimmunotherapy – Translational Opportunities and Challenges

Download Radioimmunotherapy – Translational Opportunities and Challenges PDF Online Free

Author :
Publisher : Frontiers Media SA
ISBN 13 : 2889636151
Total Pages : 144 pages
Book Rating : 4.8/5 (896 download)

DOWNLOAD NOW!


Book Synopsis Radioimmunotherapy – Translational Opportunities and Challenges by : Udo S. Gaipl

Download or read book Radioimmunotherapy – Translational Opportunities and Challenges written by Udo S. Gaipl and published by Frontiers Media SA. This book was released on 2020-03-13 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Tertiary Lymphoid Structures

Download Tertiary Lymphoid Structures PDF Online Free

Author :
Publisher : Humana Press
ISBN 13 : 9781493987085
Total Pages : 289 pages
Book Rating : 4.9/5 (87 download)

DOWNLOAD NOW!


Book Synopsis Tertiary Lymphoid Structures by : Marie-Caroline Dieu-Nosjean

Download or read book Tertiary Lymphoid Structures written by Marie-Caroline Dieu-Nosjean and published by Humana Press. This book was released on 2018-09-05 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume explores the various methods used to study tertiary lymphoid structures (TLS) in pathological situations. Pre-clinical models are also discussed in detail to show how TLS structure, development, and maintenance can be targeted and studied in vivo. The chapters in this book cover topics such as humans and mice; strategies to quantify TLS in order to use it in stained tissue sections; classifying a gene signature form fixed and paraffin-embedded tissues; and development of murine inflammatory models to help look at TLS in the context of infection or malignancy. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Authoritative and thorough, Tertiary Lymphoid Structures: Methods and Protocols is a valuable resource that increases the reader’s knowledge on immune functions and how they will pave the way to future therapeutic applications.

Central Nervous System Metastases

Download Central Nervous System Metastases PDF Online Free

Author :
Publisher : Springer Nature
ISBN 13 : 3030234177
Total Pages : 411 pages
Book Rating : 4.0/5 (32 download)

DOWNLOAD NOW!


Book Synopsis Central Nervous System Metastases by : Manmeet Ahluwalia

Download or read book Central Nervous System Metastases written by Manmeet Ahluwalia and published by Springer Nature. This book was released on 2019-11-05 with total page 411 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of brain metastases, from the molecular biology aspects to therapeutic management and perspectives. Due to the increasing incidence of these tumors and the urgent need to effectively control brain metastatic diseases in these patients, new therapeutic strategies have emerged in recent years. The volume discusses all these innovative approaches combined with new surgical techniques (fluorescence, functional mapping, integrated navigation), novel radiation therapy techniques (stereotactic radiosurgery) and new systemic treatment approaches such as targeted- and immunotherapy. These combination strategies represent a new therapeutic model in brain metastatic patients in which each medical practitioner (neurosurgeon, neurologist, medical oncologist, radiation oncologist) plays a pivotal role in defining the optimal treatment in a multidisciplinary approach. Written by recognized experts in the field, this book is a valuable tool for neurosurgeons, neuro-oncologists, neuroradiologists, medical oncologists, radiation oncologists, cognitive therapists, basic scientists and students working in the area of brain tumors.

Biomechanics in Oncology

Download Biomechanics in Oncology PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3319952943
Total Pages : 378 pages
Book Rating : 4.3/5 (199 download)

DOWNLOAD NOW!


Book Synopsis Biomechanics in Oncology by : Cheng Dong

Download or read book Biomechanics in Oncology written by Cheng Dong and published by Springer. This book was released on 2018-10-27 with total page 378 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers multi-scale biomechanics for oncology, ranging from cells and tissues to whole organ. Topics covered include, but not limited to, biomaterials in mechano-oncology, non-invasive imaging techniques, mechanical models of cell migration, cancer cell mechanics, and platelet-based drug delivery for cancer applications. This is an ideal book for graduate students, biomedical engineers, and researchers in the field of mechanobiology and oncology. This book also: Describes how mechanical properties of cancer cells, the extracellular matrix, tumor microenvironment and immuno-editing, and fluid flow dynamics contribute to tumor progression and the metastatic process Provides the latest research on non-invasive imaging, including traction force microscopy and brillouin confocal microscopy Includes insight into NCIs’ role in supporting biomechanics in oncology research Details how biomaterials in mechano-oncology can be used as a means to tune materials to study cancer

Exercise Oncology

Download Exercise Oncology PDF Online Free

Author :
Publisher : Springer Nature
ISBN 13 : 3030420116
Total Pages : 438 pages
Book Rating : 4.0/5 (34 download)

DOWNLOAD NOW!


Book Synopsis Exercise Oncology by : Kathryn H. Schmitz

Download or read book Exercise Oncology written by Kathryn H. Schmitz and published by Springer Nature. This book was released on 2020-05-04 with total page 438 pages. Available in PDF, EPUB and Kindle. Book excerpt: This groundbreaking book presents a unique and practical approach to the evolving field of exercise oncology - the study of physical activity in the context of cancer prevention and control. Presenting the current state of the art, the book is sensibly divided into four thematic sections. Following an opening chapter presenting an overview and timeline of exercise oncology, the chapters comprising part I discuss primary cancer prevention, physical activity and survivorship, and the mechanisms by which these operate. Diagnosis and treatment considerations are discussed in part II, including prehabilitation, exercise during surgical recovery, infusion and radiation therapies, and treatment efficacy. Post-treatment and end-of-life care are covered in part III, including cardio-oncology, energetics and palliative care. Part IV presents behavioral, logistical and policy-making considerations, highlighting a multidisciplinary approach to exercise oncology as well as practical matters such as reimbursement and economics. Written and edited by experts in the field, Exercise Oncology will be a go-to practical resource for sports medicine clinicians, family and primary care physicians, oncologists, physical therapy and rehabilitation specialists, and all medical professionals who treat cancer patients.

NanoBioMedicine

Download NanoBioMedicine PDF Online Free

Author :
Publisher : Springer Nature
ISBN 13 : 9813298987
Total Pages : 510 pages
Book Rating : 4.8/5 (132 download)

DOWNLOAD NOW!


Book Synopsis NanoBioMedicine by : Shailendra K. Saxena

Download or read book NanoBioMedicine written by Shailendra K. Saxena and published by Springer Nature. This book was released on 2020-02-03 with total page 510 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of the recent trends in various Nanotechnology-based therapeutics and challenges associated with its development. Nanobiotechnology is an interdisciplinary research that has wide applications in the various fields of biomedical research. The book discusses the various facets of the application of Nanotechnology in drug delivery, clinical diagnostics, Nanomedicine and treatment of infectious and chronic diseases. The book also highlights the recent advancements on important devices and applications that are based on Nanotechnology in medicine and brief the regulatory and ethical issues related to nanomedical devices. It also reviews the toxicological profile of various nanomaterials and emphasizes the need for safe nanomaterials for clinical use. Finally, the book discusses the recent developments of potential commercial applications of Nanotechnology.

Progress in Cancer Immunotherapy

Download Progress in Cancer Immunotherapy PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 9401775559
Total Pages : 293 pages
Book Rating : 4.4/5 (17 download)

DOWNLOAD NOW!


Book Synopsis Progress in Cancer Immunotherapy by : Shuren Zhang

Download or read book Progress in Cancer Immunotherapy written by Shuren Zhang and published by Springer. This book was released on 2016-05-30 with total page 293 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides readers an extensive overview of recent progress in basic and clinical research on cancer immunotherapy. Thanks to rapid advances in molecular biology and immunology, it has become increasingly evident that cancer growth is influenced by host immune responses. With the success of a number of clinical trials, immunotherapy has become a promising treatment modality of cancer. This book covers five major topics, including monoclonal antibodies, biological response modifiers, cancer vaccines, adoptive cellular therapy and oncolytic viruses. It also examines the combination of different immune strategies as well as the combination of immunotherapy with other treatments to increase anti-tumor effects. Through the comprehensive discussion of the topic, the book sheds valuable new light on the treatment of tumors.

Inflammation and Cancer

Download Inflammation and Cancer PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3034808372
Total Pages : 489 pages
Book Rating : 4.0/5 (348 download)

DOWNLOAD NOW!


Book Synopsis Inflammation and Cancer by : Bharat B. Aggarwal

Download or read book Inflammation and Cancer written by Bharat B. Aggarwal and published by Springer. This book was released on 2014-05-12 with total page 489 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume examines in detail the role of chronic inflammatory processes in the development of several types of cancer. Leading experts describe the latest results of molecular and cellular research on infection, cancer-related inflammation and tumorigenesis. Further, the clinical significance of these findings in preventing cancer progression and approaches to treating the diseases are discussed. Individual chapters cover cancer of the lung, colon, breast, brain, head and neck, pancreas, prostate, bladder, kidney, liver, cervix and skin as well as gastric cancer, sarcoma, lymphoma, leukemia and multiple myeloma.

Thoracic Malignancies

Download Thoracic Malignancies PDF Online Free

Author :
Publisher : Demos Medical Publishing
ISBN 13 : 1935281801
Total Pages : 260 pages
Book Rating : 4.9/5 (352 download)

DOWNLOAD NOW!


Book Synopsis Thoracic Malignancies by : Steven E. Schild, MD

Download or read book Thoracic Malignancies written by Steven E. Schild, MD and published by Demos Medical Publishing. This book was released on 2010-03-08 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thoracic Malignancies: Thoracic Malignancies is the first title in Radiation Medicine Rounds. These tumors take more lives than any others and they are among the most preventable of tumors. Thus it is crucial for the practitioner to be up-to-date on the latest insights regarding their management. Thoracic Malignancies addresses the multi-disciplinary nature of the care of these tumors. There is representation from radiation oncology, medical oncology, and surgery ensuring a well-rounded summarization of current practice. Included are chapters on lung cancer, esophageal cancer, and thymomas providing coverage of the vast majority of thoracic tumors. The multi-disciplinary nature of the articles provides readers with an up-to-date summary and a well-rounded review regarding these tumors and their care. Expert authors provide reviews and assessments of the most recent data and its implications for current clinical practice, along with insights into emerging new trends of importance for the near future. About the Series Radiation Medicine Rounds is an invited review publication providing a thorough analysis of new scientific, technologic, and clinical advances in all areas of radiation medicine. There is an emphasis throughout on multidisciplinary approaches to the specialty, as well as on quality and outcomes analysis. Published three times a year Radiation Medicine Rounds provides authoritative, thorough assessments of a wide range of Ïhot topicsÓ and emerging new data for the entire specialty of radiation medicine. Features of Radiation Medicine Rounds include: Editorial board of nationally recognized experts across the spectrum of radiation medicine In-depth, up-to-date expert reviews and analysis of major new developments in all areas of Radiation Medicine Issues edited by an authority in specific subject area Focuses on major topics in Radiation Medicine with in-depth articles covering advances in radiation science radiation medicine technology, radiation medicine practice, and assessment of recent quality and outcomes studies Emphasizes multidisciplinary approaches to research and practice

Oncoimmunology

Download Oncoimmunology PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3319624318
Total Pages : 700 pages
Book Rating : 4.3/5 (196 download)

DOWNLOAD NOW!


Book Synopsis Oncoimmunology by : Laurence Zitvogel

Download or read book Oncoimmunology written by Laurence Zitvogel and published by Springer. This book was released on 2017-12-13 with total page 700 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, leading experts in cancer immunotherapy join forces to provide a comprehensive guide that sets out the main principles of oncoimmunology and examines the latest advances and their implications for clinical practice, focusing in particular on drugs with FDA/EMA approvals and breakthrough status. The aim is to deliver a landmark educational tool that will serve as the definitive reference for MD and PhD students while also meeting the needs of established researchers and healthcare professionals. Immunotherapy-based approaches are now inducing long-lasting clinical responses across multiple histological types of neoplasia, in previously difficult-to-treat metastatic cancers. The future challenges for oncologists are to understand and exploit the cellular and molecular components of complex immune networks, to optimize combinatorial regimens, to avoid immune-related side effects, and to plan immunomonitoring studies for biomarker discovery. The editors hope that this book will guide future and established health professionals toward the effective application of cancer immunology and immunotherapy and contribute significantly to further progress in the field.

Immune Checkpoint Inhibitors in Cancer

Download Immune Checkpoint Inhibitors in Cancer PDF Online Free

Author :
Publisher : Elsevier Health Sciences
ISBN 13 : 0323549500
Total Pages : 271 pages
Book Rating : 4.3/5 (235 download)

DOWNLOAD NOW!


Book Synopsis Immune Checkpoint Inhibitors in Cancer by : Fumito Ito

Download or read book Immune Checkpoint Inhibitors in Cancer written by Fumito Ito and published by Elsevier Health Sciences. This book was released on 2018-09-03 with total page 271 pages. Available in PDF, EPUB and Kindle. Book excerpt: Get a quick, expert overview of the latest clinical information and guidelines for cancer checkpoint inhibitors and their implications for specific types of cancers. This practical title by Drs. Fumito Ito and Marc Ernstoff synthesizes the most up-to-date research and clinical guidance available on immune checkpoint inhibitors and presents this information in a compact, easy-to-digest resource. It's an ideal concise reference for trainee and practicing medical oncologists, as well as those in research. - Discusses the current understanding of how to best harness the immune system against different types of cancer at various stages. - Helps you translate current research and literature into practical information for daily practice. - Presents information logically organized by disease site. - Covers tumor immunology and biology; toxicities associated with immune checkpoint inhibitors; and future outlooks. - Consolidates today's available information on this timely topic into one convenient resource.

Translational Immunotherapy of Brain Tumors

Download Translational Immunotherapy of Brain Tumors PDF Online Free

Author :
Publisher : Academic Press
ISBN 13 : 0128026251
Total Pages : 406 pages
Book Rating : 4.1/5 (28 download)

DOWNLOAD NOW!


Book Synopsis Translational Immunotherapy of Brain Tumors by : John H. Sampson

Download or read book Translational Immunotherapy of Brain Tumors written by John H. Sampson and published by Academic Press. This book was released on 2017-02-06 with total page 406 pages. Available in PDF, EPUB and Kindle. Book excerpt: Translational Immunotherapy of Brain Tumors gives researchers and practitioners an up-to-date and comprehensive overview of the field. Chapters include adoptive immunotherapy, immunosuppression, CAR therapy of brain tumors, and dendritic cell therapy for brain tumors. Very few agents have been shown to be efficacious in the treatment of malignant gliomas. Recently, there have been a number of studies demonstrating the potential success of immunotherapy for brain tumors. Immunotherapeutics are becoming the most frequent drugs to be used in cancer therapy. These new breakthroughs, now approved by the FDA, are a part of multiple phase III international trials and ongoing research in malignant glioma, meaning that the information in this cutting-edge book will be of great importance to practitioners and researchers alike. 2018 BMA Medical Book Awards Highly Commended in Oncology - Comprehensive overview, providing an update on immunology, translational immunotherapy, and clinical trials relating to malignant gliomas - Edited by a prominent neurosurgeon with contributions by leading researchers in the field - Ideal resource for researchers and practitioners interested in learning about mechanisms that use the immune system to treat brain tumors

Chemokines and Cancer

Download Chemokines and Cancer PDF Online Free

Author :
Publisher : Springer Science & Business Media
ISBN 13 :
Total Pages : 346 pages
Book Rating : 4.3/5 (91 download)

DOWNLOAD NOW!


Book Synopsis Chemokines and Cancer by : Barrett Rollins

Download or read book Chemokines and Cancer written by Barrett Rollins and published by Springer Science & Business Media. This book was released on 1999 with total page 346 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the introduction of microscopy, pathologists have noted tumor infiltration by inflammatory cells and presumed that this represents the host's attempt to reject its tumor. Recent advances in the molecular biology of inflammation have revealed the signals involved in attracting inflammatory cells to tumors and, for the most part, these signals are mediated by chemokines and their receptors. Chemokines are low molecular weight proteins that attract and activate specific subsets of leukocytes to the exclusion of others.

Ovarian Cancer Immunotherapy

Download Ovarian Cancer Immunotherapy PDF Online Free

Author :
Publisher : Oxford University Press
ISBN 13 : 019024822X
Total Pages : 273 pages
Book Rating : 4.1/5 (92 download)

DOWNLOAD NOW!


Book Synopsis Ovarian Cancer Immunotherapy by : Samir A. Farghaly

Download or read book Ovarian Cancer Immunotherapy written by Samir A. Farghaly and published by Oxford University Press. This book was released on 2018-08-31 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ovarian Cancer Immunotherapy provides a broad overview of several aspects of basic sciences, and clinical and therapeutic aspects of immunotherapy for ovarian cancer, as well as state-of-the-art information on molecular genetics and biology. Chapters are written by a team of expert contributors from around the world and explore topics such as antibody therapeutics for ovarian carcinoma, emerging serum biomarkers, ovarian cancer immunity, adoptive cell immunotherapy, the biology of dendritic cells, the role of growth factors, and more. Readers will also gain a better understanding of the molecular and cellular events that underlie ovarian cancer immunology. This book is an ideal resource for clinicians, basic medical scientists, graduate basic medical science students, and medical students caring for patients with ovarian cancer, including attending surgeons and physicians, and clinical fellows and residents in the disciplines of gynecologic oncology, medical oncology, and surgical oncology.

New Prognostic and Predictive Markers in Cancer Progression

Download New Prognostic and Predictive Markers in Cancer Progression PDF Online Free

Author :
Publisher : MDPI
ISBN 13 : 3039439774
Total Pages : 294 pages
Book Rating : 4.0/5 (394 download)

DOWNLOAD NOW!


Book Synopsis New Prognostic and Predictive Markers in Cancer Progression by : Susan Costantini Alfredo Budillon

Download or read book New Prognostic and Predictive Markers in Cancer Progression written by Susan Costantini Alfredo Budillon and published by MDPI. This book was released on 2021-02-12 with total page 294 pages. Available in PDF, EPUB and Kindle. Book excerpt: Biomarkers are of critical medical importance for oncologists, allowing them to predict and detect disease and to determine the best course of action for cancer patient care. Prognostic markers are used to evaluate a patient’s outcome and cancer recurrence probability after initial interventions such as surgery or drug treatments and, hence, to select follow-up and further treatment strategies. On the other hand, predictive markers are increasingly being used to evaluate the probability of benefit from clinical intervention(s), driving personalized medicine. Evolving technologies and the increasing availability of “multiomics” data are leading to the selection of numerous potential biomarkers, based on DNA, RNA, miRNA, protein, and metabolic alterations within cancer cells or tumor microenvironment, that may be combined with clinical and pathological data to greatly improve the prediction of both cancer progression and therapeutic treatment responses. However, in recent years, few biomarkers have progressed from discovery to become validated tools to be used in clinical practice. This Special Issue comprises eight review articles and five original studies on novel potential prognostic and predictive markers for different cancer types.

Innovations for Next-Generation Antibody-Drug Conjugates

Download Innovations for Next-Generation Antibody-Drug Conjugates PDF Online Free

Author :
Publisher : Springer
ISBN 13 : 3319781545
Total Pages : 358 pages
Book Rating : 4.3/5 (197 download)

DOWNLOAD NOW!


Book Synopsis Innovations for Next-Generation Antibody-Drug Conjugates by : Marc Damelin

Download or read book Innovations for Next-Generation Antibody-Drug Conjugates written by Marc Damelin and published by Springer. This book was released on 2018-05-29 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: Antibody-drug conjugates (ADCs) stand at the verge of a transformation. Scores of clinical programs have yielded only a few regulatory approvals, but a wave of technological innovation now empowers us to overcome past technical challenges. This volume focuses on the next generation of ADCs and the innovations that will enable them. The book inspires the future by integrating the field’s history with novel strategies and cutting-edge technologies. While the book primarily addresses ADCs for solid tumors, the last chapter explores the emerging interest in using ADCs to treat other diseases. The therapeutic rationale of ADCs is strong: to direct small molecules to the desired site of action (and away from normal tissues) by conjugation to antibodies or other targeting moieties. However, the combination of small and large molecules imposes deep complexity to lead optimization, pharmacokinetics, toxicology, analytics and manufacturing. The field has made significant advances in all of these areas by improving target selection, ADC design, manufacturing methods and clinical strategies. These innovations will inspire and educate scientists who are designing next-generation ADCs with the potential to transform the lives of patients.