Author: Henry H Q Heng
Publisher: World Scientific
ISBN: 9814520861
Category : Medical
Languages : en
Pages : 463
Book Description
Cancer research is at a crossroads. Traditionally, cancer has been thought of as a disease of gene mutation, where the stepwise accumulation of cancer gene mutations is the key, and the identification of common gene mutations has been considered to be essential for diagnosis and treatment. Despite extensive research efforts and accumulated knowledge on cancer genes and pathways, the clinical benefits of this traditional approach have been limited. Recently, cancer genome sequencing has revealed an extensive amount of genetic heterogeneity where the long-expected common mutation drivers have been difficult, if not impossible, to identify. These realities ultimately challenge the conceptual framework of current cancer biology.This book introduces a new concept of genome theory of cancer evolution, in an attempt to unify the field. Many important and representative, but often confusing, questions and paradoxes are critically analyzed. By comparing gene- and genome-based theories, the hidden flaws of many popular viewpoints are addressed. This discussion is intended to initiate a much-needed critical re-evaluation of current cancer research.
Debating Cancer: The Paradox In Cancer Research
Debating Cancer
Author: Henry H. Heng
Publisher: World Scientific
ISBN: 9814520853
Category : Science
Languages : en
Pages : 463
Book Description
"Cancer research is at a crossroads. Traditionally, cancer has been thought of as a disease of gene mutation, where the stepwise accumulation of cancer gene mutations is the key, and the identification of common gene mutations has been considered to be essential for diagnosis and treatment. Despite extensive research efforts and accumulated knowledge on cancer genes and pathways, the clinical benefits of this traditional approach have been limited. Recently, cancer genome sequencing has revealed an extensive amount of genetic heterogeneity where the long-expected common mutation drivers have been difficult, if not impossible, to identify. These realities ultimately challenge the conceptual framework of current cancer biology. This book introduces a new concept of genome theory of cancer evolution, in an attempt to unify the field. Many important and representative, but often confusing, questions and paradoxes are critically analyzed. By comparing gene- and genome-based theories, the hidden flaws of many popular viewpoints are addressed. This discussion is intended to initiate a much-needed critical re-evaluation of current cancer research."--
Publisher: World Scientific
ISBN: 9814520853
Category : Science
Languages : en
Pages : 463
Book Description
"Cancer research is at a crossroads. Traditionally, cancer has been thought of as a disease of gene mutation, where the stepwise accumulation of cancer gene mutations is the key, and the identification of common gene mutations has been considered to be essential for diagnosis and treatment. Despite extensive research efforts and accumulated knowledge on cancer genes and pathways, the clinical benefits of this traditional approach have been limited. Recently, cancer genome sequencing has revealed an extensive amount of genetic heterogeneity where the long-expected common mutation drivers have been difficult, if not impossible, to identify. These realities ultimately challenge the conceptual framework of current cancer biology. This book introduces a new concept of genome theory of cancer evolution, in an attempt to unify the field. Many important and representative, but often confusing, questions and paradoxes are critically analyzed. By comparing gene- and genome-based theories, the hidden flaws of many popular viewpoints are addressed. This discussion is intended to initiate a much-needed critical re-evaluation of current cancer research."--
Genome Chaos
Author: Henry H. Heng
Publisher: Academic Press
ISBN: 0128136367
Category : Medical
Languages : en
Pages : 564
Book Description
Genome Chaos: Rethinking Genetics, Evolution, and Molecular Medicine transports readers from Mendelian Genetics to 4D-genomics, building a case for genes and genomes as distinct biological entities, and positing that the genome, rather than individual genes, defines system inheritance and represents a clear unit of selection for macro-evolution. In authoring this thought-provoking text, Dr. Heng invigorates fresh discussions in genome theory and helps readers reevaluate their current understanding of human genetics, evolution, and new pathways for advancing molecular and precision medicine. - Bridges basic research and clinical application and provides a foundation for re-examining the results of large-scale omics studies and advancing molecular medicine - Gathers the most pressing questions in genomic and cytogenomic research - Offers alternative explanations to timely puzzles in the field - Contains eight evidence-based chapters that discuss 4d-genomics, genes and genomes as distinct biological entities, genome chaos and macro-cellular evolution, evolutionary cytogenetics and cancer, chromosomal coding and fuzzy inheritance, and more
Publisher: Academic Press
ISBN: 0128136367
Category : Medical
Languages : en
Pages : 564
Book Description
Genome Chaos: Rethinking Genetics, Evolution, and Molecular Medicine transports readers from Mendelian Genetics to 4D-genomics, building a case for genes and genomes as distinct biological entities, and positing that the genome, rather than individual genes, defines system inheritance and represents a clear unit of selection for macro-evolution. In authoring this thought-provoking text, Dr. Heng invigorates fresh discussions in genome theory and helps readers reevaluate their current understanding of human genetics, evolution, and new pathways for advancing molecular and precision medicine. - Bridges basic research and clinical application and provides a foundation for re-examining the results of large-scale omics studies and advancing molecular medicine - Gathers the most pressing questions in genomic and cytogenomic research - Offers alternative explanations to timely puzzles in the field - Contains eight evidence-based chapters that discuss 4d-genomics, genes and genomes as distinct biological entities, genome chaos and macro-cellular evolution, evolutionary cytogenetics and cancer, chromosomal coding and fuzzy inheritance, and more
Rethinking Cancer
Author: Bernhard Strauss
Publisher: MIT Press
ISBN: 0262362082
Category : Science
Languages : en
Pages : 433
Book Description
Leading scientists argue for a new paradigm for cancer research, proposing a complex systems view of cancer supported by empirical evidence. Current consensus in cancer research explains cancer as a disease caused by specific mutations in certain genes. After dramatic advances in genome sequencing, never before have we known so much about the individual cancer cell--and yet never before has it been so unclear what to do with this knowledge. In this volume, leading researchers argue for a new theory framework for understanding and treating cancer. The contributors propose a complex systems view of cancer, presenting conceptual building blocks for a new research paradigm supported by empirical evidence. The contributors first discuss the new research framework in terms of theoretical foundations and then take up the relevance of a systems approach, reviewing such topics as nonlinearity, recurrence after treatment, the cellular attractor concept, network theory, and non-coding DNA--the "dark matter" of our genome. They address the temporality of cancer progression, drawing on evolutionary theory and clinical experience. Finally, they cover the dominant role of the tissue microenvironment in cancer, analyzing topics including altered metabolic pathways, the disease-defining influence on metastasis, and the interconnectedness of different environmental niches across levels of organization.
Publisher: MIT Press
ISBN: 0262362082
Category : Science
Languages : en
Pages : 433
Book Description
Leading scientists argue for a new paradigm for cancer research, proposing a complex systems view of cancer supported by empirical evidence. Current consensus in cancer research explains cancer as a disease caused by specific mutations in certain genes. After dramatic advances in genome sequencing, never before have we known so much about the individual cancer cell--and yet never before has it been so unclear what to do with this knowledge. In this volume, leading researchers argue for a new theory framework for understanding and treating cancer. The contributors propose a complex systems view of cancer, presenting conceptual building blocks for a new research paradigm supported by empirical evidence. The contributors first discuss the new research framework in terms of theoretical foundations and then take up the relevance of a systems approach, reviewing such topics as nonlinearity, recurrence after treatment, the cellular attractor concept, network theory, and non-coding DNA--the "dark matter" of our genome. They address the temporality of cancer progression, drawing on evolutionary theory and clinical experience. Finally, they cover the dominant role of the tissue microenvironment in cancer, analyzing topics including altered metabolic pathways, the disease-defining influence on metastasis, and the interconnectedness of different environmental niches across levels of organization.
Cancer through the Lens of Evolution and Ecology
Author: Jason A. Somarelli
Publisher: CRC Press
ISBN: 1040027687
Category : Medical
Languages : en
Pages : 306
Book Description
Cancer cells exist in an ever-changing “ecology” and are subject to evolutionary pressures just like any species in nature. This edited book explores the following themes: 1) how the dynamics of mutation, epigenetics, and gene expression noise are sources of genetic diversity; 2) how scarce resources influence cancer therapy resistance; 3) how predator-prey dynamics are mirrored in immune-cancer cross-talk; 4) how cancer cells parallel niche construction theory; 5) how changing fitness landscapes enable cancer growth; and 6) how cancer cells interact within the body. The book is a resource for understanding cancer as a disease of multicellularity grounded in evolutionary principles. By using this knowledge, researchers are starting to exploit these behaviors for treatment paradigms. Key Features Bridges disciplines exemplifying the ways disparate fields create new perspectives when integrated. Offers insights from leading scholars in cancer biology, ecology and evolutionary biology. Provides a timely recognition by oncologists that evolutionary paradigms are crucial for breakthroughs in cancer treatment. Integrates basic and applied sciences of oncology and evolutionary biology.
Publisher: CRC Press
ISBN: 1040027687
Category : Medical
Languages : en
Pages : 306
Book Description
Cancer cells exist in an ever-changing “ecology” and are subject to evolutionary pressures just like any species in nature. This edited book explores the following themes: 1) how the dynamics of mutation, epigenetics, and gene expression noise are sources of genetic diversity; 2) how scarce resources influence cancer therapy resistance; 3) how predator-prey dynamics are mirrored in immune-cancer cross-talk; 4) how cancer cells parallel niche construction theory; 5) how changing fitness landscapes enable cancer growth; and 6) how cancer cells interact within the body. The book is a resource for understanding cancer as a disease of multicellularity grounded in evolutionary principles. By using this knowledge, researchers are starting to exploit these behaviors for treatment paradigms. Key Features Bridges disciplines exemplifying the ways disparate fields create new perspectives when integrated. Offers insights from leading scholars in cancer biology, ecology and evolutionary biology. Provides a timely recognition by oncologists that evolutionary paradigms are crucial for breakthroughs in cancer treatment. Integrates basic and applied sciences of oncology and evolutionary biology.
Ecology and Evolution of Cancer
Author: Beata Ujvari
Publisher: Academic Press
ISBN: 0128043806
Category : Medical
Languages : en
Pages : 292
Book Description
Ecology and Evolution of Cancer is a timely work outlining ideas that not only represent a substantial and original contribution to the fields of evolution, ecology, and cancer, but also goes beyond by connecting the interfaces of these disciplines. This work engages the expertise of a multidisciplinary research team to collate and review the latest knowledge and developments in this exciting research field. The evolutionary perspective of cancer has gained significant international recognition and interest, which is fully understandable given that somatic cellular selection and evolution are elegant explanations for carcinogenesis. Cancer is now generally accepted to be an evolutionary and ecological process with complex interactions between tumor cells and their environment sharing many similarities with organismal evolution. As a critical contribution to this field of research the book is important and relevant for the applications of evolutionary biology to understand the origin of cancers, to control neoplastic progression, and to prevent therapeutic failures. - Covers all aspects of the evolution of cancer, appealing to researchers seeking to understand its origins and effects of treatments on its progression, as well as to lecturers in evolutionary medicine - Functions as both an introduction to cancer and evolution and a review of the current research on this burgeoning, exciting field, presented by an international group of leading editors and contributors - Improves understanding of the origin and the evolution of cancer, aiding efforts to determine how this disease interferes with biotic interactions that govern ecosystems - Highlights research that intends to apply evolutionary principles to help predict emergence and metastatic progression with the aim of improving therapies
Publisher: Academic Press
ISBN: 0128043806
Category : Medical
Languages : en
Pages : 292
Book Description
Ecology and Evolution of Cancer is a timely work outlining ideas that not only represent a substantial and original contribution to the fields of evolution, ecology, and cancer, but also goes beyond by connecting the interfaces of these disciplines. This work engages the expertise of a multidisciplinary research team to collate and review the latest knowledge and developments in this exciting research field. The evolutionary perspective of cancer has gained significant international recognition and interest, which is fully understandable given that somatic cellular selection and evolution are elegant explanations for carcinogenesis. Cancer is now generally accepted to be an evolutionary and ecological process with complex interactions between tumor cells and their environment sharing many similarities with organismal evolution. As a critical contribution to this field of research the book is important and relevant for the applications of evolutionary biology to understand the origin of cancers, to control neoplastic progression, and to prevent therapeutic failures. - Covers all aspects of the evolution of cancer, appealing to researchers seeking to understand its origins and effects of treatments on its progression, as well as to lecturers in evolutionary medicine - Functions as both an introduction to cancer and evolution and a review of the current research on this burgeoning, exciting field, presented by an international group of leading editors and contributors - Improves understanding of the origin and the evolution of cancer, aiding efforts to determine how this disease interferes with biotic interactions that govern ecosystems - Highlights research that intends to apply evolutionary principles to help predict emergence and metastatic progression with the aim of improving therapies
The Gene
Author: Siddhartha Mukherjee
Publisher: Simon and Schuster
ISBN: 1476733538
Category : Medical
Languages : en
Pages : 624
Book Description
The #1 NEW YORK TIMES Bestseller The basis for the PBS Ken Burns Documentary The Gene: An Intimate History Now includes an excerpt from Siddhartha Mukherjee’s new book Song of the Cell! From the Pulitzer Prize–winning author of The Emperor of All Maladies—a fascinating history of the gene and “a magisterial account of how human minds have laboriously, ingeniously picked apart what makes us tick” (Elle). “Sid Mukherjee has the uncanny ability to bring together science, history, and the future in a way that is understandable and riveting, guiding us through both time and the mystery of life itself.” —Ken Burns “Dr. Siddhartha Mukherjee dazzled readers with his Pulitzer Prize-winning The Emperor of All Maladies in 2010. That achievement was evidently just a warm-up for his virtuoso performance in The Gene: An Intimate History, in which he braids science, history, and memoir into an epic with all the range and biblical thunder of Paradise Lost” (The New York Times). In this biography Mukherjee brings to life the quest to understand human heredity and its surprising influence on our lives, personalities, identities, fates, and choices. “Mukherjee expresses abstract intellectual ideas through emotional stories…[and] swaddles his medical rigor with rhapsodic tenderness, surprising vulnerability, and occasional flashes of pure poetry” (The Washington Post). Throughout, the story of Mukherjee’s own family—with its tragic and bewildering history of mental illness—reminds us of the questions that hang over our ability to translate the science of genetics from the laboratory to the real world. In riveting and dramatic prose, he describes the centuries of research and experimentation—from Aristotle and Pythagoras to Mendel and Darwin, from Boveri and Morgan to Crick, Watson and Franklin, all the way through the revolutionary twenty-first century innovators who mapped the human genome. “A fascinating and often sobering history of how humans came to understand the roles of genes in making us who we are—and what our manipulation of those genes might mean for our future” (Milwaukee Journal-Sentinel), The Gene is the revelatory and magisterial history of a scientific idea coming to life, the most crucial science of our time, intimately explained by a master. “The Gene is a book we all should read” (USA TODAY).
Publisher: Simon and Schuster
ISBN: 1476733538
Category : Medical
Languages : en
Pages : 624
Book Description
The #1 NEW YORK TIMES Bestseller The basis for the PBS Ken Burns Documentary The Gene: An Intimate History Now includes an excerpt from Siddhartha Mukherjee’s new book Song of the Cell! From the Pulitzer Prize–winning author of The Emperor of All Maladies—a fascinating history of the gene and “a magisterial account of how human minds have laboriously, ingeniously picked apart what makes us tick” (Elle). “Sid Mukherjee has the uncanny ability to bring together science, history, and the future in a way that is understandable and riveting, guiding us through both time and the mystery of life itself.” —Ken Burns “Dr. Siddhartha Mukherjee dazzled readers with his Pulitzer Prize-winning The Emperor of All Maladies in 2010. That achievement was evidently just a warm-up for his virtuoso performance in The Gene: An Intimate History, in which he braids science, history, and memoir into an epic with all the range and biblical thunder of Paradise Lost” (The New York Times). In this biography Mukherjee brings to life the quest to understand human heredity and its surprising influence on our lives, personalities, identities, fates, and choices. “Mukherjee expresses abstract intellectual ideas through emotional stories…[and] swaddles his medical rigor with rhapsodic tenderness, surprising vulnerability, and occasional flashes of pure poetry” (The Washington Post). Throughout, the story of Mukherjee’s own family—with its tragic and bewildering history of mental illness—reminds us of the questions that hang over our ability to translate the science of genetics from the laboratory to the real world. In riveting and dramatic prose, he describes the centuries of research and experimentation—from Aristotle and Pythagoras to Mendel and Darwin, from Boveri and Morgan to Crick, Watson and Franklin, all the way through the revolutionary twenty-first century innovators who mapped the human genome. “A fascinating and often sobering history of how humans came to understand the roles of genes in making us who we are—and what our manipulation of those genes might mean for our future” (Milwaukee Journal-Sentinel), The Gene is the revelatory and magisterial history of a scientific idea coming to life, the most crucial science of our time, intimately explained by a master. “The Gene is a book we all should read” (USA TODAY).
The Value of Systems and Complexity Sciences for Healthcare
Author: Joachim P Sturmberg
Publisher: Springer
ISBN: 3319262211
Category : Medical
Languages : en
Pages : 287
Book Description
This visionary reframing of health and healthcare uses a complexity science approach to building healthcare systems that are accessible, effective, and prepared for change and challenges. Its holistic map for understanding the human organism emphasizes the interconnectedness of the individual’s physical, psychological, cognitive, and sociocultural functioning. Applications of this approach are described in primary, specialist, and emergency care and at the organizational and policy levels, from translating findings to practice, to problem solving and evaluation. In this model, the differences between disease and illness and treating illness and restoring health are not mere wordplay, but instead are robust concepts reflecting real-world issues and their solutions. Based on the Proceedings of the 1st International Conference of Systems and Complexity for Healthcare, topics covered include: • Coping with complexity and uncertainty: insights from studying epidemiology in family medicine • Anticipation in complex systems: potential implications for improving safety and quality in healthcare • Monitoring variability and complexity at the bedside • Viewing mental health through the lens of complexity science • Ethical complexities in systems healthcare: what care and for whom? • The value of systems and complexity thinking to enable change in adaptive healthcare organizations supported by informatics • If the facts don’t fit the theory, change the theory: implications for health system reform The Value of Systems and Complexity Sciences for Healthcare will interest and inspire health and disease researchers, health professionals, health care planners, health system financiers, health system administrators, health services administrators, health professional educators, and, last but not least, current and future patients.
Publisher: Springer
ISBN: 3319262211
Category : Medical
Languages : en
Pages : 287
Book Description
This visionary reframing of health and healthcare uses a complexity science approach to building healthcare systems that are accessible, effective, and prepared for change and challenges. Its holistic map for understanding the human organism emphasizes the interconnectedness of the individual’s physical, psychological, cognitive, and sociocultural functioning. Applications of this approach are described in primary, specialist, and emergency care and at the organizational and policy levels, from translating findings to practice, to problem solving and evaluation. In this model, the differences between disease and illness and treating illness and restoring health are not mere wordplay, but instead are robust concepts reflecting real-world issues and their solutions. Based on the Proceedings of the 1st International Conference of Systems and Complexity for Healthcare, topics covered include: • Coping with complexity and uncertainty: insights from studying epidemiology in family medicine • Anticipation in complex systems: potential implications for improving safety and quality in healthcare • Monitoring variability and complexity at the bedside • Viewing mental health through the lens of complexity science • Ethical complexities in systems healthcare: what care and for whom? • The value of systems and complexity thinking to enable change in adaptive healthcare organizations supported by informatics • If the facts don’t fit the theory, change the theory: implications for health system reform The Value of Systems and Complexity Sciences for Healthcare will interest and inspire health and disease researchers, health professionals, health care planners, health system financiers, health system administrators, health services administrators, health professional educators, and, last but not least, current and future patients.
Rethinking Cancer
Author: Bernhard Strauss
Publisher: MIT Press
ISBN: 0262045214
Category : Science
Languages : en
Pages : 433
Book Description
Leading scientists argue for a new paradigm for cancer research, proposing a complex systems view of cancer supported by empirical evidence. Current consensus in cancer research explains cancer as a disease caused by specific mutations in certain genes. After dramatic advances in genome sequencing, never before have we known so much about the individual cancer cell--and yet never before has it been so unclear what to do with this knowledge. In this volume, leading researchers argue for a new theory framework for understanding and treating cancer. The contributors propose a complex systems view of cancer, presenting conceptual building blocks for a new research paradigm supported by empirical evidence. The contributors first discuss the new research framework in terms of theoretical foundations and then take up the relevance of a systems approach, reviewing such topics as nonlinearity, recurrence after treatment, the cellular attractor concept, network theory, and non-coding DNA--the "dark matter" of our genome. They address the temporality of cancer progression, drawing on evolutionary theory and clinical experience. Finally, they cover the dominant role of the tissue microenvironment in cancer, analyzing topics including altered metabolic pathways, the disease-defining influence on metastasis, and the interconnectedness of different environmental niches across levels of organization.
Publisher: MIT Press
ISBN: 0262045214
Category : Science
Languages : en
Pages : 433
Book Description
Leading scientists argue for a new paradigm for cancer research, proposing a complex systems view of cancer supported by empirical evidence. Current consensus in cancer research explains cancer as a disease caused by specific mutations in certain genes. After dramatic advances in genome sequencing, never before have we known so much about the individual cancer cell--and yet never before has it been so unclear what to do with this knowledge. In this volume, leading researchers argue for a new theory framework for understanding and treating cancer. The contributors propose a complex systems view of cancer, presenting conceptual building blocks for a new research paradigm supported by empirical evidence. The contributors first discuss the new research framework in terms of theoretical foundations and then take up the relevance of a systems approach, reviewing such topics as nonlinearity, recurrence after treatment, the cellular attractor concept, network theory, and non-coding DNA--the "dark matter" of our genome. They address the temporality of cancer progression, drawing on evolutionary theory and clinical experience. Finally, they cover the dominant role of the tissue microenvironment in cancer, analyzing topics including altered metabolic pathways, the disease-defining influence on metastasis, and the interconnectedness of different environmental niches across levels of organization.
Plagues and the Paradox of Progress
Author: Thomas J. Bollyky
Publisher: MIT Press
ISBN: 0262038455
Category : Medical
Languages : en
Pages : 277
Book Description
Why the news about the global decline of infectious diseases is not all good. Plagues and parasites have played a central role in world affairs, shaping the evolution of the modern state, the growth of cities, and the disparate fortunes of national economies. This book tells that story, but it is not about the resurgence of pestilence. It is the story of its decline. For the first time in recorded history, virus, bacteria, and other infectious diseases are not the leading cause of death or disability in any region of the world. People are living longer, and fewer mothers are giving birth to many children in the hopes that some might survive. And yet, the news is not all good. Recent reductions in infectious disease have not been accompanied by the same improvements in income, job opportunities, and governance that occurred with these changes in wealthier countries decades ago. There have also been unintended consequences. In this book, Thomas Bollyky explores the paradox in our fight against infectious disease: the world is getting healthier in ways that should make us worry. Bollyky interweaves a grand historical narrative about the rise and fall of plagues in human societies with contemporary case studies of the consequences. Bollyky visits Dhaka—one of the most densely populated places on the planet—to show how low-cost health tools helped enable the phenomenon of poor world megacities. He visits China and Kenya to illustrate how dramatic declines in plagues have affected national economies. Bollyky traces the role of infectious disease in the migrations from Ireland before the potato famine and to Europe from Africa and elsewhere today. Historic health achievements are remaking a world that is both worrisome and full of opportunities. Whether the peril or promise of that progress prevails, Bollyky explains, depends on what we do next. A Council on Foreign Relations Book
Publisher: MIT Press
ISBN: 0262038455
Category : Medical
Languages : en
Pages : 277
Book Description
Why the news about the global decline of infectious diseases is not all good. Plagues and parasites have played a central role in world affairs, shaping the evolution of the modern state, the growth of cities, and the disparate fortunes of national economies. This book tells that story, but it is not about the resurgence of pestilence. It is the story of its decline. For the first time in recorded history, virus, bacteria, and other infectious diseases are not the leading cause of death or disability in any region of the world. People are living longer, and fewer mothers are giving birth to many children in the hopes that some might survive. And yet, the news is not all good. Recent reductions in infectious disease have not been accompanied by the same improvements in income, job opportunities, and governance that occurred with these changes in wealthier countries decades ago. There have also been unintended consequences. In this book, Thomas Bollyky explores the paradox in our fight against infectious disease: the world is getting healthier in ways that should make us worry. Bollyky interweaves a grand historical narrative about the rise and fall of plagues in human societies with contemporary case studies of the consequences. Bollyky visits Dhaka—one of the most densely populated places on the planet—to show how low-cost health tools helped enable the phenomenon of poor world megacities. He visits China and Kenya to illustrate how dramatic declines in plagues have affected national economies. Bollyky traces the role of infectious disease in the migrations from Ireland before the potato famine and to Europe from Africa and elsewhere today. Historic health achievements are remaking a world that is both worrisome and full of opportunities. Whether the peril or promise of that progress prevails, Bollyky explains, depends on what we do next. A Council on Foreign Relations Book