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6,500 |
Appropriate Antibiotic Use for Treatment of Nonspecific Upper Respiratory Infections, Rhinosinusitis, and Acute Bronchitis in Adults
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Acute sinusitis, bronchitis, pharyngitis, and nonspecific upper respiratory tract infections (URIs) account for the majority of antibiotics prescribed by primary care physicians in the United States. The emergence of antibiotic-resistant bacteria in the community setting is now an issue for individual patients as well as society at large, and it is the responsibility of all clinicians to limit antibiotic treatment to those patients who are most likely to benefit from it. The vast majority of acute respiratory infections are caused by viruses. Antibiotic treatment of patients with these infections selects for resistant nasopharyngeal bacteria, acutely increasing the spread of resistant pathogens through secretions and predisposing the treated patient to more serious bacterial infections in the future. The guidelines summarized in this chapter were designed by a panel of physicians representing family medicine, internal medicine, emergency medicine, and infectious diseases to provide a practical approach to the appropriate diagnosis and treatment of previously healthy adults with nonspecific URI, acute sinusitis, or acute bronchitis in the ambulatory care setting. Recommendations for the diagnosis and treatment of pharyngitis are provided in a separate chapter.
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6,501 |
7 Leverfalen
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De lever vervult tal van essentiële functies in het menselijk lichaam, waaronder ontgifting van het bloed en aanmaak van diverse eiwitten en hormonen. Tevens speelt de lever een rol in het afweersysteem. Leverfalen kan omschreven worden als een situatie van onvoldoende werking van de lever bij deze processen. Dit beeld ontstaat wanneer door het verlies van functionele cellen het totale effectieve levervolume beneden een kritische grens komt. In dit hoofdstuk wordt ingegaan op diverse vormen van leverfalen en twee specifieke bij leverfalen voorkomende problemen, namelijk hepatische encefalopathie en verhoogde bloedingsneiging.
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6,502 |
Using Emergency Department Data For Biosurveillance: The North Carolina Experience
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Biosurveillance is an emerging field that provides early detection of disease outbreaks by collecting and interpreting data on a variety of public health threats. The public health system and medical care community in the United States have wrestled with developing new and more accurate methods for earlier detection of threats to the health of the public. The benefits and challenges of using Emergency Department data for surveillance are described in this chapter through examples from one biosurveillance system, the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). ED data are a proven tool for biosurveillance, and the ED data in NC DETECT have proved to be effective for a variety of public health uses, including surveillance, monitoring and investigation. A distinctive feature of ED data for surveillance is their timeliness. With electronic health information systems, these data are available in near real-time, making them particularly useful for surveillance and situational awareness in rapidly developing public health outbreaks or disasters. Challenges to using ED data for biosurveillance include the reliance on free text data (often in chief complaints). Problems with textual data are addressed in a variety of ways, including preprocessing data to clean the text entries and address negation. The use of ED data for public health surveillance can significantly increase the speed of detecting, monitoring and investigating public health events. Biosurveillance systems that are incorporated into hospital and public health practitioner daily work flows are more effective and easily used during a public health emergency. The flexibility of a system such as NC DETECT helps it meet this level of functionality.
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6,503 |
Viral Gene Compression: Complexity and Verification
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The smallest known biological organisms are, by far, the viruses. One of the unique adaptations that many viruses have aquired is the compression of the genes in their genomes. In this paper we study a formalized model of gene compression in viruses. Specifically, we define a set of constraints that describe viral gene compression strategies and investigate the properties of these constraints from the point of view of genomes as languages. We pay special attention to the finite case (representing real viral genomes) and describe a metric for measuring the level of compression in a real viral genome. An efficient algorithm for establishing this metric is given along with applications to real genomes including automated classification of viruses and prediction of horizontal gene transfer between host and virus.
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6,504 |
Immunomodulators: interleukins, interferons, and IV immunoglobulin
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The outstanding progress in immunology and the development of new technologies have resulted in the introduction of new immunotherapies, the so-called “immunomodulators”, for autoimmune diseases, inflammatory disorders, allograft rejection, and cancer. These immunomodulators comprise recombinant cytokines and specific blocking or depleting antibodies. Many of these therapies achieve their effect by stimulating the release of cytokines. The term cytokines includes interleukins (IL-), chemokines, growth factors, interferons (IFN), colony stimulating factors (CSF), and tumor necrosis factors (TNF). These molecules are involved in inflammation, cell proliferation and apoptosis, tissue injury and repair. These new therapeutic tools can be associated with side effects among which nephrotoxicity. The most common immunomodulators associated with nephrotoxicity are described in Table 1. The nephrotoxic side effects of immunomodulators can be roughly divided into (ischemic) tubular necrosis, thrombotic microangiopathy, serum sickness, and autoimmune disorders.
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6,505 |
Designing Medical Facilities to Care for Patients with Highly Hazardous Communicable Diseases
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Certain highly hazardous communicable diseases (HHCD), including viral hemorrhagic fevers, the Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome virus (SARS), have caused nosocomial outbreaks in unprepared facilities. Consequently, biocontainment units have been constructed to protect caregivers, patients, and family members, in addition to providing optimal care of the infected patient. Biocontainment units have adopted many of the design features originally found in biocontainment laboratories and can serve as national referral facilities for the most severe and highly hazardous infections. Although a patient with a HHCD can show up at any healthcare facility unannounced, not every hospital can or should attempt to establish a biocontainment unit. Nevertheless, there are design features or management principles found in biocontainment units that can be adopted in most facilities. Awareness of the potential risk, in addition to adopting structural and policy control measures, can do a lot to prepare a facility for the next unexpected infectious disease outbreak.
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6,506 |
High Frequency Oscillatory Ventilation
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Forty years have elapsed since investigators first appreciated that tidal volumes measuring less than the physiologic dead space can produce reliable ventilation when delivered at high frequencies. Of all high frequency ventilation techniques, high frequency oscillatory ventilation (HFOV) is the most well studied and is the most commonly utilized in clinical practice today. In HFOV, small volume oscillatory vibrations are superimposed on continuous distending pressure in a manner that allows efficient CO(2) elimination during continuous alveolar recruitment. By preserving end-expiratory lung volume, minimizing cyclic stretch, and avoiding alveolar overdistension at end-inspiration, HFOV is uniquely capable of providing the ultimate “open lung” strategy of ventilation. Over the past decade, a growing evidence base implicating phasic alveolar stretch in the pathogenesis of acute and chronic lung injury in patients with respiratory failure has driven the iterative refinement of HFOV management protocols for infants, children, and adults. The next step toward applying HFOV in a manner that takes into account the heterogeneity of parenchymal involvement in diseases such as the acute respiratory distress syndrome will require the development of non-invasive bedside technologies capable of identifying regional changes in lung volume and lung mechanics. Electrical impedance tomography (EIT) is a promising technique that could play a supporting role in the conduct of future clinical trials seeking to identify HFOV strategies that are maximally lung protective.
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6,507 |
Kardiologie
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Dieses Kapitel gibt einen Überblick über Ätiologie, Häufigkeit und Einteilung angeborener Herzfehler. Die einzelnen Herzfehler werden nach Definition, Einteilung, Klinik, Diagnostik, Therapie und Prognose beschrieben. Gleiches folgt für die erworbenen Herzerkrankungen. Abschließend werden die im Kindesalter typischen Herzrhythmusstörungen betrachtet.
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6,508 |
What We Think About When We Think About Triffids: The Monstrous Vegetal in Post-war British Science Fiction
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In the face of continuing post-war reconstruction and the rising tide of urbanization, British science fiction writers such as John Wyndham (a pseudonym for John Beynon Harris) and John Christopher (Sam Youd) portrayed post-apocalyptic scenarios in which the vegetal directly determines the fate of human civilization. By destabilizing the relationship between plant and human, Wyndham and Christopher open up a space to reconsider the vegetal as a distinct life form itself, beyond its instrumental use-value, or as an anthropomorphized reflection of human thought. Although plant life is traditionally defined by its inability to move or to speak, both writers suggest that communication bound to the visual or oral is highly limited (for instance, human sight is confined to a limited spectrum). In Wyndham’s The Day of the Triffids (1951) plants become mobile and seemingly sentient, in the process becoming an invasive presence that exposes and challenges the limits of anthropocentric thought. By contrast, in Christopher’s The Death of Grass (1956), the absence of the vegetal renders manifest the subaltern status of plant life, while suggesting that plants are able to communicate through their materiality and posture. Both texts signal that what is conventionally understood as Other is actually a blank repository that ventriloquizes humans’ unconscious desire. Following the population’s sudden loss of sight in The Day of the Triffids, the characters begin to project their own thoughts and emotions onto the triffids, which highlights the indeterminate limits of anthropomorphic representation. The Death of Grass demonstrates that such anthropocentrism constitutes an act of metaphysical violence that, at the same time, under-imagines plant life and installs specialist terminology and botanical classification as a substitute. Presenting the relationship between plant life and human life as a contested space, these texts manifest the problem of anthropocentric certainties and the absolute alterity of plant-thought.
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6,509 |
Infections in Patients with Acute Leukemia
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Patients with acute leukemia are at increased risk of developing infections both as a result of the leukemia and its treatment. Neutropenia is the primary risk factor associated with the development of infection, with the severity and frequency of infection increasing as the absolute neutrophil count drops below 500 cells/mm(3), as initially described by Bodey and colleagues. Other risk factors may be present including impaired cellular or humoral immunity, breakdown of normal barriers such as the skin and mucosal surfaces, and vascular access catheters and other foreign medical devices. Multiple risk factors are often present in the same patient. Additionally, the frequent use of antimicrobial agents for various indications (prophylaxis, empiric therapy, pre-emptive administration, specific or targeted therapy, and occasionally maintenance or suppressive therapy) has an impact on the nature and spectrum of infections, with the emergence/selection of multidrug-resistant (MDR) organisms being of particular concern. Bacterial infections tend to occur early on in a neutropenic episode, with fungal infections being uncommon at this stage. If neutropenia persists, the risk for fungal infections increases. There are periodic changes in the epidemiology/spectrum of infection in patients with leukemia. It is important to conduct periodic epidemiologic and susceptibility/resistance surveys, especially at institutions dealing with large numbers of such patients, in order to detect these shifts and changes in susceptibility/resistance patterns, since empiric therapy is largely based on this information. Such surveys are conducted every 3–5 years at our institution.
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6,510 |
Physical, Social and Cultural, and Global Influences
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In Chap. 5, we examined the technological environment of the health care policy-making system. Specifically, we examined the classification, evolution, and diffusion of medical technology; the effects of medical technology on medical training and the practice of medicine; effects on medical costs, quality of care, and quality of life; effects on access to care; the ethical concerns raised by medical technology; and the practice of technology assessment. We concluded the chapter by observing that the growth of technology, as well as other human endeavors, affects other important aspects of our lives, most notably, the air we breathe, the food we eat, the generation of radioactive by-products and toxic chemicals, the manufacture of illicit drugs, and the generation of natural and man-made hazards. In other words, in addition to their effects on the health care system, technology and other human activities affect many other aspects of our lives that are associated with health.
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6,511 |
Avian Infectious Bronchitis Virus
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Avian infectious bronchitis (IB) is caused by avian infectious bronchitis virus (IBV) belonging to Coronaviridae family. The disease is prevalent in all countries with almost 100% incidence rate. Chicken and commercially reared pheasant are the natural host for IBV. Virus causes respiratory diseases, poor weight gain, feed efficiency in broiler, damage to oviduct, and abnormal egg production in mature hens resulting in economic losses. IBV also replicates in tracheal and renal epithelial cells leading to prominent tracheal and kidney lesions. Virus undergoes spontaneous mutation leading to continual emergence of new variants. The effectiveness of immunization program is diminished because of poor cross-protection among the serotypes. Identification of circulating serotypes is important in controlling IBV infection. Toll-like receptor 3 (TLR3) and TLR21 are involved in early recognition of virus resulting in induction of inflammatory cytokines. Both humoral and cellular immune responses are important in the control of infection. Humoral immunity plays an important role in recovery and clearance of viral infection. IBV-specific cytotoxic T lymphocytes induce lysis of IBV-infected cells. Effective diagnostic tools are required at field level to identify different IBV variants. Embryonated chicken eggs are effective model for virus isolation. Identification by other specific methods like virus neutralization (VN), hemagglutination inhibition (HI), enzyme linked immunosorbent assay (ELISA), immunohistochemistry, or nucleic acid analysis or by electron microscopy is also indispensable. VN test in tracheal organ culture is the best method for antigenic typing for surveillance purposes. Continuous epidemiological surveillance, strict biosecurity measures, and vaccine effective against various serotypes are necessary for controlling IB in chickens.
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6,512 |
Biotechnology Applications of Grapevine Viruses
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Plant virus genomes are engineered as vectors for functional genomics and production of foreign proteins. The application of plant virus vectors is of potential interest to the worldwide, multibillion dollar, grape and wine industries. These applications include grapevine functional genomics, pathogen control, and production of beneficial proteins such as vaccines and enzymes. However, grapevine virus biology exerts certain limitations on the utility of the virus-derived gene expression and RNA interference vectors. As is typical for viruses infecting woody plants, several grapevine viruses exhibit prolonged infection cycles and relatively low overall accumulation levels, mainly because of their phloem-specific pattern of systemic infection. Here we consider the biotechnology potential of grapevine virus vectors with a special emphasis on members of the families Closteroviridae and Betaflexiviridae.
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6,513 |
Acute Pancreatitis
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Early diagnosis and treatment are crucial in the management of acute pancreatitis to prevent complications and to reduce morbidity and mortality.
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6,514 |
Advanced Pathology Techniques for Detecting Emerging Infectious Disease Pathogens
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The control and prevention of infectious diseases remain a fundamental part of public health programs throughout the world. The modern medicine and public health have been challenged by a series of emerging and reemerging infections in the past three decades. These diseases have occurred following a false sense of victory over infectious diseases on a global scale due to effective vaccinations and antibiotic agents against certain microorganisms. Because of the unique circumstances of the modern world, these new infectious diseases are emerging at much faster rates than before, and old ones are returning with formidable strength. These infections have posed severe threats to global public health and have raised serious questions regarding the capability of modern medicine to face their challenges. Therefore, it is crucial to understand the dynamics and impact of these emerging and reemerging infectious diseases. Diagnostic pathology continues to be an essential counterpart of clinical microbiology in dealing with emerging and reemerging infections. Diagnosis with advanced pathology techniques not only helps identify or confirm the novel pathogens causing emerging infections but is also essential for epidemiologic surveillance and studying pathogenesis of these emerging infections.
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6,515 |
Beeldvormende diagnostiek
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Radiologie en nucleaire geneeskunde zijn geïntegreerd in de opleiding radiologie. Expertise binnen de radiologie is naar orgaansysteem georganiseerd, maar in dit hoofdstuk wordt de radiologie per beeldvormende techniek besproken, dat wil zeggen conventionele radiologie, computertomografie (CT), echografie, magnetische resonantie imaging (MRI) en de nucleaire geneeskunde. De binnen de interne geneeskunde meest voorkomende indicaties voor de verschillende onderzoeken worden besproken inclusief de risico’s en gevaren van beeldvormende diagnostiek. ELEKTRONISCH AANVULLEND MATERIAAL: De online versie van dit hoofdstuk (doi:10.1007/978-90-368-1841-4_2) bevat aanvullend materiaal, dat beschikbaar is voor geautoriseerde gebruikers.
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6,516 |
The Needs of Children in Natural or Manmade Disasters
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Disasters have been described as “events of sufficient scale, asset depletion, or numbers of victims to overwhelm medical resources” [1] or as “a serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses that exceed the ability of the affected community or society to cope using its own resources” [2]. Importantly, that definition goes on to state: “A disaster is a function of the risk process. It results from the combination of hazards, conditions of vulnerability and insufficient capacity or measures to reduce the potential negative consequences of risk.”
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6,517 |
Alcohol-Mediated Zinc Deficiency Within the Alveolar Space: A Potential Fundamental Mechanism Underlying Oxidative Stress and Cellular Dysfunction in the Alcoholic Lung
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Zinc is one of the most abundant trace elements in the human body, and its presence is essential for numerous biological processes including enzymatic activity, immune function, protein synthesis, and wound healing. Given these important roles, zinc has a sophisticated transport system to regulate its homeostasis. Determination of zinc status, however, is difficult to determine as serum levels are closely maintained and are not an accurate reflection of total body zinc or metabolism at the organ level. Fortunately, the discovery of zinc-specific fluorescent dyes has allowed for a much better assessment of zinc status in the respiratory system and has revealed that alcoholism perturbs this highly developed zinc metabolism such that its distribution to the lung and alveolar space is significantly decreased. As a result, this pulmonary zinc deficiency impairs function in the alveolar macrophage, which is the primary host immune cell within the lower airway. Experimental models have demonstrated that correction of this zinc deficiency restores immune function to the alveolar macrophage as best reflected by improved bacterial clearance in response to infection. While the precise mechanisms underlying alcohol-induced zinc deficiency are still under investigation, there is experimental evidence of several important connections with granulocyte–macrophage colony-stimulating factor and oxidative stress, suggesting that alteration of zinc homeostasis may be a fundamental mechanism underlying the cellular pathology seen in the alcohol lung phenotype. This chapter reviews zinc homeostasis and offers insight into our understanding of zinc deficiency in the setting of alcoholism and the potential of zinc as a therapeutic modality in the vulnerable alcoholic host.
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6,518 |
Fever in Common Infectious Diseases
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#x203A; Infection of the respiratory tract is the most common reason for seeking medical advice and hospital admission in children. A viral upper respiratory tract infection (URTI) is the most common infection of the respiratory tract. › In developing countries, acute respiratory infection remains a leading cause of childhood mortality, causing an estimated 1.5–2 million deaths annually in children younger than 5 years of age. › In developed countries, viruses are responsible for most upper and lower respiratory tract infections, including pharyngitis and pneumonia. › Although the degree of fever cannot differentiate between viral and bacterial diseases, high fever is associated with a greater incidence of serious bacterial diseases such as pneumonia or meningitis. › Worldwide, diarrheal disease is the leading cause of childhood deaths under 5 years of age. › If the fever does not have an evident source, urinary tract infection (UTI) should be considered, particularly if the fever is greater than 39.0°C and persists for longer than 24–48 h. › Widespread vaccinations against bacteria causing meningitis, such as Hib, and vaccines against meningococci and pneumococci have dramatically reduced the incidence of meningitis. › A child with fever and nonblanching rash should be promptly evaluated to exclude meningococcal diseases. › Young children with malaria may present with irregular fever and not with typical paroxysms of fever, occurring particularly in early falciparum infection or as a consequence of previous chemoprophylaxis, which modifies the typical pattern of fever.
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6,519 |
Die Zelle als gengesteuertes System
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Die genetische Information der Pflanzenzelle ist in den DNA-Molekülen des Zellkerns (nucleäres Genom), der Plastiden (plastidäres Genom) und der Mitochondrien (mitochondriales Genom) niedergelegt. Die Genome der Plastiden und Mitochondrien leiten sich von Genomen prokaryotischer Organismen ab, die während der Evolution als Endosymbionten in die Eukaryotenzelle aufgenommen wurden, Endosymbiontentheorie.Diese Organellengenome, und die zugehörigen Mechanismen der Genexpression, zeichnen sich auch heute noch durch viele prokaryotische Merkmale aus.
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6,520 |
Editoriale — Polmoniti acquisite in comunità e polmoniti nosocomiali
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Per polmonite si intende un’infezione del parenchima polmonare.
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6,521 |
Automated Solid Phase Oligosaccharide Synthesis
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Of the three classes of biopolymers—nucleic acids, proteins and glycoconjugates, nucleic acids and proteins have seen the most breakthroughs in understanding their biological role, in part due to their ready availability. The automation of oligonucleotide and peptide synthesis has been fruitful in providing biologists and biochemists with pure, well-defined structures. This work reviews the recent developments in the automated synthesis of oligosaccharides, the third class of biopolymers. Both glycosyl phosphates and glycosyl trichloroacetimidates have been used successfully in the automated assembly of oligosaccharides employing an octenediol-functionalized polystyrene resin. The product was cleaved either by methanolysis of an ester bond or by olefin cross metathesis. Several biologically important carbohydrates have been synthesized by automation, in a fraction of the time needed to synthesize them by traditional methods. For example, the tumor associated antigens Lewis Y, Le(y)-Le(x), were synthesized by automation. A Leishmania cap tetrasaccharide and a malaria toxin vaccine candidate were also assembled.
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6,522 |
Deconstructing the Medical Chart
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This chapter provides an overview of the medical chart, and its sections. The neuropsychologist will be provided with detailed information about how to decipher some of the many abbreviations, and we also provide the neuropsychologist, who may not be familiar with common lab values with descriptions of the neurologic examination common grading systems such as motor and sensory functions. In addition, this chapter provides a brief overview of neurologic terms commonly encountered in general medical and more detailed neurological examinations along with figures and illustrations of some of these terms.
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6,523 |
Diagnostic Imaging in Sepsis of Pulmonary Origin
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Lung infections (community- or hospital-acquired) represent the most common cause for sepsis. Diagnostic imaging plays a crucial role in the initial evaluation of patients with criteria for sepsis and suspected pulmonary infection. In patients with clinical signs and symptoms of respiratory infection, the chest X-ray allows confirming the diagnosis of pneumonia. On the other hand, the chest X-ray can be useful to assess response to treatment (in some patients), define a pattern suggesting specific germs (particularly TB), identify complications (empyema and ARDS), and propose a differential diagnosis.
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6,524 |
Plague as a Biological Weapon
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6,525 |
Construction and Building Applications
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The construction industry is a particularly attractive industry for nanotechnology applications. Since it employs a diversity of building materials, nanomaterials can be employed to enhance the materials’ performances, durability, longevity and sustainability. The construction and building practice is detrimental to the environment in various aspects such as electricity consumption, landfill accumulation, unhealthy aesthetics and neighborhoods. This chapter shows how nanotechnology-based building materials are playing an important role in green architectural design and construction, which has become a growing trend in many countries. Nanomaterials could be integrated with cement, concrete, or windows to conserve energy, minimize electricity bills and sanitize the surrounding atmosphere. Nevertheless, the industry is still facing many hurdles towards the wide application of nanomaterials in a cost effective manner.
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6,526 |
Infections in Burns
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Infections remain a leading cause of death in burn patients. This is as a result of loss of the environmental barrier function of the skin predisposing these patients to microbial colonization leading to invasion. Therefore, reconstitution of the environmental barrier by debriding the devitalized tissue and wound closure with application of allograft versus autograft is of optimal importance.
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6,527 |
Understanding Objectivity in Research Reported in the Journal Science & Education (Springer)
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Based on a website search with the keyword “objectivity,” 131 articles in the 23 year period (1992–2014) referred to some form of objectivity and were classified according to the following criteria: Level I, traditional understanding of objectivity as found in science textbooks and positivist philosophers of science; Level II, a simple mention of objectivity as an academic/literary objective; Level III, problematic nature of objectivity is recognized, however, no mention is made of its changing/evolving nature; Level IV, an approximation to the evolving/changing nature of objectivity based on social and cultural aspects; Level V, a detailed historical reconstruction of the evolving nature of objectivity that recognized the role of the scientific community and its implications for science education. Results obtained showed the following distribution of the 131 articles evaluated: Level I = 5, Level II = 56, Level III = 58, Level IV = 10, and Level V = 2. Only 9% (12 out of 131) of the articles were considered to have an understanding of objectivity that approximated to its historical evolution. Four articles referred to the work of Daston and Galison on objectivity and only one mentioned “trained judgment.” One article based on the work of Longino (explanatory plurality) reconciled the objectivity of science with its social and cultural construction (Level IV).
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6,528 |
Engels-Nederlands
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6,529 |
Pneumonie unter allogener Stammzelltransplantation
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Die allogene Transplantation beinhaltet im Gegensatz zur autologen Transplantation die Übertragung von Knochenmark oder Blutstammzellen eines anderen Spenders. Im Falle einer Pneumonie reflektiert die Phase der Immunsuppression das zu erwartende Erregerspektrum. Im Unterschied zur autologen Stammzelltransplantation umfasst das Risiko für bestimmte Erreger je nach Phase nicht nur das der Neutropenie, sondern auch der zellulären und humoralen Immunsuppression durch die immunsuppressive Medikation bzw. die akute und chronische GvHD. Zudem besteht das Risiko für nichtinfektiöse pulmonale Komplikationen. Das Zytomegalievirus ist einer der wichtigsten Erreger von schweren Infektionen bzw. Pneumonien. Nach Etablierung der präventiven Therapien sind CMV-Pneumonien bis Tag 100 eher selten geworden; ein Problem bleiben weiterhin die späten CMV-Pneumonien durch ihre hohe Letalität. Die Indikation zur Bronchoskopie sollte den allgemeinen Prinzipien der Diagnostik von pulmonalen Komplikationen unter Immunsuppression folgen.
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6,530 |
Semantic Tracking in Peer-to-Peer Topic Maps Management
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This paper presents a collaborative semantic tracking framework based on topic maps which aims to integrate and organize the data/information resources that spread throughout the Internet in the manner that makes them useful for tracking events such as natural disaster, and disease dispersion. We present the architecture we defined in order to support highly relevant semantic management and to provide adaptive services such as statistical information extraction technique for document summarization. In addition, this paper also carries out a case study on disease dispersion domain using the proposed framework.
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6,531 |
Agrochemical Poisoning
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A general increase in the use of chemicals in agriculture has brought about a concomitant increase in the incidence of agrochemical poisoning. Organophosphates are the most common agrochemical poisons followed closely by herbicides. Many agricultural poisons, such as parathion and paraquat are now mixed with a coloring agent such as indigocarmine to prevent their use criminally. In addition, paraquat is fortified with a “stenching” agent. Organo-chlorines have an entirely different mechanism of action. Whereas organophosphates have an anticholinesterase activity, organochlorines act on nerve cells interfering with the transmission of impulses through them. A kerosene-like smell also emanates from death due to organochlorines. The diagnosis lies in the chemical identification of organochlorines in the stomach contents or viscera. Organochlorines also resist putrefaction and can be detected long after death. Paraquat has been involved in suicidal, accidental, and homicidal poisonings. It is mildly corrosive and ulceration around lips and mouth is common in this poisoning. However, the hallmark of paraquat poisoning, especially when the victim has survived a few days, are the profound changes in lungs. Other agrochemicals such as algicides, aphicides, herbicide safeneres, fertilizers, and so on, are less commonly encountered. Governments in most countries have passed legislations to prevent accidental poisonings with these agents. The US government passed the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA) in 1962 and the Indian government passed The Insecticides Act in 1968. Among other things, these acts require manufacturers to use signal words on the labels of insecticides, so the public is warned of their toxicity and accompanying danger.
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6,532 |
Antiviral Properties of Phytochemicals
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In recent years, significant progress has been achieved for the development of novel anti-viral drugs. These newly developed drugs belong to three groups of compounds, nucleoside analogues, thymidine kinase-dependent nucleotide analogues and specific viral enzyme inhibitors. It has been found that the natural products, like plant-derived compounds (phytochemicals) as well as traditional medicines, like traditional Chinese medicines (TCM), Ayurvedic medicines and so on, are the important sources for potential and novel anti-viral drugs. In this chapter, the history of natural products as antiviral drugs, the approaches to discover potential lead compounds, and the anti-viral properties of phytochemicals with different action mechanisms are discussed. The key conclusion is that natural products are most important sources for novel anti-viral drugs.
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6,533 |
Application in Medicine Systems
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Modern pharmacological studies on Danshen have shown that the pharmacologic actions of Danshen mainly include dilating vessels, promoting blood flow, improving microcirculation, changing blood viscosity, increasing myocardial blood and oxygen supplies, reducing myocardial consumption of oxygen, etc. The drug is used to treat diseases of the cardio-cerebrovascular system. In addition, Danshen also has antitumor, antibacterial, and anti-inflammatory functions. Therefore, Danshen has wide clinical application. In recent years, there has been an increase in the number of reports on the clinical application of Danshen extract and Danshen compound preparations. Danshen is seldom used alone; rather, it is usually combined with other drugs to form compound preparations. Various Danshen preparations have been developed, such as Compound Danshen Tablets, Compound Danshen Dropping Pill ( Dantonic™), Compound Danshen Granules, Compound Danshen Capsule, Compound Danshen Oral Liquid, Compound Danshen Aerosol, and Compound Danshen Injection (CDI), etc. The successful development of these preparations has improved product quality, enhanced efficacy, and opened up broader prospects for Danshen’s clinical application.
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6,534 |
Structure of an ECMO Network for Respiratory Support
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In adult patients with respiratory failure refractory to conventional treatment, ECMO represents a potentially lifesaving option, and the CESAR trial indeed indicated that significantly more patients with severe ARDS survived without severe disability if they were transferred to a single ECMO center compared with patients who were managed conventionally at remote hospitals. During the 2009 influenza A (H1N1) pandemic, the Italian Ministry of Health instituted a national network of selected ICU centers, the Extracorporeal Membrane Oxygenation Network (ECMOnet). The Italian network was set up to centralize all potentially severe patients in a limited number of tertiary hospitals to provide advanced treatment options including ECMO and identify predictors of mortality in order to define the best timing of ECMO institution. The institution of the Italian ECMO network allowed a high survival rate of patients with severe ARDS due to H1N1 infection treated by ECMO, providing effective and safe centralization and creating an important organization platform to face future possible epidemics with high demand for critical care services and specialized respiratory support.
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6,535 |
Pädiatrische Intensivmedizin
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Dieses Kapitel soll einen verständlichen Überblick geben über Besonderheiten der intensivmedizinischen Betreuung des Kindes, insbesondere des Kleinkindes, im Vergleich zur Intensivmedizin beim Erwachsenen. Es werden deshalb nicht alle Aspekte der pädiatrischen Intensivmedizin im Sinne eines eigenständigen Lehrbuchs beleuchtet. In einem ersten Teil (·Kap. 84.2-84.4) werden allgemeine Themen und Aspekte inklusive die kardiopulmonale Reanimation behandelt, in einem zweiten Teil (·Kap. 84.5) werden spezifische pädiatrische Krankheitsbilder und ihre Therapie diskutiert.
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6,536 |
Immunisierung
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Wie funktionieren Impfungen? Wir unterscheiden aktive und passive Vakzinierungen. Bei der aktiven Vakzinierung wird Antigen appliziert, das im Organismus eine adaptive Immunantwort auslöst. Dies benötigt Zeit, doch hält die Wirkung lange an, da ein antigenspezifisches Immungedächtnis aufgebaut wird. Bei der passiven Vakzinierung werden immunologische Effektormoleküle oder Immunzellen appliziert, die ihre Wirkung sofort entfalten.
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6,537 |
Inference Claims
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A conclusion follows from given premisses if and only if an acceptable counterfactual-supporting covering generalization of the argument rules out, either definitively or with some modal qualification, simultaneous acceptability of the premisses and non-acceptability of the conclusion, even though it does not rule out acceptability of the premisses and does not require acceptability of the conclusion independently of the premisses. Hence the reiterative associated conditional of an argument is true if and only it has such a covering generalization, and a supposed unexpressed premiss supplied to make an argument formally valid should be a covering generalization.
|
6,538 |
Online Monitoring Technologies For Drinking Water Systems Security
|
More stringent constraints placed nowadays on water companies to provide high quality drinking water, increasing water resources scarcity in many areas of the planet, forcing water companies to work on marginal water bodies for supply, and the threat of hostile actions by political extremists and terrorist groups, that may willingly and deliberately cause contamination of an otherwise safe supply, are recent issues that have spurred demand for more efficient and comprehensive online water monitoring technologies. Traditionally, quality parameters associated with drinking water provision were monitored using routine grab samples followed by laboratory analysis. This approach only allowed to capture small data sets, mostly unrepresentative of the true variance at the source, and allowed potentially important events to occur undetected. This paper examines state-of-the-art technologies for online monitoring of water quality in supply water systems, and reports some recent application examples.
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6,539 |
Genetic Models
|
Genetically altered rat and mouse models have been instrumental in the functional analysis of genes in a physiological context. In particular, studies on the renin-angiotensin system (RAS) have profited from this technology in the past. In this review, we summarize the existing animal models for the protective axis of the RAS consisting of angiotensin-converting enzyme 2 (ACE2), angiotensin-(1-7)(Ang-(1-7), and its receptor Mas. With the help of models with altered expression of the components of this axis in the brain and cardiovascular organs, its physiological and pathophysiological functions have been elucidated. Thus, novel opportunities for therapeutic interventions in cardiovascular diseases were revealed targeting ACE2 or Mas.
|
6,540 |
Application of UPT-POCT in Public Health Emergencies
|
Rapid and reliable detection of infectious agents on site is essential for timely initiation of medical treatment and post-exposure prophylactic measures when public health emergencies occur. However, the referee standard for confirmation of infectious agents remains laboratory diagnosis, which is time-consuming and not available in the field. UPT-POCT technology is a versatile tool that requires limited resources and can realize rapid detection of infectious agents on site, providing timely information for the quick response to public health emergencies.
|
6,541 |
Management of Gram-Positive Bacterial Disease: Staphylococcus aureus, Streptococcal, Pneumococcal and Enterococcal Infections
|
Gram-positive bacteria are a diverse group of organisms that are a major source of morbidity and mortality in patients with cancer. The increasing use of long-term indwelling central catheters and cytotoxic chemotherapies has contributed to the emergence of Gram-positive bacteria as the leading cause of bacteremia in cancer patients. These organisms are also among the foremost causes of pneumonia, skin and soft-tissue infections, osteomyelitis, and central nervous system infections in cancer patients. Gram-positive organisms have a remarkable ability to develop resistance to many of the currently available antimicrobials, but the predilection to become antimicrobial resistant varies substantially for particular organisms and for individual antimicrobial agents. Therefore physicians treating cancer patients need to be familiar with the common clinical manifestations, complications, and treatment options for a wide variety of diseases caused by Gram-positive bacteria.
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6,542 |
Bacterial Infections
|
Bacterial infections are the most significant infectious source of morbidity and mortality in cirrhotic patients. Bacteria infections result is both acute decompensation in chronic liver disease and mortality in patients with decompensated cirrhosis. Spontaneous bacterial peritonitis (SBP), bacteremia, pneumonia, urinary tract infections (UTI) and skin and soft tissue infection (SSTI) are the most significant sources of infection in cirrhosis. Bacterial infections can precipitate renal failure and worsening hepatic encephalopathy, and patients with sepsis and liver disease have higher rates of acute respiratory distress syndrome (ARDS) and coagulopathy.
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6,543 |
Schwindsucht
| null |
6,544 |
Evolution of HIV/AIDS Policy
|
The HIV/AIDS-related policy framework in China has come a long way from initially attempting to prevent HIV from entering the country in the early stages of the epidemic to facilitating comprehensive national HIV response of today. Each step of the way, policymakers in China have strived to ensure that HIV-related policies were pragmatic, tailored to the Chinese context, aligned with international best practices, and based upon the best available information at the time. Although there have been a great many policy actions since HIV was first discovered on the mainland, a few key policies were foundational, had a major impact on the epidemic, and marked an important shift China’s HIV response, for example, the Blood Donation Law (1998), the first Five-Year Action Plan for the Containment and Control of HIV/AIDS (2001), and the “Four Frees and One Care” policy (2003). These and other key policies are highlighted here. Going forward, as China’s HIV epidemic increases in size and complexity, policymakers need to remain grounded in evidence but also be open to alternative and innovative approaches.
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6,545 |
Market Area Delineation for Airports to Predict the Spread of Infectious Disease
|
Air travel facilitates the international spread of infectious disease. While global air travel data represent the volume of travel between airports, identifying which airport an infected individual might use, or where a disease might spread after an infected passenger deplanes, remains a largely unexplored area of research and public health practice. This gap can be addressed by estimating airport catchment areas. This research aims to determine how existing market area delineation techniques estimate airport catchments differently, and which techniques are best suited to anticipate where infectious diseases may spread. Multiple techniques were tested for airports in the Province of Ontario, Canada: circular buffers, drive-time buffers, Thiessen polygons, and the Huff model, with multiple variations tested for some techniques. The results were compared qualitatively and quantitatively based on spatial patterns as well as area and population of each catchment area. There were notable differences, specifically between deterministic and probabilistic approaches. Deterministic techniques may only be suitable if all airports in a study area are similar in terms of attractiveness. The probabilistic Huff model appeared to produce more realistic results because it accounted for variation in airport attractiveness. Additionally, the Huff model requires few inputs and therefore would be efficient to execute in situations where time, resources, and data are limited.
|
6,546 |
Endemic mycosis
| null |
6,547 |
Molecular Virology of Enteric Viruses (with Emphasis on Caliciviruses)
| null |
6,548 |
Spezielle Therapieformen
|
Jede Sauerstoffgabe, die länger als 15 h/Tag über mehr als 3 Monate indiziert ist, bezeichnet man als Langzeitsauerstofftherapie (»long term oxygen therapy«, LTOT).
|
6,549 |
Therapeutic and Medicinal Uses of Terpenes
|
Terpenes, also known as terpenoids are the largest and most diverse group of naturally occurring compounds. Based on the number of isoprene units they have, they are classified as mono, di, tri, tetra, and sesquiterpenes. They are mostly found in plants and form the major constituent of essential oils from plants. Among the natural products that provide medical benefits for an organism, terpenes play a major and variety of roles. The common plant sources of terpenes are tea, thyme, cannabis, Spanish sage, and citrus fruits (e.g., lemon, orange, mandarin). Terpenes have a wide range of medicinal uses among which antiplasmodial activity is notable as its mechanism of action is similar to the popular antimalarial drug in use—chloroquine. Monoterpenes specifically are widely studied for their antiviral property. With growing incidents of cancer and diabetes in modern world, terpenes also have the potential to serve as anticancer and antidiabetic reagents. Along with these properties, terpenes also allow for flexibility in route of administration and suppression of side effects. Certain terpenes were widely used in natural folk medicine. One such terpene is curcumin which holds anti-inflammatory, antioxidant, anticancer, antiseptic, antiplasmodial, astringent, digestive, diuretic, and many other properties. Curcumin has also become a recent trend in healthy foods and open doors for several medical researches. This chapter summarizes the various terpenes, their sources, medicinal properties, mechanism of action, and the recent studies that are underway for designing terpenes as a lead molecule in the modern medicine.
|
6,550 |
Mining Candidate Viruses as Potential Bio-terrorism Weapons from Biomedical Literature
|
In this paper we present a semantic-based data mining approach to identify candidate viruses as potential bio-terrorism weapons from biomedical literature. We first identify all the possible properties of viruses as search key words based on Geissler’s 13 criteria; the identified properties are then defined using MeSH terms. Then, we assign each property an importance weight based on domain experts’ judgment. After generating all the possible valid combinations of the properties, we search the biomedical literature, retrieving all the relevant documents. Next our method extracts virus names from the downloaded documents for each search keyword and identifies the novel connection of the virus according to these 4 properties. If a virus is found in the different document sets obtained by several search keywords, the virus should be considered as suspicious and treated as candidate viruses for bio-terrorism. Our findings are intended as a guide to the virus literature to support further studies that might then lead to appropriate defense and public health measures.
|
6,551 |
The Clinical Application of Ozonetherapy
| null |
6,552 |
Viral RNA Targets and Their Small Molecule Ligands
|
RNA genomes and transcripts of viruses contain conserved structured motifs which are attractive targets for small molecule inhibitors of viral replication. Ligand binding affects conformational states, stability, and interactions of these viral RNA targets which play key roles in the infection process. Inhibition of viral RNA function by small molecule ligands has been extensively studied for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) which provide valuable insight for the future exploration of RNA targets in other viral pathogens including severe respiratory syndrome coronavirus (SARS CoV), influenza A, and insect-borne flaviviruses (Dengue, Zika, and West Nile) as well as filoviruses (Ebola and Marburg). Here, I will review recent progress on the discovery and design of small molecule ligands targeting structured viral RNA motifs.
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6,553 |
Respiratory Viral Infections in Transplant Recipients
|
Respiratory viral infections (RVIs) are common among the general population; however, these often mild viral illnesses can lead to serious morbidity and mortality among recipients of hematopoietic stem cell and solid organ transplantation. The disease spectrum ranges from asymptomatic or mild infections to life-threatening lower respiratory tract infection or long-term airflow obstruction syndromes. Progression to lower respiratory tract infection or to respiratory failure is determined by the intrinsic virulence of the specific viral pathogen as well as various host factors, including the type of transplantation, status of the host’s immune dysfunction, the underlying disease, and other comorbidities. This chapter focuses on the epidemiology, clinical manifestations, diagnosis, and management of RVIs in this susceptible population and includes respiratory syncytial virus, parainfluenza virus, human metapneumovirus, influenza virus, human coronavirus, and human rhinovirus. The optimal management of these infections is limited by the overall paucity of available treatment, highlighting the need for new antiviral drug or immunotherapies.
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6,554 |
Hemorrhage and Transfusions in the Surgical Patient
|
Hemorrhage remains the leading cause of intra-operative deaths and those in the first 24 h. Many cardiovascular and hepatobiliary procedures result in massive hemorrhage and postpartum hemorrhage events in labor and delivery place the patient at a high risk for mortality. Both upper and lower gastrointestinal bleeding (e.g., diverticulosis, esophageal and gastric varices, and peptic ulcer disease) can also result in significant blood loss requiring massive transfusion and resuscitation from hemorrhagic shock. Therefore, safe, timely, and effective transfusion of blood products is critical. The aim of this chapter is to provide clinicians with a discussion of the current literature on the various blood component products, their indications, and unique hemostatic conditions in the surgical patient. While the majority of data concerning optimal management of acquired coagulopathy and hemorrhagic shock resuscitation is based on trauma patients, many of the principles can and should be applied to the surgical patient (or likely any patient) with profound hemorrhage.
|
6,555 |
Immunoinformatics and Computational Vaccinology: A Brief Introduction
|
Immunoinformatics has recently emerged as a buoyant and dynamic sub-discipline within the wider field of bioinformatics. Immunoinformatics is the application of bioinformatic methods to the unique problems of immunology and vaccinology. Immunoinformatics, as a principal component of incipient immunomic technologies, is beginning to foment important changes within immunology, as this key discipline tries to free itself from the empirical straight jacket that has characterised its development and attempts to grapple with the post-genomic revolution. Immunoinformatics is, importantly, also beginning to establish itself as a pivotal tool within vaccine discovery.
|
6,556 |
Allergic Diseases (and Differential Diagnoses)
| null |
6,557 |
Diagnostic Techniques
|
The chapter describes diagnostic techniques adapted by avian veterinarians encompassing the procedure, pros and cons of anamnesis, physical examination, collection and processing of clinical specimens, laboratory examination, radiography, USG, CT, MRI, myelography, echocardiography, electrocardiography and endoscopy.
|
6,558 |
Land Use Change and Human Health
|
Human activity is rapidly transforming our planet. The most pervasive changes to the landscape include deforestation, extension and intensification of agriculture, and livestock management, the construction of dams, irrigation projects, and roads, and rapidly spreading urbanization. In addition to the well-known environmental costs of these changes, each also has important health implications that are often less recognized. However, a growing number of studies that combine ecology and human health are demonstrating how these activities impact the emergence of new infectious diseases and alter the distribution of already recognized diseases.
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6,559 |
Opportunistic Infections
|
Evolution in paediatric HIV management has changed the incidence and prevalence of opportunistic infections and a major reduction has been shown for most opportunistic infections with antiretroviral therapy use in lower and middle-income countries, especially in the first year of treatment. However, the high prevalence of disease still requires adequate management of opportunistic infections, to improve patient quality of life and the impact on burden of disease. Lower CD4 counts were associated with chronic infection and increased risk of opportunistic infections in patients, but some studies have shown that even children with high CD4 counts may have opportunistic infections. This chapter reviews common opportunistic infections that may infect HIV positive children and adolescents, particularly in sub Saharan Africa.
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6,560 |
Noninvasive Mechanical Ventilation in Patients with Acute Respiratory Failure Due to Pandemic Influenza A(H1N1) Virus
|
Pandemic influenza A (PA-H1N1) is a new strain of influenza virus that was first identified in Mexico and United States during the early part of 2009. The PA-H1N1 virus originated from the swine influenza (H1) virus circulating in North American pigs.
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6,561 |
Tropische ziekten
|
Aet. De verwekker is het retrovirus hiv(1). In West-Afrika is ook hiv(2) geïsoleerd. Freq. Aids komt thans overal ter wereld voor maar er zijn belangrijke regionale verschillen. Aids in de tropen onderscheidt zich van aids elders in de wereld onder meer door verschillende epidemiologische en klinische karakteristieken. De meeste van de nieuwe aidsgevallen doen zich momenteel voor in Sub-Sahara-Afrika, India en Zuidoost-Azië. Ook in Latijns-Amerika neemt de incidentie toe. Sub-Sahara-Afrika is thans de meest getroffen regio ter wereld. Meer dan 70% van het totale geschatte aantal aidsgevallen (sinds het begin van de aidsepidemie) doet zich voor in Afrika. Daar kan in endemische gebieden 30% en meer van de jonge mannen en vrouwen geïnfecteerd zijn, met hogere frequentie bij prostitué(e)s, hun cliënten en bij patiënten met tuberculose. Er zijn belangrijke verschillen tussen stad (hogere frequentie) en platteland. De verhouding man: vrouw is 1:1. De transmissie vindt bij 80% plaats door heteroseksueel contact, daarnaast door parenterale besmetting (bloedtransfusie, besmette spuiten en naalden) en ‘verticaal’ van hiv-positieve moeders naar 25-30% van de pasgeborenen, ook via borstvoeding.
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6,562 |
Informatics for Infectious Disease Research and Control
|
The goal of infectious disease informatics is to optimize the clinical and public health management of infectious diseases through improvements in the development and use of antimicrobials, the design of more effective vaccines, the identification of biomarkers for life-threatening infections, a better understanding of host-pathogen interactions, and biosurveillance and clinical decision support. Infectious disease informatics can lead to more targeted and effective approaches for the prevention, diagnosis and treatment of infections through a comprehensive review of the genetic repertoire and metabolic profiles of a pathogen. The developments in informatics have been critical in boosting the translational science and in supporting both reductionist and integrative research paradigms.
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6,563 |
Astrovirology, Astrobiology, Artificial Intelligence: Extra-Solar System Investigations
|
This chapter attempts to encompass and tackle a large problem in Astrovirology and Astrobiology. There is a huge anthropomorphic prejudice that although life is unlikely, the just-right Goldilocks terrestrial conditions mean that the just-right balance of minerals and basic small molecules inevitably result in life as we know it throughout our solar system, galaxy, and the rest of the universe. Moreover, when such conditions on planets such as ours may not be quite right for the origin of life, it is popularly opined that asteroids and comets magically produce life or at the very least, the important, if not crucial components of terrestrial life so that life then blooms, when their fragments cruise the solar system, stars, and galaxies, and plummet onto appropriately bedecked planets and moons. It is no longer extraordinary to detect extraterrestrial solar systems. Moreover, since extra-solar system space exploration has commenced, this provides the problem of detecting life with enhanced achievability. Small organisms, which replicate outside of a living cell or host, would not be catalogued as viruses. How about viruses that cohabit with life? On the Earth, viruses are a major, if underestimated, condition of life – will that be the case elsewhere? Detection of extra-solar system viruses, if they exist, requires finding life, since viruses necessitate life to replicate. (It should be noted, though, that viruses could be detected through various types of portable ultra-microscopes, including Electron Microscopes (EM) (scanning and transmission) as well as Atomic Force Microscopes (AFM).) However, extra-solar system detection of life does not oblige that viruses exist ubiquitously. Viruses are important potential components of biospheres because of their multiple interactions and influence on evolution, although viruses are small and obligatory parasitic. In addition, nanotechnology – living or replicating nano-synthetic machine organisms might also be present out there, and require consideration as well. An imposing caveat is that, if found, could some extraterrestrial viruses and synthetic nanotechnological microorganisms infect humans? Possibly, intelligence and cognition may at times be contemporaneous with life. Concomitantly, life and viruses that may be detected, could well be impacted upon by intelligences existing on such exoplanets (and vice versa). Coming to an understanding of the plurality of extraterrestrial intelligence is an optimal objective, in order to avoid causing harm on exoplanets, as well as avoiding conflict and possible human devastation. This is especially the case if we encounter greatly advanced galactic-level civilizations, compared to terrestrial civilizations. Their machine and bionic technologies on the Dyson engineering civilization scale may be prominently superior to ours; their biological expertise may be similarly critically radical. For example, they may use viruses for purposes for which we are barely aware, and which could be utterly deadly for humans. A series of steps is being taken in space exploration. Scientists hypothesize and claim that types of life may be near the Earth, in the solar system, and outside the solar system, similar to ours in the sense that only such conditions, Goldilocks conditions, are key sine qua non requirements, based on our terrestrial chemistry and biochemistry. If detected within the solar system, will life or its remnants resemble terrestrial life? Outside the solar system a similar chauvinism exists, although the likelihood for life, in any event, remains probably low, according to more cautious approaches to the problem. The study of our solar system includes planets, asteroids, comets, and other planetesimals that have been in overall contiguity during several billion years; anthropomorphisms claims life consequently has been developing along terrestrial-type mechanisms. However, a non-anthropomorphic view would surmise, probably not, especially for extra-solar system locales. The prime warning and admonition in all these deliberations is the contamination and damage, which current and past practice and procedures has caused and continues, due to insufficient biocontainment concepts and technology to date. Advances in the development of robotics, artificial intelligence (AI), and high capacity ultrafast quantum computers (QC) greatly enhance the sophisticated control and logical development of extra-solar system studies. Consequently, future long-range manned space exploration seems unwarranted. Clearly, reduced dangers to human health and safety, will result from the use of intelligent machine-based investigations and besides, with increased cost-effectiveness. Space exploration comes at great cost to humanity as a whole and utilizes global resources. Consequently, appropriate organizational measures and planning/cooperation need to be in place. Moreover, the bottom line is that despite all the slogans and claims, there have been next to no financial benefits to our planet as a whole. Such financial and heedless difficulties need to be addressed, the sooner the better. In addition, prior to exposure to exoplanetary life, deep understanding of the problems of infectious diseases and immune dysfunction risks are needed. In addition, global efforts should avoid serendipity and stochasticity as this work should be directed with long-term organization, commitment, scientific, and technological methodology. This chapter briefly reviews such questions assuming a new paradigm for oversight of extrasolar system viral investigations including intelligence and life. Finances are included as an essential adjunct.
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6,564 |
Host Factors Promoting Viral RNA Replication
|
Plus-stranded RNA viruses, the largest group among eukaryotic viruses, are capable of reprogramming host cells by subverting host proteins and membranes, by co-opting and modulating protein and ribonucleoprotein complexes, and by altering cellular pathways during infection. To achieve robust replication, plus-stranded RNA viruses interact with numerous cellular molecules via protein–protein, RNA–protein, and protein–lipid interactions using molecular mimicry and other means. These interactions lead to the transformation of the host cells into viral “factories" that can produce 10,000–1,000,000 progeny RNAs per infected cell. This chapter presents the progress that was made largely in the last 15 years in understanding virus–host interactions during RNA virus replication. The most commonly employed approaches to identify host factors that affect plus-stranded RNA virus replication are described. In addition, we discuss many of the identified host factors and their proposed roles in RNA virus replication. Altogether, host factors are key determinants of the host range of a given virus and affect virus pathology, host–virus interactions, as well as virus evolution. Studies on host factors also contribute insights into their normal cellular functions, thus promoting understanding of the basic biology of the host cell. The knowledge obtained in this fast-progressing area will likely stimulate the development of new antiviral methods as well as novel strategies that could make plus-stranded RNA viruses useful in bio- and nanotechnology.
|
6,565 |
Engineered Viruses as Vaccine Platforms
|
Many viruses have been investigated for the development of genetic vaccines and the ideal ones must be endowed with many properties, such as the quality and the quantity of the immunological response induced against the encoded antigens, safety and production on a large scale basis. Viral based vaccines must also deal with the potential problem of the pre-existing antivector immunity. Several viral vaccine vectors have emerged to date, all of them having relative advantages and limits depending on the proposed application. Recent successes reflect diverse improvements such as development of new adenovirus serotypes and prime-boost regimes. This chapter describes the features of four viral vector systems based on poxviruses, adenoviruses, alphaviruses and lentiviruses and recent results following their use with a particular emphasis on clinical research, highlighting the challenges and successes.
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6,566 |
Who Cares About Wildlife?
| null |
6,567 |
Food as a New Human and Livelihood Security Challenge
|
As a result of a process of “regressive globalization” (Kaldor/Anheier/Glasius 2003; Oswald 2008b) and of an increasing concentration of wealth in few hands, the economic gap has widened between North and South and within the countries between rich and poor, which has often affected the survival of social groups.
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6,568 |
Identification of Candidate Vaccine Antigens In Silico
|
The identification of immunogenic whole-protein antigens is fundamental to the successful discovery of candidate subunit vaccines and their rapid, effective, and efficient transformation into clinically useful, commercially successful vaccine formulations. In the wider context of the experimental discovery of vaccine antigens, with particular reference to reverse vaccinology, this chapter adumbrates the principal computational approaches currently deployed in the hunt for novel antigens: genome-level prediction of antigens, antigen identification through the use of protein sequence alignment-based approaches, antigen detection through the use of subcellular location prediction, and the use of alignment-independent approaches to antigen discovery. Reference is also made to the recent emergence of various expert systems for protein antigen identification.
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6,569 |
Bead-Based Suspension Arrays for the Detection and Identification of Respiratory Viruses
|
The clinical signs and symptoms associated with many infectious diseases are often too nonspecific to discriminate between causative agents, and thus, definitive diagnosis requires specific laboratory tests for all of the suspected pathogens. In particular, respiratory tract infections can be caused by numerous different viral, bacterial, and fungal pathogens that are indistinguishable by clinical diagnosis. Respiratory tract infections are also among the most common infections in humans, with approximately 6−9 episodes per year in children and 2−4 episodes per year in adults [1]. These infections cause considerable morbidity and mortality as well as high healthcare costs associated with doctor visits, hospitalizations, treatment, and absences from work and school. Early diagnosis of the etiological agent in a respiratory infection permits effective antimicrobial therapy and appropriate management of the disease.
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6,570 |
Epiglottitis, Acute Laryngitis, and Croup
|
Epiglottitis, acute laryngitis, and croup (acute laryngotracheobronchitis) are infections of the upper airway, affecting the epiglottis, larynx, and larynx and trachea, respectively. Epiglottitis is a bacterial infection, while viruses cause nearly all cases of acute laryngitis and croup. Acute laryngitis in adults is usually self-limited. Epiglottitis, which used to be prevalent in children under age 5, is now seen more often in adults than in children. This decline in childhood epiglottitis is due to the Haemophilus influenzae type b (Hib) vaccine. Streptococci, including Streptococcus pneumoniae, are now important causes of epiglottitis. Croup is a viral infection, usually due to parainfluenza virus, that primarily affects children ages 6 months to 3 years old. Epiglottitis and croup can cause life-threatening loss of the airway, and misdiagnosis or mismanagement can result in fatalities. This chapter reviews the clinical features and treatment of these three upper respiratory tract infections.
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6,571 |
White Paper on Risk Governance: Toward an Integrative Framework
|
This document aims to guide the work of the International Risk Governance Council and its various bodies in devising comprehensive and transparent approaches to ‘govern’ a variety of globally relevant risks. Globally relevant risks include trans-boundary risks, i.e. those that originate in one country and affect other countries (such as air pollution), international risks, i.e. those that originate in many countries simultaneously and lead to global impacts (such as carbon dioxide emissions for climate change) and ubiquitous risks, i.e. those that occur in each country in similar forms and may necessitate a co-ordinated international response (such as car accidents or airline safety). To this end the document and the framework it describes provide a common analytic structure for investigating and supporting the treatment of risk issues by the relevant actors in society. In doing so, the focus is not restricted to how governmental or supranational authorities deal with risk but equal importance is given to the roles of the corporate sector, science, other stakeholders as well as civil society — and their interplay. The analytic structure will, it is hoped, facilitate terminological and conceptual clarity, consistency and transparency in the daily operations of IRGC and assure the feasibility of comparative approaches in the governance of risks across a broad range of hazardous events and activities. In particular, this document is meant to assist members of IRGC in their tasks to provide scientifically sound, economically feasible, legally and ethically justifiable and politically acceptable advice to IRGC's targeted audiences. It is also to support IRGC in its effort to combine the best available expertise in the respective field with practical guidance for both risk managers and stakeholders.
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6,572 |
Infectieziekten
|
Aan het eind van dit hoofdstuk weet je: welke verschillende ziekteverwekkers infectieziekten kunnen veroorzaken; welke geneesmiddelen worden gebruikt bij de behandeling van infectieziekten; welk gevolg onoordeelkundig gebruik van deze geneesmiddelen kan hebben; welke gebruiksadviezen je moet geven bij de verschillende middelen tegen infectieziekten.
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6,573 |
Nederlands-Engels
| null |
6,574 |
Healthcare Emergencies in Africa: The Case of Ebola in Nigeria
|
The Ebola crisis in Africa presented a case study in both hope and despair. There were severe casualties in the weak and unprepared system of Liberia and Sierra Leone, but hope for a developing system in Nigeria, which managed to prevent a mass outbreak. This chapter takes a closer look at the Ebola crisis of 2014 in Africa and examines Nigeria as a model of political will and voluntary preparedness to tackle this national and continental health emergency. This chapter looks at risk and crisis communication in particular, and explores the concepts of ethics in the case of the Ebola outbreak.
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6,575 |
Analysis of Microorganisms in Hospital Environments and Potential Risks
|
This report provides information on indoor air quality and on associated potential risks in hospitals. Spread and persistence of microbial communities in hospital environments are of huge interest to public health. Hospitals are characterized by high infective risk, firstly cause of the compromised immunologic conditions of the patients that make them vulnerable to bacterial, viral, parasitological and fungal opportunistic infections. Evidence suggests that microbial agents spread through air, surfaces, aerosol and hands. If surfaces may act as a reservoir for some pathogens, hands are an important transmission route. Airborne and aerosolized waterborne microorganisms are taken into consideration, and their presence into the hospital environments is reviewed.
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6,576 |
Diffusion in Dynamic Social Networks: Application in Epidemiology
|
Structure and evolution of networks have been areas of growing interest in recent years, especially with the emergence of Social Network Analysis (SNA) and its application in numerous fields. Researches on diffusion are focusing on network modeling for studying spreading phenomena. While the impact of network properties on spreading is now widely studied, involvement of network dynamicity is very little known. In this paper, we address the epidemiology context and study the consequences of network evolutions on spread of diseases. Experiments are conducted by comparing incidence curves obtained by evolution strategies applied on two generated and two real networks. Results are then analyzed by investigating network properties and discussed in order to explain how network evolution influences the spread. We present the MIDEN framework, an approach to measure impact of basic changes in network structure, and DynSpread, a 2D simulation tool designed to replay infections scenarios on evolving networks.
|
6,577 |
The Role of Phosphoinositide 3-Kinase-Akt Signaling in Virus Infection
|
Successful virus infection of host cells requires efficient viral replication, production of virus progeny and spread of newly synthesized virus particles. This success, however also depends on the evasion of a multitude of antiviral signaling mechanisms. Many viruses are capable of averting antiviral signals through modulation of host cell signaling pathways. Apoptotic inhibition, for example, is a universal intracellular antiviral response, which prolongs cellular survival and allows viruses to complete their life cycle. Ongoing apoptotic inhibition contributes to the establishment of latent and chronic infections, and has been implicated in viral oncogenesis. The phosphoinositide 3-kinase (PI3K)-Akt pathway has become recognized as being pivotal to the inhibition of apoptosis and cellular survival. Thus, modulation of this pathway provides viruses with a mechanism whereby they can increase their survival, in addition to other established mechanisms such as expression of viral onco-genes and direct inhibition of proapoptotic proteins. Recent research has revealed that this pathway is up-regulated by a number of viruses during both short-term acute infections and long-term latent or chronic infections. During acute infections PI3K-Akt signaling helps to create an environment favorable for virus replication and virion assembly. In the case of long-term infections, modulation of PI3K-Akt signaling by specific viral products is believed to help create a favorable environment for virus persistence, and contribute to virus-mediated cellular transformation.
|
6,578 |
The Epidemiology of Alcohol Abuse and Pneumonia
|
The association between alcohol abuse and pneumonia has been recognized for more than two centuries and represents an enormous health burden worldwide. The first published notation of alcohol as a clinical risk factor for the development of pneumonia is now over 200 years old, and since then there have been over a 1,000 references in the medical literature confirming these observations. Even in this modern era of medicine pneumonia remains a common infection that afflicts over 450 million persons worldwide annually and causes 7 % of all deaths. When one considers that alcohol is the most commonly abused substance in the world, the enormous excessive burden that alcohol contributes to the morbidity and mortality of pneumonia represents a major public health consideration. In this chapter we review the foundational literature that has chronicled the evolution of our understanding of the association between pneumonia and alcohol abuse over the past century. In addition, we discuss some of the specific pathogens that are particularly associated with serious lung infections in individuals with alcohol use disorders. Finally, we consider some of the specific guidelines for the treatment and prevention of pneumonia in the setting of alcohol abuse.
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6,579 |
Schweinefinnenbandwurm
| null |
6,580 |
Pneumonia in the Cancer Patient
|
Lower respiratory tract infections result in unacceptably high mortality among cancer patients. Pneumonias cause death in this population both directly through impairment of gas exchange and progression to system infection/sepsis, as well as indirectly by precluding delivery of necessary, antineoplastic therapies. Malignancy and treatment-related impairments of host immune responses and the emergence of multidrug-resistant organisms associated with recurrent exposures to hospital environments may not only enhance the risks of mortality, but also exacerbate the difficulty of diagnosing pneumonia in the cancer setting. As a consequence of disordered inflammatory responses, the typical clinical observations of pneumonia, including purulent respiratory secretions and early radiographic findings, may be inapparent or absent. A comprehensive review of etiology, clinical presentation, diagnosis, and management of pulmonary infections is presented in this chapter.
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6,581 |
Sewage Disposal and Wildlife Health in Antarctica
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Sewage and its microbiology, treatment and disposal are important to the topic of Antarctic wildlife health because disposal of untreated sewage effluent into the Antarctic marine environment is both allowed and commonplace. Human sewage contains enteric bacteria as normal flora, and has the potential to contain parasites, bacteria and viruses which may prove pathogenic to Antarctic wildlife. Treatment can reduce levels of micro-organisms in sewage effluent, but is not a requirement of the Environmental Protocol to the Antarctic Treaty (the Madrid Protocol). In contrast, the deliberate release of non-native organisms for any other reason is prohibited. Hence, disposal of sewage effluent to the marine environment is the only activity routinely undertaken in Antarctica knowing that it will likely result in the release of large numbers of potentially non-native species. When the Madrid Protocol was negotiated, the decision to allow release of untreated sewage effluent was considered the only pragmatic option, as a prohibition would have been costly, and may not have been achievable by many Antarctic operators. In addition, at that time the potential for transmission of pathogens to wildlife from sewage was not emphasised as a significant potential risk. Since then, the transmission of disease-causing agents between species is more widely recognised and it is now timely to consider the risks of continued discharge of sewage effluent in Antarctica and whether there are practical alternatives.
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6,582 |
Whole-Genome Sequencing of Porcine Epidemic Diarrhea Virus by Illumina MiSeq Platform
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Porcine epidemic diarrhea virus (PEDV) belongs to the genus Alphacoronavirus of the family Coronaviridae. PEDV was identified as an emerging pathogen in US pig populations in 2013. Since then, this virus has been detected in at least 31 states in the USA and has caused significant economic loss to the swine industry. Active surveillance and characterization of PEDV are essential for monitoring the virus. Obtaining comprehensive information about the PEDV genome can improve our understanding of the evolution of PEDV viruses, and the emergence of new strains, and can enhance vaccine designs. In this chapter, both a targeted amplification method and a random-priming method are described to amplify the complete genome of PEDV for sequencing using the MiSeq platform. Overall, this protocol provides a useful two-pronged approach to complete whole-genome sequences of PEDV depending on the amount of virus in the clinical samples.
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6,583 |
Reducing Spreading Processes on Networks to Markov Population Models
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Stochastic processes on complex networks, where each node is in one of several compartments, and neighboring nodes interact with each other, can be used to describe a variety of real-world spreading phenomena. However, computational analysis of such processes is hindered by the enormous size of their underlying state space. In this work, we demonstrate that lumping can be used to reduce any epidemic model to a Markov Population Model (MPM). Therefore, we propose a novel lumping scheme based on a partitioning of the nodes. By imposing different types of counting abstractions, we obtain coarse-grained Markov models with a natural MPM representation that approximate the original systems. This makes it possible to transfer the rich pool of approximation techniques developed for MPMs to the computational analysis of complex networks’ dynamics. We present numerical examples to investigate the relationship between the accuracy of the MPMs, the size of the lumped state space, and the type of counting abstraction.
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6,584 |
Laboratories
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Patient test samples are taken and examined at outpatient clinics, in bed posts and at policlinic consultations and treatment units. They are collected and transported to central laboratories or examined by smaller laboratory units, adapted to the patient group. Samples are sent in pipes or transported by defined methods to the laboratory. A large number of samples are also sent to other hospitals, laboratories or diverse private laboratories. The following chapter is focused on laboratory safety for patients and personnel to avoid spread of infections between patients, personnel and environment.
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6,585 |
DATA, DATA, AND MORE DATA
| null |
6,586 |
Interstitial Lung Disease in Infants and Children: New Classification System with Emphasis on Clinical, Imaging, and Pathological Correlation
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Interstitial lung diseases in infants and children comprise a rare heterogeneous group of parenchymal lung disorders, with clinical syndromes characterized by dyspnea, tachypnea, crackles, and hypoxemia. They arise from a wide spectrum of developmental, genetic, inflammatory, infectious, and reactive disorders. In the past, there has been a paucity of information and limited understanding regarding their pathogenesis, natural history, imaging findings, and histopathologic features, which often resulted in enormous diagnostic challenges and confusion. In recent years, there has been a substantial improvement in the understanding of interstitial lung disease in the pediatric patient, due to the development of a structured classification system based on etiology of the lung disease, established pathologic criteria for consistent diagnosis, and improvement of thoracoscopic techniques for lung biopsy. Imaging plays an important role in evaluating interstitial lung diseases in infants and children by confirming and characterizing the disorder, generating differential diagnoses, and providing localization for lung biopsy for pathological diagnosis. In this chapter, the authors present epidemiology, challenges and uncertainties of diagnosis, and amplify a recently developed classification system for interstitial lung disease in infants and children with clinical, imaging, and pathological correlation.
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6,587 |
Care of the Postoperative Pulmonary Resection Patient
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Patients undergoing pulmonary resection all exhibit, to some degree, a level of pulmonary dysfunction. This is due to the physiologic stress of the procedure performed, the patient’s comorbidities, and preexisting cardiopulmonary reserve. Although prognostic factors for intensive care requirement exist, to date, there is no consensus for postoperative admission. Institutional practices vary across the country, with patients often admitted to intensive care for surveillance. Guidelines published from the American Thoracic Society in 1999 emphasize that admission to the ICU be reserved for those patients requiring care and monitoring for severe physiologic instability. Admissions following pulmonary resection are typically due to respiratory complications and are an independent predictor of mortality. The following chapter will review the indications for admission to the ICU and common issues encountered following pulmonary resection and conclude with a discussion of the management of patients undergoing pulmonary transplantation.
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6,588 |
Infections in the Long-Term Care Setting
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In the long-term care setting The diagnosis of infection is primarily based from the clinical assessment. Infection is a common cause of fever, when present, and acute change in functional status. Infection can often present atypically; usual symptoms, physical findings, and diagnostic abnormalities may be lacking. Evaluation of fever and suspected infection should initially focus on the most common clinical syndromes. Treatment should initially focus on the most common organisms that are present at the most likely suspect site of infection.
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6,589 |
Virus Evolution in the Face of the Host Response
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Microbial infections are highly dynamic. Viruses have evolved two main strategies against the host response: interaction or evasion. Interaction is typical of complex DNA viruses. Their genomes encode a number of proteins that exert modulatory functions that alter the immune response of the host. Evasion strategy is used mainly by RNA viruses, and is based on high mutation rates and quasispecies dynamics. The complexity of viral populations demands research on new antiviral strategies that take into consideration the adaptive potential of viruses, in particular RNA viruses.
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6,590 |
Learning About Nature of Science Through Listening to Scientists’ Stories of Scientific Enquiry
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This chapter first reviews a series of curricular reforms of science education in Hong Kong that started at the turn of the 21st Century. It moves on to share the decade of efforts in promoting teachers’ learning and their subsequent teaching of the nature of science (NOS). Among these efforts, two teacher professional development programmes received overwhelmingly positive views from teachers in terms of developing their understanding about NOS and scientists. Both programmes provided teachers with special encounters with world-renowned local scientists.
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6,591 |
Airway Pathology in Lung Transplants
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The histologic diagnosis of lung transplant rejection is based on the assessment of perivascular mononuclear cell inflammation, airway inflammation and fibrosis, and vasculopathic changes. This chapter describes the pathologic features of acute and chronic rejection of the small airways (i.e., lymphocytic and obliterative bronchiolitis). As transbronchial lung biopsy is the mainstay for the assessment of rejection, a brief discussion of some of the limitations of this technique is provided from the pathologist’s perspective. Several important and common entities that can mimic airway rejection are described with practical guidance for distinguishing these potential confounders on transbronchial biopsy. The non-rejection findings that are discussed include the normal biopsy, nonspecific forms of chronic bronchiolitis, cytomegalovirus and pneumocystis pneumonia, bronchiolitis obliterans-organizing pneumonia, and aspiration pneumonia.
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6,592 |
Venues of Counter-Hegemonic Visuality; Days of Contention
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This chapter introduces and describes how, as the arguable center of the Hong Kong Special Administrative Region’s protest culture and tradition, Hong Kong, and especially Hong Kong Island, contains a number of venues where demonstrations, rallies, and protests are prepared, deployed from, or held. The chapter, and the associated repertoire of images, begins the visual exploration of how the city has been visually re-imagined, transformed, and utilized by its subalterns to reproduce their aspirations and demands for greater democracy and social justice while subversively contesting and resisting hegemonic pressures to accept mainland Chinese cultural, economic, and political domination. The co-optation by anti-hegemonic Hongkongers of key cultural, economic, social, and political venues within the city during its many demonstrations, processions, rallies, and protests can be seen as visual resistance and as an effort to create a rich countervisuality by giving “voice to the visual.” Similarly, the conflation of special days (January 1st, May 4th, June 4th, July 1st, October 1st) with identifiable protests in Hong Kong—“Days of Contention”—suggest a similar impetus.
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6,593 |
Targeting Oncoproteins for Molecular Cancer Therapy
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Cancer and efforts to treat cancer are described in Ancient Egyptian documents dating back to 1600B.C. The first successful cancer treatments were arsenic-based therapies for leukemias, with the first reported application to cancer in the nineteenth century. However, nitrogen mustards are often accredited as the first modern chemotherapy. Originally intended as a chemical warfare agent in World War I, nitrogen mustard was stockpiled by several countries. During World War II, Axis bombers sunk a ship containing large quantities of nitrogen mustard and killed numerous Allied sailors. This observation birthed the hypothesis that nitrogen mustards might prevent the rapid division of cancer cells, one of the few properties of cancer understood at that time. Today, the hallmarks of cancer as recently redefined by Hanahan and Weinberg include several complex and connected cellular properties that allow for this phenotype: resistance to cell death, sustained angiogenesis, limitless ability to replicate, self-sufficiency in growth factor signaling, unresponsiveness to anti-growth factor signaling, genomic instability and mutation, deregulating cellular energetics, evading immune-mediated destruction, oncogenic inflammation, and invasiveness and metastasis. The identification and understanding of these hallmarks is a direct result of our molecular understanding of cancer that has surfaced relatively recently. Each of these hallmarks is determined by a host of molecules that together represent distinct therapeutic opportunities to target molecules that give rise to these defining properties of cancer.
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6,594 |
Health Care Workers’ Obligations in CBRNE Crises
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Health care workers (HCWs) often suffer the brunt of injuries during chemical, biological radiological, nuclear and explosive (CBRNE) events. Throughout history, those caring for the injured, dying and dead put themselves at risk of harm, infection or contamination. Recent events include the 2014–2016 infectious outbreak of Ebola virus disease in West Africa and the targeting of health facilities in the conflict in Syria. Decisions by HCWs to care for others in the face of such risks have been lauded as heroic whether undertaken for personal moral reasons or in response to an ethical duty to care. However, some have questioned whether such a duty to care is ethically obligatory in the face of some CBRNE events. Ethical analysis of the SARS outbreak found that additional ethical reflection was needed on HCWs’ obligations during CBRNE events. The ethical arguments used to justify the duty to care are reviewed in this chapter. However, other duties exist for HCWs which may conflict with the duty to care. The World Health Organization’s guidance on ethics in pandemics notes that the duty to provide care in pandemics is not unlimited, and that employers and governments have reciprocal obligations to provide training and protective equipment to HCWs during CBRNE. Empirical research raises questions about whether health care organisations are adequately prepared for CBRNE, particularly for the ethical decision-making that will be required. Rather than taking a regulatory or legal approach to this issue, this chapter will argue that the ethical virtues of courage and volunteerism should be fostered in HCW training. In keeping with a virtue ethics approach, leadership takes on an important role in ethical decision-making, as well as praising those who respond to CBRNE by caring for others in spite of the personal risks and their conflicting obligations.
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6,595 |
Respiratory Tract Infections: Sinusitis, Bronchitis, and Pneumonia
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Solid organ and hematopoietic stem cell transplant recipients are at increased risk of upper and lower respiratory tract infections. While these infections are frequently encountered in the general population, the spectrum of their clinical presentation including morbidity and mortality is increased in patients undergoing transplantation procedures. Impaired innate and adaptive immunity, potential anatomical abnormalities resulting from extensive surgical procedures, presences of indwelling medical devices, and increased healthcare exposure put transplant recipients at particularly high risk for respiratory tract disease. Infections of the respiratory tract can be divided into those affecting the paranasal sinuses, the upper airways such as bronchitis and tracheobronchitis, and the lower airways like pneumonia. Each of these clinical syndromes can further be classified based on their chronicity, acute vs. chronic; their setting, community vs. nosocomial; and the etiology such as bacteria, viruses, fungi, and rarely parasites. It is also important to realize that such immunologically vulnerable patients are at risk for polymicrobial infection that may present concurrently or in a sequential, consecutive fashion. This chapter reviews the common respiratory tract infections affecting transplant recipients with particular attention directed toward epidemiological risk factors, clinical presentations, diagnostic strategies, and common pathogens. Specific causes of opportunistic pneumonias are also reviewed.
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6,596 |
Characteristics of the Dynamic of Mobile Networks
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We propose in this paper a novel framework for the study of dynamic mobility networks. We address the characterization of dynamics by proposing an in-depth description and analysis of two real-world data sets. We show in particular that links creation and deletion processes are independent of other graph properties and that such networks exhibit a large number of possible configurations, from sparse to dense. From those observations, we propose simple yet very accurate models that allow to generate random mobility graphs with similar temporal behavior as the one observed in experimental data.
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6,597 |
Future Applications of GMOs
| null |
6,598 |
Prediction and Prevention: Interventions to Enhance Blood Safety
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The transmission of infectious disease by blood transfusion has been a major problem since the middle of the twentieth century. Since about 1960, there has been a concerted and prolonged effort to reduce or eliminate this outcome; the efforts have been successful, but new challenges continue to appear, mostly in the form of emerging infectious diseases. This chapter reviews two relevant issues: the possibility of predicting microbial threats to blood safety and the interventions that may be used to reduce the risks of transfusion transmission. While there are only limited opportunities to predict relevant infections, there are effective measures to enhance blood safety. These involve appropriate selection of donors, implementation of effective tests, and development and implementation of pathogen reduction.
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6,599 |
Die Evolution der Viren
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Viren sind aufgrund ihrer kurzen Generationszeit, der großen Zahl von Nachkommen, die sie im Infektionsverlauf produzieren, und nicht zuletzt aufgrund ihrer einfachen Struktur ideale Objekte zum Studium von Evolutionsprozessen. Viren müssen sich ständig den Bedingungen ihres Wirtes oder ihrer Wirtspopulationen anpassen, sodass Mechanismen der Selektion experimentellen Ansätzen zugänglich sind. Dabei spielen unterschiedliche Kriterien, wie die antigene Diversität, das Ausmaß der Virusausscheidung, der Grad der Virulenz und viele andere Faktoren eine wichtige Rolle. Die vollständige Adaptation eines Virus an seinen Wirt, welche in eine möglichst geringe Virulenz des Infektionserregers mündet, ist die für beide erstrebenswerte Konsequenz: ein problemloses Zusammen- und Überleben. So scheinen die Hepatitis-G-Viren, die zwar erstmals aus Patienten mit einer Leberentzündung isoliert wurden, ähnlich wie die TT-Viren in vielen Menschen zu persistieren, ohne dass sie dabei Erkrankungen verursachen (▸Abschnitte 14.5 und 20.2).
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