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8,700 |
Polymers in the Delivery of siRNA for the Treatment of Virus Infections
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Viral diseases remain a major cause of death worldwide. Despite advances in vaccine and antiviral drug technology, each year over three million people die from a range of viral infections. Predominant viruses include human immunodeficiency virus, hepatitis viruses, and gastrointestinal and respiratory viruses. Now more than ever, robust, easily mobilised and cost-effective antiviral strategies are needed to combat both known and emerging disease threats. RNA interference and small interfering (si)RNAs were initially hailed as a ‘‘magic bullet’’, due to their ability to inhibit the synthesis of any protein via the degradation of its complementary messenger RNA sequence. Of particular interest was the potential for attenuating viral mRNAs contributing to the pathogenesis of disease that were not able to be targeted by vaccines or antiviral drugs. However, it was soon discovered that delivery of active siRNA molecules to the infection site in vivo was considerably more difficult than anticipated, due to a number of physiological barriers in the body. This spurred a new wave of investigation into nucleic acid delivery vehicles which could facilitate safe, targeted and effective administration of the siRNA as therapy. Amongst these, cationic polymer delivery vehicles have emerged as a promising candidate as they are low-cost and easy to produce at an industrial scale, and bind to the siRNA by nonspecific electrostatic interactions. These nanoparticles (NPs) can be functionally designed to target the infection site, improve uptake in infected cells, release the siRNA inside the endosome and facilitate delivery into the cell cytoplasm. They may also have the added benefit of acting as adjuvants. This chapter provides a background around problems associated with the translation of siRNA as antiviral treatments, reviews the progress made in nucleic acid therapeutics and discusses current methods and progress in overcoming these challenges. It also addresses the importance of combining physicochemical characterisation of the NPs with in vitro and in vivo data.
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8,701 |
Host defenses
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Repeated episodes of viral upper respiratory tract infections occur anywhere from four to eight times per year in healthy individuals Local and systemic defense mechanisms exist to battle respiratory tract pathogens. Clinical manifestations are mainly due to host inflammatory response. Unfortunately, the host defense mechanisms are very often not sufficient to prevent subsequent/repeated episodes of infections(s). Further insight into the interaction of infectious agent and host immune response, genetic factors, and environmental factors is needed for a better understanding of why humans repeatedly and frequently suffer from infections with respiratory agents and develop a disease syndrome known as common cold.
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8,702 |
Helix-helix interaction patterns in membrane proteins
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Membrane-spanning α-helices represent major sites of protein-protein interaction in membrane protein oligomerization and folding. As such, these interactions may be of exquisite specificity. Specificity often rests on a complex interplay of different types of residues forming the helix-helix interfaces via dense packing and different non-covalent forces, including van der Waal’s forces, hydrogen bonding, charge-charge interactions, and aromatic interactions. These interfaces often contain complex residue motifs where the contribution of constituent amino acids depends on the context of the surrounding sequence. Moreover, transmembrane helix-helix interactions are increasingly recognized as being dynamic and dependent on the functional state of a given protein.
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8,703 |
Acute Respiratory Failure and Management
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Acute respiratory failure is a common reason for admission to the pediatric intensive care unit in oncology patients. Acute respiratory complications are also common after pediatric hematopoietic stem cell transplant (HSCT), accounting for a high proportion of HSCT-related morbidity and mortality. Evaluation of these patients requires a thorough workup that includes identification and treatment of infectious etiologies, and treatment for noninfectious causes once infectious causes are ruled out. These patients should be closely monitored for development of pediatric acute respiratory distress syndrome (PARDS) with early escalation of respiratory support. Patients undergoing a trial of noninvasive ventilation (NIV) should be continuously monitored to ensure they are responding. Prolonged delay of endotracheal intubation in patients who do not improve or worsen on NIV could worsen their outcome. Optimal treatment of immunocompromised patients with acute lung failure requires early and aggressive lung protective ventilation, prevention of fluid overload, and rapid diagnosis of underlying causes to facilitate prompt disease-directed therapy.
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8,704 |
Conclusion
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This chapter provides a summary of the global response to the AIDS pandemic and offers seven valuable lessons that can be learned from its history, which will hopefully be of value to the global community when confronted with future pandemics. These lessons relate to the behavior of donors, the importance of accountability, the need to understand the reality of the UN system, the advantage of a balanced and comprehensive approach to global challenges, and the importance of engaging civil society. The future of the World Health Organization, and its ability to provide leadership in addressing global pandemics and restore its credibility and legitimacy as the world’s leader in global health, is unclear. Hopefully, reforms now underway and the election of a new Director General, Tedros Ghebreyesus will enable this transformation.
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8,705 |
The Discovery and Early Clinical Evaluation of the HCV NS3/4A Protease Inhibitor Asunaprevir (BMS-650032)
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The discovery of asunaprevir (1) began with the concept of engaging the small and well-defined S(1)’ pocket of the hepatitis C virus (HCV) NS3/4A protease that was explored in the context of tripeptide carboxylic acid-based inhibitors. A cyclopropyl-acyl sulfonamide moiety was found to be the optimal element at the P(1)-P(1)’ interface enhancing the potency of carboxylic acid-based prototypes by 10- to >100-fold, dependent upon the specific background. Optimization for oral bioavailability identified a 1-substituted isoquinoline-based P(2)* element that conferred a significant exposure advantage in rats compared to the matched 4-substituted quinoline isomer. BMS-605339 (30) was the first cyclopropyl-acyl sulfonamide derivative advanced into clinical trials that demonstrated dose-related reductions in plasma viral RNA in HCV-infected patients. However, 30 was associated with cardiac events observed in a normal healthy volunteer (NHV) and an HCV-infected patient that led to the suspension of the development program. Using a Langendorff rabbit heart model, a limited structure-cardiac liability relationship was quickly established that led to the discovery of 1. This compound, which differs from 30 only by changes in the substitution pattern of the P(2)* isoquinoline heterocycle and the addition of a single chlorine atom to the molecular formula, gave a dose-dependent reduction in plasma viral RNA following oral administration to HCV-infected patients without the burden of the cardiac events that had been observed with 30. A small clinical trial of the combination of 1 with the HCV NS5A inhibitor daclatasvir (2) established for the first time that a chronic genotype 1 (GT-1) HCV infection could be cured by therapy with two direct-acting antiviral agents in the absence of exogenous immune-stimulating agents. Development of the combination of 1 and 2 was initially focused on Japan where the patient population is predominantly infected with GT-1b virus, culminating in marketing approval which was granted on July 4, 2014. In order to broaden therapy to include GT-1a infections, a fixed dose triple combination of 1, 2, and the allosteric NS5B inhibitor beclabuvir (3) was developed, approved by the Japanese health authorities for the treatment of HCV GT-1 infection on December 20, 2016 and marketed as Ximency(®).
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8,706 |
Rethinking Sepsis: New Insights from Gene Expression Profiling Studies
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Critically ill patients encompass an enormously heterogeneous population and, as such, therapeutic interventions, including drug therapy, can produce multiple outcomes in different patient subgroups. For example, researchers not only look for an ‘average effect’ of a drug on a typical patient, but also seek to understand individual variability. The presence of variability impacts significantly on the success of clinical trials and failure to identify this variability can result in the clinical trial being under-powdered to detect a treatment effect. For clinicians, failure to recognize variability can result in unintended toxicity or excessive harm in certain patients. Hence, understanding variability is critically important in both research and clinical practice.
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8,707 |
Fortsetzung des Wandels unter Präsident Mbeki (1999–2009)
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Sowohl seitens des ANC als auch der SACP, und zwar vor wie nach den Wahlen 1999, wurde die fortdauernde Bedeutung des RDP hervorgehoben und es kam zu einer auch vom COSATU unwidersprochenen und geradezu zelebrierten Neubestätigung bzw. Wiederbestätigung des RDP („reaffirmation of the RDP“) durch die Tripartite Alliance.
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8,708 |
Nanoparticles as Precious Stones in the Crown of Modern Molecular Biology
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The interdisciplinary field of research on biosystems at the nanoscale involving physical sciences, molecular engineering, biology, biotechnology, and medicine supplements the knowledge of synthesizing new drugs, targeted delivery, regenerative medicine, and neuromorphic engineering forms the booming research in the present society. The present chapter deals with the role of nanoparticles in modern molecular biology. This is an interesting area of research that creates great impact on the healthcare of the society. The prime focus is to give the reader a historic background of nanomaterial application in biology and medicine. We have also provided the overview of most recent developments in this field leading to discussion of hard road to commercialization.
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8,709 |
Multi-agents Simulation on Unconventional Emergencies Evolution Mechanism in Public Health
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Based on the cellular automaton principle and multi-agents theory of complex systems, this essay studied the public health unconventional emergencies generation and evolution mechanism, established evolution model and carried out simulation of the public health unconventional emergencies evolution mechanism, and finally took SARS emergency for an example. Research results showed that the evolution of the public health emergency often promots other linkage emergencies, the damage of linkage system is larger than that of promotion system, and the damage is uncontrolled except for controlling the promotion system effectively, just like isolation measures or inject vaccine for individual of the promotion system so as to prevent promotion system from producing linkage hazards.
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8,710 |
Regional Innovation Systems Analysis and Evaluation: The Case of the Czech Republic
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Regional innovation systems (RIS) have become a very important regional policy instrument. This instrument is based on linkages among the region’s institutions from the public and private sector. These linkages are very important because they provide an environment for the innovation process, which is the primary goal of the RIS. In this paper, we have defined and described the main characteristics common to every RIS. Knowledge of these characteristics allows us to create a new method to make it possible to analyze individual RISes. The goal of this chapter is to present a new method for evaluating RISes. The method must by easily applied in order for it to be used practically to map the development of the individual innovative systems in a region. The method is based on evaluating both qualitative and quantitative indicators and on applying WSA methods. The paper presents the application of this method on individual regions in the Czech Republic (NUTS3).
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8,711 |
Live-Attenuated Bacterial Vectors for Delivery of Mucosal Vaccines, DNA Vaccines, and Cancer Immunotherapy
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Vaccines save millions of lives each year from various life-threatening infectious diseases, and there are more than 20 vaccines currently licensed for human use worldwide. Moreover, in recent decades immunotherapy has become the mainstream therapy, which highlights the tremendous potential of immune response mediators, including vaccines for prevention and treatment of various forms of cancer. However, despite the tremendous advances in microbiology and immunology, there are several vaccine preventable diseases which still lack effective vaccines. Classically, weakened forms (attenuated) of pathogenic microbes were used as vaccines. Although the attenuated microbes induce effective immune response, a significant risk of reversion to pathogenic forms remains. While in the twenty-first century, with the advent of genetic engineering, microbes can be tailored with desired properties. In this review, I have focused on the use of genetically modified bacteria for the delivery of vaccine antigens. More specifically, the live-attenuated bacteria, derived from pathogenic bacteria, possess many features that make them highly suitable vectors for the delivery of vaccine antigens. Bacteria can theoretically express any heterologous gene or can deliver mammalian expression vectors harboring vaccine antigens (DNA vaccines). These properties of live-attenuated microbes are being harnessed to make vaccines against several infectious and noninfectious diseases. In this regard, I have described the desired features of live-attenuated bacterial vectors and the mechanisms of immune responses manifested by live-attenuated bacterial vectors. Interestingly anaerobic bacteria are naturally attracted to tumors, which make them suitable vehicles to deliver tumor-associated antigens thus I have discussed important studies investigating the role of bacterial vectors in immunotherapy. Finally, I have provided important discussion on novel approaches for improvement and tailoring of live-attenuated bacterial vectors for the generation of desired immune responses.
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8,712 |
Communication III (Immunological Control)
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One of controlling systems in the body which the body also uses for communication (externally and internally) is the Immune system, based upon existence of MHC molecules fundamental for recognition, and other molecules responsible for antigen-presentation and immediate or postponed reaction to it. The fundamental unique feature of immune system cells is the capability of distinguishing “self” from “non-self” cells and proteins. Communication between different cell types of the immune system is critical in the recognition of self, surveillance, defense, and clearance of foreign invaders. These signaling mechanisms involve direct cell–cell signaling as well as autocrine and paracrine signaling. The essential feature of particular cells of immunological system is memory and although still known at the level of phenomenology, presents the basis for vaccines.
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8,713 |
Genus Parapoxvirus
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Highly contagious pustular skin infections of sheep, goats and cattle that were unwittingly transmitted to humans from close contact with infected animals, have been the scourge of shepherds, herdsmen and dairy farmers for centuries. In more recent times we recognise that these proliferative pustular lesions are likely to be caused by a group of zoonotic viruses that are classified as parapoxviruses. In addition to infecting the above ungulates, parapoxviruses have more recently been isolated from seals, camels, red deer and reindeer and most have been shown to infect man. The parapoxviruses have one of the smallest genomes of the poxvirus family (140 kb) yet share over 70% of their genes with the most virulent members. Like other poxviruses, the central core of the genomes encode factors for virus transcription and replication, and structural proteins, whereas the terminal regions encode accessory factors that give the parapoxvirus group many of its unique features. Several genes of parapoxviruses are unique to this genus and encode factors that target inflammation, the innate immune responses and the development of acquired immunity. These factors include a homologue of mammalian interleukin (IL)-10, a chemokine binding protein and a granulocyte-macrophage colony stimulating factor /IL-2 binding protein. The ability of this group to reinfect their hosts, even though a cell-mediated memory response is induced during primary infection, may be related to their epitheliotropic niche and the immunomodulators they produce. In this highly localised environment, the secreted immunomodulators only interfere with the local immune response and thus do not compromise the host’s immune system. The discovery of a vascular endothelial growth factor-like gene may explain the highly vascular nature of parapoxvirus lesions. There are many genes of parapoxviruses which do not encode polypeptides with significant matches with protein sequences in public databases, separating this genus from most other mammalian poxviruses. These genes appear to be involved in inhibiting apoptosis, manipulating cell cycle progression and degradation of cellular proteins that may be involved in the stress response, thus allowing the virus to subvert intracellular antiviral mechanisms and enhance the availability of cellular molecules required for replication. Parapoxviruses in common with Molluscum contagiosum virus lack a number of genes that are highly conserved in other poxviruses, including factors for nucleotide metabolism, serine protease inhibitors and kelch-like proteins. It is apparent that parapoxviruses have evolved a unique repertoire of genes that have allowed adaptation to the highly specialised environment of the epidermis.
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8,714 |
B-Cell Targeted Therapies in Autoimmune Cytopenias and Thrombosis
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Ever since the advent of Rituximab and subsequently the emergence of other compounds targeting B cells, a cornucopia of medical applications have been found for this family of compounds. After their establishment as standard of care in many conditions such as rituximab in lymphoma and rheumatoid arthritis, they have been progressively found to aid in the treatment of many other conditions. This area constituted a fertile area of research in the past 12 years. Physicians have investigated the B-cell depleting agents use in cases of autoimmune hematologic cytopenias such as immune thrombocytopenia, Evans syndrome, cold and warm autoimmune hemolytic anemia, and other thrombophilic disorders such as the antiphospholipid syndrome and thrombocytopenic purpura. This chapter presents a historical perspective reviewing the various studies that have been published in this field. In addition, it offers a current assessment of the evidence regarding the use of B-cell depleting agents in the aforementioned conditions.
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8,715 |
The Use of Antimicrobial Nanoparticles to Control Oral Infections
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The potential of antimicrobial nanoparticles to control oral infections is reviewed. Such particles can be classified as having a size no greater than 100 nm and are produced using traditional or more novel techniques. Exploitation of the toxic properties of nanoparticles to bacteria, fungi and viruses, in particular metals and metal oxides, and their incorporation into polymeric materials have increased markedly over the past decade. The potential of nanoparticles to control the formation of biofilms within the oral cavity, as a function of their biocidal, anti-adhesive and delivery capabilities, is now receiving close attention. The latest insights into the application of nanoparticles within this field, including their use in photodynamic therapy, will be discussed. Possible approaches to alter biocompatibility and desired function will also be covered.
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8,716 |
The Biological Fight Against Pathogenic Bacteria and Protozoa
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The animal gastrointestinal tract is a tube with two open ends; hence, from the microbial point of view it constitutes an open system, as opposed to the circulatory system that must be a tightly closed microbial-free environment. In particular, the human intestine spans ca. 200 m(2) and represents a massive absorptive surface composed of a layer of epithelial cells as well as a paracellular barrier. The permeability of this paracellular barrier is regulated by transmembrane proteins known as claudins that play a critical role in tight junctions.
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8,717 |
Tuberkulose und andere durch Luft übertragbare Infektionserkrankungen: Krankenhaushygiene zur Vermeidung und Eindämmung
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Die Tuberkulose (TB) gehört weltweit zu den am häufigsten auftretenden Infektionskrankheiten und wird fast ausschließlich über die Luft (aerogen) übertragen. Nachdem in Deutschland die Lungentuberkulosefallzahlen über Jahre hinweg stagnierten, ist seit 2013 wieder ein Anstieg der Inzidenzen zu verzeichnen (RKI 2016). Als Ursache hierfür werden die aktuellen demographischen Entwicklungen (Migration und Mobilität) gesehen. Die Kenntnis der epidemiologischen Situation ist von zentraler Bedeutung, um bei Vorliegen der Verdachtsdiagnose Tuberkulose sowie der Einbeziehung einer möglichen Resistenzproblematik frühzeitig adäquate krankenhaushygienische Maßnahmen einzuleiten. Als aerogen übertragbar werden auch die Aspergillose sowie Masern, Windpocken und Herpes zoster eingestuft (CDC 2007). Die Aspergillose ist eine relativ seltene, aber häufig letal verlaufende Pilzinfektion, die überwiegend bei immunsupprimierten Patienten auftritt. Krankenhaushygienische Schutzmaßnahmen können die Risiken einer Exposition und somit das Erkrankungsrisiko minimieren. Die zentralen Maßnahmen zur Kontrolle und Prävention von aerogen übertragbaren Infektionen sind Gegenstand dieses Kapitels.
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8,718 |
Nierentransplantation
|
Die Nierentransplantation ist die effektivste Behandlungsmethode der chronischen terminalen Niereninsuffizienz. Seit den 1960er Jahren entwickelte sie sich zu einer Standardtherapie. Wichtige Voraussetzungen waren die Entdeckung des HLASystems, die Entwicklung der Immunsuppressiva sowie die technische Perfektionierung des Organerhaltes außerhalb eines lebenden Körpers. Die 5- Jahres-Überlebensrate für Allotransplantate beträgt etwa 65%, diejenige von Lebendspenden 79%. Die Einrichtung von zentralen Erfassungsstellen, wie z. B. Eurotransplant (Deutschland, Benelux- Staaten, Österreich, Slowenien), ist für die Organisation des zeitgebundenen Ablaufes von großer Bedeutung. Bei diesen Institutionen sind alle potentiellen Nierenempfänger registriert. Dort werden auch alle potentiellen Spenderorgane gemeldet und dem passenden Empfänger zugeordnet.
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8,719 |
Nanomolecular Diagnostics
|
Clinical application of molecular technologies to elucidate, diagnose, and monitor human diseases is referred to as molecular diagnosis. It is a broader term than DNA (deoxyribonucleic acid) diagnostics and refers to the use of technologies that use DNA, RNA (ribonucleic acid), genes, or proteins as bases for diagnostic tests. The scope of the subject is much wider and includes in vivo imaging and diagnosis at the single-molecule level. A more detailed description of molecular diagnostics is presented elsewhere (Jain 2012a).
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8,720 |
Modeling and Predicting Human Infectious Diseases
|
The spreading of infectious diseases has dramatically shaped our history and society. The quest to understand and prevent their spreading dates more than two centuries. Over the years, advances in Medicine, Biology, Mathematics, Physics, Network Science, Computer Science, and Technology in general contributed to the development of modern epidemiology. In this chapter, we present a summary of different mathematical and computational approaches aimed at describing, modeling, and forecasting the diffusion of viruses. We start from the basic concepts and models in an unstructured population and gradually increase the realism by adding the effects of realistic contact structures within a population as well as the effects of human mobility coupling different subpopulations. Building on these concepts we present two realistic data-driven epidemiological models able to forecast the spreading of infectious diseases at different geographical granularities. We conclude by introducing some recent developments in diseases modeling rooted in the big-data revolution.
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8,721 |
Diagnostic Approach to Life-Threatening Pulmonary Infiltrates
|
Diagnosis of pulmonary disease is typically based upon consideration of presenting symptoms, physical examination, and pulmonary function testing in combination with classification of radiographic features, to guide diagnostic tests and initiate empiric treatment. When diagnostic efforts and/or empiric treatment fails, thoracic surgeons have traditionally been called upon to perform surgical biopsy of the lung to aid in the diagnosis of indeterminate, life-threatening pulmonary disease. Such biopsy has been requested specifically in the case of diffuse lung disease among patients receiving treatment for solid-organ or hematologic cancers, particularly when symptoms of respiratory failure progress and when noninvasive diagnostic tests and empiric treatments fail to halt progression. In such circumstances, radiologists, pulmonologists, and thoracic surgeons may be consulted and asked to provide tissue specimens that will allow rapid, accurate diagnosis leading to specific treatment. It is imperative that biopsy take place before respiratory failure supervenes [1], and that the specimens provided to clinical laboratories, pathologists, and microbiologists are comprehensive and properly preserved.
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8,722 |
Pederin, Psymberin and the Structurally Related Mycalamides: Synthetic Aspects and Biological Activities
|
Pederin, psymberin, and mycalamides are related members of a relatively new family of potent natural antiviral and antitumor compounds originally isolated from marine sponges in 1988. This natural family of chemicals is of great interest to medicinal chemists and biologists, stemming from its extremely low abundance in source organisms and strikingly potent biological activity. They have clearly emerged as promising new synthetic targets, and are the focus of quite an interdisciplinary approach to molecular characterization. In this chapter we review diverse synthetic approaches to this family of natural products that has been demonstrating remarkable biological activity. We discuss relevant history, biological origins with the latest information on source organisms and their hosts, in-depth synthetic approaches, and biological data supporting their potential as therapeutic compounds.
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8,723 |
Transformation and Carcinogenesis
|
It was acknowledged long ago that viruses may cause cancer in animals. In 1911, Peyton Rous described viruses as causing sarcomas in poultry. The tumour-inducing virus responsible was later named after him, Rous sarcoma virus. In the following decades, a large number of viruses were discovered that can cause various cancers in poultry and rodents, such as lymphomas, sarcomas and carcinomas. Many of them belong to the family Retroviridae, and were classified into the genera Alpharetrovirus, Betaretrovirus and Gammaretrovirus. Most of these pathogens were isolated from inbred strains of the respective species or from cell cultures; under natural conditions, these strains are likely irrelevant as a cause of cancer in the corresponding species. An exception is feline leukaemia virus (10.1007/978-3-642-20718-1_18). The tumorigenic potential of oncogenic retroviruses is based on transformationally active proteins. They are similar to cellular products which are ordinarily involved in the regulation of cell division. In contrast to the cellular products, viral oncogene proteins are altered by mutations in such a way that they are not subject to regulatory control, and are thus constitutively active. In fact, the discovery of viral oncogenes was pioneering and has paved the way for deciphering cellular oncogenes, and thus for understanding the molecular basis of carcinogenesis. Evidence for the existence of retroviruses that cause cancer in humans was found only in 1982 when Robert Gallo discovered human T-lymphotropic virus (HTLV; 10.1007/978-3-642-20718-1_18).
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8,724 |
Disaster Risk Management in China
|
Disasters have been endemic throughout history. In Judeo history, the flood survived by Noah was about as complete a disaster to contemporary humankind as can be imagined. Egypt was plagued with droughts and floods of the Nile. In Greek/Roman culture, events such as eruptions of Mount Vesuvius caused tremendous suffering and damage. Similar disasters disrupted human activity throughout the world, to include unrecorded events at Easter Island. The International Federation of Red Cross and Red Crescent Societies stated that over a recent 10 year period, almost two billion people have been affected by disasters. People in Asia accounted for almost 89% of the population affected by natural disasters between 1975 and 2003.
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8,725 |
The Impact of Movement on Disease Dynamics in a Multi-city Compartmental Model Including Residency Patch
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The impact of population dispersal between two cities on the spread of a disease is investigated analytically. A general SIRS model is presented that tracks the place of residence of individuals, allowing for different movement rates of local residents and visitors in a city. Provided the basic reproduction number is greater than one, we demonstrate in our model that increasing the travel volumes of some infected groups may result in the extinction of a disease, even though the disease cannot be eliminated in each city when the cities are isolated.
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8,726 |
Pandemic Influenza Planning for the Mental Health Security of Survivors of Mass Deaths
|
Influenza A pandemics have been documented to occur at 10- to 50-year intervals—an average of three events per century, dating back from the 16th century. Each recorded pandemic has resulted in an increase in annual mortality rates in the infected population, with mass deaths in one pandemic wave equalling fatalities sustained over six months of an epidemic season. This chapter aims to rectify the oversight in pandemic preparedness plans by presenting a compendium of guidelines and recommendations by international health organisations, pandemic fatality experts, and experienced mass death management professionals. Its objective is to have available a mass fatality framework to complement the WHO Pandemic Influenza Preparedness and Response (2009) guideline, from which individual national pandemic preparedness plans are based. It is written in a format that incorporates WHO’s emphasis on finding the ethical balance between human rights and successful plan implementation; the assimilation of national pandemic plans with existing national emergency measures; and the ‘whole group’ system of engaging individuals, families, localities, and business establishments in the process. This chapter is also written such that it can be made applicable to analogous infectious disease outbreaks such as SARS and Ebola, as well as comparable mass fatality events.
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8,727 |
The Biologics Revolution and Endotoxin Test Concerns
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The advent of “at will” production of biologics in lieu of harvesting animal proteins (i.e. insulin) or human cadaver proteins (i.e. growth hormone) has revolutionized the treatment of disease. While the fruits of the biotechnology revolution are widely acknowledged, the realization of the differences in the means of production and changes in the manner of control of potential impurities and contaminants in regard to the new versus the old are less widely appreciated. This chapter is an overview of the biologics revolution in terms of the rigors of manufacturing required to produce them, their mechanism of action, and caveats of endotoxin control. It is a continulation of the previous chapter that established a basic background knowledge of adaptive immune principles necessary to understand the mode of action of both disease causation and biologics therapeutic treatment via immune modulation.
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8,728 |
Intraoperativer Volumenersatz, Transfusion und Behandlung von Gerinnungsstörungen
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Sowohl der operative Eingriff als auch die Narkose führen zu Veränderungen des intravasalen Volumenstatus des Patienten.
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8,729 |
Modelling of Experimental Infections
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This chapter aims to give a clear idea of how mathematical analysis for experimental systems could help in the process of data assimilation, parameter estimation and hypothesis testing.
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8,730 |
Metaphernreflexion und -analyse in sozialwissenschaftlichen Disziplinen
|
Im vierten Kapitel erfolgt eine umfassende Rekonstruktion von Metaphernanalysen in den Disziplinen Soziologie, Erziehungswissenschaften, Soziale Arbeit, Politologie, Gesundheitswissenschaften und Psychologie sowie in einem Exkurs zur Geschlechterforschung. Metaphernanalysen haben sich in den verschiedenen Bereichen seit der Herausbildung des für sozialwissenschaftliche Forschungen anschlussfähigen Metaphernbegriffs in unterschiedlichem Tempo und mit heterogener Methodik entwickelt. Hier interessieren die bereits explorierten Fragestellungen, ihre Ergebnisse und die im Feld entwickelten methodische Besonderheiten.
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8,731 |
Genotyping Arrays
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Although the most common use of DNA microarrays is gene expression profiling, microarrays are also used for many other applications, including genotyping, resequencing, SNP analysis, and DNA methylation assays. Here we describe genotyping arrays for Influenza A subtype identification and for upper respiratory pathogen diagnostics using standard hybridization techniques and we also describe resequencing, SNP, and methylation assays using an enzyme-based strategy [25, 26].
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8,732 |
Differential Diagnosis of Vasovagal Syncope: Postural Orthostatic Tachycardia
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Postural tachycardia syndrome (POTS) is a syndrome defined as an increase in heart rate (HR) of ≥30 bpm within 10 min of assuming an upright posture in the absence of orthostatic hypotension (decrease in blood pressure (BP) >20/10 mmHg). The prevalence of POTS has been estimated as 500,000–3,000,000 patients in the USA. Because it affects mainly women between 13 and 50 years of age, the impact on productivity at work and lifestyle can be devastating. Considerable clinical overlap exists between POTS and vasovagal syncope (VVS) with patients experiencing similar orthostatic symptoms related to insufficient adaptation to blood volume shifts during upright posture. Nevertheless, differences emerge during head up tilt table testing. In patients with POTS, during upright tilt, sympathetic tone increases, there is an early and sustained tachycardia, and patients complain of presyncope without frank syncope. In contrast, patients with VVS experience delayed symptoms and abrupt drops in BP and HR and are more likely to lose consciousness. Treatment of POTS includes exercise and medications directed at decreasing sympathetic tone or increasing blood volume.
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8,733 |
History Repeating? A Comparison of the Launch and Uses of Fixed and Mobile Phones
| null |
8,734 |
Health Effects of Changing Environment
|
Environment plays a crucial role in our economic, social and cultural behaviour as well as on health. However, since the beginning of industrialization era, focus on economic development has caused detrimental effects on the environment. Last two centuries have witnessed changes in global environmental factors such as rise in temperature leading to global warming, depletion of stratospheric ozone layer, loss of biodiversity and marked degradation in air and water quality due to atmospheric pollution, thereby causing upsurge in infectious and non-infectious diseases. Environmental health has emerged as an important part of medicine. The World Health Organization (WHO) estimates that 24% of global disease burden and 23% of all deaths can be attributed to environmental factors. Deaths from heart disease, cancer, respiratory disorders and many vector-borne diseases such as malaria, dengue, chikungunya and cholera have increased due to changes in climate, especially in developing countries. Besides limited attention to sanitation, hygiene, as well as quality of food and drinking water, factors such as deforestation, increasing vehicular traffic, migration from rural to urban areas, decreasing water resources and inadequate drainage systems contribute to increase incidence of diseases. The need of the hour is to sensitize ourselves about the way our ecology is being degraded and the health effects it is causing. A holistic view is needed to address the problem of environmental health where agriculture, animal husbandry, public health, water safety and air pollution need to be looked at in a combined manner for education, planning and resource allocation. Therefore, a close association between scientists, public health professionals and administrators is needed for integrated design and development of framework to attain harmony between man and nature.
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8,735 |
Technical Annexes
|
This chapter provides guidance on technical issues in the health sector. The annexes contain selective compilations of frequently used reference information.
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8,736 |
Challenges for the Application of GIS Interoperability in Emergency Management
|
This paper highlights application challenges for GIS interoperability for emergency management with emphasis on critical infrastructure sectors. In the first part, this paper provides a comparative analysis of emergency management operations in the City of Vancouver; the City of Toronto, the Kitchener Waterloo Region, and the Dufferin County. A variety of qualitative research methods were employed for gathering information from key decision-makers involved with emergency management. The second part of this paper presents a scenario-based case study, which aims to provide a demonstration of the utility of GIS interoperability, for disaster management. This paper also discusses the strengths and weaknesses of leveraging GIS interoperability for disaster management.
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8,737 |
Rapid and Low-Cost Tools Derived from Plants to Face Emerging/Re-emerging Infectious Diseases and Bioterrorism Agents
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Whether naturally occurring or man-made, biological threats pose a severe risk in an increasingly globalized world. The dual-use nature of biological research, with its most recent advances in biotechnology (‘synthetic biology’, gene editing, nanotechnologies etc.) and the rapid diffusion of knowledge, raise proliferation concerns of biological weapons by non-state actors. Thus, there is an urgent need to develop measures intended to enhance diagnostic, prophylactic and therapeutic capabilities and capacities to improve the ability of society to combat infectious diseases outbreaks, as well as to alleviate the effects of bioterrorism attacks. We present here two examples of biotechnology usage for biodefence purposes: (i) plants as biofactories for the rapid production of improved biopharmaceuticals (‘Plant Molecular Farming’), and (ii) plant sequences as immune-modulating agents to enhance the efficacy of genetic vaccines. These platforms represent two promising (and complementary) approaches for the rapid and low-cost production of countermeasures (diagnostics and vaccine candidates) against emerging, re-emerging and bioterrorism-related infections.
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8,738 |
The molecular basis of paediatric malarial disease
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Severe falciparum malaria is an acute systemic disease that can affect multiple organs, including those in which few parasites are found. The acute disease bears many similarities both clinically and, potentially, mechanistically, to the systemic diseases caused by bacteria, rickettsia, and viruses. Traditionally the morbidity and mortality associated with severe malarial disease has been explained in terms of mechanical obstruction to vascular flow by adherence to endothelium (termed sequestration) of erythrocytes containing mature-stage parasites. However, over the past few decades an alternative ‘cytokine theory of disease’ has also evolved, where malarial pathology is explained in terms of a balance between the pro- and anti-inflammatory cytokines. The final common pathway for this pro-inflammatory imbalance is believed to be a limitation in the supply and mitochondrial utilisation of energy to cells. Different patterns of ensuing energy depletion (both temporal and spatial) throughout the cells in the body present as different clinical syndromes. This chapter draws attention to the over-arching position that inflammatory cytokines are beginning to occupy in the pathogenesis of acute malaria and other acute infections. The influence of inflammatory cytokines on cellular function offers a molecular framework to explain the multiple clinical syndromes that are observed during acute malarial illness, and provides a fresh avenue of investigation for adjunct therapies to ameliorate the malarial disease process.
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8,739 |
Use of Filgrastim (r-metHuG-CSF) in Human Immunodeficiency Virus Infection
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In 2008, an estimated 33.4 million individuals worldwide were infected with the human immunodeficiency virus (HIV) [1]. Only a few years ago, infection with HIV almost invariably culminated in the development of the acquired immunodeficiency syndrome (AIDS), characterized by severe depletion of CD4(+) lymphocytes leading to derangements predominantly affecting cell-mediated immunity, but affecting humoral immunity as well [2]. In the later stages of AIDS, neutropenia and neutrophil functional deficits were common sequelae of HIV infection, other opportunistic infections, or HIV- or opportunistic infection-related treatment [3]. The care of the HIV-infected patient was palliative in nature, and the possibility that use of filgrastim (rHuG-CSF) might extend survival in late-stage AIDS patients with severe neutropenia or severe opportunistic infections, or might be a treatment for HIV infection itself, was explored [4]. Subsequently, however, the development of protease inhibitors and the widespread adoption of their use in multidrug regimens of highly active antiretroviral therapy (HAART) revolutionized the care of HIV-infected patients, and the number of patients dying from HIV decreased dramatically [5].
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8,740 |
Evaluation Findings and Policy Suggestions
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The foregoing Chaps. 10.1007/978-981-13-0644-0_3–10.1007/978-981-13-0644-0_7 have dealt with the five aspects of China’s Influenza A (H1N1) prevention and control efforts respectively, namely, strategies, systems and mechanisms, emergency response measures, costs and benefits, and social comments. This chapter will summarize the evaluation team’s findings in three respects of Influenza A (H1N1) prevention and control—main effects, basic experience, and inadequacies, and go on to raise issues worth further discussion and provide relevant policy suggestions.
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8,741 |
Emerging Viral Zoonoses from Wildlife Associated with Animal-Based Food Systems: Risks and Opportunities
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Zoonotic viruses of wildlife origin have caused the majority of recent emerging infectious diseases (EIDs) that have had significant impacts on human health or economies. Animal consumption-based food systems, ranging from the harvest of free-ranging wild species (hereafter, wild harvest systems) to the in situ stocking of domestic or farmed wild animals (hereafter, animal production systems), have been implicated in the emergence of many of these viruses, including HIV, Ebola, SARS, and highly pathogenic avian influenza (HPAI).
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8,742 |
Infectious Diseases
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This chapter introduces infectious diseases faced by many populations in the world. The role of the environment and how and why these diseases are transmitted as well as prevention strategies are also discussed. The story takes place at a disco funeral in Kenya, where HIV prevalence is high and risky sexual behavior takes place.
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8,743 |
Local and Recurrent Regional Metastases of Melanoma
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Up to 10% of patients with cutaneous melanoma will develop recurrent locoregional disease. While surgical resection remains the mainstay of treatment for isolated recurrences, locoregional melanoma can often present as bulky, unresectable disease and can pose a significant therapeutic challenge. This chapter focuses on the natural history of local and regionally recurrent metastases and the multiple treatment modalities which exist for advanced locoregional melanoma, including regional perfusion procedures such as hyperthermic isolated limb perfusion and isolated limb infusion, intralesional therapies, and neo-adjuvant systemic therapy strategies for borderline resectable regional disease. Hyperthermic limb perfusion (HILP) and isolated limb infusion (ILI) are generally well-tolerated and have shown overall response rates between 44% and 90%. Intralesional therapies also appear to be well-tolerated as adverse events are usually limited to the site of injection and minor transient flu-like symptoms. Systemic targeted therapies have shown to have response rates up to 85% when used as neoadjuvant therapy in patients with borderline resectable disease. While combination immunotherapy in the neoadjuvant setting has also shown promising results, this data has not yet matured.
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8,744 |
Donor Evaluation for Hematopoietic Stem and Progenitor Cell Collection
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With the increasing incidence of hematopoietic allogeneic cell transplantation (allo-HCT), the importance of securing a cellular product, safely from a donor, and ensuring that the product is without additional risk to the recipient, continues to be of paramount importance. The evaluation of the donor’s medical eligibility and suitability is designed to identify and limit the risk of transmitting infectious, genetic, or neoplastic diseases to the recipient through the product. It also aims to ensure a maximum level of safety for the donor and informs them of the risks of donation. Several regulatory agencies, national and international registries, and accreditation bodies have facilitated the availability and safe provision of human cells, tissues, and cellular- and tissue-based products not only at local institutions but also through international exchange.
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8,745 |
Bluttransfusion
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Bei einem 58-jährigen Patienten mit einem Hb-Wert von 6,5 g/dl, der nach operativer Ausschaltung eines Bauchaortenaneurysmas auf der Intensivstation unerwartet nachblutet, soll eine Bluttransfusion durchgeführt werden. Wenige Minuten nach der Anforderung aus der Blutbank treffen die bestellten Erythrozytenkonzentrate ein – es sind Erythrozytenkonzentrate der Blutgruppe A. Sie sind eindeutig auf den Namen des Patienten ausgezeichnet, die Identität des Patienten wird erneut überprüft. Der durchgeführte Bedside-Test zeigt aber die Blutgruppe B! Was muss der Intensivarzt nun tun?
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8,746 |
Modern Patient Blood Management in Arthroplasty
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One of the oldest and still commonest procedures in clinical practice, allogeneic blood transfusion (ABT), is not fully supported by available evidence. In the last few decades, increasing concerns about unfavorable outcomes associated with ABT, anticipation of future insufficient blood supply, and awareness of the cost (direct and indirect) of transfusion have led to the promotion of patient blood management (PBM) as a cost-effective strategy, beneficial for patients as well as for society (Shander et al. 2010). PBM programs utilize a series of measures with a proven ability to reduce ABT and to be cost-effective. Despite that the impact of PBM on patient clinical outcomes needs to be fully defined and future studies are needed, PBM should be adopted as a new standard of care.
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8,747 |
Prediction of TGEV Spike Protein Secondary Structure and B Cell Epitopes
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The spike gene of TGEV TH98 strain was translated into amino sequence by Editseq. The secondary structure and B cell epitope of spike protein of TGEV TH98 strain were predicted by Protean. Combining the results according to these methods, the spike protein of TGEV TH98 strain has complicated secondary structure. There are several epitopes of the B-cells in spike protein, including 43-56aa, 97-104aa, 117-128aa, 132-173aa, 238-257aa, 391-398aa, 535-706aa, 779-799aa, 918-987aa, 1165-1200aa, 1257-1266aa and 1430-1446aa.
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8,748 |
Kidney-Organ Interaction
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The practice of critical care nephrology demands an intimate understanding of the interactions and “crosstalk” that occurs between the kidney and multiple organ systems, in particular the heart, lung, gut, and brain. Accumulating evidence suggests that acute injury and dysfunction to the kidney can incite and propagate cardiac, pulmonary, gastrointestinal, and neurologic injury and dysfunction through a host of mechanisms.
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8,749 |
Die medizinische Mikrobiologie im 21. Jahrhundert
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Die medizinische Mikrobiologie befasst sich mit der ursächlichen Rolle pathogener (d. h. krankheitserzeugender) Mikroorganismen bei der Entstehung von Störungen im Funktionsablauf des menschlichen Organismus. Störungen dieser Art entstehen durch Ansiedlung und Vermehrung von Mikroorganismen im Sinne des Parasitismus; sie treten als Infektionskrankheit in Erscheinung. Demgemäß betrachtet man die parasitierenden Mikroorganismen als Krankheitserreger; das befallene Individuum wird als »Wirt« oder »Makroorganismus« bezeichnet. Da bei der Betrachtung von Infektionen sowohl der Wirt mit seinen Reaktionen als auch die krankheitserzeugenden Eigenschaften eines Mikroorganismus (d. h. seine Pathogenität) im Vordergrundstehen, lässt sich die medizinische Mikrobiologie am ehesten als Infektionslehre begreifen – als Lehre von der Auseinandersetzung des Wirtes mit den krankheitserzeugenden Eigenschaften des Erregers.
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8,750 |
Lagos the Mega-City: A Report on How the Metropolis Handled an Outbreak of the Ebola Epidemic
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Lagos State, Nigeria, is a mega-city with an estimated population of 16–21 million people. In the last ten years, the mega-city has made tremendous progress in terms of: sustained rapid economic growth, improved infrastructure and services, and a significant reduction in crime rates. This has provided an enabling environment for millions of Lagos state inhabitants to find their way out of poverty. The Lagos State Government has also made great strides in its quest to: increase value for money in public spending; improve the business climate in Lagos; maintain fiscal sustainability; and properly monitor and manage financial and health risks.
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8,751 |
Modeling State Interventions
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In the context of the modern nation state, the ecology of infectious diseases cannot be described by interacting populations alone, as much of the modeling literature implicitly presumes (Wallace and Wallace 2016). Modern states incorporate elaborate public health bureaucracies tasked with either containing or eliminating pathogen outbreaks. States are thus highly cognitive entities at the institutional level. It is then appropriate, indeed arguably necessary, to reconsider vector-borne infection from a control theory perspective.
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8,752 |
Risks and Epidemiology of Infections After Lung or Heart–Lung Transplantation
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Nowadays, lung transplantation is an established treatment option of end-stage pulmonary parenchymal and vascular disease. Post-transplant infections are a significant contributor to overall morbidity and mortality in the lung transplant recipient that, in turn, are higher than in other solid organ transplant recipients. This is likely due to several specific factors such as the constant exposure to the outside environment and the colonized native airway, and the disruption of usual mechanisms of defense including the cough reflex, bronchial circulation, and lymphatic drainage. This chapter will review the common infections that develop in the lung or heart–lung transplant recipient, including the general risk factors for infection in this population, and specific features of prophylaxis and treatment for the most frequent bacterial, viral, and fungal infections. The effects of infection on lung transplant rejection will also be discussed.
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8,753 |
Future Directions in Food Safety
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The recent success that the USDA Food Safety Inspection Service has had in 2003 and 2004 of reversing the steadily increasing trend in Class 1 recalls is welcomed. In agreement with those statistics are the FSIS microbiological results for Escherichia coli O157:H7 in raw ground beef, which also showed a decrease in 2003. But there is much work to be done in food safety and much more to achieve. It is imperative that while addressing food-safety issues, we should understand the role that the environmental microbiology, public health epidemiology, aerobiology, molecular microbial ecology, occupational health, industrial processes, municipal water quality, and animal health have on food safety. Although it is a difficult task, a concerted effort by industry, academic, and governmental researchers can accomplish the goal. Here we discuss the future directions and applications in the distribution and spread of foodborne hazards, methods for microbial detection and differentiation, intervention strategies for farm pathogen reduction, targeting waste at animal production sites, considerations on antimicrobial resistance, food-safety storage and preparation strategies, food irradiation, new and emerging food-safety hazards, and quantitative microbial food-safety risk assessment. Although this does not comprise an exhaustive list of food-safety issues, these are the areas that, we think, require considerable attention by researchers. Not only we need to strive to improve food safety through new strategies, processes, and applications, but we also need to be flexible and observant to readily handle the new and emerging food-safety problems, whether they are within our borders or global. At present, the United States has one of the safest food-safety systems in place. However, although this is not a time for complacency, our research endeavors should be designed to keep pace with the food-safety needs of the future.
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8,754 |
Evaluation of the Person Under Investigation
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A person under investigation (PUI) is defined as a patient who presents with both clinical and epidemiological risk factors for a specific infectious disease. In the case of infectious diseases that present risks of transmission to healthcare workers (HCWs) and patients, the use of the identify-isolate-inform framework is essential to protect staff and patients and the delivery of safe and effective care. This includes early identification of PUIs, institution of appropriate transmission-based precautions including use of specific personal protective equipment (PPE) and isolation, and prompt notification of relevant personnel, including relevant experts and authorities. Depending on the specific infection suspected, once appropriate infection control measures have been implemented, clinical evaluation of PUIs can vary in complexity. In the case of Ebola virus disease (EVD), the need for specialized PPE and training, well-developed procedures, and dedicated space can be extremely resource-intensive and costly for facilities. In addition, depending upon the need to reduce risks to other patients and HCWs, regular laboratory and imaging equipment may not be available (or available at the standard frequency or turnaround time) to support medical care. Lastly, diagnostic tests needed to confirm the diagnosis may not be available at the healthcare facility and may instead be accessible through public health authorities. This testing may take several days to confirm the diagnosis or rule out the presence of the suspected infection. Thus, the potential period of evaluation for a PUI can extend well beyond a typical clinic or emergency department (ED) visit. Thoughtful and coordinated planning efforts are required across the community and across the hospital to be able to adequately care for the PUI.
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8,755 |
SARS and West Nile Virus
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Clinical presentation of SARS is nonspecific; the important clinical findings in West Nile virus infection are those associated with neurological complications. Rapid and accurate diagnosis of SARS and West Nile virus infection remains an important clinical challenge. Older adults are at higher risk of complications, including death from SARS and West Nile virus. At present, there is no effective therapy for these infections. Although efforts are under way, there are presently no effective vaccines for SARS or West Nile virus.
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8,756 |
Population Genomics of Human Viruses
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Viruses, and a few RNA viruses in particular, represent one of the greatest threats for human health. High mutation rates, large population sizes, and short generation times contribute to their typically fast evolutionary rates. However, many additional processes operate on their genomes, often in opposite directions, driving their evolution and allowing them to adapt to diverse host populations and antiviral drugs. Until recently, the high levels of genetic variation of most viruses have been explored only at a few genes or genome regions. The recent advent and increasing affordability of next-generation sequencing techniques have allowed obtaining complete genome sequences of large numbers of viruses, mainly HIV, HCV, influenza A, and others associated with emerging infections, such as Zika, chikungunya, or dengue virus. This opens the possibility to explore the effects of the different processes affecting viral diversity and evolution at the genome level. Consequently, population genomics provides the conceptual and empirical tools necessary to interpret genetic variation in viruses and its dynamics and drivers and to transform these results into information that may complement the epidemiological surveillance of the virus and its disease. This chapter provides an overview of human viruses from a population genomics perspective, with a special emphasis on RNA viruses, and the potential benefits of “genomic surveillance” to establish public health policies that improve the control and monitoring of the diseases caused by these viruses.
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8,757 |
Hämatologie
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Die Hämatologie umfasst alle Erkrankungen, die das Blut, Blutbestandteile und die Blutfunktionen betreffen. In diesem Kapitel werden die Ätiologie, Pathologie, Klinik, Diagnostik und Therapie der wichtigsten Anämien (u. a. Eisenmangel-, Kugelzell-, Sichelzellänamie) und der akuten Leukämien (AML bzw. ALL) behandelt. Des Weiteren stehen maligne Lymphome und das multiple Myelom im Fokus. Darüber hinaus ist ein eigener Abschnitt den Gerinnungsstörungen gewidmet, darunter die Thrombozytopenien, Hämophilien und Koagulopathien. Abschließend wird auf Immundefizienzen und die Amyloidose eingegangen.
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8,758 |
Public Health Disasters
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Public health disasters reflect the uncharted conceptual, ethical, and pragmatic intersections between public health ethics and the emerging discourse on disaster bioethics. This novel concept reflects public health issues with calamitous social consequences such as infectious disease outbreaks, the attendant public health impacts of natural or man-made disasters, and currently latent or low prevalence public health issues with the potential to rapidly acquire pandemic capacities. The attendant moral dilemmas that PHDs generate have local and global dimensions. For this reason, they demand a multifaceted ethically grounded and pragmatically oriented approach. This chapter presents the conceptual foreground to the ethical and pragmatic dimensions of these issues.
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8,759 |
Infection in Kidney Transplantation
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Infection is an important cause of morbidity and mortality after kidney transplantation. It has been estimated that 70% of kidney transplant recipients will experience an infection episode within the first 3 years after transplantation (Dharnidharka et al. 2007). After cardiovascular disease, infection is the second leading cause of death in recipients with allograft function (Snyder et al. 2009). The immunosuppressive therapy required to prevent organ rejection places the kidney transplant recipient at increased risk for donor-derived, nosocomial, and community-acquired infections as well as reactivation of latent pathogens. Pretransplant screening, immunizations, and optimal antibacterial and antiviral prophylaxis can help to reduce the impact of infection. Awareness of the approach to infection in the transplant recipient including diagnostic and management strategies is essential to optimizing outcomes.
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8,760 |
Control Strategies
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This chapter studies control strategies. Control strategies are listed and explained. It focuses on modeling vaccination in single-strain and multistrain diseases. Different modes of introducing vaccination in models are shown. Imperfect vaccination as a mechanism leading to backward bifurcation and strain replacement is explained. Strain replacement with perfect vaccination is demonstrated. Quarantine and isolation are discussed and included in a model. Introduction to optimal control theory is incorporated and the theory is illustrated on a specific example with optimal control treatment. Matlab code for computing the optimal control is included.
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8,761 |
Ecological Context of Epidemiology
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This chapter is focused on ecoepidemiology. It introduces and studies a number of models related to infectious diseases in animal populations. Animals are typically subject to ecological interactions. The chapter first introduces SI and SIR models of species subject to a generalist predator and studies the impact of selective and indiscriminate predation. The classical Lotka–Volterra predator–prey and competition models are reviewed together with their basic mathematical properties. Furthermore, the chapter includes and discusses a Lotka–Volterra predator–prey model with disease in prey and a Lotka–Volterra competition model with disease in one of the species. Hopf bifurcation and chaos are found in some of the ecoepidemiological models.
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8,762 |
Common respiratory infections diagnosed in general practice
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Acute respiratory infections are one of the most common causes for presentation to a general practitioner. The range of symptoms associated with each infection can be wide ranging in both presentation and severity, depending on age of the patient, underlying co-morbidities and other confounding factors. In this chapter we describe the most common respiratory infections ranging from relatively mild infections such as the common cold, through to more serious presentations including pneumonia. Data are presented from a general practitioner morbidity surveillance system based in England and Wales. Each acute respiratory syndrome is described in respect of seasonality, secular trends and microbiological aetiology providing an insight into the complex nature of these acute respiratory episodes. The more serious endpoints of acute respiratory infections are hospitalisation and death. Many acute respiratory infections are mild in nature and generally self-limiting and therefore do not commonly require further medical interventions. However, despite major advances in the prevention and treatment of acute respiratory infections in recent years, hospitalisation and deaths continue to exert pressures on national health resources and provide an economic burden in countries across the world on an annual basis.
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8,763 |
Quantitative Man-Made Risks’ Modelling
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Catastrophe modelling began with earthquakes, then expanded to cover windstorms, floods, tsunamis, volcanic eruptions and other natural hazards, and has evolved in the twenty-first century to cover significant man-made risks like terrorism, and cyber crime. The modelling of man-made risks is reviewed, with particular attention given to the principles of terrorism risk modelling. Pandemic risk is also covered because of its historical linkage with political risk. The application of man-made risk modelling to financial risk transfer is discussed.
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8,764 |
Gastroenterologie
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—. : —. gastrointestinale Passagestörung, z. B. Magenausgangsstenose, Duodenalstenose, mechanischer Ileus; —. andere gastrointestinale Störungen, z. B. Gallenkolik, Gastroenteritis, Pankreatitis, Ulcus ventriculi/duodeni, Ileus, „Afferent-loop“-Syndrom nach Billroth-II-Magen, Achalasie, Zenker-Divertikel, obere GI-Blutung; —. zentralnervös, z. B. Meningitis, Enzephalitis, Hirntumor, Hirndrucksteigerung; —. vestibulär, z. B. M. Menière, Kinetosen; —. Stoffwechselentgleisungen, z. B. diabetische Ketoazidose, Urämie; —. schmerzbedingt, z. B. Nierenkolik, Myokardinfarkt; —. medikamentös-toxisch, z. B. Alkohol, Zytostatika; —. Schwangerschaft (β-HCG-assoziiert); —. Essstörungen, z. B. Anorexia nervosa, Bulimie;
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8,765 |
Recent Developments in 3D QSAR and Molecular Docking Studies of Organic and Nanostructures
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The development of quantitative structure–activity relationship (QSAR) methods is going very fast for the last decades. OSAR approach already plays an important role in lead structure optimization, and nowadays, with development of big data approaches and computer power, it can even handle a huge amount of data associated with combinatorial chemistry. One of the recent developments is a three-dimensional QSAR, i.e., 3D QSAR. For the last two decades, 3D-OSAR has already been successfully applied to many datasets, especially of enzyme and receptor ligands. Moreover, quite often 3D QSAR investigations are going together with protein–ligand docking studies and this combination works synergistically. In this review, we outline recent advances in development and applications of 3D QSAR and protein–ligand docking approaches, as well as combined approaches for conventional organic compounds and for nanostructured materials, such as fullerenes and carbon nanotubes.
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8,766 |
Early disease management strategies in case of a smallpox outbreak
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As a consequence of the threat of smallpox being potentially used as a means of bioterrorism, many countries have developed preparedness plans for smallpox in the past few years. This chapter summarizes some of the most important issues for the management of smallpox. Usually, the strategy for the management of clinical cases of poxviruses includes the early detection of cases, rapid laboratory diagnosis, an assessment of the risk of further spread and containment measures. For the early detection, different systems are being tested to identify suspected cases before a diagnosis is confirmed (e.g., syndromic surveillance). Also it is necessary to provide special training on the disease pattern, including differential diagnosis, to clinicians and practitioners. If a suspected case has been identified, rapid diagnostic tests are required. In addition to the national and international notifications based on given case definitions, certain measures are necessary to allow an initial risk assessment of the epidemic development. For a rapid risk assessment, the investigations should follow the algorithms of epidemiological outbreak investigation such as the tracing and identification of exposed contacts and the sources of infection. Further decisions have to be taken on the basis of a continuous risk assessment. Countermeasures can be divided into medical and non-medical ones. The choice of an adequate vaccination strategy as a medical countermeasure for the case of a re-emergence of smallpox very much depends on the epidemic scenario, and the general availability and quality of a vaccine. Logistic aspects of the vaccination strategies have to be considered in preparedness planning (e.g., resources necessary for the implementation of mass vaccinations), and also the prioritization of groups to be vaccinated. In addition non-medical measures to prevent the spread of infection, such as the isolation of cases and quarantining of exposed persons (e.g., contact persons of confirmed cases) have to be foreseen. The effectiveness of other measures like prohibition of mass gatherings or closure of institutions is often assessed in the light of historical events. However, they have to be considered within today’s ethical and societal context, taking into account, in particular, the increased number of people who are immunocompromised. Since our knowledge of how the virus would behave today is limited to extrapolations from historical data and is therefore imperfect, these measures are still under discussion. All relevant groups should be involved in exercises to assure the effective operation of the plan mainly regarding communication and cooperation.
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8,767 |
Pulmonary System
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Pulmonary disease is a highly prevalent cause of premature morbidity and mortality in long-term childhood cancer survivors. Pulmonary toxicity is frequently reported in survivors of Hodgkin lymphoma, germ cell tumors, acute lymphoblastic lymphoma and metastatic Wilms tumor survivors, as the chemotherapy, radiation and surgeries used to treat these pediatric cancer (among others) can result in permanent lung damage. This damage can manifest as acute pneumonitis, late onset fibrosis, and structurally induced dysfunction from developmental abnormalities due to impaired growth of the thorax attributable to surgery or radiation. The cumulative incidence of pulmonary problems after childhood cancer increases with time since diagnosis, as with other late-effects, suggesting that survivors are at an elevated risk of developing later-onset pulmonary morbidities as they age.
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8,768 |
Promoting Universal Coverage of Basic Public Services Among Urban Residents
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In 2012, China’s urbanization rate reached 52.57 % but, if we counted only people with urban hukous, this was only 35.29 %; there were 263 million migrant workers in China, where they have already been playing a leading role in urbanization. Nonetheless, governments are still managing applications for new permanent urban residents’ registration, demanded by rural migrant workers, by using the long-established hukou-based public service policies. This has constituted a big obstacle to the citizenization of rural migrant workers in China, caused a great deal of problems with urban management, and is contrary to social justice. In 2013, it was made clear in the Report on the Work of the Government that relevant authorities should accelerate reform of the household registration system and related institutions; that they should register eligible rural workers as permanent urban residents in an orderly manner, “progressively expand the coverage of basic public services in urban areas to include all their permanent residents and create an equitable institutional environment for freedom of movement and for people to live and work in contentment.” Accordingly, in order to protect the rights of migrants and improve the quality of the process of social urbanization in China, the most significant tasks involve investigating the current status of basic public services in Chinese towns and cities, especially the public services provided for potential new permanent migrant worker residents, and exploring methods to expand the coverage of these basic public services in urban areas to all their permanent residents.
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8,769 |
Great Plains Societal Considerations: Impacts and Consequences, Vulnerability and Risk, Adaptive Capacity, Response Options
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A variety of factors related to climate variability and change will impact the Great Plains across human and ecological communities. The changes and associated stress are triggering response strategies and other mitigation and adaptation measures from land managers, government officials and staff, and various industries. The impacts and responses address water, energy, and other essential resources for both human and environmental well-being.
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8,770 |
Examples of Applications of Electrophysiology
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All the techniques that we have discussed, flux measurements, steady-state and transient current measurements, as well as single-channel recordings and the corresponding analysis can be applied to the analysis of structure-function relationships. Such structure-function information can be obtained if we characterize and compare the function of wild-type and chemically or genetically modified transporters by using these techniques. The latter also includes naturally occurring mutations that are the source of various diseases; this is an important feature for the understanding and curing of such diseases. For many of the transporters the amino acid sequence and the possible orientation of the protein in the membrane, or even the three-dimensional structures have been determined. In this chapter on Examples of Applications of Electrophysiology, we will illustrate the strategy of an electrophysiologist in investigating structure, function and regulation of membrane transport using as an example the Na(+),K(+)-ATPase, the neurotransmitter transporter GAT (Na(+)-dependent GABA transporter), and the nucleotide receptors that form channels in the presence of extracellular ATP. For an understanding of drug action as well as the development of new drugs for the treatment of diseases, electrophysiology is a powerful method to elucidate drug receptor interaction. As an example, this will be illustrated for viral ion channels that are essential for virus reproduction.
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8,771 |
Gastrointestinal Disorders
|
This chapter reviews extensively gastrointestinal bleeding that require intensive care unit admission. Its management, including with assessment of the airway, breathing, and circulation (ABCs), is emphasized as well as the use of proton pump inhibitors and H(2)-receptor blockers to prevent further hemorrhage. Acute mesenteric ischemia (AMI), an acute reduction in blood flow to the intestine leading to inadequate perfusion, is reviewed. Acute pancreatitis, an inflammatory process of the pancreas, having alcoholism, gallstones, hyperlipidemia, trauma, and infections as the most common etiologies, is also reviewed.
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8,772 |
RNAi for Resistance Against Biotic Stresses in Crop Plants
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RNA interference (RNAi)-based gene silencing has become one of the most successful strategies in not only identifying gene function but also in improving agronomical traits of crops by silencing genes of different pathogens/pests and also plant genes for improvement of desired trait. The conserved nature of RNAi pathway across different organisms increases its applicability in various basic and applied fields. Here we attempt to summarize the knowledge generated on the fundamental mechanisms of RNAi over the years, with emphasis on insects and plant-parasitic nematodes (PPNs). This chapter also reviews the rich history of RNAi research, gene regulation by small RNAs across different organisms, and application potential of RNAi for generating transgenic plants resistant to major pests(.) But, there are some limitations too which restrict wider applications of this technology to its full potential. Further refinement of this technology in terms of resolving these shortcomings constitutes one of the thrust areas in present RNAi research. Nevertheless, its application especially in breeding agricultural crops resistant against biotic stresses will certainly offer the possible solutions for some of the breeding objectives which are otherwise unattainable.
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8,773 |
The Network Source Location Problem in the Context of Foodborne Disease Outbreaks
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In today’s globally interconnected food system, outbreaks of foodborne disease can spread widely and cause considerable impact on public health. Food distribution is a complex system that can be seen as a network of trade flows connecting supply chain actors. Identifying the source of an outbreak of foodborne disease distributed across this network can be solved by considering this network structure and the dimensions of information it contains. The literature on the network source identification problem has grown widely in recent years covering problems in many different contexts, from contagious disease infecting a human population, to computer viruses spreading through the Internet, to rumors or trends diffusing through a social network. Much of this work has focused on studying this problem in analytically tractable frameworks, designing approaches to work on trees and extending to general network structures in an ad hoc manner. These simplified frameworks lack many features of real-world networks and problem contexts that can dramatically impact transmission dynamics, and therefore, backwards inference of the transmission process. Moreover, the features that distinguish foodborne disease in the context of source identification have not previously been studied or identified. In this article we identify these features, then provide a review of existing work on the network source identification problem, categorizing approaches according to these features. We conclude that much of the existing work cannot be implemented in the foodborne disease problem because it makes assumptions about the transmission process that are unrealistic in the context of food supply networks—that is, identifying the source of an epidemic contagion whereas foodborne contamination spreads through a transport network-mediated diffusion process, or because it requires data that is not available—complete observations of the contamination status of all nodes in the network.
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8,774 |
Business Continuity Management (BCM)
|
This chapter elaborates on a review of BCM. As the background, it describes the historical development of BCM and its relationships with other concepts. It will be followed by reviews on BCM as a management system, BCM’s main principles, and Business Continuity Planning overview. The next section will describe the implementation of BCM, related with regulations or standards that support the concept and the development of BCM level of preparedness. Several reviews on BC plans from various sectors are elaborated in the final part of the chapter, followed by reviewing the need for BCM in organizations based on its benefits and challenges.
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8,775 |
Care of the Patient with Liver Failure Requiring Transplantation
|
Patients undergo liver transplantation to address chronic liver failure, acute fulminant liver failure, or primary liver cancer. Depending on acuity, patients with decompensated chronic or acute fulminant liver failure generally require preoperative intensive care unit admission to manage organ dysfunction. Those with chronic liver failure are allocated an organ based on waiting list position determined by their local organ procurement organization (OPO). This position is dependent upon blood type and Model for End- Stage Liver Disease (MELD) score. These patients thus are critically ill and require preoperative ICU monitoring and care. Patients with hepatocellular carcinoma (HCC) who require liver transplantation are given a MELD exception and rarely require preoperative ICU care. The patient’s ability to undergo liver transplant in the setting of HCC is determined by the Milan criteria or the University of California, San Francisco (UCSF) criteria.
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8,776 |
Secondary Metabolites of Plants
|
Orchid phytochemicals that have been studied include alkaloids, bibenzyls, phenanthrenes, stilbenoids, phenols, flavonoids, anthocyanins and polysaccharides. Many of these compounds exhibit antioxidant, anti-inflammatory, antimicrobial, antihelminthic, anticoagulant, antidiabetic and lipid-lowering properties. Some compounds are cytotoxic, prevent angiogenesis and tumour spread and promote programmed cell death of cancer cells. Some compounds protect nerve cells against chemicals and oxygen deprivation (stroke), promote nerve cell regeneration, protect the skin from ultraviolet damage, protect the liver against poisons such as carbon tetrachloride, prevent calcium loss from bone and enhance foetal lung maturation. This chapter provides a short account of the characteristics of the various groups of compounds, including their properties.
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8,777 |
Fulfilling a Promise: Universal Care
|
Even before the extent of the epidemic became more reliably known, China’s leaders had signalled their renewed determination to tackle HIV in all of its dimensions, social and economic as well as medical. Because dedicated health officials and researchers had been running pilot programmes and building up evidence for well over a decade, there was a lot of information available about which approaches might work best. But most of these approaches went against the grain for many of the local politicians and senior bureaucrats who would have to implement them across the nation.
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8,778 |
Genetic Variability in RNA Viruses: Consequences in Epidemiology and in the Development of New Stratgies for the Extinction of Infectivity
| null |
8,779 |
Influenza
|
Influenza is a highly contagious virus that causes an acute respiratory tract infection. Disease occurs in yearly outbreaks in humans, lasting 2–6 weeks in length. Influenza A and B predominate in these outbreaks, with more severe disease occurring with Influenza A. Additional infections with avian subtypes of influenza have also occurred in humans in the past decade, with notably increased morbidity and mortality. Vaccination is the mainstay for preventing disease. Antiviral drugs may be effective in decreasing duration and severity of disease, but evolving resistance has narrowed treatment options. This chapter provides a broad overview of influenza, from basic virology to epidemiology, disease, treatment, and prevention.
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8,780 |
A Comprehensive Analytical Framework for Risks, Disasters and Crises
|
Early warning and emergency management is a comprehensive and integrated system that deals with all sorts of emergencies, risks and crises, and involves various sectors of society and government departments. A consistent and holistic approach, however, has previously been lacking in both research and practice.
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8,781 |
Economic Implications of Influenza and Influenza Vaccine
|
The objective of this chapter is to review and summarize the current economic estimates of influenza and the cost-effectiveness of its vaccines. We reviewed the published assessments of the economic costs of human seasonal and pandemic influenza internationally. Seasonal influenza costs Germany, France, and the USA between $4 and $87 billion annually. Depending upon the intensity of transmission and severity of disease, pandemic influenza may cause as many as 350 million deaths and result in economic losses topping $1 trillion – an impact great enough to create a worldwide recession. We then reviewed 100 papers primarily from more than a dozen countries which studied the cost-effectiveness of influenza vaccine in children, adults, and the elderly. These studies demonstrate that influenza vaccination is quite cost-effective among children 6 months to 18 years old, in health care workers and pregnant women, and in high-risk individuals. Remarkably, compared with the other recently introduced vaccines for children, such as rotavirus and pneumococcal polysaccharide, vaccinating children and school attendees results in societal cost savings because it obviates lost productivity and wages among infected individuals and their caretakers. Vaccination for children is recommended in the USA and in Canada, but public health policy makers in Europe have undervalued this vaccine and not recommended it so widely.
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8,782 |
Dengue
|
Dengue is one of the most important mosquito-borne viral infections caused by single-stranded RNA virus that are transmitted by the Aedes aegypti and Aedes albopictus mosquito species. Dengue is endemic in over 140 countries in Asia, the USA, the Eastern Mediterranean, and Africa. The World Health Organization (WHO) estimated that there are more than 2.5 billion people—mainly occurs in children living in tropical and subtropical countries—at risk of dengue infection with one or more dengue viruses. There are estimated nearly 100 million symptomatic dengue infections occurring worldwide annually, nearly 75% in Asia and the Western Pacific region [1]. During the past decades, the outbreaks of dengue infection have been reported throughout the world with increased severity. Ecologic and demographic changes are considered to be the contributing factors to the emergence of dengue infection in the past decades. Dengue has expanded into new countries and into urban settings associated with increased distribution of A. aegypti, population growth, urbanization, development of slums, migration of population, movement of dengue virus by infected travelers, trade development, and improved diagnostic capabilities in medical practice [2, 3]. Increased transmission of dengue virus in tropical urban areas has been created by substandard housing and crowding as well as deterioration in water, sewer, and waste management systems, all of which are intimately associated with unplanned urbanization [4–7]. So it is likely that dengue will expand its geographic reach and become an increasing burden on health resources in affected areas during the next decade. An effective vector-control management is the only means to reduce dengue infection in endemic areas. Because vector control has achieved only limited success so far in reducing the transmission of dengue, the usage of effective dengue vaccine in target population along with the preventive measures already used such as raising public awareness may be the means to effectively control of this disease in endemic area [8].
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8,783 |
Hemostatic Resuscitation
|
Component therapy is useful for the majority of patients when blood requirements are minimal and there is no associated coagulopathy. Of concern are requirements for massive transfusion and resuscitation that absorb resources and create a short-fall for patients whose injuries are less severe. Additionally, the conventional massive transfusion model of packed RBCs, plasma and platelets actually further dilutes the patient compared to the blood he or she has lost and thus is not the ideal fluid for patients who require this massive transfusion of products. Fresh whole blood has three vital properties: oxygen carrying capacity, volume, and hemostatic effect. In the austere environment of combat the practice of fresh whole blood transfusion has proven beneficial to patients who are coagulopathic and require massive transfusion. Appropriate use following established guidelines can be beneficial and may even be superior to packed RBCs. A fluid containing the vital properties of fresh whole blood would serve as a bridge to allow a patient to be resuscitated without initiating the ‘bloody cycle of death’ that is seen all too often in our current paradigm of massive resuscitation.
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8,784 |
Introduction: A Short History of Virology
|
Viral infections have been recorded unknowingly from the beginning of recorded history. The ancient Greeks and Romans described plagues of unknown origin. In general, infections were blamed on sins and punishment, balances of “vital humors” or on “miasma,” (rotten smells). In the sixteenth century, Girolamo Fracastoro suggested that infectious agents might spread disease, as did Agostino Bassi, studying diseases of silkworms. The development of the microscope by Hook and Van Leeuwenhoek in the seventeenth century led to the discovery of a new living world inhabited by very small creatures. Edward Jenner in England demonstrated that smallpox, a dreaded disease, could be prevented by inoculation with an organism that caused pockmarks on cows and dairymaids; this was the beginning of the concept of vaccination. Louis Pasteur proved that fermentation only occurred in the presence of air and was due to microorganisms. Pasteur and Pierre Roux, a colleague, as well as Jacob Henle and Robert Koch, proved that germs caused bacterial diseases such as anthrax and tuberculosis; Pasteur and Roux developed a vaccine against rabies by passaging the infectious material through rabbits. By the end of the nineteenth century it had been established that most infectious diseases were the result of germs. In parallel with this research, plant scientists had isolated material that passed through a low pore filter that was infectious to tobacco plants. This was called a “virus,” from the Latin for poison. Viruses were also found to be associated with leukemia and other cancers of chickens. The twentieth century saw the discovery of bacteriophage, viruses that attack bacteria, and the use of such bacteriophage to launch studies of molecular biology, and DNA and RNA structure.
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8,785 |
Influenza Vaccines Have a Short but Illustrious History of Dedicated Science Enabling the Rapid Global Production of A/Swine (H1N1) Vaccine in the Current Pandemic
|
Vaccines for the swine flu pandemic of 2009 have been produced in an exquisitely short time frame. This speed of production comes because of 50 years of hard work by virologists worldwide in pharma groups, research laboratories, and government licensing units. The present chapter presents the background framework of influenza vaccine production and its evolution over 50 years. Isolation of the causative virus of influenza in 1933, followed by the discovery of embryonated hen eggs as a substrate, quickly led to the formulation of vaccines. Virus-containing allantoic fluid was inactivated with formalin. The phenomenon of antigenic drift of the virus HA was soon recognized and as WHO began to coordinate the world influenza surveillance, it became easier for manufacturers to select an up-to-date virus. Influenza vaccines remain unique in that the virus strain composition is reviewed yearly, but modern attempts are being made to free manufacturers from this yolk by investigating internal virus proteins including M2e and NP as “universal” vaccines covering all virus subtypes. Recent technical innovations have been the use of Vero and MDCK cells as the virus cell substrate, the testing of two new adjuvants, and the exploration of new presentations to the nose or epidermal layers as DNA or antigen mixtures. The international investment into public health measures for a global human outbreak of avian H5N1 influenza together with a focus of swine influenza H1N1 is leading to enhanced production of conventional vaccine and to a new research searchlight on T-cell epitope vaccines, viral live-attenuated carriers of influenza proteins, and even more innovative substrates to cultivate virus, including plant cells.
|
8,786 |
Impacts of Climate Change on the Environment, Economy, and Society of China
|
This chapter evaluates the characteristics and extent of impacts of modern climate change on the hydrology, ecology, agriculture, health, economy, and society of China. The impacts of climate change on water resources, hydrological processes, the cryosphere, and ocean hydrological processes are analyzed, as well as the impacts on land ecosystems, desertification, and soil erosion. The impact of global sea-level change on marine ecology and the coastal environment is comprehensively assessed. The chapter also summarized the impact of climate change on farming, animal husbandry, forestry, aquaculture, and fisheries.
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8,787 |
A Mathematical Model of Cytokine Dynamics During a Cytokine Storm
|
Cytokine storms are a potentially fatal exaggerated immune response consisting of an uncontrolled positive feedback loop between immune cells and cytokines. The dynamics of cytokines are highly complex and little is known about specific interactions. Researchers at the Ontario Veterinary College have encountered cytokine storms during virotherapy. Multiple mouse trials were conducted where a virus was injected into mice whose leukocytes lacked expression of the type I interferon receptor. In each case a rapid, fatal cytokine storm occurred. A nonlinear differential equation model of the recorded cytokine amounts was produced to obtain some information on their mutual interactions. Results provide insight into the complex mechanism that drives the storm and possible ways to prevent such immune responses.
|
8,788 |
Environmental Risks
|
Production and consumption pose a number of burdens on our ecological systems. The risk of causing damage to human health by environmental contamination is called, in general, environmental risk. Climate changes and infection to new pandemic influenza are believed also to be caused by the global human activities affecting global environment and ecological systems; thus, they often make part of environmental risks in the broad sense. This chapter explains each of these risks and unveils our unique methods in counter them.
|
8,789 |
Infectious Complications
|
Infections remain a cause of significant morbidity and mortality following hematopoietic stem cell transplantation (HSCT). The conditioning regimen (chemotherapy, radiation therapy), mucosal damage, type of transplant, immune suppressive therapy, and graft-versus-host disease (GVHD) all predispose the HSCT recipient to infection. Abnormal B- and T-lymphocyte function results in impaired humoral and cellular immunity, respectively. Neutrophil function is impaired by the use of corticosteroids and other medications. Hypogammaglobulinemia and functional asplenia are common. The occurrence of infections in an individual patient varies according to the phase of the transplant process and reflects the type(s) of immune defect(s), underlying disease, endogenous host flora, exposure history, and pre-treatment infections.
|
8,790 |
Viral Pulmonary Disorders in Animals: Neoplastic and Nonneoplastic
|
Respiratory infections in animal species are as ubiquitous as they are in humans. Species that may be affected include mammals, birds, and reptiles. In these animal species some viruses primarily infect the respiratory tract, while other viruses infect non-respiratory organs. Viruses are generally classified according to the type of their nucleic acid, their protein structure, and whether or not they have a lipid-containing envelope surrounding the viral particle. In general, most viruses gain entry into the lungs via the conducting airways. In nonprimate mammalians these infections are most prominent in the cranioventral lung lobes because of their horizontal position. Table 24.1 lists some of the major viruses that cause pneumonia and other lung diseases in animals.
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8,791 |
Akuttherapie
|
In Kürze: Die Anforderungen zum Monitoring und zur Basisdiagnostik nach stattgehabtem Schlaganfall wurden bereits ausführlich in 7 Abschn. 5.1 dargestellt. Ziel der Basistherapie auf der Stroke Unit ist vornehmlich eine allgemeine Stabilisierung der Vitalparameter, der Homöostase sowie die Verhinderung von Komplikationen. Sie schafft damit die Voraussetzung für spezifische Therapien und die frühe Erholung der Patienten. Die im Folgenden aufgeführten generellen Überlegungen orientieren sich an den Empfehlungen der Europäischen Schlaganfall Organisation (ESO) (Ringleb 2008, Schellinger 2008).
|
8,792 |
Avian Influenza
| null |
8,793 |
Application of Molecular Beacons in Real-Time PCR
|
Real-time PCR or quantitative PCR (QPCR) is a powerful technique that allows measurement of PCR product while the amplification reaction proceeds. It incorporates the fluorescent element into conventional PCR as the calculation standard to provide a quantitative result. In this sense, fluorescent chemistry is the key component in QPCR. Till now, two types of fluorescent chemistries have been adopted in the QPCR systems: one is nonspecific probe and the other is specific. As a brilliant invention by Kramer et al. in 1996, molecular beacon is naturally suited as the reporting element in real-time PCR and has been adapted for many molecular biology applications. In this chapter, we briefly introduce the working principle of QPCR and overview different fluorescent chemistries, and then we focus on the applications of molecular beacons-like gene expression study, single-nucleotide polymorphisms and mutation detection, and pathogenic detection.
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8,794 |
The Pharmacological Activities of Glycyrrhizinic Acid (“Glycyrrhizin”) and Glycyrrhetinic Acid
|
Glycyrrhizin or, more correctly, Glycyrrhizinic acid is a triterpenoid saponin obtained from the root and rhizome extracts of Licorice (Glycyrrhiza glabra), being commonly used as a sweetener, being reported as – at least – 30 times sweeter than sucrose. This natural product, along with its aglycone glycyrrhetinic acid, is known in the literature for its several pharmacological and biological activities. This chapter summarizes the activities reported in the literature for the saponin and its aglycone since 2010.
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8,795 |
Sociality, Parasites, and Pathogens in Bats
|
Little is known about the ecology of many of the parasites and pathogens affecting bats, but host social behavior almost certainly plays an important role in bat-parasite dynamics. Understanding parasite dynamics for bats is important from a human public health perspective because of their role as natural reservoirs for recent high-profile emerging zoonotic pathogens (e.g. Ebola, Hendra) and from a bat conservation perspective because of the recent emergence of white-nose syndrome (WNS) in North America highlighting the potential population impacts of parasites and pathogens. Although some bat species are among the most gregarious of mammals, species vary widely in terms of their social behavior and this variation could influence pathogen transmission and impacts. Here, we review the literature on links between bat social behavior and parasite dynamics. Using standardized search terms in Web of Science, we identified articles that explicitly tested or discussed links between some aspect of bat sociality and parasite transmission or host population impacts. We identified social network analysis, epidemiological modeling, and interspecific comparative analyses as the most commonly used methods to quantify relationships between social behavior and parasite-risk in bats while WNS, Hendra virus, and arthropod ectoparasites were the most commonly studied host-parasite systems. We summarize known host-parasite relationships in these three systems and propose testable hypotheses that could improve our understanding of links between host sociality and parasite-dynamics in bats.
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8,796 |
Hydroids (Cnidaria, Hydrozoa): A Neglected Component of Animal Forests
|
Hydroids, one of the dominant components of the zoobenthic communities, share comparable growth patterns with higher plants because of their modular body organization, high potential of asexual reproduction, and phenotypic plasticity. These features, together with the ability to enter dormancy to overcome unfavorable conditions, make hydroids successful organisms adaptable to a wide range of environmental scenarios. Depending on their wide range of shapes and sizes, hydroids form three-dimensional forests at different dimensional scales, establishing both trophic and non-trophic relationships with several other organisms, from virus to vertebrates. Despite numerous researches conducted to study the hydroid ecology, the putative importance of hydroids in structuring zoobenthic communities is underestimated. Here, information available about hydroid ecology is summarized, in order to emphasize the role of hydroids as forest formers, as well as their function in the bentho-pelagic coupling.
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8,797 |
Fremddarstellung – Selbstdarstellung: Über Grenzen der Medialisierung menschlichen Leidens
|
Der zwölfte Beitrag behandelt die Frage nach den Grenzen der Medialisierung menschlichen Leidens am Beispiel der Medialisierung von Aids. Während aber Aids als gesellschaftliche Metapher das endlose und globale Zirkulieren von Menschen, Bildern, Waren, Müll, Informationen und Kapital anzeigt, deutet inzwischen eine andere Krankheit, nämlich Alzheimer, sozusagen auf das Herz oder genauer gesagt auf das Gehirn der Informationsgesellschaft hin.
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8,798 |
Pleuropulmonary Changes Induced by Drugs in Patients with Hematologic Diseases
|
Patients with hematologic diseases who are being treated with therapy drugs, or receive radiation therapy or blood transfusions may develop a host of potentially fatal infectious and noninfectious pulmonary complications [1]. The increased complexity of multimodality and high-dose treatment regimens with the intended benefit of augmented antineoplastic efficacy and prolonged disease-free survival, the use of a panel of novel drugs to treat malignant and nonmalignant hematologic conditions (e.g., azacytidine, bortezomib, cladribine, dasatinib, fludarabine, imatinib, lenalidomide, rituximab, and thalidomide), total body irradiation (TBI) and hematopietic stem cell transplantation (HSCT) have increased the incidence of severe sometimes life-threatening pulmonary complications.
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8,799 |
Ziekten en afwijkingen die de zwangerschap compliceren
|
In dit hoofdstuk komen aan de orde: frequent voorkomende ziekten en afwijkingen die de zwangerschap kunnen compliceren, zoals
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