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8,800 |
Sphingolipid Metabolism in Systemic Inflammation
|
The inflammatory response — induced and regulated by a variety of mediators such as cytokines, prostaglandins, and reactive oxygen species (ROS) — is the localized host’s response of the tissue to injury, irritation, or infection. In a very similar and stereotyped sequence, the mediators are thought to induce an acute phase response orchestrated by an array of substances produced locally or near the source or origin of the inflammatory response. Despite its basically protective function, the response can become inappropriate in intensity or duration damaging host tissues or interfering with normal metabolism. Thus, inflammation is the cause and/or consequence of a diversity of diseases and plays a major role in the development of remote organ failure. Better knowledge of the underlying mechanisms of these processes is, therefore, a fundamental pre-requisite fostering the molecular understanding of novel therapeutic targets or diagnostic variables.
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8,801 |
Pathogenesis of Kingella kingae Disease
|
The pathogenesis of Kingella kingae disease begins with colonization of the oropharynx, a process facilitated by type IV pili and a non-pilus trimeric autotransporter adhesin called Knh, factors that mediate adherence to respiratory epithelial cells. A potent RTX cytotoxin with broad cellular specificity may play a role in disrupting the epithelial barrier and facilitating invasion of the bloodstream, possibly in concert with a viral coinfection. Once in the bloodstream, the organism can disseminate to sites of invasive disease, primarily the joints, bones, and endocardium. Survival in the bloodstream and dissemination are likely aided by expression of a capsular polysaccharide and an exopolysaccharide galactan. The evidence for antigenic diversity of K. kingae surface exposed protein epitopes and the observation that type IV pili are selected against during invasive disease suggest that immune system pressure plays an important role in K. kingae pathogenicity.
|
8,802 |
Biosensors for Security and Bioterrorism: Definitions, History, Types of Agents, New Trends and Applications
|
Biosensors are making a large impact in environmental, food, biomedical, and in many other applications. They provide many advantages. in comparison to standard analytical detection methods (i.e., chromatographic techniques) such as minimal sample preparation and handling, faster time analysis, simpler steps of analysis, rapid detection of the analytes of concern, use of non-skilled personnel, and portability for uses in the field applications. The aim of this chapter is to focus on novel research related to the rapid detection of agents and weapons of bioterrorism and provide a comprehensive review of the research topics most pertinent to advancing devices applicable to the rapid real-time detection of toxicants and bioterrorism weapons such as microbes, pathogens, toxins, virus, or nerve gases. The ongoing war on terrorism and the rising security concerns are driving the need for newer faster biosensing devices against bio-warfare agents for both military and civil defense applications. Readers of these review article will learn new schemes of biological weapons that can lead to the construction of devices that will minimize the risk of bio-terrorism.
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8,803 |
The genetic transformation of plastids
|
Biolistic delivery of DNA initiated plastid transformation research and still is the most widelyused approach to generate transplastomic lines in both algae and higher plants. The principal designof transformation vectors is similar in both phylogenetic groups. Although important additions tothe list of species transformed in their plastomes have been made in algae and in higher plants, thekey organisms in the area are still the two species, in which stable plastid transformation was initiallysuccessful, i.e., Chlamydomonas reinhardtii and tobacco. Basicresearch into organelle biology has substantially benefited from the homologous recombination-basedcapability to precisely insert at predetermined loci, delete, disrupt, or exchange plastid genomesequences. Successful expression of recombinant proteins, including pharmaceutical proteins, hasbeen demonstrated in Chlamydomonas as well as in higher plants,where some interesting agronomic traits were also engineered through plastid transformation.
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8,804 |
Holistic Integrative Medicine
|
Many people engaging in medical science asked me, “You’ve been working on the exploration of Holistic Integrative Medicine (HIM) for quite a while. What is the progress you have made in your research? Have you got your article published? May I be your first reader?” Each time I was confronted with such a situation, I felt embarrassed and speechless. Just as an old saying goes, it is easy to put the boat along with the current but it is difficult to sail against the current [1].
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8,805 |
Open Source Chemoinformatics Software including KNIME Analytics
|
In this chapter, we present a brief description of compound datasets and programs developed to serve chemoinformatics as well as, more specifically, nanoinformatics purposes. Emphasis has been placed on publicly available tools and particularly on KNIME (Konstanz Information Miner), the most widely used freely available platform for data processing and analysis. Among a multitude of studies that have demonstrated the usefulness of chemoinformatics tools to chemical and medicinal applications, herein we present indicative cases of five successful KNIME-based approaches. The first two studies include the risk assessment of nanoparticles (NPs) through the Enalos InSilicoNano platform, namely, (1) the prediction of the toxicity of iron oxide NPs and (2) the cellular uptake prediction of computationally designed NPs with the aid of reliable quantitative nanostructure–activity relationships (QNAR) models. The third case study deals with the recognition of organic substances as corrosion inhibitors though the construction of predictive quantitative structure–property relationships (QSPR) models with Enalos KNIME nodes. Finally, two more cases are briefly described and involve the accurate prediction of yellow fever inhibitors from the ChEMBL database and the de novo design of compounds with the reaction vectors methodology. The aim of this work is to familiarize the interested reader with the freely available in silico tools in KNIME analytics platform and to demonstrate their value and effectiveness toward specific computational applications.
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8,806 |
Dynamical Behavior of an SVIR Epidemiological Model with Two Stage Characteristics of Vaccine Effectiveness and Numerical Simulation
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An SVIR epidemiological model with two stage characteristics of vaccine effectiveness is formulated. By constructing the appropriate Lyapunov functionals, it is proved that the disease free equilibrium of the system is globally stable when the basic reproduction number is less than or equal to one, and that the unique endemic equilibrium of the system is globally stable when the basic reproduction number is greater than one.
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8,807 |
Context and Ethical Challenges During the Ebola Outbreak in West Africa
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The philosophical discipline of ethics examines good, bad, right, wrong and how people live as individuals within a community. Bioethics investigates research in healthcare and medicine, examining public policy as it relates to healthcare and how resources are allocated. This includes: difficult, private, individual decisions, which occur in clinical settings; dilemmas during clinical trials; and controversies surrounding novel research. It is important to understand that ethical considerations related to health care ethics and those that pertain to public health are often seen from different perspectives. In public health, decisions are made within a context and a framework through principles which guide action that affect communities and populations. These decisions and actions are made with and involve, stakeholders to include: traditional, community and religious leaders; government officials; and private and commercial stake holders. The underlying principles of both public health ethics and bioethics are the same, namely equality, justice, beneficence, non-maleficence, veracity and fidelity. Health care ethics supports the rights of individuals. Under the same umbrella of health care ethics are medical ethics, clinical ethics and research ethics. These disciplines offer views that support the rights of individuals. Ethics in public health is very complex with a myriad of issues to include diverse groups of people in different situations, which have to be taken into account from the view of what is best for the population. Evaluating the components of a public health system, how resources are developed and the economic support available to communities is crucial. Access to care and the equitable and just allocation of resources are important factors; and questions about equal access for the poor, the socially disadvantaged and immigrants should be examined.
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8,808 |
The Perioperative Use of Albumin
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Human serum albumin (HSA) is the predominant product of hepatic protein synthesis and one of the more abundant plasma proteins. HSA is a monomeric multidomain macromolecule, representing the main determinant of plasma oncotic pressure and the main modulator of fluid distribution between body compartments. HSA displays an essential role in maintaining the integrity of the vascular barrier. HSA is the most important antioxidant capacity of human plasma, in addition to its ability to protect the body from the harmful effects of heavy metals such as iron and copper and reduce their ability to produce reactive oxygen radicals. HSA is the main depot for nitric oxide (NO) transport in the blood. HSA represents the main carrier for fatty acids, affects pharmacokinetics of many drugs, and provides the metabolic modification of some drugs and displays pseudo-enzymatic properties. HSA has been widely used successfully for more than 50 years in many settings of perioperative medicine including hypovolemia, shock, burns, surgical blood loss, sepsis, and acute respiratory distress syndrome (ARDS). Recently, the use of HSA has shown a promising neuroprotective effect in patients with subarachnoid hemorrhage. The most recent evidence-based functions and uses of HSA in the perioperative period are reviewed in this chapter.
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8,809 |
Acute and Chronic Respiratory Failure in Cancer Patients
|
In 2016, there was an estimated 1.8 million new cases of cancer diagnosed in the United States. Remarkable advances have been made in cancer therapy and the 5-year survival has increased for most patients affected by malignancy. There are growing numbers of patients admitted to intensive care units (ICU) and up to 20% of all patients admitted to an ICU carry a diagnosis of malignancy. Respiratory failure remains the most common reason for ICU admission and remains the leading causes of death in oncology patients. There are many causes of respiratory failure in this population. Pneumonia is the most common cause of respiratory failure, yet there are many causes of respiratory insufficiency unique to the cancer patient. These causes are often a result of immunosuppression, chemotherapy, radiation treatment, or hematopoietic stem cell transplant (HCT). Treatment is focused on supportive care and specific therapy for the underlying cause of respiratory failure. Noninvasive modalities of respiratory support are available; however, careful patient selection is paramount as indiscriminate use of noninvasive positive pressure ventilation is associated with a higher mortality if mechanical ventilation is later required. Historically, respiratory failure in the cancer patient had a grim prognosis. Outcomes have improved over the past 20 years. Survivors are often left with significant disability.
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8,810 |
Infectious Diseases in Pregnancy
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Many infectious diseases have the potential to complicate pregnancy. Some illnesses may only impact maternal health, but others can infect the fetus with possible devastating or long-term sequelae. In this chapter we aim to review common infectious diseases such as urinary tract infections and influenza as well as those that can cause major neonatal morbidity and mortality including TORCH infections. We will also discuss the challenges that pregnancy creates for the management of these infectious diseases as some antibiotics that would typically be used may not be safe for the developing fetus depending on the stage of pregnancy.
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8,811 |
Rethinking the financial network
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On 16 November 2002, the first official case of Severe Acute Respiratory Syndrome (SARS) was recorded in Guangdong Province, China. Panic ensued. Uncertainty about its causes and contagious consequences brought many neighbouring economies across Asia to a standstill. Hotel occupancy rates in Hong Kong fell from over 80 % to less than 15 %, while among Beijing’s 5-star hotels occupancy rates fell below 2 %.
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8,812 |
Neue Infektionserreger mit pandemischem Potential: Ursache – Verbreitung – Management
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Die im vergangenen Jahrhundert errungenen Erfolge bei der Reduzierung der Mortalität durch Infektionskrankheiten können nicht verdecken, dass beständig neue Infektionskrankheiten mit weltweiter Verbreitung auftreten. Diese gehen entweder auf „neue“ Erreger zurück („emerging diseases“), oder sind durch bekannte Erreger bedingt, die neue Verbreitungsgebiete erobert haben. Bei der Expansion der endemischen Zirkulation von Infektionserregern spielen anthropogene Faktoren eine entscheidende Rolle, und eine große Zahl völlig unterschiedlicher Erreger kommt für solche Geschehen in Betracht (Kaufmann 2010).
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8,813 |
Disaster Theory
|
To find a conclusive definition for contemporary purposes and uses, we look at many of the various definitions of disasters through cataclysmic events, historical records, public policies, laws, and organizational usage. Our natural progression leads us to modern theories of disaster and Disaster Risk Management (DRM) that have had to tackle new types of disasters that are being brought about by the interconnectivity of societies, people, diseases, technology, etc., increasing in magnitude and complexity like what was seen in Fukushima, Japan, in 2011 and on-setting disasters like climate change. After looking at all the historical evidence, we come to a definition for the term disaster for modern usage and what it means for policy implications.
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8,814 |
Role of Immunoglobulin Therapy to Prevent and Treat Infections
|
Immunoglobulins have been used widely in medicine for a variety of diseases including infectious diseases. While the main clinical applications of immunoglobulin therapy concern their use as replacement for patients with primary immunodeficiencies, or as treatment for autoimmune and inflammatory disorders, their role in infectious disease is limited largely to viral and toxin neutralization and replacement therapy in patients with immunoglobulin deficiencies. Many aspects of the therapeutic regimen of immunoglobulins even in the established indications remain open. Recently, due to the worldwide surge of immunosuppression caused by AIDS, organ transplantation, cancer, and autoimmune therapies, as well as the emergence of multidrug-resistant bacteria, there has been renewed interest in the use of antibody preparation to prevent infections in high-risk groups. Knowing the limitations of the current anti-infective armamentarium, approaches that target the host through manipulations to augment the host immune response provide a helpful aid to conventional treatment options. A substantial body of evidence has demonstrated that strategies aiming to support or stimulate immune response could be feasible approaches that would benefit immunocompromised patients. In the present chapter, we present contemporary indications of immunoglobulin administration for therapy and prophylaxis of infections in the immunocompromised population.
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8,815 |
Cryptococcosis
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Infection with encapsulated yeast Cryptococcus neoformans or gattii. C. neoformans is found in bird and bat droppings and contaminated soil/dust; C. gattii colonizes trees/wood debris.
|
8,816 |
Vaccines
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Since the introduction of smallpox vaccination more than two centuries ago, vaccines have been—and still are—instrumental in the prevention of infectious diseases. Nowadays vaccines form a heterogeneous group of pharmaceutical products that differ in several aspects from other biopharmaceuticals. In this chapter, after a brief introduction we first cover immunological principles that are important for vaccine design. Next, we give an overview of the different vaccine categories and current approaches to vaccine development, illustrated with representative examples. We also describe current trends in the field of vaccines against non-infectious diseases, such as therapeutic vaccines against cancer and other diseases. Moreover, routes of administration relevant to vaccination and pharmaceutical aspects of vaccines are briefly discussed.
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8,817 |
Healthcare-Associated Infections in Pediatrics
| null |
8,818 |
Volume 3 Isolated Compounds (H-M)
|
Hemanthamine [466-75-1] C17H19NO4 (301.35). mp 203~203.5ºC, [a]D 25 = +19.7º (c = 3.8, methanol), [a]D 25 = +33 (c = 1.25, CHCl3). Pharm: Antihypertensive (mild); antiretroviral and cytotoxic (ID50 = 0.8µg/mL, TC50 = 1.0µg/mL, TI50 (TC50/ID50) = 1.3)[5026].
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8,819 |
Gewinnung, Herstellung und Lagerung von Blut und Blutkomponenten
|
Blutspender leisten einen wertvollen Dienst für die Gemeinschaft: Die ständige Verfügbarkeit von Blutkomponenten ist zur unverzichtbaren Voraussetzung für viele Bereiche der Medizin geworden. Nicht nur die Gewinnung und Aufarbeitung von Blut und Blutbestandteilen zur Sicherstellung einer qualitativ wie quantitativ guten Versorgung, sondern auch die kompetente Betreuung der Spender ist eine der großen Aufgaben der Transfusionsmedizin.
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8,820 |
Tonsillitis and Peritonsillar Abscess
|
Tonsillitis is one of the most common childhood infections. Occasionally, it can lead to one of the most common deep space head and neck infections, peritonsillar abscess. The epidemiology, microbiology and treatment of tonsillitis and peritonsillar abscess are similar and crucial for the primary care physician, infectious disease specialist, otolaryngologist, and emergency medicine physician to understand. The routine use of tonsillectomy as a treatment option for recurrent tonsillitis and peritonsillar abscess has decreased over the last decade and clearer indications for surgery have emerged. This chapter provides an overview of the most recent literature regarding the epidemiology, microbiology, diagnosis, complications and management of tonsillitis and peritonsillar abscess. It also discusses the indications for tonsillectomy along with its complications.
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8,821 |
Applications of Infrared Thermography for Noncontact and Noninvasive Mass Screening of Febrile International Travelers at Airport Quarantine Stations
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Infrared thermography (IRT), one of the most valuable tools, is used for noncontact, noninvasive, and rapid monitoring of body temperature; this has been used for mass screening of febrile travelers at places such as airport quarantine stations for over 10 years after the 2003 severe acute respiratory syndrome (SARS) outbreak. The usefulness of thermography for mass screening has been evaluated in many recent studies; its sensitivity varies from 40 to 89.4% under various circumstances. In this chapter, we perform IRT evaluations for detecting febrile international travelers entering Japan at Nagoya Airport, immediately after the SARS epidemic, from June 2003 to February 2004, and at Naha International Airport from April 2005 to March 2009. The correlation of body surface temperature measured via thermography with the axillary temperature was significant. Through IRT, febrile individuals were detected with good accuracy and the detection accuracy was improved by corroborating surveillance with self-reporting questionnaires. However, there are several limitations associated with the use of IRT for fever screening. For instance, taking antifebrile medications results in rapid modification of the body temperature and directly affects the efficiency of IRT. To solve this unreliability and obtain higher accuracy in mass screening, we have developed a novel infection screening system using multisensor data, i.e., heart and respiration rates are determined by microwave radar in noncontact manner and facial skin temperature is monitored through IRT. The detection accuracy of the system improved, which is notably higher compared to the conventional screening method using only IRT.
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8,822 |
Mikrobiologische Schnelltests und molekularbiologische Analytik
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Die meisten der derzeit am Markt verfügbaren mikrobiologischen Schnelltests basieren auf immunologischen Nachweisverfahren. Charakteristisch für alle immunologischen Verfahren ist, dass sie auf einer hochspezifischen Antigen-Antikörper-Reaktion beruhen. Mittels dieses immunologischen Prinzips ist sowohl der qualitative Nachweis eines Analyten als auch die quantitative Bestimmung seiner Konzentration möglich. Der Testaufbau eines immunchemischen Tests kann besonders hinsichtlich der Entstehung und Auswertung der Testsignale erheblich variieren. Bewährte und für mikrobiologische Schnelltests häufig benutzte Formate sind die Partikelagglutination und die Immunchromatographie sowie die daraus hervorgegangenen Weiterentwicklungen, beispielsweise der optische Immunoassay. Auf Basis von Nukleinsäure-Amplifikationstechniken (vor allem der Polymerase- Kettenreaktion, PCR) sind bislang nur wenige POC-Tests verfügbar; ihre Praktikabilität und Bewährung in der Praxis wird sich erst in den nächsten Jahren zeigen.
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8,823 |
Interferons
|
Interferon was discovered by Alick Isaacs and Jean Lindenmann in 1957. It was originally thought that interferon could be used as a general anti-viral agent and in anti-cancer therapy. There are many different types of interferons, now known as interferons “alpha,” “beta,” “gamma” and “lambda,” with different cellular receptors and modes of action, and there are possibly 24 different types of alpha interferon. Independently and simultaneously, a group of Japanese scientists found an “interfering factor,” which upon subsequent analysis turned out to be interferon, probably of the alpha type. The interferon alpha gene was the first mammalian gene to be cloned in a bacterial system and became the prototype for gene cloning technology. Until the cloning of the interferons in Escherichia coli, and expression of the interferon genes in mammalian cells in culture, it was impossible to obtain enough material for clinical use. Interferon today is predominantly used in the treatment of hepatitis B and C, leukemia and Kaposi’s sarcoma. As an anti-viral agent, interferon has not lived up to its initial promise, since in vitro most viruses block the activity of interferon and clinical trials have given inconclusive results with severe side effects. Interferon induces hundreds of genes in vivo and in vitro, each interferon producing overlapping and distinct gene profiles. The mechanism of both interferon induction and anti-viral response is complicated and involves the interaction of many regulatory molecules. Interferon is now known to be a component of the large family of cytokines or interleukins.
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8,824 |
Short- and Long-Term Reaction of European Airlines to Exogenous Demand Shifts
| null |
8,825 |
Carriage of Dangerous Goods by Air
|
The subject of carriage of dangerous goods by air is addressed in Annex 18 to the Chicago Convention. The material in this Annex was developed by the Air Navigation Commission in response to a need expressed by Contracting States for an internationally agreed set of provisions governing the safe transport of dangerous goods by air. In order to assist in achieving compatibility with the regulations covering the transport of dangerous goods by other modes of transport, the provisions of this Annex are based on the Recommendations of the United Nations Committee of Experts on the Transport of Dangerous Goods and the Regulations for the Safe Transport of Radioactive Materials of the International Atomic Energy Agency. More than half of the cargo carried by all modes of transport in the world is dangerous cargo—explosive, corrosive, flammable, toxic and even radioactive. These dangerous goods are essential for a wide variety of global industrial, commercial, medical and research requirements and processes. Because of the advantages of air transport, a great deal of this dangerous cargo is carried by aircraft.
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8,826 |
National E-Commerce Strategy
|
Before discussing national e-commerce strategies in detail, we would like to explain why we determined to write this chapter in such a rich and colorful manner and the motivation for our further research at the national level. It is this point which makes this book different from others of the same kind.
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8,827 |
Nanoparticles: Antimicrobial Applications and Its Prospects
|
Nowadays, nanomaterials [NPs; size, 1–100 nm] have emerged as unique antimicrobial agents. Specially, several classes of antimicrobial NPs and nanosized carriers for antibiotic delivery have proven their efficacy for handling infectious diseases, including antibiotic-resistant ones, in vitro as well as in animal models, which can offer better therapy than classical drugs due to their high surface area-to-volume ratio, resulting in appearance of new mechanical, chemical, electrical, optical, magnetic, electro-optical, and magneto-optical properties, unlike from their bulk properties. Thus, scientifically NPs have been validated to be fascinating in fighting bacteria. In this chapter, we will discuss precise properties of microorganisms and their modifications among each strain specifically. The toxicity mechanisms vary from one stain to another. Even the NP’s efficacy to treat against bacteria and drug-resistant bacteria and their defense mechanisms change according to strains in particular composition of cell walls, the enzymic composition, and so on. Thus, we provide an outlook on NPs in the microbial world and mechanism to overcome the drug resistance by tagging antibiotics in NPs and its future prospects for the scientific world.
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8,828 |
Regulation of Neutrophil Serine Proteases by Intracellular Serpins
|
Neutrophil granules contain serine proteases that are central components of the antimicrobial weapons of the innate immune system. Neutrophil proteases also contribute to the amplification and resolution of inflammatory responses through defined proteolytic cleavage of mediators, cell surface receptors, and extracellular matrix proteins. In the blood and at mucosal surfaces, neutrophil serine proteases are regulated by serpins found in plasma and by non-serpin secreted inhibitors. Distinct mechanisms leading to neutrophil cell death have been described for the granule serine proteases, neutrophil elastase, cathepsin G, and proteinase-3. Granule leakage in neutrophils triggers death pathways mediated by cathepsin G and proteinase-3, and both proteases are tightly regulated by their inhibitor SERPINB1 in a cell intrinsic manner. Although stored in the same types of granules, neutrophil elastase does not significantly contribute to cell death following intracellular release from granules into the cytoplasm. However, heterozygous mutations in ELANE, the gene encoding elastase, are the cause of severe congenital neutropenia, a life-threatening condition characterized by the death of neutrophils at an early precursor stage in the bone marrow. This chapter focuses on recent work exploring the biology of clade B intracellular serpins that inhibit neutrophil serine proteases and their functions in neutrophil homeostasis and serine protease control at sites of inflammation.
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8,829 |
Der Mann ohne Worte
|
Ein Patient sucht verwirrt die Notaufnahme auf. Er kann nicht mehr sprechen, hat Kopfschmerzen. Dann kommen epileptische Anfälle dazu. Das Ärzte-Team steht vor einem Rätsel. Nichts scheint die Symptome zu erklären, keine Therapie schlägt an. Endlich gibt es eine Spur. Doch wer ist der Kranke eigentlich? Als der Zustand des Patienten sich dramatisch verschlechtert, beginnt ein Wettlauf mit der Zeit.
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8,830 |
Practice of Humidification During Noninvasive Mechanical Ventilation (NIV): Determinants of Humidification Strategies
|
1. Who will benefit from humidification? 2. When to apply humidification? 3. How to incorporate humidification into NIV?
|
8,831 |
Bacterial Infections
|
Molecular techniques have revolutionized the detection and identification of microorganisms. Real-time PCR has allowed for the rapid and accurate detection of MRSA, VRE, and group B Streptococcus. The identification of difficult and slow-growing organisms has been expedited by sequence-based methods such as 16S rRNA gene sequencing. Rapid identification of organisms and detection of resistance markers directly from positive blood culture bottles has become a reality. Finally, a transformation is taking place with the introduction of MALDI-TOF into clinical laboratories that promises to improve the accuracy and speed of bacterial and fungal identifications by days. The advantages of these methodologies and their associated clinical applications, along with their inherent pitfalls and problems, are elucidated in this chapter.
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8,832 |
Management of Ventilator-associated Pneumonia
|
Pneumonia is the most important respiratory infection in mechanically ventilated patients. It is defined as the presence of microorganisms in the pulmonary parenchyma leading to the development of an inflammatory response by the host, which may be localized in the lung or may extend systemically. Nosocomial pneumonia is an infectious process which develops within 48 hours after admission to the hospital and that was not incubating at the time of hospitalization. Ventilator-associated pneumonia (VAP) is considered as a subgroup of nosocomial pneumonia and is an infectious pulmonary process which develops 48 hours after the presence of an artificial airway and mechanical ventilation. Since a large proportion of the patients who develop nosocomial pneumonia are intubated and receive mechanical ventilation, most epidemiological and clinical studies on nosocomial pneumonia have been focused on critically ill patients and those receiving mechanical ventilation. From a clinical point of view, nosocomial pneumonia is of great importance not only because of the consequences of the important morbidity and mortality but also due to the high costs associated with development of this disease.
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8,833 |
The Lung Endothelial Barrier in Acute Inflammation
|
In the lungs, alveolar endo- and epithelial cells and their merged basal laminae form a delicate membrane, which allows rapid and effective gas exchange between alveolar and vascular lumen and, at the same time, provides a barrier to protect against inhaled particles and pathogens. Following infectious or sterile inflammatory conditions, strictly controlled endothelial leakiness is required for leukocyte transmigration. However, increased permeability caused by host-dependent inflammatory mechanisms or pathogen-induced endothelial injury may lead to uncontrolled protein-rich fluid extravasation, lung edema and finally acute respiratory distress syndrome (ARDS), which still carries an unacceptably high mortality rate. This chapter gives an overview of major mechanisms underlying pulmonary endothelial barrier regulation and disruption, focusing on the role of specific cell populations, complement and coagulation systems and mediators including angiopoietins, sphingolipids, adrenomedullin, as well as reactive oxygen and nitrogen species in the regulation of pulmonary vascular permeability. Further, current therapeutic strategies targeting the pulmonary endothelial barrier to improve barrier function are discussed.
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8,834 |
Monitoring the ECMO
|
The ECMO device is complex and requires a precise, thorough, and constant management. The aim of this chapter is to describe and explain the different aspects of managing ECMO patients at bedside after implantation. We will be discussing here only about centrifugal pumps. The monitoring of an ECMO patient starts first like the surveillance of any ICU patient starting with a head-to-toe assessment of the patient. In addition to these regular ICU rounds will be added the following: The monitoring of the ECMO device itself. The surveillance of all the potential risks linked to the ECMO. Some clues to troubleshoot the main adverse events.
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8,835 |
Diagnosis, Treatment, and Management of Hemophagocytic Lymphohistiocytosis in the Critical Care Unit
|
Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening condition characterized by uncontrolled inflammation. The management of HLH is challenging, in part, due to the multiple etiologies of the disease, the variations in presentations, and the rapidity of the progression of the disease. Due to the severity of their disease, these patients often require significant critical care support. HLH can be due to familial (genetic) causes or can be secondary to triggers such as infections, autoimmune disorders, and malignancy. Underlying conditions such as sepsis or malignancy could pose as major confounders while applying universal diagnostic criteria and therefore could lead to delay in diagnosis. This chapter focuses on the characteristics of the disease, pathophysiology, diagnostic criteria, treatment, and intensive care management of pediatric patients with HLH.
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8,836 |
Anti-infective Compounds from Marine Organisms
|
The marine environment is a prolific source of bioactive compounds. During the last decades, research on marine-derived plants, animals, and microbes has provided an impressive number of structurally diverse anti-infective agents with antibacterial, antifungal, antiprotozoal, or antiviral activities. Moreover, several of these compounds possess novel mechanisms of action, which underlines their potential as leads in drug discovery. The present chapter provides an overview on marine-derived anti-infective agents, covering the literature between 2010 and 2016, with special focus on their structural features and mechanisms of action.
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8,837 |
Biologische Waffen – eine Herausforderung an Diagnostik, Therapie, Klinik und Prävention
|
Es existiert keine international akzeptierte Legaldefinition für den Begriff »biologische Waffe« (B-Waffe). Manchmal werden bestimmte Erreger und Toxine als Biowaffen bezeichnet. Experten sprechen normalerweise erst dann von solchen, wenn biologische Agenzien (Organismen, Toxine, sich replizierende Einheiten) durch Konzentrationsprozesse, Stabilisatoren und andere Zusätze in Kampfstoffe verwandelt wurden oder/und wenn sich diese in Vorrichtungen zur Dispersion und Dissemination befinden.
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8,838 |
Attachment of human immunodeficiency virus to cells and its inhibition
|
The entry of enveloped viruses involves virus adsorption followed by close apposition of the viral and plasma membranes. This multistep process is initiated by specific binding interactions between glycoproteins in the viral envelope and appropriate receptors on the cell surface. In the case of HIV-1, attachment of virions to the cell surface is attributed to a high affinity interaction between envelope spike glycoproteins (Env, composed of the surface protein gp120 and the transmembrane protein gp41) and a complex made of the primary CD4 receptor and a seven-transmembrane co-receptor (e.g., CXCR4 or CCR5) (reviewed in [1]). Then a chain of dynamic events take place that enable the viral nucleocapsid to penetrate within the target cell following the destabilization of membrane microenvironment and the formation of a fusion pore.
|
8,839 |
Express Transmissible Gastroenteritis Virus Spike Gene B and C Antigen Sites in Multiple Expression Systems
|
In order to illuminate the antigenicity of porcine transmissible gastroenteritis virus (TGEV) spike protein B and C antigen sites, the truncated spike gene including B and C antigen sites of Chinese isolate TH-98 was expressed respectively in E.coli, baculovirus and pichia pastoris expression systems. Dot enzyme-linked immunosorbent assays (Dot-ELISA) based on these three recombinant proteins were developed preliminarily. Ten sera obtained correspondingly from ten piglets two months old which showed up clinical symptom were used for examination. The study indicates that the assays are rapid, reliable and sensitive and it has the potential for use as serological methods for TGEV diagnosis.
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8,840 |
Neurologie
| null |
8,841 |
Monitoring Immune Dysfunction in Septic Patients: Toward Tailored Immunotherapy
|
Septic syndromes represent a major although largely under-recognized healthcare problem worldwide accounting for thousands of deaths every year [1–3]. Mortality remains high ranging from 20 % for sepsis to over 50 % for septic shock despite almost 20 years of anti-inflammatory clinical trials [1–3]. The inability of these therapies to mitigate the devastating effects of this condition indicates that the initial hypotheses for sepsis pathophysiology may have been misconstrued or inadequately addressed. Two major explanations have been proposed: 1) Septic patients have mainly been treated as a group despite the extreme heterogeneity characterizing this population [1]; 2) The postulate that death after sepsis is solely due to an overwhelming pro-inflammatory immune response may actually be inaccurate [1, 3]. Indeed, several lines of evidence have now established that death from septic shock is probably due to the effect of distinct mechanisms over time [1–3]. Early in the course of the disease, a massive release of inflammatory mediators (normally designed to trigger an immune response against pathogens) is occurring that may be responsible for organ dysfunction and hypoperfusion [1, 3]. Concomitantly, the body develops compensatory mechanisms to prevent overwhelming inflammation and dampen an over-zealous anti-infectious response [1–3]. These negative feedback mechanisms, although having protective effects during the first initial hours, may paradoxically become deleterious as they persist over time leading to immune paralysis (Fig. 1) [1, 3]. Indeed, considerable clinical and experimental evidence indicates that patients rapidly present with numerous compromised immune functions [1, 3]. As our capacity to treat patients during the very first hours of shock has improved (early and aggressive initial supportive therapy) [1], many patients now survive this critical step but eventually die later in a state of immunosuppression that is illustrated by difficulty fighting the primary bacterial infection and decreased resistance to secondary nosocomial infections [1, 3]. Consequently, immunostimulatory therapies are now considered as an innovative strategy for the treatment of sepsis [1, 3]. However, the first critical step is to be able to identify patients who would actually benefit from these therapies [2, 3]. Indeed, in the absence of specific clinical signs of immune status, it is critical to determine the best biological tools to stratify patients according to their immune status (a missing step in most previous clinical trials) [1–3]. This would define the right action (i.e., stimulating innate immunity and/or adaptive immunity, blocking apoptosis, restoring other altered functions) at the right time (early or delayed treatment) in the right patient (individualized/tailored therapy).
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8,842 |
Disasters from 1948 to 2015 in Korea and Power-Law Distribution
|
The Korean peninsula is no stranger to disaster, experiencing natural disasters such as severe downpours, floods, and typhoons and human-caused disasters such as industrial accidents, building collapses, and infernos. Fortunately, for the purposes of learning from each event, it has well documented many aspects of each disaster, policy and law changes, institutional reforms, and future risk management alternatives. However, to take the almost 2000-year documented history of Korea in a more manageable period, we focus on the major disaster events, those that are quantifiable and that took place between 1948 and 2015 to see if the disaster trend in Korea is producing power-law distributed disasters. We specifically analyzed the statistical characteristics of these major disaster events and their functional relationship between frequency and magnitude to see if a change in one produces a proportional relative change in the other.
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8,843 |
Allgemeine Chirurgie
|
Definition. Retrograder Transport von Magen- bzw. Dünndarminhalt durch Speiseröhre und Mund nach außen, begleitet durch Würgen und Übelkeit (Nausea) Symptomatik. Der Zeitpunkt des Erbrechens in Relation zur Nahrungsaufnahme und das Aussehen bzw. der Geruch des Erbrochenen können Hinweise auf die Lokalisation des Passagehindernisses geben.
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8,844 |
Disease management strategies in SARS
| null |
8,845 |
Infectious Disease in Wild Animal Populations: Examining Transmission and Control with Mathematical Models
|
The mathematical modeling of ecological interactions is an essential tool in predicting the behavior of complex systems across landscapes. The scientific literature is growing with examples of models used to explore predator-prey interactions, resource selection, population growth, and dynamics of disease transmission. These models provide managers with an efficient alternative means of testing new management and control strategies without resorting to empirical testing that is often costly, time-consuming, and impractical. This chapter presents a review of four types of mathematical models used to understand and predict the spread of infectious diseases in wild animals: compartmental, metapopulation, spatial, and contact network models. Descriptions of each model’s uses and limitations are used to provide a look at the complexities involved in modeling the spread of diseases and the trade-offs that accompany selecting one modeling approach over another. Potential avenues for the improvement and use of these models in future studies are also discussed, as are specific examples of how each type of model has improved our understanding of infectious diseases in populations of wild animals.
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8,846 |
Kardiologie
|
Die Kardiologie ist ein wichtiges und sehr umfangreiches Themengebiet der Inneren Medizin. In diesem Kapitel werden die wichtigsten Pathologien, die sich am Herzen manifestieren können, ihre Diagnostik und Therapie dargestellt. Hierzu zählen vor allem Erkrankungen des Endokards, Herzklappenfehler (erworben wie angeboren), Herzrhythmusstörungen, aber auch Erkrankungen des Myo- und Perikards. Ebenso werden die Herzinsuffizienz und die koronare Herzkrankheit (KHK) in einem eigenen Abschnitt behandelt. Am Ende des Kapitels wird kurz auf die seltenen Tumoren am Herzen und funktionelle Herzbeschwerden eingegangen.
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8,847 |
Primate Infectious Disease Ecology: Insights and Future Directions at the Human-Macaque Interface
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Global population expansion has increased interactions and conflicts between humans and nonhuman primates over shared ecological space and resources. Such ecological overlap, along with our shared evolutionary histories, makes human-nonhuman primate interfaces hot spots for the acquisition and transmission of parasites. In this chapter, we bring to light the importance of human-macaque interfaces in particular as hot spots for infectious disease ecological and epidemiological assessments. We first outline the significance and broader objectives behind research related to the subfield of primate infectious disease ecology and epidemiology. We then reveal how members of the genus Macaca, being among the most socioecologically flexible and invasive of all primate taxa, live under varying degrees of overlap with humans in anthropogenic landscapes. Thus, human-macaque interfaces may favor the bidirectional exchange of parasites. We then review studies that have isolated various types of parasites at human-macaque interfaces, using information from the Global Mammal Parasite Database (GMPD: http://www.mammalparasites.org/). Finally, we elaborate on avenues through which the implementation of both novel conceptual frameworks (e.g., Coupled Systems, One Health) and quantitative network-based approaches (e.g., social and bipartite networks, agent-based modeling) may potentially address some of the critical gaps in our current knowledge of infectious disease ecology at human-primate interfaces.
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8,848 |
Interventions to prevent transmission of the common cold
|
Theoretically, there are several ways of preventing the common cold: quarantine, immunisation (or vaccination); early treatment of effected individuals; or physical barriers to reduce transmission. All these methods can be dismissed after considering the epidemiology of the common cold, apart from the last. Evidence for effectiveness for physical barriers (which include masks to reduce aerosol transmission; handwashing; and gloves and gowns) come from a variety of empirical studies. The chance of bias for these studies is variable, but we can conclude that all of these barrier methods have important potential for preventing transmission of the common cold, although some methods will not be acceptable to the community currently.
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8,849 |
Hemotransfusion in Combat Trauma
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The collaboration of blood transfusion service in the management of severely combat-injured individuals has proved to be an essential factor for the successful treatment of these patients. While the operating and anesthesiology teams are engaged in maintaining the vital signs and controlling blood loss of the injured, the transfusion service representatives follow the information on the amount of blood products given and the latest laboratory tests, as well as provide consultations regarding further blood component requirements on the basis of data obtained. A major effort of the treating team should be aimed at diagnosis and correction of coagulopathy, acidosis, and hypothermia. For the massively bleeding combat trauma injured, which can amount to as high as 8% of all trauma patients, a generous use of plasma at a one-to-one ratio with packed cells, along with the early addition of platelets and cryoprecipitates, should be considered. Early point-of-care thromboelastography is helpful for identification of coagulopathies. The use of a preset massive transfusion protocol is beneficial; however, it should be tailored according to the patient’s actual needs, depending on the type of injury and the individual’s general condition.
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8,850 |
Food Policies’ Roles on Nutrition Goals and Outcomes: Connecting of Food and Public Health Systems
|
Nutrition exists when food security is combined with a sanitary environment, adequate health services, and proper care and feeding practices to ensure a healthy life for all household members. Despite increased attention to undernutrition, it remains a devastating multi-faceted problem for infants, young children, and women around the world, resulting in increased morbidity, mortality, and long-term disability. Undernutrition can also lead to poor health into adulthood, which affects social and economic development of nations. On the other end of the malnutrition spectrum, overweight and obesity are growing problems, linked to changing diets and activity patterns, which also lead to serious health problems and impact the economies of nations. This chapter attempts to unpack the importance of food and agriculture policies on nutrition outcomes and why engagement of food and public health systems remain critically important. External pressures, such as climate variability and population growth, that tax these systems are discussed, as well as the globalization of our food system and why that has shifted dietary patterns and nutrition and health status trends. The multi-sectoral integration of food and health systems and its importance to improve nutrition is demonstrated through three models. Three very brief case studies are presented that help exemplify some of the food and health system trends that influence policy and ultimately, nutrition outcomes.
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8,851 |
Infektiologische Erkrankungen
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Sytemische Reaktion des Körpers auf generalisierte Infektionen (Bakteriämie, Fungämie, Virämie, Parasitämie oder schwere Organinfektion). Klinisch nicht zu unterscheiden von SER = SIRS (systemische entzündliche Reaktion), z.B. durch Trauma, Verbrennung u.a.
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8,852 |
Phytochemical Constituents and Pharmacological Effects of Licorice: A Review
|
Licorice (or “liquorice”) is one of most widely used in foods, herbal medicine, and extensively researched medicinal plants of the world. In traditional medicine licorice roots have been used against treating many ailments including lung diseases, arthritis, kidney diseases, eczema, heart diseases, gastric ulcer, low blood pressure, allergies, liver toxicity, and certain microbial infections. Licorice extract contains sugars, starch, bitters, resins, essential oils, tannins, inorganic salts, and low levels of nitrogenous constituents such as proteins, individual amino acids, and nucleic acids. A large number of biological active compounds have been isolated from Glycyrrhiza species, where triterpene saponins and flavonoids are the main constitutes which show broad biological activity. This review examines recent studies on the phytochemical and pharmacological data and describes some side effects and toxicity of licorice and its bioactive components.
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8,853 |
Notification and Disease Control: Obligations of the Medical Practitioner Under Public Health Legislation
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Effective disease control requires a strong partnership between clinicians and public health personnel. The vital role medical practitioners play is reflected globally in the obligation under health legislation for medical practitioners to notify the public health authority of specific details of named patients suspected of having these diseases. While the principle is universal that the notification include the identity of the patient, to allow prompt and direct public health action, if needed, jurisdictions have varying approaches to many other aspects of notification: the actual list of notifiable conditions; who must notify and based on what degree of diagnostic certainty; in what timeframe and with what specific details; what information is to be provided to the case; and who bears responsibility for contact tracing. In addition, in some jurisdictions, medical practitioners have associated statutory obligations and powers, related to the examination of a patient directed for assessment by the public health authority, the furnishing of reports of such examinations, the role of the practitioner in ordering a patient into isolation, and responsibilities of medical practitioners in public health emergencies. Following a concise historical survey, finishing with the impact of the International Health Regulations 2005, this chapter systematically discusses the statutory obligations of medical practitioners for disease notification and related provisions, taking examples from English-language public health legislation used in Oceania, Europe, North America, Asia, and Africa.
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8,854 |
Caspase-7
| null |
8,855 |
Work-Associated Trauma
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Traumatic events are experienced by most people at some point in their life. Following a traumatic event many individuals return to previous functioning and some feel an increased sense of efficacy. However, a sizable minority experience adverse psychological and behavioral effects. These effects include distress reactions, health risk behaviors, and psychiatric disorders. Workplace traumatic events and responses most studied in physicians include exposure to injured and dying patients, medical errors and complications, bullying, disasters, and workplace violence. Developmental issues confer specific risks for medical students and residents, as well as early and late career physicians. Prevention measures which reduce exposure to workplace trauma are optimal. Physicians exposed to traumatic events will benefit from the use of prompt, evidence-based interventions. Many will seek and benefit from self-help interventions and peer support, but some may need formal assessment and treatment through employee assistance programs and traditional psychiatric care. Effective prevention and treatment can enhance physician well-being and career retention as well as patient outcomes.
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8,856 |
A Tool for Comparing Outbreak Detection Algorithms
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Despite of the main objective of recent biosurveillance researches is bioterrorist attack threats, detection of natural outbreaks are also being tried to solve by governments all over the world. Such that, international foundations as WHO, OECD and EU publish public declaration about necessity of an international central surveillance system. Each data source and contagious disease carries its own patterns. Therefore, standardizing the process of outbreak detection cannot be applicable. Various methods have been analyzed and published on test results in biosurveillance researches. In general, these methods are the algorithms in literature of SPC and Machine Learning, although specific algorithms have been proposed like Early Aberration Reporting System (EARS) methods. Differences between published results show that, the characteristic of time series are tested with algorithm and the chosen parameters of this algorithm are also determine results. Our tool provides preprocessing of data; testing, analyzing and reporting on anomaly detection algorithms specialized at biosurveillance. These functionalities make it possible to use outputs for comparing algorithms and decision making.
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8,857 |
Lessons from History
|
Resilience has a lengthy history of practice and implementation for events of extreme consequence and high uncertainty. One of the clearest cases of embryonic resilience thinking includes Medieval Venice, which was forced to grapple with the recurring threat of plague that threatened to destroy the fabric of European society and cripple the juggernaut of Venetian maritime trade (Linkov et al. 2014a, b, c, d, e; Lane 1973). This early resilience thinking did not fully inoculate Venetian society from the ravages of disease—on the contrary, limitations of medical knowledge and border control allowed for outbreaks throughout the early modern era—yet it did allow Venetian policymakers to begin to address the question of how to combat deadly disease. The cumulative successes in reducing disease incidence and spread throughout the city and its dependent settlements eventually brought policymakers to embrace resilience thinking for other unrelated projects ranging from climate change to land reclamation efforts—all centered on the idea of strengthening Venetian social, economic, and cultural capabilities in the midst of an uncertain future (Vergano and Nunes 2007; Linkov et al. 2014a, b, c, d, e). This all goes to show that while resilience thinking and resilience analysis are growing buzzwords in the early twenty-first century, their roots go back centuries before even the printing press or functional medicine.
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8,858 |
Prevention and Treatment of Respiratory Virus Infection
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There is increasing recognition of infections caused by respiratory viruses (RVs) as a major cause of morbidity and mortality in solid organ transplant (SOT) recipients, especially within the thoracic and pediatric population. In addition to their direct, cytopathic, and tissue-invasive effects, RVs can create an inflammatory environment, autoimmune responses, resulting in acute and chronic rejection, although this relationship remains controversial. A laboratory diagnosis in SOT with respiratory syndrome should be performed with nucleic acid amplification tests on respiratory specimens, mainly nasopharyngeal swabs (NPS) and bronchoalveolar lavage (BAL). Treatment options remain limited and consist of supportive care, reduction of immunosuppression, and, if available, antiviral therapy. The use of immunomodulatory agents remains a clinical dilemma. Since treatment options for RVs are limited, maximizing prevention measures against viral infections in SOT is mandatory. The main preventive strategy against influenza remains the administration of yearly inactivated influenza vaccine in all SOT. The aim of this review is to summarize the evidence-based recommendations on the diagnostic, preventive, and therapeutic strategies to decrease the burden of RV infections in SOT recipients.
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8,859 |
Intensivtherapie bei HIV-Infektion
|
In den ersten Jahren der AIDS-Epidemie war die Behandlung von HIV-assoziierten Komplikationen mit einer ICU-Mortalität von 80–90% verknüpft [6]. Mit der rascheren Diagnose und besseren Therapie zuerst der opportunistischen Erkrankungen und der HIVInfektion verbesserte sich die Prognose deutlich [9]. Heute ist die Langzeitprognose HIV-infizierter Patienten mit einer wirksamen antiretroviralen Therapie am ehesten vergleichbar mit der anderer chronischer Erkrankungen [1].
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8,860 |
Erkrankungen des Kehlkopfs
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Der Kehlkopf bildet als Teil des Atemtrakts den Übergang vom Rachen zur Luftröhre im vorderen Halsbereich. Embryonal entsteht er sich aus dem 4.–6. Kiemenbogen. Der Kehlkopf besteht aus drei großen Knorpel, dem Schildknorpel (Cartilago thyroideus), dem Ringknorpel (Cartilago cricoides) und dem Kehldeckel (Epiglottis) sowie den zwei kleineren Stellknorpeln (Cartilago arytaenoidea). Der Schildknorpel bildet die vordere Wand des Kehlkopfs und ist v. a. an seiner Oberkante von außen zu sehen und zu tasten. Der Kehlkopf hat im Wesentlichen zwei Funktionen: er schützt die Luftröhre vor Speisestücken, in dem der Kehlkopf beim Schlucken nach vorne oben gezogen und damit mit dem Kehldeckel verschlossen wird und zum anderen regulieren die Stimmlippen den Strom der Atemluft und erzeugen durch ihre Schwingungen Töne bzw. die menschliche Stimme.
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8,861 |
SARS
| null |
8,862 |
Novel vaccination strategies
| null |
8,863 |
The State of Health System(s) in Africa: Challenges and Opportunities
|
As study after study has pointed out, the health care systems in Africa pay little attention to the critical interface between education and good health, especially when it comes to the education of women and mothers, who are the primary line of defense against child diseases, and perform simultaneously most domestic chores and critical agricultural activities. While many medical educational institutions on the continent tend to perpetuate, at times, skewed and irrelevant Eurocentric health training, the national pyramidal health structure, weakened at the village level, and disproportionately favoring the provincial and national hospitals, gives the illusion that rural areas are well-served, when in actuality they are not. This chapter endorses the restrengthening of an uncompromised health care system to make it effective and efficient for both rural and urban areas; one that finds ways of trimming financial and human resource waste; revamps the institutions that train health care and service providers to make the system responsive to the real health needs of the people and not just the wealthy; one that compensates physicians just as civil servants; and aligns the educational system with targeted and expected measurable health outcomes.
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8,864 |
Prospective Study About the Influence of Human Mobility in Dengue Transmission in the State of Rio de Janeiro
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Dengue is a human arboviral disease transmitted by Aedes mosquitoes and it is currently a major public health problem in which around 2–5 billion people are at risk of infection each year. Climate changes and human mobility contribute to increase the number of cases and to spread the disease all around the world. In this work, the influence of human mobility is evaluated by analyzing a sequence of correlations of dengue incidence between cities in southeastern Brazil. The methodology initially identifies the cities were the epidemy begins, considered as focus for that epidemic year. The strength of the linear association between all pairs of cities were calculated identifying the cities which have high correlations with the focus-cities. The correlations are also calculated between all pairs considering a time lag of 1, 2 or 3 weeks ahead for all cities except the focus ones. Centred differences of the notification number are used to detect the outbreaks. The tests were made with DATASUS-SINAN data of the state of Rio de Janeiro, from January 2008 to December 2013. Preliminary results indicate that the spread of dengue from one city to another can be characterized by the development of the sequence of shifted correlations. The proposal may be useful to consider control strategies against disease transmission.
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8,865 |
Das Virus aus dem Labor (1)
|
Kann uns das drohen? Eine Grippe-Pandemie, ausgelöst durch einen Laborunfall mit einer »aufgerüsteten« Version des Vogelgrippe-Virus H5N1? Die US-Regierung sieht das offenbar so. In einem bisher beispiellosen Schritt hat sie Wissenschaftler aufgefordert, eine Arbeit zum Vogelgrippevirus nicht vollständig zu veröffentlichen.
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8,866 |
Towards a Practical Cosmopolitanism
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Claiming the airport as an exemplar of contemporary global space and the incessant logics of movement seen to be at the heart of globalisation, the introductory chapter asks what is it to move in the airport space? What is the choreography of the airport? Reviewing debates on critical cosmopolitanism, and the corporeal and spatial turns, this chapter argues for the need to further embodied analysis of global movement through a kind of kinaesthetic ethnography, which puts the wealth of thinking about moving bodies in space from dance studies into dialogue with mobility studies. Such an approach, the chapter argues, can lead us to important knowledge about the ongoing tensions between sameness and difference, national and transnational, self and other, as experienced in the transit spaces of global mobility—a practice of cosmopolitanism.
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8,867 |
‘Black Swans’, ‘Dragon Kings’ and Beyond: Towards Predictability and Suppression of Extreme All-Hazards Events Through Modeling and Simulation
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Shocks to regional, national and global systems stemming from natural or man-made hazards can have dramatic implications. Disasters such as Katrina (2005), Hurricane Sandy (2012), Alberta (Canada) Floods (2013), and Super Typhoon Haiyan (2013) are examples that highlight the vulnerability of communities to natural hazards and the crippling effect they have on the social and economic well-being. Through foresight and scenario planning, such events can be expected but can they be predicted to support resilience and enable suppression of the impacts? With consideration of emerging and systemic risks and inherent uncertainty associated with surprising events, planning for and managing risk, crisis and disasters requires understanding of the outliers that challenge our resilience. ‘Black Swans’ represent the unpredictable. They represent “… our misunderstanding of the likelihood of surprises” (Taleb in The black swan: the impact of the highly improbable, 2007). A ‘Black Swan’ is described by Taleb (2007) as that which is an outlier, that which is outside the realm of regular expectations which carries with it an extreme impact such as natural disasters, market crashes, catastrophic failure of complex socio-technical systems and terrorist events such as 9/11. Sornette (Int J Terraspace Sci Eng 2(1):1–18, 2009) identifies a different class of extreme events (outliers) that he calls ‘Dragon Kings’. Sornette (2009) argues that Dragon Kings may have properties that make them not only identifiable in real time but also predictable. The evolving science on complexity (and, more specifically, on complex networks) and on resilience suggest that modeling and simulation of such extreme events can assist in the predictability and the suppression of low probability extremely high consequence events such as natural hazards (flood, earthquake, wildfire, tsunami, extreme weather), cyber-attacks, and financial events. Furthermore, the science of complex networks is developing rapidly and has fundamentally reshaped our understanding of complexity, potentially leading to innovative methods for the prediction of emergent behavior on natural and technological networks, as well as specific strategies for designing networks that are more resistant (resilient) to both failure and attack. Governments and owners of critical physical and digital infrastructure may benefit from analyses, advice and exercises that involve predictable and suppressible “Dragon-King” type of low probability extremely high consequence extreme events, as well as from the utilization of recent advances in complex network theory, to ultimately enhance resiliency. This chapter contributes to the discourse on Dragon Kings arguing for continued and concerted efforts to explore this domain.
|
8,868 |
Proinflammatory and Antiinflammatory Mediators in Critical Illness
| null |
8,869 |
angiotensin-converting enzyme 2 3.4.17.23
|
EC number 3.4.17.23 Recommended name angiotensin-converting enzyme 2 Synonyms ACE <4> [12] ACE 2 <10,12,13> [74] ACE-2 <2,3,4,9> [38,68] ACE-related carboxypeptidase <9> [3] ACE2 <1,2,3,4,5,6,9,10,11,12,13> [1,2,3,5,6,9,14,15,16,17,19,20,22,25,26,30,37,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,65,66,67,68,69,70,71,72,73,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97] ACE2 homologue <2> [41] ACEH <9> [7] Ang converting enzyme 2 <10,12,13> [74] angiotensin II converting enzyme 2 <3> [81] angiotensin converting enzyme 2 <2,3,4,6,9,10,11,12,13> (<3> functions as a carboxypeptidase [41]) [14,41,43,46,47,51,55,57,58,60,63,74,78,84] angiotensin converting enzyme II <9> [95] angiotensin converting enzyme-2 <2,3,4> [38] angiotensin-converting enzyme <4,9> [22] angiotensin-converting enzyme 2 <4,8,9,10,12,13> [10,19,67,68,70,76] angiotensin-converting enzyme homolog <9> [7] angiotensin-converting enzyme homologue <9> [6] angiotensin-converting enzyme type 2 <13> [79] angiotensin-converting enzyme-2 <3,4> [37,53,97] angiotensin-converting enzyme-like protein <9> [7] angiotensin-converting enzyme-related carboxypeptidase <9> [1,6] angiotensinase <9> [4] hACE2 <3,10,13> [36,67,74] CAS registry number 328404-18-8
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8,870 |
Biologische Waffen – eine Herausforderung an Diagnostik, Therapie, Klinik und Prävention
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Mediziner und Wissenschaftler müssen die Gefahren, die von biologischen Waffen ausgehen, kennen und über mögliche vorsätzlich freigesetzte Mikroorganismen informiert sein, um Bevölkerung und Patienten behandeln und ggf. beruhigen zu können.
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8,871 |
Nanowire Field-Effect Transistor Sensors
|
Sensitive and quantitative analysis of proteins and other biochemical species are central to disease diagnosis, drug screening and proteomic studies. Research advances exploiting SiNWs configured as FETs for biomolecule analysis have emerged as one of the most promising and powerful platforms for label-free, real-time, and sensitive electrical detection of proteins as well as many other biological species. In this chapter, we first briefly introduce the fundamental principle for semiconductor NW-FET sensors. Representative examples of semiconductor NW sensors are then summarized for sensitive chemical and biomolecule detection, including proteins, nucleic acids, viruses and small molecules. In addition, this chapter discusses several electrical and surface functionalization methods for enhancing the sensitivity of semiconductor NW sensors.
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8,872 |
Targeting Immunomodulatory Agents to the Gut-Associated Lymphoid Tissue
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In addition to fluid haemostasis and lipid absorption, the lymphatic system and lymphoid tissues serve as the major host of immune cells where immune responses are evoked. Impaired function of the immune system might lead to serious diseases which are often treated by immunomodulators. This chapter briefly explores the physiology of an important part of the lymphatic system, the gut-associated lymphoid tissues (GALT). Currently used strategies for targeting GALT by immunomodulators for enhanced activity and/or decreased side effects are discussed. Strategies range from simple oral co-administration of immunomodulators with lipids to more advanced lipid-based formulations, polymer-based nanoparticle formulations and prodrugs. These targeting approaches successfully increase the concentration of immunomodulators achieved in the GALT and, more importantly, enhance immunomodulatory effects. Therefore, targeting immunomodulators to GALT represent a promising approach in the treatment of diseases where the immune system is actively involved.
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8,873 |
Epidemic Models
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Communicable diseases such as measles, influenza, and tuberculosis are a fact of life. We will be concerned with both epidemics, which are sudden outbreaks of a disease, and endemic situations, in which a disease is always present. The AIDS epidemic, the recent SARS epidemic, recurring influenza pandemics, and outbursts of diseases such as the Ebola virus are events of concern and interest to many people. The prevalence and effects of many diseases in less-developed countries are probably not as well known but may be of even more importance. Every year millions, of people die of measles, respiratory infections, diarrhea, and other diseases that are easily treated and not considered dangerous in the Western world. Diseases such as malaria, typhus, cholera, schistosomiasis, and sleeping sickness are endemic in many parts of the world. The effects of high disease mortality on mean life span and of disease debilitation and mortality on the economy in afflicted countries are considerable.
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8,874 |
Krisenmanagement
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Erfolgreiche Unternehmen und Organisationen entwickeln ein umfassendes Bewusstsein für mögliche Krisen, sie betreiben professionelle Krisenprävention. Das Rezept für eine dauerhafte und erfolgreiche Krisenprävention lautet: Jeden Tag nach vorne schauen, Risiken wahrnehmen, richtig abschätzen und möglichst neutralisieren. Systematische Verfahren zur Früherkennung von Warnsignalen spielen dabei eine wichtige Rolle. Krisenpotenziale erkennen und antizipieren, Infrastrukturen schaffen, Abläufe einüben und Mitarbeiter schulen sind gute Voraussetzungen, um in krisenhaften Situationen souverän zu agieren, statt in einen Schockzustand zu verfallen. Leider sind noch zu viele Unternehmen und Organisationen von diesem Ideal weit entfernt. Krisen gefährden außerdem immer das Image und die Reputation eines Unternehmens. In diesem Zusammenhang darf das mediale Interesse nicht unterschätzt werden. Die Mediengesellschaft, in der wir leben, liebt und produziert deswegen unentwegt große und kleine Krisen, indem sie schlicht jede Gelegenheit zur Berichterstattung nutzt. Schließlich ist die Krise – mehr noch als die bloß schlechte Nachricht – ein hervorragend verkäufliches Gut (Mörle 2004). Leider verfügen noch zu wenig Unternehmen über professionelle Konzepte, die auch den Aspekt der Krisenkommunikation hinreichend berücksichtigen. Auch ist einzelnen Studien zu entnehmen, dass das Bewusstsein in Deutschland für das Thema Krisenprävention und ‑bewältigung in einigen Branchen noch nicht hinreichend ausgeprägt ist.
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8,875 |
Lost Trust: Socio-biological Hazard—From AIDS Pandemic to Viral Outbreaks
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Iatrogenic HIV infection refers here to cases of infection with the human immunodeficiency virus (HIV) caused by private and public administration of blood products [1]. Following the discovery of acquired immunodeficiency syndrome (AIDS) in 1981, numerous warnings were issued by specialists regarding the use of blood products. In spite of this, no effective measures such as a switch to cryoprecipitate were taken, and the authorization of safe heated products was also delayed, as a result of which 40 % of Japanese hemophiliacs, or some 2000 people, fell victim as a result of ‘human error’ [2]. Additionally, since insufficient risk data was provided, the infection spread to partners, families, and other associates of hemophiliacs through secondary and tertiary infection. In connection, questions were asked as to the degree of responsibility of those institutions involved in the outbreak and spread of the infection.
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8,876 |
Commercial Buildings
|
Applications for UVGI systems in commercial buildings vary with the type of building, but virtually every type of building can benefit from the use of in-duct air disinfection and many buildings can benefit from the use of other types of UV systems. The health hazards and microbiological problems associated with various types of commercial buildings are often unique to the type of facility. The problem of air quality is paramount in commercial office buildings while the problem of biocontamination is of the highest concern in the food industry. Other types of buildings have their own microbial concerns and even their own standards. The pharmaceutical industry has the highest aerobiological air quality standards (and lowest airborne microbial levels) while the other extreme, the agricultural industry, has the highest airborne microbial levels and unique aerobiological concerns. The individual problems of these facilities are addressed in the following sections, and industry experience relating to UV applications are discussed, along with recommendations for how UV systems can be applied. The specific types of UVGI systems are described in previous chapters and these should be referred to for detailed information on such applications.
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8,877 |
Molekulare Struktur eukaryotischer Chromosomen
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Die Chromosomen sind die lichtmikroskopisch sichtbaren, materiellen Träger der Gene. Bedeutet das aber, dass sie lediglich eine Ansammlung kettenartig aneinandergefügter Gene sind? Aus cytologischen Beobachtungen wissen wir, dass die Chromosomen, und damit die Gene, in Mitose und Meiose gleichmäßig auf die Tochterzellen verteilt werden. In den Centromerbereichen der Chromosomen dienen die Kinetochore als Ansatzpunkte für die Mikrotubuli des Spindelapparates. So werden die Chromosomen bzw. deren Untereinheiten, die Chromatiden, bei der Zellteilung auf die Tochterzellen aufgeteilt. Besondere terminale Domänen, die Telomere, gewährleisten, dass die freien Enden der DNA im Chromosom nicht von Exonukleasen abgebaut werden oder durch Reparaturenzyme mit den freien Enden der DNA eines anderen Chromosoms verschmelzen.
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8,878 |
Viruses: Definition, Structure, Classification
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Viruses are infectious units with diameters of about 16 nm (circoviruses) to over 300 nm (poxviruses; Table 2.1). Their small size makes them ultrafilterable, i.e. they are not retained by bacteria-proof filters. Viruses have evolved over millions of years, and have adapted to specific organisms or their cells. The infectious virus particles, or virions, are composed of proteins and are surrounded in some species of viruses by a lipid membrane, which is referred to as an envelope; the particles contain only one kind of nucleic acid, either DNA or RNA. Viruses do not reproduce by division, such as bacteria, yeasts or other cells, but they replicate in the living cells that they infect. In them, they develop their genomic activity and produce the components from which they are made. They encode neither their own protein synthesis machinery (ribosomes) nor energy-generating metabolic pathways. Therefore, viruses are intracellular parasites. They are able to re-route and modify the course of cellular processes for the optimal execution of their own reproduction. Besides the genetic information encoding their structural components, they additionally possess genes that code for several regulatory active proteins (such as transactivators) and enzymes (e.g. proteases and polymerases).
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8,879 |
Acute Myeloid Leukemia: Epidemiology and Etiology
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Although acute leukemias are infrequent diseases, they are highly malignant neoplasms responsible for a large number of cancer-related deaths. Acute myeloid leukemia (AML) is the most common type of leukemia in adults, yet continues to have the lowest survival rate of all leukemias. While results of treatment have improved steadily in younger adults over the past 20 years, there have been limited changes in survival among individuals of age >60 years [1, 2].
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8,880 |
Pulmonary Complications
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After hematopoietic stem cell transplant (HSCT), up to 60 % of patients develop pulmonary complications. In spite of antibacterial, antiviral, and antifungal prophylaxis, reduced host defenses render the HSCT patient vulnerable to pulmonary and other infections in the early weeks and even months post-transplantation. This chapter suggests an integrative approach followed by a description of the most common pulmonary syndromes seen in HSCT patients, including diffuse alveolar hemorrhage (DAH), idiopathic pneumonia syndrome (IPS), bronchiolitis obliterans syndrome (BOS), and cryptogenic organizing pneumonia (COP). The high risk of developing pulmonary complications after HSCT necessitates a pre-transplant pulmonary workup. Pulmonary function tests (PFTs) are done prior to HSCT and include spirometry and diffusion capacity of carbon monoxide (DLCO). Low DLCO and alveolar–arterial oxygen gradient on PFTs carry increased mortality post-HSCT. Decreased DLCO and forced expiratory volume in one second (FEV1) < 80 % are indicators of developing respiratory failure post-HSCT. Investigating new pulmonary complaints is challenging. All patients should undergo an extensive workup of new pulmonary findings, including dyspnea, cough, fever, and hypoxia. In the first 4–6 weeks post-HSCT, immunocompromised patients can develop bacterial pneumonia. Pathogens include gram-negative rods (Pseudomonas or Klebsiella), Staphylococcus aureus, and Nocardia. While chest X-rays could show typical lobar or multilobar opacities, computed tomography (CT) scan of the chest (noncontrast CT scans are adequate for workup of infectious processes) may yield additional characteristic findings (nodules, ground glass opacities, etc.). Fungal pneumonias, primarily aspergillus, can also develop in this early period. There is a very strong association between invasive Aspergillus pneumonia and neutropenia lasting more than 10 days. Viral pneumonia may develop as well in this patient population; however, it tends to occur later. Cytomegalovirus (CMV) is the most common viral pathogen, but with monitoring and preemptive therapy, the incidence has declined. Other viruses have emerged as pathogens, including respiratory syncytial virus (RSV), influenza, parainfluenza, and human metapneumovirus (see Chap. 17).
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8,881 |
Infections in the Immunocompromised Host
| null |
8,882 |
Modeling Disease Spread at Global Mass Gatherings: Data Requirements and Challenges
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Spread of infectious diseases at global mass gatherings can pose health threats to both the hosting country and the countries where participants originate. The travel patterns at the end of these international events may result in epidemics that can grow to pandemic levels within a short period of time. Computational models are essential tools to estimate, study, and control disease outbreaks at mass gatherings. These models can be integrated in the planning and preparation process of mass gatherings. In this paper, we present a review of the key data requirements and the challenges encountered when modeling infectious diseases epidemics initiated by global mass gatherings. This review can assist epidemic modeling at global mass gatherings providing researchers with insights of the main aspects and possible big data opportunities in this emerging research area.
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8,883 |
Viral Evolution
|
Viruses are ideal objects for studying evolutionary processes because of their short generation time, high numbers of offspring that they produce during infection and not least because of their simple structure. Viruses must continuously adapt to the conditions of their host or their host populations, so selection mechanisms are accessible to experimental approaches. In this context, different criteria play an important role, such as the antigenic diversity, the extent of virus excretion, and the degree of virulence. The complete adaptation of a virus to its host, which leads to a minimization of virulence of the infectious agent, is for both parties the desirable consequence: i.e. a problem-free coexistence and survival. For example, hepatitis G virus (GB virus C) which was initially isolated from patients with liver inflammation, seems to persist in many people without causing illnesses. A similar situation is observed with torque teno viruses (10.1007/978-3-642-20718-1_14 and 10.1007/978-3-642-20718-1_20). Spumaviruses are also found in many animal species and humans without causing symptomatic infections (10.1007/978-3-642-20718-1_18). For many viruses, the maximum exploitation of genetic variability is not always useful. Viruses reach a limit at which a greater variance is no longer advantageous: the proportion of non-infectious virus variants among the progeny becomes too high, whereby the potentially possible error limit is reached.
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8,884 |
Blut und Blutprodukte
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Um Blut oder Blutprodukte bei Bedarf substituieren zu können, sind grundlegende Kenntnisse zu den Blutgruppen, Serumantikörpern und den Blutprodukten selbst nötig. Das Kapitel enthält hierzu die wesentlichen Fakten und zeigt Indikationen spezieller Blutprodukte (z. B. FFP oder TK) auf.
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8,885 |
Integrating Landscape Hierarchies in the Discovery and Modeling of Ecological Drivers of Zoonotically Transmitted Disease from Wildlife
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Changes in landscape and land use can drive the emergence of zoonoses, and hence, there has been great interest in understanding how land cover change and the cascade of ecological effect associated with it are associated with emerging infectious diseases. In this chapter, we review how a spatially hierarchical approach can be used to guide research into the links between landscape properties and zoonotic diseases. Methodological advances have played a role in the revival of landscape epidemiology and we introduce the role of methodologies such as geospatial analysis and mathematical modeling. Importantly, we discuss cross-scale analysis and how this would provide a richer perspective of the ecology of zoonotic diseases. Finally, we will provide an overview of how hierarchical research strategies and modeling might be generally used in analyses of infectious zoonoses originating in wildlife.
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8,886 |
Measles Virus
|
Name of Virus: Measles virus
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8,887 |
Innovationen im Dialogmarketing
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Das Dialogmarketing steht durch technische Innovationen vor massiven Veränderungen. Vor allem die digitale Kommunikation in sozialen Netzwerken rückt zunehmend in den Fokus des Dialogmarketing und stellt neue Herausforderungen an das Management. Diese bestehen insbesondere in der Analyse der sozialen Struktur der Kommunikation und den Beziehungen der Akteure zueinander. Die Kernaufgaben in der Initiierung eines Dialoges im Rahmen von sozialen Netzwerken liegen darin, (1) diejenigen Personen im Netzwerk zu identifizieren, die als „Superspreader“ fungieren und (2) diese dann so zu motivieren, dass sie sich als Multiplikatoren im Netzwerk einsetzen.
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8,888 |
(13)C Chemical Shifts in Proteins: A Rich Source of Encoded Structural Information
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Despite the formidable progress in Nuclear Magnetic Resonance (NMR) spectroscopy, quality assessment of NMR-derived structures remains as an important problem. Thus, validation of protein structures is essential for the spectroscopists, since it could enable them to detect structural flaws and potentially guide their efforts in further refinement. Moreover, availability of accurate and efficient validation tools would help molecular biologists and computational chemists to evaluate quality of available experimental structures and to select a protein model which is the most suitable for a given scientific problem. The (13)C(α) nuclei are ubiquitous in proteins, moreover, their shieldings are easily obtainable from NMR experiments and represent a rich source of encoded structural information that makes (13)C(α) chemical shifts an attractive candidate for use in computational methods aimed at determination and validation of protein structures. In this chapter, the basis of a novel methodology of computing, at the quantum chemical level of theory, the (13)C(α) shielding for the amino acid residues in proteins is described. We also identify and examine the main factors affecting the (13)C(α)-shielding computation. Finally, we illustrate how the information encoded in the (13)C chemical shifts can be used for a number of applications, viz., from protein structure prediction of both α-helical and β-sheet conformations, to determination of the fraction of the tautomeric forms of the imidazole ring of histidine in proteins as a function of pH or to accurate detection of structural flaws, at a residue-level, in NMR-determined protein models.
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8,889 |
Infectious Diseases
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Infectious disease is one of the most common causes of acute care visits to outpatient pediatric clinics, urgent care facilities, and hospital emergency departments.
|
8,890 |
Philosophy and Public Health
|
In order to develop a new theory of reasoning, public health must embrace certain logical and epistemological concepts which have almost exclusively been examined within philosophy. These concepts include presumption and a group of arguments known as the informal fallacies. It is argued that presumption is a highly versatile concept which has not received the attention it deserves in epistemology. Features of this concept such as its defeasibility make it well suited to reasoning in contexts of uncertainty. However, in order to achieve any purchase in reasoning, presumption must find a logical home. It is argued that that home is as part of a group of arguments known as the informal fallacies. Throughout the long history of logic, informal fallacies have been characterized as weak or bad forms of reasoning. However, with the emergence of informal logic, traditionally negative characterizations of these arguments have lost some of their dominance. The journey taken by these arguments, from their treatment in the logical treatises of historical thinkers to present-day analyses, is examined in this chapter.
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8,891 |
Informatics in Disease Prevention and Epidemiology
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This chapter provides a description of the components of disease prevention and control programs, and then focuses on information systems designed to support public health surveillance, epidemiologic investigation of cases and outbreaks, and case management. For each such system, we describe sources used to acquire necessary data for use by public health agencies, and the technology used to clean, manage, organize, and display the information. We discuss challenges and successes in sharing information among these various systems, and opportunities presented by emerging technologies. Systems to support public health surveillance may support traditional passive case-reporting, as enhanced by electronic laboratory reporting and (emerging) direct reporting from electronic health records, and also a wide variety of different surveillance systems. We address syndromic surveillance and other novel approaches including registries for reporting and follow-up of cases of cancer, birth defects, lead poisoning, hepatitis B, etc., and population-based surveys (such as BRFSS or PRAMS). Systems to support epidemiologic investigation of outbreaks and clusters include generic tools such as Excel, SAS, SPSS, and R, and specialized tool-kits for epidemiologic analysis such as Epi-Info. In addition to supporting outbreak investigation, agencies also need systems to collect and manage summary information about outbreaks, investigations, and responses. Systems to support case management, contact tracing, and case-based disease control interventions are often integrated to some degree with surveillance systems. We focus on opportunities and choices in the design and implementation of these systems.
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8,892 |
Epidemic Models with Switching
|
In this chapter, the methods developed thus far are applied to a variety of infectious disease models with different physiological and epidemiological assumptions. Many of the previous results are immediately applicable, thanks to the flexibility of the simple techniques used here. However, some complicating modeling assumptions lead to a need for different switched systems techniques not present in the previous chapter. First, the so-called SIS model is considered, followed by incorporation of media coverage, network epidemic models with interconnected cities (or patches), and diseases spread by vector agents (e.g., mosquitoes) which are modeled using time delays. Straightforward extensions of eradication results are given for models with vertical transmission, disease-induced mortality, waning immunity, passive immunity, and a model with general compartments.
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8,893 |
Household-Based Studies
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In Chapter 2 we introduced vaccine efficacy parameters that require conditioning on exposure to infection. Household studies were used as the basis for defining exposure to infection in vaccine studies as early as the 1930s in evaluating the efficacy of pertussis vaccines (Kendrick and Eldering 1939). In addition to evaluating vaccine efficacy, household studies have been used to learn about transmission and natural history of many infections. Aspects of the natural history studied in households include the transmissibility, the incubation and latent periods, the duration of infectiousness, and the serial interval between cases (Hope-Simpson 1952; Bailey 1957). Household studies have also been used to evaluate other interventions, such as post-exposure prophylaxis with influenza antiviral agents (Welliver et al 2001; Hayden et al 2004). Exposure to an infectious case within a household can be used as a natural challenge study, for example, when studying immunological correlates of protection (Storsaeter et al 1998). Longitudinal studies of pneumococcal carriage in households and schools have been used to estimate the acquisition and clearance rates for asymptomatic pneumococcal carriage. The general idea of a transmission unit is that individuals make contact sufficient for transmission within it. Households are the most common form of transmission unit used in studies. It allows easy identification of contacts between a case and susceptibles, and families are convenient units of study. Many other settings are also used as transmission units in studies and analyses that condition on exposure to infection. These include sexual partnerships, classrooms, schools, school buses, airplanes, day care centers, and workplaces, among others. Here we talk mostly about household studies, but many of the study designs and analyses are applicable with possibly slight modification to other transmission units as well. The term household is much easier for exposition than is “transmission unit”.
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8,894 |
Intensivtherapie nach Transplantation solider Organe
|
Der Intensivmedizin kommt eine zentrale Bedeutung in Rahmen der Transplantationsmedizin zu. Aufgrund ihrer marginalen Organfunktion benötigen die Patienten nicht selten bereits im Vorfeld der Transplantation eine intensivmedizinische Versorgung, zu der dann auch die Evaluation und Listung sowie die Koordination des zeitkritischen Transplantationsablaufs gehören können. Die direkte postoperative Betreuung nach komplexen Organtransplantationen bedarf fast ausschließlich der Versorgung im Rahmen von Überwachungsstationen, in denen sowohl direkt transplantationsassoziierte Komplikationen als auch Nebenerkrankungen eine intensivmedizinische Behandlungen notwendig machen. Sie zielt auf die Stabilisierung der Organfunktion, Behandlung begleitender Organdysfunktionen, adäquate Induktion der Immunsuppression und die möglichst frühe Wiedererlangung der Eigenständigkeit des Transplantierten ab.
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8,895 |
Is Peking Man Still Our Ancestor?—Race and National Lineage
|
Since China participated in the Human Genome Project in the 1990s, implications of the debate surrounding the Homo erectus Peking Man’s ancestorship for nationalism wrapped in scientific jargon have been well comprehended by various segments of the society with ultranationalists and a liberal public opinion as the two extremes contesting each other. This divergence also cuts through the Chinese party-state. The discourse on a pure ancestry, an ancestral home, a natural bond between this ancestor and the environment, and most of all, a narrative that attributes remarkable lineal continuity to physical, mental, intellectual and even moral traits unique to this ancestor and its posterity, support fanatical racial nationalisms.
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8,896 |
Price Matters – Relevance of Strategic Pricing for Swiss Tourism in the Past, Present and Future
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In his paper from 2003, Peter Keller postulates that a strategic pricing policy can pose an opportunity for Swiss tourism, strengthening the competitiveness and growth of the industry. This contribution from Peter Keller’s celebratory publication on the occasion of his 20th presidency of the International Association of Scientific Experts in Tourism (AIEST) picks up on this assumption and discusses the touristic development and enhancement of strategic pricing over the past ten years of Swiss tourism. In the first section of this paper, empirical evidence of the development of Swiss tourism over time and a discussion of its challenges are presented. The second section addresses the postulated value-based pricing concept, including practical examples from Swiss tourism over the past ten years. The third section offers a conclusion, which discusses the relevance of strategic pricing as a means to strengthen competitiveness with respect to future terms. Peter Keller has been involved in scientific tourism research as the president of the AIEST for 20 years. Believing strongly in the fact that sustainable tourism research should be dedicated to a holistic, systemic as well as pragmatic approach, he constantly warned of disciplinary and autarchic traits of tourism research (Keller 2007, S. 96ff.). As an advocate of tourism science, which should be concerned with a human, social and cultural scientific reflection without excluding the viewpoint of economics or business administration, he also crucially influenced national tourism politics as a head of the Tourism Department at the State Secretariat for Economic Affairs (SECO). In his article "Strategic pricing policy as a chance for Swiss tourism" (Keller, 2003, S. 193ff.), he emphasises a "back-to-growth strategy" for Swiss tourism by focusing on a strategic marketing approach, which is oriented towards the "value-based pricing principle" and focuses more on price as a constitutive element. The following paper discusses the past development of the Swiss tourism industry since Peter Keller’s article was published in 2003 and notes the valuebased pricing approach. For this purpose, we examine the development of Swiss tourism, outline the postulated "value-based pricing principle" and discuss some practical applications from daily touristic business. Finally, we draw a conclusion about the applicability of strategic pricing in the future.
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8,897 |
Public Health Surveillance
|
Public health surveillance enables public health practitioners to assess and monitor changes in the population’s health and make recommendations for action. The systematic, ongoing collection, analysis and dissemination of data ensures that the right information is available at the right time to inform public health action. This chapter will introduce you to the key concepts and objectives of public health surveillance, and will help you to understand how effective surveillance systems are based on four basic steps: data collection, analysis, interpretation and response. This chapter will also help you to understand the advantages and disadvantages of the different surveillance systems which are used to collect information on public health. The chapter concludes with a look at how advances in technology, social media and the internet are shaping the future of public health surveillance. After reading this chapter you will be able to: Describe the purpose and key features of public health surveillance. Describe the basic steps which underpin public health surveillance systems. Define different surveillance systems and critically compare their advantages and disadvantages.
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8,898 |
Bispecific Antibodies and Gene Therapy
|
Gene therapy is the transfer of therapeutic genes, via gene transfer vectors, into patients for therapeutic purposes. Different gene therapy strategies are being pursued, including long-term gene correction of monogenetic diseases, eradication of tumor cells in cancer patients, or genetic vaccination for infectious diseases. Bispecific antibodies and gene therapy are connected in two ways. First, bispecific antibodies are tools of interest for the development of targeted gene transfer vectors. Different gene therapy strategies require different vectors, frequently replication-ablated viruses. Similar to the role of antibody engineering in antibody therapy, the engineering of gene transfer vectors has become key to the implementation of genetic therapies. Cytoablative cancer gene therapy and efficient genetic vaccination, for example, depend on vectors that are targeted to cancer cells and antigen-presenting cells, respectively, in order to avoid side effects and vector sequestration. To this end, bispecific antibodies have been engineered as adapters that link the vector to a specific molecule on the targeted cell and at the same time block the interaction with the native virus receptor. Different formats of bispecific antibodies and related molecules have been developed and succeeded in re-directing vectors to target cells in vitro and in vivo. These adapters also improved gene therapies in animal models. Second, gene transfer is a promising tool for delivery of bispecific antibodies to patients. Therefore, vectors can be injected directly into patients for antibody gene transfer, or cells isolated from patients can be genetically modified in vitro and then re-injected for in vivo antibody production. Genetic antibody delivery, compared with standard antibody injection, can be advantageous with respect to achieving persistent antibody titers or effective antibody biodistribution in patients. Initial studies have shown antibody production and therapeutic activity in animal models, setting the stage for more widespread investigations. Moreover, gene therapy can enable novel therapeutic applications for bispecific antibodies by facilitating the delivery of membrane associated or intracellular antibody formats.
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8,899 |
Spezifische Infektionen
|
In diesem Kapitel wird auf die Infektionen eingegangen, die nicht im Rahmen der einzelnen Erkrankungsentitäten in den übrigen Kapiteln behandelt werden. Der Schwerpunkt liegt dabei auf den Infektionen bzw. Erregern, die auch dem Intensivmediziner häufiger begegnen können. Fragestellungen außerhalb dieser Gruppe sollten mit Hilfe spezieller Literatur beantwortet werden, Hilfestellungen geben auch die Verweise auf Webseiten am Ende des Kapitels.
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