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9,000 |
Viral Hepatitis: Other Viral Hepatides
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Non-hepatotropic viruses cause acute hepatitis and/or acute liver failure, without causing any chronic damage to the liver. These viruses do not primarily target the liver. These viruses include the herpes viruses (Epstein-Barr virus, cytomegalovirus, and herpes simplex virus), parvovirus, adenovirus, influenza, and severe acute respiratory syndrome (SARS)-associated coronavirus. The risk of acquiring infection from any of the non-hepatotropic viruses is specific to each virus. Infection with the herpesviruses is ubiquitous, with clinically significant hepatitis being less common. Considerations for determining the risk of hepatitis from non-hepatotropic viruses include prior exposure (risk of reactivation), host immune status (increase severity in immunosuppressed), and duration of infection in the contact. Diagnosis is made with a combination of serology, polymerase chain reaction, or liver biopsy. Treatment is supportive in the majority. In certain clinical scenarios, such as cytomegalovirus infection in transplant patients, and acute liver failure from herpes simplex virus, specific antiviral therapy is warranted.
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9,001 |
Role of the Microbial Burden in the Acquisition and Control of Healthcare Associated Infections: The Utility of Solid Copper Surfaces
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For more than a century, healthcare has been challenged to keep environmental surfaces clean to control microbes and improve patient outcomes. However despite an annual cost exceeding ten billion dollars cleaning with disinfection has done little to reduce the incidence of healthcare-associated infections (HAI). This chapter will review the scientific evidence delineating the role that the environment and healthcare workers play in the acquisition and movement of the microbes implicated in HAI and how through controlling the microbial burden of the built clinical environment it is possible to mitigate the rate of HAI acquisition. Specifically evidence demonstrating the effectiveness of solid copper surfaces for its ability to continuously limit the concentration of bacteria found on surfaces and objects within the built environment will be reviewed in concert with a discussion of how through the mitigation of the environmental burden copper surfaces are able to concomitantly reduce the incidence of HAI. Insights provided by this chapter are intended to facilitate an understanding and importance of the need to use a comprehensive or systems based approach to fight healthcare associated infections.
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9,002 |
Applications of Multi-Type Branching Processes
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Two applications of multi-type branching processes to epidemic models are presented. The first application is to an SEIR epidemic model and the second application is to the same epidemic model but with dispersal. The SEIR epidemic is modeled as a two-type branching process. Occurrence of an outbreak depends on the number of exposed and infectious individuals. It is shown that the offspring pgfs for the exposed and infectious populations lead to an explicit formula for the probability of an outbreak.
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9,003 |
Hygiene auf der IMC-Station
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Im Kapitel Hygiene auf der IMC-Station wird dargelegt, dass die Einhaltung von Hygienemaßnahmen nach den neuesten wissenschaftlichen Erkenntnissen zu den Basismaßnahmen einer jeden IMC-Station gehört. Neben den Standard-Hygienemaßnahmen einer IMC-Station werden die besonderen Aspekte der hygienischen Körperpflege beschrieben. Die erforderlichen Interventionen zur Vermeidung von Katheterinfektionen werden begründet. Die Vorbereitung, Anlage und Pflege der Katheter werden detailliert dargestellt, sodass jeder Lernende dies als Handlungsanweisung verwenden kann und dem Erfahrenen eine Detailprüfung ermöglicht wird. Wichtige Aspekte der Wund-, Drainagen- und Stomapflege werden besprochen und eine Kurzübersicht zur Pflege von Patienten mit MRE gegeben.
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9,004 |
Recombinant Human Deoxyribonuclease I
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Human deoxyribonuclease I (DNase I) is an endonuclease that catalyzes the hydrolysis of extracellular DNA and is just one of the numerous types of nucleases found in nature. The enzymatic mechanism for a single turnover is reasonably well understood based on biochemical and structural studies that are consistent with divalent metal ion dependent nonspecific nicking of a phosphodiester bond in one of the strands of double stranded DNA. Recombinant human DNase I (rhDNase I, rhDNase, Pulmozyme(®), dornase alfa) has been expressed in mammalian cell culture in Chinese hamster ovary cells and developed clinically where it is aerosolized into the airways for treatment of pulmonary disease in patients with cystic fibrosis (CF). rhDNase I hydrolyzes the DNA in purulent sputum of CF patients and reduces sputum viscoelasticity. Reduction of high molecular weight DNA into smaller fragments by treatment with aerosolized rhDNase I has been proposed as the mechanism to reduce the mucus viscosity and improve mucus clearability from obstructed airways in patients. The improved clearance of the purulent mucus enhances pulmonary function and reduces recurrent exacerbations of respiratory symptoms. rhDNase I was approved for clinical use in 1993 and has been widely used as a safe and effective therapy for CF patients. The use of rhDNase I has also been investigated in other diseases where exogenous DNA has been implicated in the disease pathology.
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9,005 |
Social Dilemma Analysis of the Spread of Infectious Disease
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Understanding and controlling the spread of infectious disease is a pressing issue for our society. Contemporary globally connected civilization is more at risk from various modern infectious diseases than classical ones such as pests, cholera, and tuberculosis. Over the last few years, pandemic outbreaks of highly virulent influenza, possibly related to avian flu, severe acute respiratory syndrome (SARS), and middle-eastern respiratory syndrome coronavirus (MARSE) have been a threat. Beyond this, the intentional spread of infectious disease, e.g., “bioterrorism”, has come to be recognized as being just as dangerous as nuclear weapons. An infectious disease spreads on human social networks. Each individual can protect himself through several measures. Pre-emptive vaccination is thought to be most effective, although it incurs a partial cost to each individual. This brings about a social dilemma, because an individual may be able to rely on so-called “herd immunity” to avoid his own infection without himself being vaccinated. Also, besides vaccination, there may be several practical ways to protect against contagion, such as wearing a mask, keeping away from crowds, and self-isolation by leaving the home less often, which may be less costly and less effective than vaccination. In any case, there is a human-decision-making process regarding what steps should be taken, while the dynamics of infectious-disease spread can themselves be evaluated as a diffusion problem that has been well-studied in physics for many years. Thus, based on the concept of human–environment–social interaction, a basic-physics model for this diffusion problem that considers evolutionary game theory (EGT) may lead us to obtain some meaningful solutions that can be proposed to our society. Following the previous chapter explaining how EGT can be applied to traffic-flow analysis, this chapter describes this practical problem.
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9,006 |
China
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9,007 |
Humans, Other Animals and ‘One Health’ in the Early Twenty-First Century
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This chapter explores the history of recent movements for One Health, which argue that because many of today’s pressing health problems lie at the interface of human, animal and environmental health, they can only be managed effectively by breaking down traditional disciplinary silos. It explores how Schwabe’s work influenced, and was reconfigured by, this movement, and locates its early development in several different research and policy networks, which produced not one but several different forms of One Health. The chapter also examines how human–animal health relationships have inspired and shaped One Health, and how they are represented—in sometimes contradictory ways—in the texts and images produced by One Health researchers and advocates. It argues that in foregrounding the roles of animals as transmitters of diseases to humans, and as experimental models of human disease, One Health rebrands existing longstanding research agendas that are more concerned with the health of humans than that of animals.
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9,008 |
Short- and Long-Term Reaction to Exogenous Demand Shifts
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In less than 10 years, the liberalization of the European airline industry has placed flag carriers in a highly competitive and dynamic environment. One of the reasons for the demand dynamic clearly results from the peculiarity of the industry: airline carriers have to produce one of the most perishable goods (passenger transport). This fact has forced carriers to implement and refine practices and strategies in order to react promptly to the ups and downs of the demand. In Chap. 2 we described the common practices employed to face short-term demand fluctuations that usually rely on advanced pricing policies, called ‘yield management’. Long-lasting demand shifts require a reaction in terms of capacity supply described in Sect. 2.4.2 as ‘network planning’.
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9,009 |
We Do Not Live in an Age of Cosmopolitanism but in an Age of Cosmopolitization: The ‘Global Other’ is in Our Midst
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The collapse of a world order is often a moment for reflection on the dominant social theory and research of the time, but surprisingly this is not the case today. Mainstream social theory still floats loftily above the lowlands of epochal transformations (climate change, financial crisis, nation-states) in a condition of universalistic superiority and instinctive certainty. This universalistic social theory, whether structuralist, interactionist, Marxist, critical or systems-theory, is now both out of date and provincial.
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9,010 |
Influence of Gender on Outcome of Severe Sepsis
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Whether gender influences the outcome of severe sepsis remains a matter of debate. Because many confounding variables may affect observed associations between gender and mortality, high-quality statistical analyses are essential to carefully adjust the two groups of patients. About 55% to 65% of patients with sepsis have chronic co-morbidities associated with immune dysfunction (e.g., chronic renal failure, diabetes mellitus, human immunodeficiency virus [HIV] infection, and alcohol abuse), which increase the susceptibility to sepsis [1]. Genetic polymorphisms that affect the susceptibility to infection and/or the severity of the systemic response to infection [2] may lead to variability among individuals and between males and females [3]. Access to healthcare, another determinant of the incidence and outcome of sepsis, varies according to age, ethnic group, and gender, although a recent study conducted in the USA found only relatively small quality-of-care differences between males and females or across income groups compared to the gap for each subgroup between observed and desirable quality of health care [4]. Here, we review the data on the existence of, and reasons for, associations between gender and outcome of severe sepsis (Fig. 1).
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9,011 |
Cardiopulmonary Resuscitation Injuries in Children
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Cardiopulmonary resuscitation (CPR) is an emergency intervention to maintain circulation and breathing in an unresponsive individual suffering from cardiopulmonary arrest. However, CPR is not without its own risks. Injuries secondary to compression and ventilation are well documented in the medical and scientific literature. Most of these injuries are minor, but some can result in significant morbidity and even death. It is important to identify those injuries that could be secondary to CPR versus inflicted traumatic injuries of child maltreatment.
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9,012 |
General Medicine and Surgery for Dental Practitioners: Infections and Infection Control
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Infection control and knowledge of common infectious agents are cornerstones of safe dental practice. This paper summarises the measures that need to be taken to control cross infection and discusses some of the infectious agents of concern to dental practitioners.
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9,013 |
The Pancreas
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9,014 |
Human Security in Practice: The Chinese Experience
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This chapter elaborates on how the idea of human security is defined and understood by the government and various actors in China. As one of the permanent members of the United Nations (UN) Security Council, China, has been supportive of international norms advocated by the UN, and even though the term human security has not been frequently used, in effect it has been vigorously practiced. For both the government and the academic community in China, human security and national security are not necessarily in confrontation but rather can complement and strengthen one another. The purpose is to improve the quality of people’s everyday life and the government is expected to contribute to this end. Chinese people expect the government to extend a parental roof over the people.
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9,015 |
Case Studies
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Ms A was a 28 year old woman in her second pregnancy (she had one previous termination of pregnancy) who booked-in at 19 weeks’ gestation. She was known to have sickle cell disease (specifically sickle cell anaemia [HbSS]), and her last crisis had occurred 3 years before this pregnancy.
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9,016 |
Bildgebende Verfahren: Röntgen, Ultraschall, CT, Nuklearmedizin
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9,017 |
Chronic Kidney Disease in the Intensive Care Unit
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The incidence and prevalence of chronic kidney disease (CKD) and end-stage renal disease are increasing, and these patients have a higher risk of developing critical illness and being admitted to the intensive care unit (ICU) compared to the general population. The higher prevalence of comorbid disease puts this population at higher risk for worse short- and long-term outcomes following ICU admission compared to the general population, although short-term mortality seems to be determined largely by the acute illness severity rather than CKD status per se. The pathophysiologic changes accompanying CKD present unique challenges to the management of acute critical illness most notably volume and metabolic homeostasis and drug dosing adjustment. CKD is an important risk factor for the development of acute kidney injury (AKI) complicating critical illness and can predispose to further accelerated decline in kidney function among ICU survivors. Renal replacement therapy (RRT) support is frequently used in ICU settings, and continuous renal replacement therapy modality remains the most commonly used among critically ill patients.
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9,018 |
Role of CD14 in Lung Inflammation and Infection
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Toll-like receptors (TLR) on the surface of cells of the respiratory tract play an essential role in sensing the presence of microorganisms in the airways and lungs. These receptors trigger inflammatory responses, activate innate immune responses, and prime adaptive immune responses to eradicate invading microbes [1]. TLR are members of a family of pattern-recognition receptors, which recognize molecular structures of bacteria, viruses, fungi and protozoa (pathogen-associated molecular patterns or PAMPs), as well as endogenous structures and proteins released during inflammation (damage/danger-associated molecular patterns or DAMPs). To date, ten different TLR have been identified in humans and twelve in mice. TLR are expressed on all cells of the immune system, but also on parenchymal cells of many organs and tissues. The binding of a PAMP to a TLR results in cellular activation and initiates a variety of effector functions, including cytokine secretion, proliferation, co-stimulation or phagocyte maturation. To facilitate microbial recognition and to amplify cellular responses, certain TLR require additional proteins, such as lipopolysaccharide (LPS) binding protein (LBP), CD14, CD36 and high mobility group box-1 protein (HMGB-1). In this chapter, the role of CD14 as an accessory receptor for TLR in lung inflammation and infection is discussed. The central role of CD14 in the recognition of various PAMPs and amplification of immune and inflammatory responses in the lung is depicted in Figure 1.
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9,019 |
Ocimum Genome Sequencing—A Futuristic Therapeutic Mine
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Next-generation sequencing (NGS) platforms from the past decade are in the continuous efforts of changing the impact of sequencing on our current knowledge about plant genes, genomes, and their regulation. Holy basil (Ocimum tenuiflorum L. or sanctum L.) genome sequencing has also paved the path for deeper exploration of the medicinal properties of this beneficial herb making it a true ‘elixir of life.’ The draft genome sequence of the holy basil has not only opened the avenues for the drug discovery but has also widened the prospects of the molecular breeding for development of new improved plant varieties.
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9,020 |
Laryngeal Infections
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The following chapter is a review of the most common viral and bacterial etiologies of pediatric laryngeal infections. The chapter reviews the diagnostic approach to laryngeal infections, focusing on key points of the history and physical exam, including concerning signs and symptoms suggestive of airway distress. Viral and bacterial laryngitis, croup, epiglottis, recurrent respiratory papillomatosis, as well as some less common causes of bacterial infections are discussed in detail with each etiology’s epidemiology, clinical features, associated diagnostic evaluation, and management reviewed.
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9,021 |
G-Protein-Coupled Receptors
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Receptors coupled to heterotrimeric guanine nucleotide-binding proteins, the socalled G-protein-coupled receptors (GPCR), represent the largest set of plasmalemmal receptors
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9,022 |
Coronavirus
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Name of Virus: Coronavirus
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9,023 |
Hematopoietic Stem Cell Transplantation
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Hematopoietic stem cell transplantation offers patients the only prospect of long-term survival for a substantial variety of otherwise incurable malignant neoplasms as well as selected non-neoplastic conditions. This therapeutic modality, however, carries significant risks and is associated with a wide range of complications affecting not only the bone marrow but many organ systems, in particular by graft-versus-host disease. Patients before, during, and following stem cell transplantation thus require close monitoring and the pathologist is frequently implicated in this process. The aim of this chapter is to provide the pathologist with the tools required to interpret biopsies from these patients at all stages of the transplantation process. Following an overview of hematopoietic stem cell transplantation and graft-versus-host disease, the chapter will focus on the histopathologic findings of graft-versus-host disease and other complications in several organs and tissue including bone marrow, skin, lung, kidney, gastrointestinal tract and liver, with emphasis on the diagnostic criteria and approaches to graft-versus-host disease.
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9,024 |
Bioinformatics and Nanotechnologies: Nanomedicine
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In this chapter we focus on the bioinformatics strategies for translating genome-wide expression analyses into clinically useful cancer markers with a specific focus on breast cancer with a perspective on new diagnostic device tools coming from the field of nanobiotechnology and the challenges related to high-throughput data integration, analysis, and assessment from multiple sources. Great progress in the development of molecular biology techniques has been seen since the discovery of the structure of deoxyribonucleic acid (DNA) and the implementation of a polymerase chain reaction (PCR) method. This started a new era of research on the structure of nucleic acids molecules, the development of new analytical tools, and DNA-based analyses that allowed the sequencing of the human genome, the completion of which has led to intensified efforts toward comprehensive analysis of mammalian cell struc ture and metabolism in order to better understand the mechanisms that regulate normal cell behavior and identify the gene alterations responsible for a broad spectrum of human diseases, such as cancer, diabetes, cardiovascular diseases, neurodegenerative disorders, and others.
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9,025 |
The role of viruses in the etiology and pathogenesis of common cold
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Numerous viruses are able to cause respiratory tract infections. With the availability of new molecular techniques, the number of pathogens detected in specimens from the human respiratory tract has increased. Some of these viral infections have the potential to lead to severe systemic disease. Other viruses are limited to playing a role in the pathogenesis of the common cold syndrome. This chapter focuses on the viral pathogens that are linked to common cold. It is not the intention to comprehensively review all the viruses that are able to cause respiratory tract infections—this would go beyond the scope of this book. The list of viruses that are briefly reviewed here includes rhinoviruses, respiratory syncytial virus, parainfluenza virus, adenovirus, metapneumovirus and coronavirus. Bocavirus is discussed as one example of a newly identified pathogen with a less established role in the etiology and pathogenesis of common cold. Influenza virus does not cause what is defined as common cold. However, influenza viruses are associated with respiratory disease and the clinical picture of mild influenza and common cold frequently overlaps. Therefore, influenza virus has been included in this chapter. It is important to note that a number of viruses are frequently co-detected with other viruses in humans with respiratory diseases. Therefore, the viral etiology and the role of viruses in the pathogenesis of common cold is complex, and numberous questions remain to be answered.
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9,026 |
Chirurgische Infektionen
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Der menschliche Organismus ist von einer unzähligen Menge von Mikroorganismen umgeben. Dringen diese Krankheitserreger in uns ein, dann laufen Wechselbeziehungen zwischen dem Eindringling und dem Wirtsorganismus ab. Krankheit resultiert, wenn die Mikroorganismen aufgrund ihrer verschiedenen Determinanten der Pathogenität und Virulenz den Wettlauf mit der Infektabwehr des Makroorganismus gewonnen haben. Mit diesem Problem hatten sich Chirurgen zu allen Zeiten auseinanderzusetzen und es hat bis heute nicht an Aktualität verloren.
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9,027 |
Anti-angiogenic Targets: Angiopoietin and Angiopoietin Receptors
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Tumor blood vessel formation (angiogenesis) is essential for tumor growth and metastasis. Two main endothelial ligand–receptor pathways regulating angiogenesis are vascular endothelial growth factor (VEGF) receptor and angiopoietin-TIE receptor pathways. The angiopoietin-TIE pathway is required for the remodeling and maturation of the blood and lymphatic vessels during embryonic development after VEGF and VEGF-C mediated development of the primary vascular plexus. Angiopoietin-1 (ANGPT1) stabilizes the vasculature after angiogenic processes, via tyrosine kinase with immunoglobulin-like and EGF-like domains 2 (TIE2) activation. In contrast, ANGPT2 is upregulated at sites of vascular remodeling. ANGPT2 is secreted by activated endothelial cells in inflammation, promoting vascular destabilization. ANGPT2 has been found to be expressed in many human cancers. Intriguingly, in preclinical models inhibition of ANGPT2 has provided promising results in preventing tumor angiogenesis, tumor growth, and metastasis, making it an attractive candidate to target in tumors. However, until now the first ANGPT2 targeting therapies have been less effective in clinical trials than in experimental models. Additionally, in preclinical models combined therapy against ANGPT2 and VEGF or immune checkpoint inhibitors has been superior to monotherapies, and these pathways are also targeted in early clinical trials. In order to improve current anti-angiogenic therapies and successfully exploit ANGPT2 as a target for cancer treatment, the biology of the angiopoietin-TIE pathway needs to be profoundly clarified.
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9,028 |
Nanomaterial-Based Antibacterial Paper
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Antibacterial materials are widely used in everyday life and plays important roles in the public health system. There are a wide range of materials that have been known to prevent attachment and proliferation of microbes on material surfaces. These include antibiotics, metal ions and quaternary ammonium compounds. Given the availability of these various antibacterial materials, concerns about antibiotics-resistance, environmental pollution, relatively complex processing and high cost have been of much recent interest. Antimicrobial properties of nanomaterials have been explored to meet these challenges. Various nanomaterials including silver nanoparticles (AgNPs), titanium oxide nanoparticles and carbon nanotubes (CNTs) have been found to be highly effective bacterial-killing materials. The most well-known examples are silver and silver-based compounds, which were well known to be antiseptic to a spectrum of bacterium even in ancient times. AgNPs have proven to possess high antibacterial activity with minimal perturbation to human cells. Consequently, widespread applications of AgNPs have been found in medical and environmental areas [1]. More recently, carbon nanomaterials have emerged as a type of novel antibacterial nanomaterials, including CNTs and graphene. In this chapter, we aim to provide a review on the fabrication of nanomaterials-based paper-like films and their antibacterial applications.
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9,029 |
Disease Spreading in Time-Evolving Networked Communities
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Human communities are organized in complex webs of contacts that may be represented by a graph or network. In this graph, vertices identify individuals and edges establish the existence of some type of relations between them. In real communities, the possible edges may be active or not for variable periods of time. These so-called temporal networks typically result from an endogenous social dynamics, usually coupled to the process under study taking place in the community. For instance, disease spreading may be affected by local information that makes individuals aware of the health status of their social contacts, allowing them to reconsider maintaining or not their social contacts. Here we investigate the impact of such a dynamical network structure on disease dynamics, where infection occurs along the edges of the network. To this end, we define an endogenous network dynamics coupled with disease spreading. We show that the effective infectiousness of a disease taking place along the edges of this temporal network depends on the population size, the number of infected individuals in the population and the capacity of healthy individuals to sever contacts with the infected, ultimately dictated by availability of information regarding each individual’s health status. Importantly, we also show how dynamical networks strongly decrease the average time required to eradicate a disease.
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9,030 |
Applications
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The ability of materials to dramatically change their properties at nanoscale has opened up the possibility of making new devices, instruments and consumer goods to function in a much better way than was possible earlier. We have seen in Chaps. 10.1007/978-3-319-09171-6_10 and 10.1007/978-3-319-09171-6_11 that nanomaterials have enabled us to design new products which were not possible using bulk materials. Rapid progress in the synthesis and understanding of nanomaterials in just a few years has led them to enter the world market in a big way. Figure 12.1 shows an overview of various fields in which nanomaterials have entered or are about to enter. In this chapter we shall briefly discuss some of these applications.
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9,031 |
Pandemic Influenza: A Comparative Ethical Approach
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Community-networks such as families and schools may foster and propagate some types of public health disasters. For such disasters, a communitarian-oriented ethical lens offers useful perspectives into the underlying relational nexus that favors the spread of infection. This chapter compares two traditional bioethical lenses—the communitarian and care ethics framework—vis-à-vis their capacities to engage the moral quandaries elicited by pandemic influenza. It argues that these quandaries preclude the analytical lens of ethical prisms that are individual-oriented but warrant a people-oriented approach. Adopting this dual approach offers both a contrastive and a complementary way of rethinking the underlying socioethical tensions elicited by pandemic influenza in particular and other public health disasters generally.
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9,032 |
Software Support for Common Criteria Security Development Process on the Example of a Data Diode
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The data diodes are very often used to protect users’ networks and sensitive data and that is why additional assurance of those devices is demanded. This assurance can be obtained by applying the Common Criteria security development process. The process is very difficult and time-consuming specially for those not familiar with the standard. Although there are many guidelines and templates telling how to define the security problem still there is a lack of computer aiding tools. This paper describes the plug-in application which supports identification of protected assets, threats, security objectives and security functions – the main elements of security specification. The tool facilitates and speeds up the security development process of IT products.
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9,033 |
Extracorporeal Membrane Oxygenation (ECMO)/Extracorporeal Carbon Dioxide Removal (ECCO(2)R)
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Extracorporeal membrane oxygenation (ECMO) is a means of supporting severe pulmonary and cardiac dysfunction. It stabilizes critical derangements of oxygenation and ventilation, allowing time to diagnose, treat, and recover from the underlying cause of organ failure. The extracorporeal circuit has three main components: large-bore cannulae and circuit tubing to provide access to the native circulation, an artificial membrane lung to provide gas exchange, and an active pump to facilitate perfusion. Multiple clinical studies have evaluated this technology, the strongest evidence to date supporting its use being the Conventional Ventilation or ECMO for Severe Adult Respiratory Failure (CESAR) trial, which showed survival advantage when patients were treated with a protocol that included ECMO. Extracorporeal carbon dioxide removal (ECCO(2)R) is similar in concept to ECMO, but has a lower flow rate and does not significantly oxygenate the patient. It is a primary treatment for hypercarbic respiratory failure or is an adjunct to reduce potentially injurious levels of mechanical ventilator support in hypoxemic respiratory failure. Complications are common occurrences on both types of therapy. Strong institutional commitment and a team approach are critical to successful implementation. Additional randomized trials are needed to clarify the appropriate indications and best practices for these lifesaving therapies.
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9,034 |
Respiratory Filters and Ventilator-Associated Pneumonia: Composition, Efficacy Tests and Advantages and Disadvantages
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Respiratory filters are devices with a high capacity to prevent the passage of microorganisms. The use of respiratory filters interposed in respiratory circuits to avoid ventilator-associated pneumonia (VAP) was proposed after reports between 1952 and 1972 of several outbreaks of respiratory infections attributed to contamination of anesthesia machines; however, none of the reports presented a bacteriological demonstration of a cause-and-effect relationship. The use of respiratory filters has not decreased the incidence of VAP in patients on anesthesia machines and in critically ill patients. Besides, respiratory filters could have some undesirable effects such as the increase of resistance to inspiratory airflow, increase of resistance to expiratory airflow and increase of dead space in the breathing circuit. Thus, the use of respiratory filters is not routinely necessary; however, they should be used in patients with suspected or confirmed highly communicable respiratory infections (such as bacillary pulmonary tuberculosis) and who require mechanical ventilation).
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9,035 |
Transfusion of Blood and Blood Products
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In transfusion medicine, several blood products can be prepared and used as replacement therapy; however, four of these products are more commonly used in general practice: RBCs, fresh frozen plasma (FFP), platelets and cryoprecipitate. RBC transfusions are mainly administered to improve tissue oxygenation in cases of anaemia or acute blood loss due to trauma or surgery. FFP, platelets and cryoprecipitate are used for the prevention and treatment of bleeding.
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9,036 |
“Can’t Stop Coughing (But I Need to Get Back to the Shelter by 6)”
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In this chapter, we will explore a case involving an outbreak of tuberculosis that occurred among men living in a homeless shelter. The case delves into both the public health challenges involved in investigating a disease outbreak in a vulnerable population and the delicate balance of protecting individuals’ autonomy and confidentiality while protecting the public’s health. By the conclusion of the case, learners will be able to apply the socioecological model to tuberculosis, analyze an outbreak of disease using epidemiologic tools, and identify conflicts in balancing autonomy and justice while managing potential public health threats.
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9,037 |
Diagnosis of Pulmonary Parasitic Diseases
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The protozoal and helminthic parasites that traverse the respiratory tract during their life cycles can cause lung diseases, though the most common habitats of these parasites are the gastrointestinal tract and the blood or lymphatic circulations. These diseases are commonly encountered in the tropical regions of the world. However, parasitic lung diseases are increasingly being reported from other parts of the world due to an increase in the occurrence of immunosuppression (acquired immunodeficiency syndrome, organ transplantations, the use of immunosuppressive drugs) and transcontinental travel. The lung diseases that may result from these infections range from asymptomatic phase to life-threatening acute respiratory distress syndrome. These diseases can also mimic common respiratory diseases such as bacterial pneumonias, pulmonary tuberculosis, lung cancer, bronchial asthma, interstitial lung disease, and pulmonary hypertension. The diagnosis of parasitic lung diseases is a challenge to physicians, if they are not aware of the entity or these diseases are not investigated properly. The diagnosis of these diseases is based on the identification of the causative organism in the stool, sputum, other body fluids, or tissue specimens. Radiological imaging studies of the thorax including chest radiographs, high-resolution computerized tomograms, and ultrasonograms may aid in the diagnosis. In certain situations, invasive investigations such as fiberoptic bronchoscopic evaluation (transbronchial lung biopsies and bronchoalveolar lavage studies) and thoracic surgical procedures (thoracoscopy and open lung biopsy) may be required for a diagnosis and also to exclude other lung diseases. Serologic and molecular diagnostic methods are being developed for accurate diagnosis of the parasitic diseases.
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9,038 |
Extraglandular Manifestations of Sjögren’s Syndrome (SS): Dermatologic, Arthritic, Endocrine, Pulmonary, Cardiovascular, Gastroenterology, Renal, Urology, and Gynecologic Manifestations
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Primary Sjögren’s syndrome (1° SS) is an autoimmune disorder characterized by dry eyes (keratoconjunctivitis sicca) and dry mouth due to lymphocytic infiltrates of lacrimal and salivary glands. However, SS also affects many extraglandular systems. In SS patients, the pattern of extraglandular manifestations may have a close similarity with the vasculitic features seen in SLE patients that are mediated by immune complexes and complement. However, SS patients also have an increased frequency of lymphocytic infiltration into extraglandular tissues, as might be expected by their increased frequency of lymphoma in comparison to SLE patients. For example, SS patients need to be evaluated for interstitial nephritis (in contrast to the glomerulonephritis of SLE) or interstitial pneumonitis (in comparison to pleurisy of SLE). This chapter will focus on the clinical extraglandular manifestations of primary SS that are not specifically covered in other chapters. These extraglandular manifestations have led to a recently introduced “disease activity” and “organ damage index.” The recognition of these extraglandular manifestations is important since they have prognostic and therapeutic implications. The differential diagnosis of these extraglandular manifestations includes overlapping features with other autoimmune diseases (particularly systemic lupus erythematosus (SLE), scleroderma, dermatomyositis, celiac sprue, and small- and medium-sized vessel vasculitis), infectious diseases that mimic autoimmune disease (particularly hepatitis C, HIV, syphilis, tuberculosis), and predisposition to drug toxicities that may involve extraglandular organs (particularly skin rashes, nephritis, pneumonitis, myositis, and hematopoietic abnormalities).
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9,039 |
Sicherheitspolitische Bedrohungen und Risiken und das „geltende“ Recht in der 2. Hälfte des 2. Jahrzehnts des 21. Jahrhunderts unter besonderer Berücksichtigung der Sicherstellungs- und Vorsorgegesetze. Sicherheitspolitik in Zeiten der Uneindeutigkeit
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Das Grundgesetz (GG) kennt klare Regelungen zum Spannungs- und Verteidigungsfall, vgl. nur Art. 80a, 115a Abs. 1 GG. Diese Bestimmungen wurden unter den Bedrohungslagen des Kalten Krieges und seiner gefährlichsten Tage in der Kuba- Krise in einer Notstandsverfassung zusammengefasst, bei einer großen Wintex-Übung im Ausweichsitz der Verfassungsorgane in Mariental erprobt und von der ersten großen Koalition „verabschiedet“ (1966–1969, Kabinett Kiesinger/Brandt). Veränderungen folgten.
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9,040 |
Akute Störungen der Atmung: spezielle Krankheitsbilder
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Postoperative respiratorische Insuffizienz, Rippenserienfrakturen, Lungenkontusion, akutes Lungenversagen, pulmonale Aspiration von Magensaft, Pneumonie und akut dekompensierte COPD gehören zu den häufigsten Erkrankungen, die eine intensivmedizinische Behandlung mit apparativer Unterstützung der Atmung erfordern. Bei schwersten Formen – v. a. bei ARDS – ist ein erheblicher apparativer und personeller Aufwand erforderlich, nicht selten trotz aller Maßnahmen mit tödlichem Ausgang.
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9,041 |
Volume 4 Isolated Compounds (N-S)
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9,042 |
Life Cycle and Life History Strategies of Parasitic Crustacea
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Different parasitic life strategies are described including four new life cycles: complex rebrooding, micro-male, mesoparasite and prey-predator transfer. Four new life cycle behaviours are named: nursery hiding, mid-moult stage, positive precursor (intraspecific antagonism) and negative precursor (ambush strategy). Further strategies discussed are opossum attack, double parasitism (doubling of the normal reproductive set), duplex arrangement (separated male-female pairs), simple rebrooding, and describing how displaced parasites and superinfections may partly elucidate life cycles. Proportional stunting masks life history effects of parasitism; cuckoo copepods are true parasites and not just associates; burrowing barnacles (acrothoracicans) are not parasites. Further findings based on life cycle information: branchiurans and pentastomes are possibly not related; firefly seed shrimp are not parasites; copepod pre-adult life cycle stages are common in the western pacific but rare in Caribbean; harpacticoids on vertebrates are not parasites; cuckoo copepods are true parasites; explained the importance of pennellid intermediate hosts. Crustacean parasite life cycles are largely unknown (1% of species). Most crustacean life cycles represent minor modifications from the ancestral free-living mode. Crustacean parasites have less complex and less modified life cycles than other major parasite groups. This limits their exploitation of, and effectiveness, in parasitism. However, these life cycles will be an advantage in Global Change. Most metazoan parasites will be eliminated while crustaceans (and nematodes) will inherit the new world of parasites.
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9,043 |
The Way Forward: The Power of Diversity
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This chapter wraps up the discussion of all chapters by incorporating perspectives of JICA practitioners. We can advance the human security practice in the three dimensions: national, regional, and global. In the national dimension, capacity development and empowerment will play a key role. In the regional dimension, the diversity of “ASEAN Plus Three” can be the source of dynamic community formation in East Asia. In the global dimension, human security can effectively supplement the Sustainable Development Goals (SDGs) by means of its emphasis on risks and vulnerability. Finally, the entanglement of human security and responsibility to protest (R2P) is discussed. Making much of national ownership and dignity, human security is expected to reinforce its influence in East Asia and worldwide.
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9,044 |
Emerging Diseases from Animals
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December 2013, an outbreak of the deadly Ebola virus began in a small village in southern Guinea, the first outbreak of the Zaire Ebola strain in West Africa. Within a year’s time, the outbreak, which was not officially noticed by health authorities until March 2014, had led to approximately 18,000 known human cases and 6,300 deaths, posing an unprecedented challenge to global public health. Air travel helped the disease leap from West Africa to other continents, including North America and Europe.
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9,045 |
Inpatient Medicine
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This chapter covers all aspects of inpatient care including emergency room evaluation, ongoing care in a standard medical unit, and care of the patient in the intensive care unit. The format consists of clinical vignettes with questions pertaining to diagnosis and treatments. There is an emphasis on actual complex cases and practical solutions supported by current evidence. Psychiatry, Neurology, General Internal Medicine, and its subspecialties are reviewed in this section.
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9,046 |
Platforms for Plant-Based Protein Production
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Plant molecular farming depends on a diversity of plant systems for production of useful recombinant proteins. These proteins include protein biopolymers, industrial proteins and enzymes, and therapeutic proteins. Plant production systems include microalgae, cells, hairy roots, moss, and whole plants with both stable and transient expression. Production processes involve a narrowing diversity of bioreactors for cell, hairy root, microalgae, and moss cultivation. For whole plants, both field and automated greenhouse cultivation methods are used with products expressed and produced either in leaves or seeds. Many successful expression systems now exist for a variety of different products with a list of increasingly successful commercialized products. This chapter provides an overview and examples of the current state of plant-based production systems for different types of recombinant proteins.
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9,047 |
Biomolecular Structure and Modeling: Problem and Application Perspective
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The experimental progress described in the previous chapter has been accompanied by an increasing desire to relate the complex three-dimensional (3D) shapes of biomolecules to their biological functions and interactions with other molecular systems. Structural biology, computational biology, genomics, proteomics, bioinformatics, chemoinformatics, and others are natural partner disciplines in such endeavors.
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9,048 |
Introduction to In Vitro Diagnostic Devices
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Healthcare investment keeps on increasing substantially in recent years. Such investment has also focused on fighting major diseases, enabled by the novel invention of cost-effective and valid drug development for treatment and side effect reduction, along with improved vector control. In addition, the demand for diagnostics that is essential in determining prognosis, identifying disease stages, monitoring treatment, and assessing the spreading as health services has expanded. Molecular-based diagnostics is critical for prevention, identification, and treatment of disease. Current laboratory analyses support correct diagnosis in over 70 % of all diseases and can be used to aid the continuous monitoring of drug therapy. However, classic diagnostic technologies are not completely well suited to meeting the expanded testing requirement because they rely on complicated sample purification and sophisticated instruments which are labor-intensive, timely, and expensive and require well-trained operators. One of the main challenges for industry is to develop fast, relatively accurate, easy-to-use, and inexpensive devices. In addition to the improved efficiency in laboratory diagnostics, there has been a trend toward a more decentralized diagnostics which occurs directly at patients’ bedside, in outpatient clinics, or at the sites of accidents, so-called point-of-care (POC) systems. The concept of POC testing is mainly for the patient, so short turnaround time, minimum sample preparation, reagent storage and transferring, user-friendly analytical instruments, and digital or visible quantitative or semiquantitative single readout are required. POC test is a great option of potential in vitro diagnostics (IVD) for resource-limited settings. It is clear that on-site or minimum sample preparation and on-chip storage limit the delays that caused by transport and preparation of clinical samples. Shorter turnaround time leads to rapid clinical decision-making and may save fatal consequences. No previous knowledge in sample analysis should be required, so elders can perform the tests at home with minimum training to improve health outcome. Lateral-flow immunoassay (LFIA) devices, for example, which were originally proposed in the 1980s, remain popular largely because of their design simplicity. The purpose of this article is to introduce readers with basic information regarding the LFIA approach that we think the most representative product of IVD test for solving global health issues.
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9,049 |
Alveolar Pattern
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An alveolar pattern is defined by the existence of more or less broad portions of the lung more opaque than normal due to partial or complete alveolar filling. With a few exceptions, the pulmonary architecture is overall preserved, and, if signs of interstitial involvement are present, they are not prevalent. On HRCT the different opacity of the alveolar pattern reminds the variable density of the clouds.
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9,050 |
Expression and Functions of SARS Coronavirus Replicative Proteins
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The discovery of a previously unknown coronavirus as the causative agent of the SARS epidemic in 2002/2003 stimulated a large number of studies into the molecular biology of SARS coronavirus (SARS-CoV) and related viruses. This research has provided significant new insight into the functions and activities of the coronavirus replicase–transcriptase complex, a multiprotein complex that directs coordinated processes of both continuous and discontinuous RNA synthesis to replicate and transcribe the large coronavirus genome, a single-stranded, positive-sense RNA of ~30 kb. In this chapter, we review our current understanding of the expression and functions of key replicative enzymes, such as RNA polymerases, helicase, ribonucleases, ribose-2′-O-methyltransferase and other replicase gene-encoded proteins involved in genome expression, virus–host interactions and other processes. Collectively, these recent studies reveal fascinating details of an enzymatic machinery that, in the RNA virus world, is unparalleled in terms of the number and nature of virally encoded activities involved in virus replication and host interactions.
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9,051 |
Etiology of the common cold: Modulating factors
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The development of a “cold-like illness” (CLI) usually requires infection with an upper respiratory virus such as rhinovirus, influenza virus, respiratory syncytial virus, parainfuluenza virus, coronavirus or adenovirus, among others, and the development of sufficient signs, symptoms and pathophysiologies to qualify as being ill based on personal and cultural definitions. A viral upper respiratory tract infection (vURTI) in the absence of overt illness (subclinical vURTI) will not be made manifest to the individual or to observers and, therefore, will not be diagnosed as a CLI. The degree of illness occurring during a vURTI is directly related to the extent of provoked inflammation, which in turn depends on the engagement of antiviral defense systems. Thus, risk factors for CLI can modulate either the vURTI risk by affecting virus exposure and/or susceptibility to infection, or the CLI risk given a vURTI by affecting immunocompetence, the provoked inflammation and/or the interpretation of ilness as a CLI. In this chapter, we review published studies for evidence of CLI risk-modulating factors and report that climate, crowding and perhaps female gender can affect the probability of exposure to vURTI viruses, that extant immunological factors and age can affect the probability of virus infection given exposure, that stress levels (moderated by social environment), health practices (exercise, tobacco and alcohol consumption, sleep efficiency) and genetics contribute to CLI risk most probably by modulating the immune-inflammatory response to infection, and that other factors such as pollution, home environment and certain personality traits affect CLI risk by biasing illness interpretation for a given set of symptoms and signs.
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9,052 |
Nephrologie
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9,053 |
Synthesis and Antimicrobial Activity of Copper Nanomaterials
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Bioactive copper nanomaterials are an emerging class of nano-antimicrobials providing complimentary effects and characteristics, as compared to other nano-sized metals, such as silver or zinc oxide nanoparticles. In this chapter, copper nano-antimicrobials are reviewed and classified firstly as a function of the preparation methods, and secondly as a function of the target microorganism used for testing their antimicrobial activity. The antimicrobial activity of copper-based nanostructures depends on the microbial species and on the experimental set-up. As a consequence, in this chapter details are provided on methods, as well as on experimental details such as contact time, microorganism strain, concentration of the interacting species, etc. Finally, real-life applications of copper-based nanoantimicrobials are briefly discussed.
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9,054 |
Entzündliche Erkrankungen
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Meningitiden zeigen die Trias Kopfschmerz, Meningismus und Fieber mit positiven Dehnungszeichen. Bei Kindern sind gramnegative Enterokeime und Hämophilus, bei Erwachsenen Meningo- und Pneumokokken wichtigste Erreger der bakteriellen Meningitis. Entscheidend für die Diagnose ist die Liquordiagnostik mit Gramfärbung. Empirisch werden ein Cephalosporin der dritten Generation und Ampicillin eingesetzt. Der Hirnabszess entsteht hämatogen oder fortgeleitet und zeigt sich in der CT oder MRT mit ringförmigem Enhancement. Wichtige Erreger sind Streptokokken, Bacteroides und andere Anaerobier, Enterobakterien und Staphylokokken. Enzephalitiden führen zu Bewusstseinsstörung, fokalen Symptomen und epileptischen Anfällen, wichtigster Erreger ist Herpes simplex. Diagnose mittels Liquor (PCR), EEG, CT und MRT (ab dem 2. Tag), Therapie mit Aciclovir parenteral bereits bei begründetem Verdacht.
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9,055 |
Hospital Systems Management
|
All concepts of hospitals systems including professional standards, ethics, quality improvement, and resource utilization are covered in this chapter. The structure of successful hospitalist programs is used as a template. Then tools utilized for quality improvement, which have been adopted from other industries, are discussed as well. The transition to post-acute care and the complications encountered are examined in this chapter.
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9,056 |
Variation in Active Site Amino Residues of H1N1 Swine Flu Neuraminidase
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In this paper, we report the variations of amino acid residues between H5N1 and H1N1 swine flu neuraminidase sequences at protein level. Random search in NCBI Flu database resulted in Canadian viral gene and analysis using blast technique revealed sites that are variant among sequences for which 3-dimensional structures were known. PDB summary database and multiple alignments were employed for validation of the results. Based on the mutations observed within active site region, homology derived model was constructed using swiss-pdb viewer. The residue variation observed was with respect to Tyr347 in H5N1 versus Asn344 in H1N1 neuraminidase sequence, which resulted in geometrical modification of ligand binding domain.
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9,057 |
Reverse Pharmacology and Drug Discovery: Artemisia annua and Its Anti-HIV Activity
|
There are various ways in which new drugs can be developed. One approach is in silico drug design based on our existing knowledge of the biology of a specific disease and the specific target site binding chemistry. Based on this knowledge, a range of molecules will be designed and synthesised after which they will be tested in in vitro bioassays for activity and toxicity. The best candidates, called lead compounds, will then be “fine-tuned” by chemical derivatisation in order to improve their activity and/or to reduce their toxicity. Lead compounds are then tested in various animal models before entering clinical trials in people. Another approach is to screen a large number of biological samples (plants, bacteria and fungi) for activity against a specific disease. Any active extract, consisting of many compounds, will be fractionated by chromatographic techniques, and each fraction will be tested for in vitro activity. Active fractions will again be fractionated until the active compound is identified. This process, also called bioguided fractionation, can go through a number of fractionation cycles before the active compound is identified. The active compound will be chemically derivatised in order to improve its properties before in vivo animal studies will be conducted. Based on these test results, the most promising lead compounds will then be tested in clinical trials in people. There are however a number of shortcomings with both approaches. It is expensive, time consuming, makes use of in vitro bioassays and it suffers from a very low success rate. Due to these shortcomings, it is currently estimated that the development of one new drug costs around $1–1.5 billion, simply because so many lead compounds fail during clinical trials. Keeping these high costs in mind, one would think that all registered drugs are effective and importantly non-toxic. Unfortunately, this is not the case, as there are a number of drugs currently on the market that are causing severe side effects and whose efficacy should be questioned. This holds true particularly for cancer chemotherapeutics. It was estimated that cancer chemotherapy improves the average 5-year survival rate of patients (for all cancer types) by only 2 % (Morgan et al. 2004). Another relatively unknown fact is that each year, 200,000 people die in the EU due to adverse drug reactions (all types of drugs), highlighting the severe shortcomings of the drug development and drug licensing pipelines (Archibald and Coleman 2012). To put this into perspective, there are a large number of drugs that work perfectly well and are safe to use, but we have to concede that our approach to drug discovery and our overall approach to health care suffers from some major problems.
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9,058 |
Responses of Tropical Bats to Habitat Fragmentation, Logging, and Deforestation
|
Land-use change is a key driver of the global biodiversity crisis and a particularly serious threat to tropical biodiversity. Throughout the tropics, the staggering pace of deforestation, logging, and conversion of forested habitat to other land uses has created highly fragmented landscapes that are increasingly dominated by human-modified habitats and degraded forests. In this chapter, we review the responses of tropical bats to a range of land-use change scenarios, focusing on the effects of habitat fragmentation, logging, and conversion of tropical forest to various forms of agricultural production. Recent landscape-scale studies have considerably advanced our understanding of how tropical bats respond to habitat fragmentation and disturbance at the population, ensemble, and assemblage level. This research emphasizes that responses of bats are often species and ensemble specific, sensitive to spatial scale, and strongly molded by the characteristics of the prevailing landscape matrix. Nonetheless, substantial knowledge gaps exist concerning other types of response by bats. Few studies have assessed responses at the genetic, behavioral, or physiological level, with regard to disease prevalence, or the extent to which human disturbance erodes the capacity of tropical bats to provide key ecosystem services. A strong geographic bias, with Asia and, most notably, Africa, being strongly understudied, precludes a comprehensive understanding of the effects of fragmentation and disturbance on tropical bats. We strongly encourage increased research in the Paleotropics and emphasize the need for long-term studies, approaches designed to integrate multiple scales, and answering questions that are key to conserving tropical bats in an era of environmental change and dominance of modified habitats (i.e., the Anthropocene).
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9,059 |
Konstruktion von Zukunftsängsten über dystopische Filme – Vier Rahmungen (Settings)
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Die Entscheidung, die filmischen Imaginationen von zukünftigen gesellschaftlichen Bedrohungen in ihrer vollen Breite in den Blick zu nehmen, um dann spezielle Filme tiefergehend zu betrachten, hatte zur Konsequenz, dass aufgrund des umfangreichen Datenmaterials ein vorstrukturierender Analyseschritt zwingend notwendig war. Aus der qualitativen Inhaltsanalyse und den Grobsichtungen der Filme ergaben sich vier übergeordnete Rahmungen – vier fi lmische Settingtypen –, von denen sich wiederum drei in Untertypen gliedern, die zunächst im Gesamten vorgestellt werden und denen anschließend eigene ausführliche Kapitel gewidmet sind.
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9,060 |
Glycyrrhiza glabra: Chemistry and Pharmacological Activity
|
Nature is an attractive source of new therapeutic candidate compounds as a tremendous chemical diversity is found in millions of species of plants, animals, marine organisms, and microorganisms as potential medicinal agents. This chapter of research is an effort to highlight the phytochemical/chemical constituents of an ancient medicinal plant G. glabra and their pharmacological importance. G. glabra is an old age medicinal plant that belongs to Leguminosae/Fabaceae/Papilionaceae family and commonly known as mulaithi in north India. The chemical composition of G. glabra is glycyrrhizin, glycyrrhetic acid, isoliquiritin, isoflavones, etc., and their derivatives have been reported for several pharmacological activities like, expectorant, antidemulcent, antiulcer, anticancer, anti-inflammatory, antidiabetic, etc. These phytochemicals hold strong promise for designing new herbal drugs, and derivatives of these compounds are being generated to evaluate their pharmacological purposes for future drug use. Natural products have been a prime source for the treatment of many forms of ailments, many of which are consumed daily with the diet. They provide significant protection against various diseases and disorders.
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9,061 |
Uncharakteristisches Fieber (UF), afebrile Allgemeinreaktion (AFAR), Luftwegekatarrhe, Tonsillitis
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In diesem Kapitel werden jene Fälle behandelt, die diagnostisch und therapeutisch eng zusammengehören und die sich durch ihre überragende Häufigkeit auszeichnen.
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9,062 |
Infektiologie
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—. akute oder chronische Entzündung des Alveolarraumes und/oder des Interstitiums der Lunge; —. häufigste infektionsbedingte Todesursache; —. Einteilung der Pneumonien nach Pathologie (lobär, interstitiell), Åtiologie (bakteriell, viral, mykotisch, parasitär, physikalisch- oder chemischtoxisch, allergisch) und Klinik (typisch, atypisch) möglich; —. : —. : • bei Neugeborenen/Säuglingen Pneumokokken, Haemophilus influenzae, Staphylococcus aureus, Chlamydia pneumoniae, Mycoplasma pneumoniae, Respiratory-syncytial-Viren; • im Erwachsenenalter zusätzlich Legionellen, Influenza-Virus, Parainfluenza-Virus, Adeno-Virus, Corona-Viren, z. B. SARS („severe acute respiratory syndrome“); bei älteren Patienten vermehrt gramnegative Erreger (Klebsiellen, Enterobacter, Escherichia coli); —. : • bis zum 5. Tag der Hospitalisierung Keimspektrum der ambulant erworbenen Pneumonien; • nach dem 5. Tag der Hospitalisierung gehäuft Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiellen, Enterobacter, Escherichia coli; • nach Aspiration Anaerobierinfektionen; • Problemkeime, z. B. methicillinresistenter Staphylococcus aureus (MRSA), penicillinresistente Pneumokokken, vancomycinresistente Enterokokken, ESBL („extended spectrum beta-lactamase“)-Bildner; —. bei Immunsuppression Pneumocystis jirovecii, Zytomegalie-, Herpessimplex-, Varizella-Zoster-Virus, Mycobacterium tuberculosis, atypische Mykobakterien (M. avium, M. intracellulare, M. xenopi u. a.), Pilze; —. : —. Anschoppung am 1. Tag (Hyperämie und alveoläres Ödem); —. rote Hepatisation am 2./3. Tag (Konsolidierung durch alveoläre Infiltration mit Erythrozyten und durch fibrinreiches Exsudat); —. gelbe Hepatisation am 4.–8. Tag (Leukozyten-/Makrophageninfiltration); —. Lyse nach dem 8. Tag (enzymatische Auflösung und Resorption des Exsudats); —. bei fehlender Lyse chronisch karnifizierende Pneumonie durch Granulationsgewebe; —. bei Lobulärpneumonie „buntes Bild“ (alle Stadien der Lobärpneumonie) mit initial einzelnen, verstreuten alveolär-pneumonischen Herden, die im Verlauf konfluieren; —. bei interstitieller Pneumonie interlobuläre, peribronchioläre und selten alveoläre Formen;
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9,063 |
Infections
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Lower respiratory tract infection is a very common illness in children and is a significant cause of morbidity and mortality. Clinical signs and symptoms are nonspecific especially in infants and younger children and some even present with nonrespiratory complaints. Infectious agents causing pneumonia is not limited to viruses and bacteria, but it could also be due to Mycoplasma, Mycobacteria, fungi, protozoa, and parasites. Coinfection with two or more microbial agents can also occur. The etiologic agent of lower respiratory infection in a child is often difficult to obtain, but the patient’s age can help narrow the possible cause. Microbiological tests are important but could be difficult to obtain especially in younger children. Various medical imaging modalities not only play an important role as an aid in diagnosis but can also help during and after therapy. Imaging can also help evaluate complications to pneumonia and exclude other causes of respiratory distress including underlying developmental anomalies, foreign body, gastroesophageal reflux disease, and aspiration. In this chapter, the imaging modalities utilized in the detection of pulmonary infections will be discussed. The spectrum of typical imaging findings for various etiologic agents in both immunocompetent and immunocompromised children will be presented.
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9,064 |
Laboratory Surveillance of Hospital-acquired Infection Rates of Respiratory Viruses in a Tertiary Care Hospital from 2012 to 2014
| null |
9,065 |
CYBER NEWS
| null |
9,066 |
What's coming in Annals January 2004
| null |
9,067 |
Safe zone in isolation rooms
| null |
9,068 |
Frederick Chapman Robbins
| null |
9,069 |
The Twenty-Second International Conference on Antiviral Research
| null |
9,070 |
The Twenty-First International Conference on Antiviral Research
| null |
9,071 |
New CHEs – Nouveaux titulaires CHE
| null |
9,072 |
Reversible splenial lesion syndrome: A differential diagnosis of corpus callosum lesions
| null |
9,073 |
Beyond our pages()
| null |
9,074 |
VIRUS-INDUCED WHEEZING IN CHILDREN: Respiratory Syncytial Virus (RSV) and Rhinovirus
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The strong association between infantile wheezing and respiratory tract infections caused by the respiratory syncytial virus (RSV) has been well established. In studies of older children, rhinovirus becomes the major virus associated with asthma. These relationships are outlined in the box on page 36. In the past, this relationship was more difficult to appreciate, because rhinovirus does not always grow well in culture. In addition, the linkage between asthma and atopy during childhood has raised the question whether viral infections alone can precipitate exacerbations of asthma. Use of the polymerase chain reaction (PCR) to measure viral nucleic acid material has provided the opportunity to study virus-induced wheezing among children in greater detail, and investigations of experimental rhinovirus infections in adults have demonstrated how this virus can augment both the early and late phase manifestations of airway hyperreactivity. This article reviews recent advances that have enhanced our understanding of virus-induced wheezing, along with new information indicating that interactions between viral infections and allergic inflammation may be critical to the pathogenesis of acute symptoms.
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9,075 |
NOVEL THERAPEUTIC APPROACHES FOR ALLERGIC RHINITIS
|
The last 2 decades have witnessed enormous changes in our understanding of allergic rhinitis. As we have begun to unravel the complex underlying immunologic and inflammatory pathophysiology of the disease, new therapeutic strategies as well as specific molecular and cellular constituents have emerged as potential targets for clinical intervention. These efforts also have shed light on the mechanisms by which current antiallergy medications act—or sometimes fail to be effective.7, 31, 51, 89 The similar pathophysiologic basis for allergic rhinitis and the often comorbid condition, asthma, was underscored in the recently published American Thoracic Society Workshop Summary on the Immunobiology of Asthma and Rhinitis: Pathogenic Factors and Therapeutic Options.(18) In his conclusion, workshop chair, Thomas Casale,(18) counsels readers to consider that “…allergic asthma and rhinitis represent a systemic disease affecting two organs, the lung and the nose. Asthma and allergic rhinitis share many of the same pathogenic factors, but they operate in different parts of the airway. Inflammatory cells and mediators are often the same, and there may be common alterations that occur in the immune system.” Thus, therapeutic strategies and potential therapeutic agents found to be beneficial in the treatment of one airway target may show similar effects in the other. For this reason, and because many of the therapies now being developed are at early stages in their evolution, physicians interested in rhinitis therapy also must examine what is known about these agents in asthma. One avenue of active research has been the role of leukotrienes and other mediators in the pathophysiology of asthma and rhinitis. Three leukotriene modifiers now have been approved for the treatment of asthma in the United States; their potential use in the treatment of rhinitis has been a focus of considerable speculation and investigation. An early “day in the park” study showed that with antileukotriene therapy, patients with rhinitis had demonstrable improvements in their rhinitic symptoms.(29) Roquet et al(83) reported that in the treatment of asthma, there was a synergistic effect when an antileukotriene agent and an antihistamine were used, compared with either drug alone. A product combining an antileukotriene with an antihistamine is currently under development. The most exciting developments, however, may be in the immunology arena. As described by Baraniuk elsewhere in this issue, the pathophysiology of allergic rhinitis is highly complex. Multiple interacting, interdependent, and redundant pathways and molecular and cellular constituents are involved in the pathogenesis of allergic rhinitis. Briefly, exposure of the nasal mucosa to allergen in a sensitized individual leads to the release and further production of inflammatory mediators and the release of cytokines.(5) These released cytokines activate endothelial cells, thereby inducing expression of adhesion receptors on the cell surface and initiating a cascade of events that facilitates transendothelial migration of inflammatory cells. T lymphocytes also are activated by these cytokines. Within a given tissue, specific patterns of cytokines are released, dependent on the dominant subset of local T lymphocytes. These, in turn, lead to the preferential activation and recruitment of specific inflammatory cells and the characteristic cellular inflammation observed in allergic rhinitis.
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9,076 |
Impacts and responsibilities for sustainable tourism: a tour operator’s perspective
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Tourism is currently responsible for the largest, annual human migration in history. This great movement of people has significant positive and negative consequences on nature, societies, cultures and economies. Desired worldwide for its economic benefits, tourism is anticipated to double during the next 20 years, and the multiple consequences of such rapid growth, call for a preventative approach at all strategic and professional levels, in order to avoid negative impacts. Considering mass tourism as a reality of our contemporary life that cannot be neglected by current efforts to endorse sustainable tourism, this paper draws attention to one of its key players—the tour operators—advancing the proposition that they play significant roles in affecting changes in behaviors and attitudes towards more responsible forms of tourism. Aiming to facilitate a constructive debate on the matter, the article presents a few of the most important arguments that underscore the potential that tour operators’ have in promoting sustainable tourism.
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9,077 |
Developing animal model systems for embryo technologies in rare and endangered wildlife()
| null |
9,078 |
An empirical study on the impact of quality antecedents on tax payers' acceptance of Internet tax-filing systems
|
This study used the Technology Acceptance Model (TAM) to examine taxpayers' acceptance of the Internet tax-filing system. Based on data collected from 141 experienced taxpayers in Taiwan, the acceptance and the impact of quality antecedents on taxpayers' perceived usefulness (PU) and perceived ease of use (PEOU) of the system were assessed and evaluated. The results indicated that the model of Internet tax-filing system was accepted with a reasonable goodness-of-fit. Three important findings include the following items. First, TAM proves to be a valid model to explain the taxpayers' acceptance of the Internet tax-filers' system. Meanwhile, PU has created more impact than PEOU on taxpayers' intention to use the system. Second, PU is positively influenced by such factors as information system quality (ISQ), information quality (IQ), as well as perceived credibility (PC). Third, IQ has a positive impact on PEOU. Based on the research findings, implications and limitations are then discussed for future possible research.
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9,079 |
Infectious Diseases in Pregnancy
| null |
9,080 |
Culture and decision making
|
The study of culture and decision making addresses variations in how and why people from different cultures sometimes tend to decide differently. This review is organized around what is intended to be a comprehensive analysis of the distinct fundamental questions that people must answer in the process of making virtually all real-life decisions. Our emphasis was on recent developments as well as identifying important yet neglected topics (e.g., how decision episodes get started—or not, and why some decisions are never implemented). Early as well as current efforts have focused mainly on East Asian and North American Caucasian cultures, with little treatment of other populations. In such studies, individualism and collectivism have been the dominant explanatory factors although related but distinct concepts such as “tightness” and “looseness” have been welcome additions to recent discussions. Throughout, the review emphasizes practical concerns, such as the challenges of intercultural learning and collaboration.
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9,081 |
Pneumonia in the Hospital Setting
| null |
9,082 |
What's news
| null |
9,083 |
Balaji Sadasivan – 1955–2010
| null |
9,084 |
Science foresight using life-cycle analysis, text mining and clustering: A case study on natural ventilation
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Science foresight comprises a range of methods to analyze past, present and expected research trends, and uses this information to predict the future status of different fields of science and technology. With the ability to identify high-potential development directions, science foresight can be a useful tool to support the management and planning of future research activities. Science foresight analysts can choose from a rather large variety of approaches. There is, however, relatively little information about how the various approaches can be applied in an effective way. This paper describes a three-step methodological framework for science foresight on the basis of published research papers, consisting of (i) life-cycle analysis, (ii) text mining and (iii) knowledge gap identification by means of automated clustering. The three steps are connected using the research methodology of the research papers, as identified by text mining. The potential of combining these three steps in one framework is illustrated by analyzing scientific literature on wind catchers; a natural ventilation concept which has received considerable attention from academia, but with quite low application in practice. The knowledge gaps that are identified show that the automated foresight analysis is indeed able to find uncharted research areas. Results from a sensitivity analysis further show the importance of using full-texts for text mining instead of only title, keywords and abstract. The paper concludes with a reflection on the methodological framework, and gives directions for its intended use in future studies.
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9,085 |
Flaviviruses
| null |
9,086 |
The Twenty-Third International Conference on Antiviral Research
| null |
9,087 |
Integral membrane protein structure: transmembrane α-helices as autonomous folding domains: Current opinion in structural biology 1993, 3: 532–540
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The transmembrane region of many integral membrane proteins is made up of a bundle of hydrophobic α-helices. Such a structure could result from a two-stage folding process, during which preformed transmembrane helices with independent stability pack without topological rearrangement. This view was originally prompted by experiments in which fragments of transmembrane regions were separately refolded into lipid bilayers and subsequently brought together to yield a functional protein. Other lines of evidence, including the existence of ‘one-helix’ miniproteins, gene-fusion experiments, helix-driven oligomerization of bitopic proteins, and sequence rearrangements in the course of evolution support this view. Although it forms a useful basis for structural predictions, the limitations of the two-stage folding hypothesis are not clearly defined, and the proportion of integral membrane proteins to which it applies remains uncertain. The papers discussed in the present review illustrate recent progress along these lines.
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9,088 |
Epidemic dynamics on information-driven adaptive networks
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Research on the interplay between the dynamics on the network and the dynamics of the network has attracted much attention in recent years. In this work, we propose an information-driven adaptive model, where disease and disease information can evolve simultaneously. For the information-driven adaptive process, susceptible (infected) individuals who have abilities to recognize the disease would break the links of their infected (susceptible) neighbors to prevent the epidemic from further spreading. Simulation results and numerical analyses based on the pairwise approach indicate that the information-driven adaptive process can not only slow down the speed of epidemic spreading, but can also diminish the epidemic prevalence at the final state significantly. In addition, the disease spreading and information diffusion pattern on the lattice as well as on a real-world network give visual representations about how the disease is trapped into an isolated field with the information-driven adaptive process. Furthermore, we perform the local bifurcation analysis on four types of dynamical regions, including healthy, a continuous dynamic behavior, bistable and endemic, to understand the evolution of the observed dynamical behaviors. This work may shed some lights on understanding how information affects human activities on responding to epidemic spreading.
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9,089 |
Helicases as molecular motors: An insight
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Helicases are one of the smallest motors of biological system, which harness the chemical free energy of ATP hydrolysis to catalyze the opening of energetically stable duplex nucleic acids and thereby are involved in almost all aspect of nucleic acid metabolism including replication, repair, recombination, transcription, translation, and ribosome biogenesis. Basically, they break the hydrogen bonding between the duplex helix and translocate unidirectionally along the bound strand. Mostly all the helicases contain some conserved signature motifs, which act as an engine to power the unwinding. After the discovery of the first prokaryotic DNA helicase from Escherichia coli bacteria in 1976 and the first eukaryotic one from the lily plant in 1978, many more (>100) have been isolated. All the helicases share some common properties, including nucleic acid binding, NTP hydrolysis and unwinding of the duplex. Many helicases have been crystallized and their structures have revealed an underlying common structural fold for their function. The defects in helicases gene have also been reported to be responsible for variety of human genetic disorders, which can lead to cancer, premature aging or mental retardation. Recently, a new role of a helicase in abiotic stress signaling in plant has been discovered. Overall, helicases act as essential molecular tools for cellular machinery and help in maintaining the integrity of genome. Here an overview of helicases has been covered which includes history, biochemical assay, properties, classification, role in human disease and mechanism of unwinding and translocation.
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9,090 |
Infectious Disease and Bioterrorism
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9,091 |
The Twentieth International Conference on Antiviral Research
| null |
9,092 |
Marian Horzinek, Obituary
| null |
9,093 |
Feature-based recommendations for one-to-one marketing
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Most recommendation systems face challenges from products that change with time, such as popular or seasonal products, since traditional market basket analysis or collaborative filtering analysis are unable to recommend new products to customers due to the fact that the products are not yet purchased by customers. Although the recommendation systems can find customer groups that have similar interests as target customers, brand new products often lack ratings and comments. Similarly, products that are less often purchased, such as furniture and home appliances, have fewer records of ratings; therefore, the chances of being recommended are often lower. This research attempts to analyze customers' purchasing behaviors based on product features from transaction records and product feature databases. Customers' preferences toward particular features of products are analyzed and then rules of customer interest profiles are thus drawn in order to recommend customers products that have potential attraction with customers. The advantage of this research is its ability of recommending to customers brand new products or rarely purchased products as long as they fit customer interest profiles; a deduction which traditional market basket analysis and collaborative filtering methods are unable to do. This research uses a two-stage clustering technique to find customers that have similar interests as target customers and recommend products to fit customers' potential requirements. Customers' interest profiles can explain recommendation results and the interests on particular features of products can be referenced for product development, while a one-to-one marketing strategy can improve profitability for companies.
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9,094 |
The scientific basis of multiple sclerosis
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9,095 |
Synthesis of both enantiomers of halitunal
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Both enantiomers of halitunal (1), a novel diterpene aldehyde having an iridoid carbon framework with a heteroaromatic 10π-system, have been synthesized from (+)-genipin (2).
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9,096 |
Volume TOC
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9,097 |
Greek measles epidemic strain, 2005–2006
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9,098 |
PIV-20 Detection of WU/KI polyomaviruses in respiratory samples from Leeds Teaching Hospitals NHS Trust
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9,099 |
O.7.5 Human bocavirus infections have seasonal transmission dynamics
| null |
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