title: Die medizinische Mikrobiologie im 21. Jahrhundert

text: Die medizinische Mikrobiologie befasst sich mit der ursächlichen Rolle pathogener (d. h. krankheitserzeugender) Mikroorganismen bei der Entstehung von Störungen im Funktionsablauf des menschlichen Organismus. Störungen dieser Art entstehen durch Ansiedlung und Vermehrung von Mikroorganismen im Sinne des Parasitismus; sie treten als Infektionskrankheit in Erscheinung. Demgemäß betrachtet man die parasitierenden Mikroorganismen als Krankheitserreger; das befallene Individuum wird als »Wirt« oder »Makroorganismus« bezeichnet. Da bei der Betrachtung von Infektionen sowohl der Wirt mit seinen Reaktionen als auch die krankheitserzeugenden Eigenschaften eines Mikroorganismus (d. h. seine Pathogenität) im Vordergrund stehen, lässt sich die medizinische Mikrobiologie am ehesten als Infektionslehre begreifen – als Lehre von der Auseinandersetzung des Wirtes mit den krankheitserzeugenden Eigenschaften des Erregers.


Severe Sepsis in the Elderly


title: The Role of Bats as Reservoir Hosts of Emerging Neuroviruses

text: Recent studies have clearly shown that bats are the reservoir hosts of a wide diversity of novel viruses with representatives from most of the known animal virus families. In many respects bats make ideal reservoir hosts for viruses: they are the only mammals that fly, thus assisting in virus dispersal; they roost in large numbers, thus aiding transmission cycles; some bats hibernate over winter, thus providing a mechanism for viruses to persist between seasons; and genetic factors may play a role in the ability of bats to host viruses without resulting in clinical disease. Within the broad diversity of viruses found in bats are some important neurological pathogens, including rabies and other lyssaviruses, and Hendra and Nipah viruses, two recently described viruses that have been placed in a new genus, Henipaviruses in the family Paramyxoviridae. In addition, bats can also act as alternative hosts for the flaviviruses Japanese encephalitis and St Louis encephalitis viruses, two important mosquito-borne encephalitogenic viruses, and bats can assist in the dispersal and over-wintering of these viruses. Bats are also the reservoir hosts of progenitors of SARS and MERS coronaviruses, although other animals act as spillover hosts. This chapter presents the physiological and ecological factors affecting the ability of bats to act as reservoirs of neurotropic viruses, and describes the major transmission cycles leading to human infection.


title: Pulmonary Complications Associated with HSCT

text: While outcomes for patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT) have improved over the past 10–20 years, pulmonary complications after allogeneic HSCT remain a leading cause of morbidity and mortality. Overall, 25–50% of pediatric HSCT patients will develop pulmonary complications. Thus, prevention, early detection, and intervention are key to minimizing the sequelae from HSCT-associated pulmonary complications. HSCT-associated pulmonary complications can be classified as infectious or noninfectious, and they often follow a predictable timeline, occurring during discrete phases of HSCT (pre-engraftment, early post-engraftment, late post-engraftment). However, certain post-HSCT pulmonary complications span the entire post-HSCT course. The most common causes of noninfectious pulmonary complications are related to the conditioning regimen used which can result in varying degrees of acute or delayed lung injury, the degree of recipient–donor HLA histoincompatibility, the hematopoietic stem cell (HSC) source, the degree of graft manipulation, and the development of graft-versus-host disease (GvHD), both acute and chronic. Infectious etiologies can be caused by any class of pathogen including bacterial, viral, fungal, and protozoan. They usually occur during periods of profound and/or prolonged neutropenia and/or impaired or delayed cellular and humoral immune recovery. Immunosuppression used to prevent or treat GvHD also places a HSCT recipient at high risk for developing pulmonary infections that can be life-threatening. This chapter discusses the most common pulmonary complications associated with HSCT by time period post-HSCT.


title: Public Health in Africa: Theoretical Framework

text: These are examined as parts of the health or medical systems from an historical perspective that enables the reader to link the present to the past and vice-versa.


title: Antiphospholipid (Hughes) Syndrome: An Overview

text: In conclusion, the following observations can be made. aPL are present in approximately 2% to 4% of the normal population and the prevalence increases with age. There is a high prevalence among patients with autoimmune connective tissue disorders, especially SLE. There is an association with both venous and arterial thrombosis as well as with pregnancy morbidity, but the strength of association varies amongst studies. This probably reflects different populations, study designs, and different assays and definitions used. In several studies the risk of thrombosis appears to be higher with LA and the data suggests a true association rather than epiphenomenon. In a given patient, both aCL and LA should be measured. A significant impact on long-term survival has been noted and aPL also contribute significantly to accumulated damage in diseases such as SLE. The clinical spectrum of APS features is enormous and continues to expand. It behoves us all as clinicians and health care professionals to consider an early diagnosis of Hughes syndrome, with its distinct clinical and serological features, to reduce the risk of morbidity and mortality in our patients.


Kardiologie


title: How Disease Affected the End of the Bronze Age

text: Dr. Norrie provides a summary of the fifteen currently accepted causes for the end of the Bronze Age in the Near East and then goes on to discuss the sixteenth reason—infectious disease epidemics. These are the real reason that the end of the Bronze Age in the Near East was called either the “catastrophe” or the “collapse” due to its short time frame of 50 years, the mass migration of the general population and the “Sea Peoples” plus the abandonment of cities such as Hattusa, the capital of the Hittite Empire c.1200 bce. The diseases most likely to cause this collapse are smallpox, bubonic plague and tularemia.


title: Contagio cine qua non oder wie Al Gore die Zukunft in Brand steckte: Zukunftswissen im Filmszenario

text: Die Antwort eines Handbuchs der Szenariotechnik auf die Frage, was ein Szenario ist, lautet wie folgt.


title: Evolution of the BCL-2-Regulated Apoptotic Pathway

text: The mitochondrion descends from a bacterium that, about two billion years ago, became endosymbiotic. This organelle represents a Pandora’s box whose opening triggers cytochrome-c release and apoptosis of cells from multicellular animals, which evolved much later, about six hundred million years ago. BCL-2 proteins, which are critical apoptosis regulators, were recruited at a certain time point in evolution to either lock or unlock this mitochondrial Pandora’s box. Hence, particularly intriguing is the issue of when and how the “BCL-2 proteins–mitochondria–apoptosis” triptych emerged. This chapter explains what it takes from an evolutionary perspective to evolve a BCL-2-regulated apoptotic pathway, by focusing on the events occurring upstream of mitochondria.


title: Pathophysiologic Role of Autophagy in Human Airways

text: Lung diseases are among the most common and widespread disorders worldwide. They refer to many different pathological conditions affecting the pulmonary system in acute or chronic forms, such as asthma, chronic obstructive pulmonary disease, infections, cystic fibrosis, lung cancer and many other breath complications. Environmental, epigenetic and genetic co-factors are responsible for these pathologies that can lead to respiratory failure, and, even, ultimately death. Increasing evidences have highlighted the implication of the autophagic pathways in the pathogenesis of lung diseases and, in some cases, the deregulated molecular mechanisms underlying autophagy may be considered as potential new therapeutic targets. This chapter summarizes recent advances in understanding the pathophysiological functions of autophagy and its possible roles in the causation and/or prevention of human lung diseases.


title: Exam 3 Questions

text: 1. Which of thefollowing is true regarding the Barrow classification system for carotid cavernous fistulae? A. Type A shunts are indirect shunts between branches of the internal carotid artery (ICA) and cavernous sinus. B. Type B shunts are direct shunts between the ICA and cavernous sinus. C. Type C shunts are indirect shunts between branches of the external carotid artery (ECA) and cavernous sinus. D. Type D shunts are high-flow shunts. E. All of the above. 2. A 80-year-old male with an intracranial neoplasm presents to the emergency department with weight loss, drowsiness, and tachypnea for 1 month. On examination, his respiratory rate is 28 breaths/minute with a normal oxygen saturation. His lungs are clear to auscultation. An arterial blood gas reveals the following: pH 7.60, PCO(2) 14 mmHg, PaO(2) A. Central neurogenic hyperventilation. B. Cheyne-Stokes respirations. C. Apneustic breathing. D. Ataxic breathing. E. Cluster breathing. 3. A 48-year-old female is admitted to the ICU with a Hunt-Hess 2 modified Fisher 2 subarachnoid hemorrhage (SAH). She remains intact neuro-cognitively, but has transcranial doppler (TCD) mean flow velocities up to 150 cm/s, and a serum platelet count twice her baseline. You are worried about vasospasm and impending delayed cerebral ischemia. Which of the following should be performed next? A. An additional 100 mL/h of normal saline should be given on top of maintenance fluids. B. CT perfusion scan to assess for any ongoing hypoperfusion. C. Evaluate volume status with hemodynamic monitoring and give fluid boluses accordingly. D. Induce hypertension to a systolic pressure of 160 mmHg. E. Conventional angiography. 4. A 25-year-old male is currently in the ICU with an anoxic brain injury after diving into shallow waters and suffering a high cervical cord transection. Two weeks after his injury, he remains comatose, has diffuse loss of gray-white differentiation on noncontrast head CT, and exhibits myoclonic status epilepticus. The family is devastated by his poor prognosis, and distraught by his uncontrollable shaking. What is your rationale behind your decision about starting an antiepileptic regimen? A. Phenytoin and propofol will be used, and escalated until eradication of his myoclonus to assess his underlying brain damage. B. Levetiracetam and lacosamide will be used, and escalated until eradication of his myoclonus to assess his underlying brain damage. C. If EEG reveals dyssynchronous spikes on a severely slow background, myoclonus invariably portends death or a vegetative state, and midazolam should only be used for palliative purposes. D. Regardless of EEG or clinical exam, half of patients in myoclonic status epilepticus will have a good neurologic recovery by 90 days. E. Regardless of EEG or clinical exam, myoclonic status epilepticus is always ominous, not amenable to treatment. and should lead to immediate withdrawal of life-support. 5. An 18-year-old female presents to the emergency department with several months of progressive left-sided hearing loss and tinnitus. An MRI of the brain is performed, demonstrating bilateral enhancing dumbbell shaped lesions extending from the auditory canal to the cerebellopontine angle. Which of the following genetic disorders is associated with this finding? A. Von Hippel-Lindau syndrome. B. Neurofibromatosis type II. C. Tuberous sclerosis. D. Schwannomatosis. E. Alport syndrome. 6. A 23-year-old female is brought to the emergency department by her boyfriend with difficulty breathing. She cannot provide her history, but her boyfriend states that she has asthma, although he is unsure of her medications. On physical exam the woman is noted to have nasal flaring, is diaphoretic, cannot lie flat, and is breathing at a rate of 40 breaths/minute. She is given short acting ß(2) agonist treatments with no obvious relief of her symptoms. Serial arterial blood gases are done and show a pCO(2) A. Continue short-acting ß(2) agonist treatment, as her pCO(2) is normalizing, and continue observation in the emergency department. B. Intubate the patient and admit to the ICU. C. Administer intravenous corticosteroids and admit to the general medical ward. D. Place the patient on non-invasive positive pressure ventilation and admit to the general medical ward. E. Administer a long-acting ß(2) agonist agent and admit to the general medical ward. 7. Cerebellar hypoplasia without displacement through the foramen magnum is best described as a: A. Chiari I malformation. B. Chiari II malformation. C. Chiari III malformation. D. Chiari IV malformation. E. Chiari V malformation. 8. A 77-year-old female with a history of hypertension, atrial fibrillation, and diabetes mellitus has recently been taken off of warfarin due to frequent falls and gait instability. She has not had any prior significant bleeding or ischemic events. A recent echocardiogram demonstrates moderate aortic regurgitation with grossly preserved systolic and diastolic function. Which of the following elements is not a stroke risk factor in this patient? A. Age. B. Female gender. C. Hypertension. D. Diabetes mellitus. E. Aortic regurgitation. 9. Which of the following is the most effective measure to prevent aspiration in an intubated patient? A. Elevation of the head of the bed. B. Subglottic drainage. C. Gastric volume monitoring. D. Nasogastric tube placement. E. Percutaneous endoscopic gastrotomy. 10. Which of the following is a unique feature of Comprehensive Stroke Centers? A. Dedicated stroke unit availability. B. 24/7 ability to administer tPA. C. 24/7 interventional neuroradiology availability. D. 24/7 CT angiography availability. E. Ambulance receiving capability. 11. Which of the following segments of the internal carotid artery is farthest from it’s origin? A. Ophthalmic segment. B. Petrous segment. C. Cavernous segment. D. Clinoid segment. E. Lacerum segment. 12. A 44-year-old male is intubated secondary to a high-grade subarachnoid hemorrhage, and is admitted to the ICU. On the sixth postoperative day, he develops worsening hypoxemia and bilateral interstitial infiltrates on his chest x-ray, consistent with acute respiratory distress syndrome (ARDS). Which of the following interventions has not been demonstrated to improve outcomes in ARDS in a prospective randomized trial? A. Prone positioning. B. Lung-protective ventilation. C. Extracorporeal membrane oxygenation (ECMO). D. Neuromuscular blocking agents. E. High-frequency oscillatory ventilation (HFOV). 13. A 56-year-old female is currently intubated in the ICU following a left basal ganglia hemorrhage. The nurse reports the patient is having copious thick secretions, and you are considering initiating inhaled N-acetylcysteine therapy. What element of the patient’s past medical history may serve as a relative contraindication to this treatment? A. Amiodarine-induced pulmonary fibrosis. B. Newly diagnosed metastatic adenocarcinoma of the lung. C. Recent course of outpatient antibiotics for community-acquired pneumonia. D. Poorly controlled asthma. E. All of the above. 14. An 18-year-old female is currently being evaluated for amenorrhea. In addition, she endorses fatigue, cold intolerance, polyuria and dizziness upon standing. On examination, she is thin but appears well hydrated. Blood pressure and heart rate when supine are 90/60 mmHg and 80 beats/minute, respectively. When standing, they are 60/40 mmHg and 120 beats/minute, respectively. Pubic and axillary hair growth is sparse. Eye examination reveals an asymmetric bitemporal hemianopsia. Imaging reveals a cystic, calcified suprasellar mass. Which of the following statements is true regarding the most likely diagnosis? A. Medical management is the mainstay of treatment. B. Recovery of pituitary function is common. C. This patient likely has the papillary subtype of this neoplasm. D. This neoplasm has a bimodal age distribution. E. This neoplasm arises from modified glial cells that reside in the infundibular neurohypophysis. 15. A 55-year-old female presents to the emergency department after collapsing at home. The patient was arguing with her husband before she suddenly became unresponsive. The patient is intubated, and a non-contrast head CT is performed (see Image 1). The patient then undergoes conventional angiography, revealing occlusion of the proximal bilateral middle cerebral and anterior cerebral arteries with extensive collateral vessels noted. All of the following are true regarding the most likely diagnosis except: A. The disease can be either congenital or acquired. B. Patients may suffer recurrent infarcts, or remain completely asymptomatic. C. There are no effective surgical interventions available. D. It is more commonly seen in women than in men. E. Patients may initially present with persistent headaches;


title: Adult-Onset Still’s Disease

text: Adult-onset Still’s disease (AoSD) is a rare but clinically well-known, polygenic, systemic autoinflammatory disease. It is typically characterized by four main (cardinal) symptoms: spiking fever ≥39 °C, arthralgia or arthritis, skin rash, and hyperleukocytosis (≥10,000 cells/mm(3)). However, many other clinical features are possible, and it can appear in all age groups with potentially severe inflammatory onset accompanied by a broad spectrum of disease manifestation and complications. Hence, it remains a diagnostic challenge, and the clinician should first rule out infectious, tumoral, or inflammatory differential diagnoses. Determination of the total and glycosylated ferritin levels, although not pathognomonic, can help in diagnosis. New biomarkers have recently been described, but they need to be validated. The disease evolution of AoSD can be monocyclic, polycyclic, or chronic. In chronic disease, a joint involvement is often predominant, and erosions are noted in one-third of patients. Many progresses have been made in the understanding of the pathogenesis over the last decades. This chapter provides a comprehensive insight into the complex and heterogeneous nature of AoSD describing the identified cytokine signaling pathways and biomarkers. It also discusses the current evidence for the usage of biologics in AoSD to provide guidance for treatment decisions, taking into account both the efficacy and the safety of the different therapeutic options.


title: The Chemical and Biological Properties of Propolis

text: The term propolis comes from two Greek words, pro (which means for or in defence of) and polis (which means the city); thus, propolis means in defence of the city or beehive. Propolis is a sticky resinous substance, which is gathered from buds and the bark of trees. It is also known as “bee glue” as bees use it to cover surfaces, seal holes and close gaps in their hives, thus providing a sterile environment that protects them from microbes and spore-producing organisms, including fungi and molds. It can be considered to be a potent chemical weapon against bacteria, viruses, and other pathogenic microorganisms that may invade the bee colony. Also, bees use propolis as an embalming substance, to mummify invaders such as other insects, that have been killed and are too heavy to remove from the colony. Thus, propolis is important for bee health but it also has activity against many human diseases. It is a powerful anti-oxidant and can modulate the activity of reactive oxygen species within the human body. The most studied aspect of propolis is its anti-bacterial activity, which is almost always present at a moderate to high level depending on the exact type of propolis. It is in general more active against Gram positive than Gram negative bacteria, but activity against Gram negative bacteria has been observed. Propolis has been found to be active against a range of viruses and also is almost always active against protozoa such as Tryanosoma brucei and Leishmania donovani. Propolis also shows activity against cardiovascular diseases and diabetes and has immunomodulatory effects. Anti-cancer activity has also been observed. In summary, propolis is remarkable for its range of biological activities and for the variety of its chemical composition. It may be of great importance both to bees and humans.


title: Case Study – Romania

text: Countering bioterrorism, as other health threats caused by infectious agents, requires good preparedness, and early warning and response, which can be achieved by an efficient epidemiological surveillance system. In 1990, Romania inherited a functional and quite efficient epidemiological surveillance system from the former communist regime, based on pyramidal and autocratic principles where the state control was absolute. In 2001, the assessment conducted by WHO/Europe showed many unsatisfactory elements of the remaining epidemiological surveillance system for communicable diseases, with a lack of procedures, poor microbiology laboratory capacities, and overlapping responsibilities. The lack of a coordinating body was evident, especially during bioterrorist threats following 9/11 attacks in New York. In 2003 and 2004, the PHARE Project offered an important opportunity for Romania to improve the Romanian System of Epidemiological Surveillance and Control of Communicable Diseases. At the end of this project many of the technical capacities had been improved, specialized trainings of epidemiologists and microbiologists were carried out, and a coordinating body of the epidemiological surveillance network was established [1]. Furthermore, a National Plan of Action was approved by the Minister of Health with the declared objective to improve the system in order to comply with EU standards. At present, the National Institute of Public Health hosts the National Center for Communicable Diseases Surveillance and Control which coordinates the epidemiological network and serves as the Romanian focal point for international institutions such as WHO and ECDC. Each year, comprehensive reports regarding surveillance in Romania of many communicable diseases are published, including diseases potentially related to bioterrorism. Until now, no evidence of a bioterrorism event has been registered in Romania.


Time and Travel


Nanomolecular Diagnostics


title: Phylogenetics Algorithms and Applications

text: Phylogenetics is a powerful approach in finding evolution of current day species. By studying phylogenetic trees, scientists gain a better understanding of how species have evolved while explaining the similarities and differences among species. The phylogenetic study can help in analysing the evolution and the similarities among diseases and viruses, and further help in prescribing their vaccines against them. This paper explores computational solutions for building phylogeny of species along with highlighting benefits of alignment-free methods of phylogenetics. The paper has also discussed the application of phylogenetic study in disease diagnosis and evolution.


title: SARS coronavirus main proteinase 3.4.22.69

text: EC number 3.4.22.69 Recommended name SARS coronavirus main proteinase Synonyms 3C-like protease <2,3> [9,16,38,49,51] 3CL protease <2> [14,48] 3cLpro <1,2,3> [7,11,13,16,19,28,38,49,51] C30.004 (Merops-ID) Mpro SARS 3C-like protease <2> [17] SARS 3C-like proteinase <2> [15,18,27] SARS 3CL protease <2> [31] SARS 3CLpro <2> [49] SARS CoV main proteinase <2> [1,2,4,5] SARS CoVMpro <2> [33] SARS Mpro <2> [25] SARS coronavirus 3C-like protease <2> [48] SARS coronavirus 3C-like proteinase <2> [50] SARS coronavirus 3CL protease <2> [20] SARS coronavirus main peptidase <2> [23] SARS coronavirus main protease <2> [25] SARS coronavirus main proteinase <2> [5,33] SARS main protease <2> [12,25] SARS-3CL protease <2> [48] SARS-3CLpro <2> [29,50] SARS-CoV 3C-like peptidaseSARS-CoV 3C-like peptidase<2> [24] SARS-CoV 3C-like protease<1> [19] SARS-CoV 3CL protease <2> [22,30,44,46] SARS-CoV 3CLpro <2> [32,36,38,44,45] SARS-CoV 3CLpro enzyme <2> [11] SARS-CoV Mpro <2> [21,40] SARS-CoV main protease <2> [21,26,43] SARS-coronavirus 3CL protease <2> [8] SARS-coronavirus main protease <2> [47] TGEV Mpro coronavirus 3C-like protease <1> [19] porcine transmissible gastroenteritis virus Mpro severe acute respiratory syndrome coronavirus 3C-like protease <2> [41,42] severe acute respiratory syndrome coronavirus main protease <2> [21] severe acute respiratory syndrome coronavirus main proteinase <2> [33] CAS registry number 218925-73-6 37353-41-6


title: Inflammation

text: Inflammation was described as early as 3000 BC in an Egyptian papyrus [1] and is still a common problem despite continuous advancements in prevention and treatment methods. The delineation of the site and extent of inflammation are crucial to the clinical management of infection and for monitoring the response to therapy [2].


title: Intensivmedizin bei neurologischen Erkrankungen

text: Eine 73-jährige Frau wird verwahrlost und wesensverändert im Treppenhaus ihres Wohnhauses vorgefunden. Die Notärztin stellt eine Temperatur von 39,5°C, eine deutliche Exsikkose und basale Rasselgeräusche beidseits fest. Die Patientin lehnt eine stationäre Krankenhausbehandlung vehement ab und muss daher mittels Psychisch-Kranken-Gesetz (PsychKG) eingewiesen werden. Bei Verdacht auf eine Pneumonie ruft die Pflegekraft in der Notaufnahme den diensthabenden Internisten hinzu.


title: Synthetic Biology, Dual Use Research, and Possibilities for Control

text: The anthrax attack on the human population in the United States in 2001/2002 may be considered the naissance of modern bioterrorism. This attack, e.g. the planned killing by means of deadly microorganisms (Bacillus anthracis) caused enormous public concern, because, numerous other deadly agents, now known as “select agents”, occur in nature and are available for misuse. The anthrax attack coincided with the first report in 2002 of the de novo synthesis in the test tube of a pathogenic human virus, poliovirus, that was equally shocking because it indicated that dangerous infectious agents could be produced in laboratories outside of government control. These events were synchronous with the advent of a new discipline, Synthetic Biology, which was an emerging area of research that can broadly be described “as the design and construction of novel artificial biological pathways, organisms or devices, or the redesign of existing natural biological systems.” The synthesis of viruses, or more broadly expressed: each experiment in Synthetic Biology, fits the definition of “Dual Use Research” – the dual use dilemma in which the same technologies can be used for the good of humans and misused for bioterrorism. In view of these threats the US Government has formulated rules that can lower the chances of misuse of biological research. That includes all research with select agents or the modification of agents to acquire dangerous traits (“Gain of Function”). It also calls for the continuous education of all generations entering research: to be aware that results of research can be dangerous, if not immediately then possibly at later times.


title: The Microbe: The Basics of Structure, Morphology, and Physiology as They Relate to Microbial Characterization and Attribution

text: This chapter is meant to (1) review classical methods used to characterize and classify microbes and (2) introduce new molecular methods used in microbial characterization. The fundamental composition of microbes is discussed as well as their importance in classification of microbes into genus and species. Classical microbiological methods in general seek to define the common features of specific bacterial groups as a means of classification and identification of microbes. Thus, the focus was to describe the common features which discriminated closely related groups of organisms. In contrast, the newer molecular methods often seek to expand the classification of microbes not only as a means to organize microbial phylogeny but also to differentiate signatures between microbes identified within a species in greater detail. Molecular biology tools are used both as an adjunct to established methods and as replacement for classical methods for detection, discrimination, or identification of bacterial and viral species.


title: In-Vehicle Exposures at Transportation and the Health Concerns

text: In-vehicle environment is a special indoor environment, which is mobile, either open or closed. This chapter reviewed in-vehicle air quality and passenger exposures for roadway commuters, commercial airplanes, and marine transportation. The sources of pollutants in-vehicle can be categorized as the same as other indoor environments, including outdoor air, human activity, emission from building material and interior furnisher, and biological metabolic process from animals and microbes. However, the exposure in vehicles varies from now and then, influenced by window open/closed, speed, air flow, ventilation on/off, air conditioner on/off, pollutants from ambient outdoor air, interior material, and number of passengers. There are few studies on health condition of passengers, except infectious disease during airway transportation. Some health studies of related occupations are reviewed.


Environmental survival and microbicide inactivation of coronaviruses


title: Carbohydrate Microarrays

text: Carbohydrates, like nucleic acids and proteins, are essential biological molecules. Owing to their intrinsic physicochemical properties, carbohydrates are capable of generating structural diversity in a multitude of ways and are prominently displayed on the surfaces of cell membranes or on the exposed regions of macromolecules. Recent studies highlight that carbohydrate moieties are critical for molecular recognition, cell-cell interactions, and cell signaling in many physiological and pathological processes, and for biocommunication between microbes and host species. Modern carbohydrate microarrays emerged in 2002 and brought in new high-throughput tools for “glyco code” exploration. In this section, some basic concepts of sugar chain diversity, glyco-epitope recognition, and the evolving area of glyco-epitomics and biomarker discovery are discussed. Two complementary technologies, carbohydrate antigen arrays and photogenerated glyco-chips, serve as models to illustrate how to apply carbohydrate microarrays to address biomedical questions.


title: Allgemeine Chirurgie

text: Die chirurgische Diagnostik, bestehend aus Anamnese, klinischer Untersuchung und der meist nachfolgenden technischen Diagnostik, unterscheidet sich in ihren Grundprinzipien grundsätzlich nicht von denen anderer klinischer Fachgebiete. Bei akuten Erkrankungen muss sie schnell und zielführend erfolgen, um die Indikationsstellung zu einer Operation oder dem interventionellen oder konservativem Behandlungsverfahren nicht zu verzögern.


title: Nephrologie

text: Zentrale Themen in der Nephrologie und auch in diesem Kapitel sind akute und chronische Niereninsuffizienz. Ebenfalls behandelt werden Krankheiten aus der Gruppe der Glomerulonephritiden (wie z. B. IgA-Nephropathie oder rasch progrediente Glomerulonephritis), der tubulointerstitiellen Nierenerkrankungen (z. B. infolge von Hanta-Virus-Infektionen oder die Analgetika-Nephropathie) und der Nierentumoren/-zysten. Darüber hinaus ist ein Abschnitt den Harnwegsinfektionen sowie den Nierensteinen gewidmet.


title: Multiple Sequence Alignment

text: The multiple sequence alignment (MA) plays an important role in sequence analysis. However, it has been proven to be an NP-hard problem. This means the computation complexity of MSA increases exponentially with the number of sequences. The presented algorithms are mostly heuristic and many of them are based on pairwise sequence alignment. Hence we begin with pairwise alignment of multiple sequences and discuss the topological space induced by pairwise alignment of multiple sequences, since different optimization criteria may lead to different results. We discuss several optimization indices here: the sum of pairs (SP); Shannon entropy; similarity rate and the rate of virtual symbols. Based on this discussion, we present a new multiple sequence alignment based on SPA called super multiple sequence alignment (SMA). We give a detailed description of the algorithm and compare it to some popular MA algorithms and find that it works well enough, especially with respect to speed. An example of SARS multiple sequence alignment is given at the end of this chapter.


title: Emerging Viral Infections

text: Emerging viral pathogens are a major cause of severe infections that constitute serious complications in patients with hematological disorders. During the last decade, a large number of viruses were discovered using optimized molecular techniques and systematic screening approaches. Most of the newly detected viruses affect the respiratory tract, causing common colds and also, especially in high-risk patients, life-threatening events. On the other hand, a substantial proportion of patients are reinfected by old viruses that were previously described only rarely or not at all in cancer patients. This chapter focuses on both emerging viruses and reemerging viral infections that affect patients with hematological malignancies.


title: Update in Pediatric Emergency Medicine: Pediatric Resuscitation, Pediatric Sepsis, Interfacility Transport of the Pediatric Patient, Pain and sedation in the Emergency Department, Pediatric Trauma

text: This chapter summarizes the state-of-the-art approach to several critical aspects of pediatric emergency care. While the field of pediatric emergency medicine is much broader, we have chosen some key topics which are essential for every physician providing care to children. The resuscitation section highlights the challenges and the particularities of pediatric airway management as well as the correct technique for effective cardiopulmonary resuscitation, defibrillation and vascular access. The sepsis section stresses that the key to a successful outcome is early recognition; it outlines the clinical spectrum of sepsis, the systemic inflammatory response and the pathophysiology of septic shock, with emphasis on early clinical signs, airway management, volume resuscitation, vasoactive support and antibiotic therapy. In the last decade, attention to pediatric pain management has resulted in increasing awareness of assessment tools and pharmacologic as well as non-pharmacologic strategies for pain control and anxiolysis. The pain section updates these important aspects of pediatric care and includes management of procedural sedation. Although the general principles of trauma care in children are similar to those of adults, the trauma section highlights the key differences, with respect to anatomy and physiology, and how these impact on early recognition of hemorrhagic shock, susceptibility to specific injuries, indications for imaging (no pan-CTs!) and the more prevalent non-surgical management. Healthcare providers must also know how to safely transport a child who requires additional resources or an escalation in level of care. The regionalization of pediatric intensive care units and trauma services has made it imperative for pediatricians to understand the general principles of transport medicine outlined in this chapter. The overview of pediatric inter-facility transport discusses choice of transport team and modality, emphasizes patient stabilization prior to transport and outlines required medications and supplies.


Prevention Strategies and Promoting Psychological Resilience to Bioterrorism Through Communication


title: A Compact Imaging Ellipsometer for Label-free Biosensor

text: A compact model of imaging ellipsometer is used for the data acquisition and analysis of label free protein microarray. Its principle, methodology, and experimental setup as well as sampling conditions and a demonstration result are presented here. Furthermore, results of protein adsorption and protein interaction in the microarray may be deduced. This shows that the compact model is effectively performed as a reader for the protein microarray sampling and provides a potential for applications of label free protein microarrays on site of care.


title: Pathogenesis

text: Pathogenesis describes the spread of a virus in the organism and the mutual relationship between the pathogen and its host during infection. These processes can be analysed in several ways by using different histological, virological and immunological methods. Viral infections can be with or without symptoms (also called apparent or inapparent infection courses). In both cases, the host organism responds with immunological defence responses, which usually lead to overcoming the primary disease symptoms and to the elimination of the virus. The immune response may also contribute in the context of immunopathogenesis to specific disease symptoms and either temporary or permanent damage to the host.


title: A Historical Perspective on Paper Microfluidic Based Point-of-Care Diagnostics

text: Paper-based microfluidic systems have emerged as one of the most favorable technologies used in many potential applications such as point-of-care diagnostics, flexible electronics, energy storage, etc. From the past several decades, paper-based technology has readily accepted in the academic research lab and industries as well. The paper-based devices have changed the life of humankind. The distinguishing characteristics of paper substrate like low cost, biodegradability, biocompatibility, and ease of fabrication helped their adaptability in biosensing applications. This chapter gives a concise overview of the historical perspective of paper-based devices, classification of paper types, and their recent applications.


title: Applications of Microbial Biopolymers in Display Technology

text: Microorganisms produce a variety of different polymers such as polyamides, polysaccharides, and polyesters. The polyesters, the polyhydroxyalkanoates (PHAs), are the most extensively studied polymers in regard to their use in display technology. The material properties of bacterial PHAs in combination with their biocompatibility and biodegradability make them attractive substrates for use in display technology applications. By translationally fusing bioactive molecules to a gene encoding a PHA-binding domain, the appropriate functionalization for a given application can be achieved such that the need for chemical immobilization is circumvented. By separately extracting and processing the biopolymer, using it to coat a surface, and then treating this surface with the fusion proteins, surface functionalization for immunodiagnostic microarray or tissue engineering applications can be accomplished. Conversely, by expressing the fusion protein directly in the PHA-producing organisms, one-step production of functionalized beads can be achieved. Such beads have been demonstrated in diverse applications, including fluorescence-activated cell sorting, enzyme-linked immunosorbent assays, microarrays, diagnostic skin test for tuberculosis, vaccines, protein purification, and affinity bioseparation.


title: Lungenfunktionsdiagnostik

text: Lungenfunktionsdiagnostik beinhaltet eine Vielzahl von Messmethoden, mit denen jeweils bestimmte Qualitten der Lungen in verschiedenen Altersgruppen überwiegend nichtinvasiv untersucht werden können.


title: A Tour of the Basic Reproductive Number and the Next Generation of Researchers

text: The Mathematical and Theoretical Biology Institute (MTBI) is a national award winning Research Experience for Undergraduates (REU) that has been running every summer since 1996. Since 1997, students have developed and proposed their own research questions and derived their research projects from them as the keystone of the program. Because MTBI’s mentors have no control over what students are interested in, we need to introduce a suite of flexible techniques that can be applied to a broad variety of interests. In this paper, we walk through examples of some of the most popular techniques at MTBI: epidemiological or contagion modeling and reproductive number analysis. We include an overview of the next generation matrix method of finding the basic reproductive number, sensitivity analysis as a technique for investigating the effect of parameters on the reproductive number, and recommendations for interpreting the results. Lastly, we provide some advice to mentors who are looking to advise student-led research projects. All examples are taken from actual student projects that are generally available through the MTBI website.


title: Volume 6 Indexes

text: This index lists all 3367 normalized pharmacological activity terms appeared in the encyclopedia in alphabetical order and a number code sequence of the related compounds follows the bold term immediately.


title: Medical Technology Management in Hospital Certification in Mexico

text: Mexican health policy is promoting the quality of health services by hospital certification meeting the NMX-CC standards family, which is the Mexican equivalent of the ISO 9000 standards family. These standards can help both product- and service-oriented organizations achieve standards of quality that are recognized and respected throughout the world in developing a quality management system (QMS).


Blut und Blutprodukte


title: Bildgebende Verfahren: Röntgen, Ultraschall, CT, Nuklearmedizin

text: In der Intensivmedizin findet die radiologische Diagnostik überwiegend am Krankenbett statt (»bedside radiology«). Etwa 90 % der radiologischen Untersuchungen in der Intensiv- und Notfallmedizin stellen projektionsradiographische Röntgenaufnahmen des Thorax, des Abdomens und des Skelettsystems dar. In zunehmendem Maße werden neben den klassischen Aufnahmen auch die Schnittbildverfahren eingesetzt. Hier kommt der Ultraschalldiagnostik eine führende Rolle zu, gefolgt von der Computertomographie (CT).


title: Sports-Related Injuries and Deaths

text: Physical activity in children and adolescents should be strongly encouraged. While there is a very low risk of death associated with participation in athletics within this age group, the epidemic of childhood obesity and sedentary lifestyle must be combated to ensure the long-term health and quality of life of today’s youth. Sports-related deaths due to trauma are usually readily identified; others require careful examination, adjunctive testing, and/or the expertise of consultants. A thorough investigation of circumstances surrounding the death, review of the medical records, and autopsy is mandated in these cases.


title: Hyperlipidemias and Obesity

text: The organs require oxygen and other types of nutrients (amino acids, sugars, and lipids) to function, the heart consuming large amounts of fatty acids for oxidation and adenosine triphosphate (ATP) generation.


title: Survival of Microorganisms on Inanimate Surfaces

text: In healthcare settings microbial contaminated surfaces play an important role in indirect transmission of infection. Especially surfaces close to the patients’ environment may be touched at high frequencies, allowing transmission from animated sources to others via contaminated inanimate surfaces. Therefore, the knowledge on the survival of bacteria, fungi, viruses and protozoa on surfaces, and hence, in a broader sense, in the human environment, is important for implementing tactics for prevention of Healthcare-acquired Infections (HAI). This chapter will elaborate the role of surfaces in the transmission of pathogens. Particular emphasis is laid on the current knowledge of the survival time and conditions favouring survival of the pathogens. Finally, mechanisms of transmission from inanimate surfaces to patients are highlighted. Within the multi-barrier strategy of the prevention of HAI, environmental disinfection policies should be based on risk assessments for surfaces with different risks for cross contamination such as high- and low-touched surfaces with appropriate standards for adequate disinfection measures under consideration of the persistence and infectious dose of the pathogens. As a result, surface disinfection is indicated in the following situations: Frequently touched surfaces adjacent to patients. Surfaces with assumed or visible contamination. Terminal disinfection in rooms or areas where infected or colonized patients with easily transferable nosocomial pathogens are cared for, and in outbreak situations. Furthermore, the knowledge of the persistence of pathogens will also support ensuring the biosafety in microbiological and biomedical laboratories, food-handling settings, and for hygienic behaviour in the everyday life to prevent transmission of infectious diseases.


title: The Nucleolus: Structure and Function

text: The nucleolus is the largest nuclear organelle and is the primary site of ribosome subunit biogenesis in eukaryotic cells. It is assembled around arrays of ribosomal DNA genes, forming specific chromosomal features known as nucleolar organizing regions (NORs) which are the sites of ribosomal DNA transcription. While the nucleolus main activity involve different steps of ribosome biogenesis, the presence of proteins with no obvious relationship with ribosome subunit production suggests additional functions for the nucleolus, such as regulation of mitosis, cell cycle progression, stress response and biogenesis of multiple ribonucleoprotein complexes. The many novel factors and separate classes of proteins identified within the nucleolus support this view that the nucleolus may perform additional functions beyond its known role in ribosome subunit biogenesis. Here we review our knowledge of the nucleolar functions and will provide a detailed picture of how the nucleolus is involved in many cellular pathways.


SARS coronavirus infection: pathology and pathogenesis of an emerging virus disease


title: Cardiology

text: myocardial—myocardial infarction, angina, myocarditis


title: Dried Plasma

text: Dried plasma provides an alternative for early plasma transfusion in the resuscitation of hemorrhagic shock in environments where fresh frozen plasma is not immediately available. It is produced by freeze-drying or spray-drying liquid or thawed plasma. It is shelf-stable for prolonged periods, can be stored at room temperature, and is easy to transport, reconstitute, and administer. It was widely used in WWII but fell out of favor due to the risk of infectious disease transmission. The German and French experiences with lyophilized plasma are the most extensive and show a good track record of efficacy and safety. Recent studies show many beneficial effects of dried plasma in the treatment of shock in large animal models. Currently, no FDA-licensed product is available in the USA, but several are under development.


title: Importance of Natural Proteins in Infectious Diseases

text: Proteins are important biomolecules, extensively involved in almost all biological processes. A number of proteins are also implicated in infectious diseases. Bacterial proteins used in adhesion to host epithelium, bacterial toxins, and viral membrane glycoproteins are some of the proteins involved in infectious diseases. Even components of the host innate immune system like Toll-like receptors and Nod-like receptors and adaptive immune components like immunoglobulins aiding in defense against pathogens are important biological proteins. Chaperones like acid and heat shock proteins provide protection from high temperatures, metabolic poisons, and other stressful conditions. Several natural and artificial proteins are components of vaccines, a key strategy to control fatal diseases, lacking empirical treatment. It is necessary to investigate these proteins, to develop new biomedical tools and technologies, aiding in eradication of various diseases. Thus, further research should be carried out in this field, for saving and improving quality of human lives.


title: Current Concepts of Severe Pneumococcal Community-acquired Pneumonia

text: Community-acquired pneumonia (CAP) is a major health problem, even in developed countries, being the leading cause of death due to infectious diseases in the USA [1]. CAP has a wide clinical spectrum of severity: up to 80% of patients are successfully managed in primary care, but 1% of patients with CAP are classified as having severe disease, needing intensive care unit (ICU) admission, with 20–50% dying despite all available support and treatment options being utilized. Streptococcus pneumoniae is the most common cause of CAP, enclosing the subset group of patients having severe disease [2]. Moreover, bacteremia is not uncommon in pneumococcal CAP (20%) and has been associated with increased severity and mortality compared with non-bacteremic pneumonia [3].


title: Argument from Analogy

text: Similarities between objects, people and places pervade our thinking and influence our interaction with the environment. Many of these similarities serve no logical purpose but have a descriptive or explanatory function in our cognitive affairs. However, for the substantial number of analogies which are used in argument, their logical and other attributes have long been a source of fascination for investigators in a range of disciplines. It is argued in this chapter that cognitive agents use the argument from analogy as a facilitative heuristic to guide their judgements about public health problems when evidence or knowledge is not available in a particular context. To this extent, the argument is one type of adaptation of our rational procedures to the problem of uncertainty in the cognitive domain. Several examples of the use of this argument in a public health context are examined. The dialectical and epistemic features of this argument are addressed within a discussion of the use of analogical argument in systematic and heuristic reasoning. The results of a study of public health reasoning reveal that members of the public are adept at identifying the conditions under which the use of analogical argument is more or less rationally warranted.


title: Vaccinia and Pox-Virus

text: Vaccinia virus has been studied extensively since its discovery as a smallpox vaccine in 1798. Its use as a smallpox vaccine documented its safety profile. It was later found that its large size and ability to accept large fragments of DNA combined with its natural tumor affinity make it an attractive agent for cancer therapy. This chapter discusses the history of the vaccinia, the various strains available, the biology of the virus as well as the steps in creating recombinants. The various clinical and safety considerations will be addressed. We will also discuss the various methods used to treat cancer using the vaccinia virus and will review the recent clinical trials using vaccinia in the treatment of cancer.


Economic aspects of vaccines and vaccination: a global perspective


title: Infectious Diseases

text: Commercial airline travel creates conditions conducive to the spread of infectious diseases: the proximity of passengers in a confined space and the origin of flights from anywhere on the globe. This chapter describes symptoms of infectious diseases that might emerge in an airline passenger and the steps that a responding medical professional can take to stabilize the person and minimize the exposure risk for other passengers and the crew. It also reviews guidelines issued by the Centers for Disease Control regarding infectious diseases that might be encountered during flights, procedures for working with pilots to alert ground crews about passengers’ medical needs, and requirements for reporting incidents to authorities after landing.


title: The Basic Concept of Microbiology

text: Aseptic technique is a method that involves target-specific practices and procedures under suitably controlled conditions to reduce the contamination from microbes. It is a compulsory laboratory skill to conduct research related in the field of microbiology. Mycologist/microbiologists must follow aseptic techniques for multiplicity procedures such as screening of isolates/strains, pure cultures, slant cultures, single spore cultures, microbes transferring cultures, inoculating media, and conducting several microbiological experiments. Proper aseptic technique has prevented the cultures contamination from inborn and outborn microbes in the environment. As example, airborne microbes (e.g., fungi) handpicked from the surveyor’s health, the lab benchtop, unsterilized glassware and equipment, dust, and other areas, thus interfering to get proper experiment results. Using the proper aseptic technique can significantly reduce/minimize the risk of contamination.


title: Respiratory Viruses and Other Relevant Viral Infections in the Lung Transplant Recipient

text: As advances occur in surgical technique, postoperative care, and immunosuppressive therapy, the rate of mortality in the early postoperative period following lung transplantation continues to decline. With the improvements in immediate and early posttransplant mortality, infections and their sequel as well as rejection and chronic allograft dysfunction are increasingly a major cause of posttransplant mortality. This chapter will focus on infections by respiratory viruses and other viral infections relevant to lung transplantation, including data regarding the link between viral infections and allograft dysfunction.


title: Attainment – achieving compliance with ESARIS standards

text: The ESARIS Attainment Model (or: ESARIS Compliance Attainment Model) relates to activities ensuring that the ESARIS security standards are actually implemented and comprise methods for verifying this (Sect. 7.1). In the first place, the ESARIS security standards have to be developed by starting with requirements engineering as the basis (Sect. 7.2). The “Attainment” is organized into five ESARIS Attainment Levels which relate to the achievement of milestones in delivering ICT services according to the methods, procedures, and standards of ESARIS. The first three levels are related to more technical activities (IT engineering, implementation), the set-up for delivery (operations) and include methods for measuring the compliance (Sect. 7.3). The other two levels relate to the integration into portfolio and service catalogs. The portfolio development and the consideration of security in service catalogs (Sect. 7.4) are important for user organizations or even the next party in the internal supply chain of the ICT Service Provider.


title: Noncoding RNA Expression During Viral Infection: The Long and the Short of It

text: New technologies have expanded our view of viral–host interactions with the growing identification of non-coding RNAs (ncRNAs) that act as key regulators of viral infection. In this chapter, we explore novel genomics-based approaches used to characterize ncRNAs involved in viral infection, focusing mainly on microRNAs and long noncoding RNAs. We present recent evidence implicating virally encoded and host-derived ncRNAs in viral replication and pathogenesis regulation, focusing on four different viral diseases (IAV, KHSV, HIV, and HBV). Finally, we discuss the current knowledge of ncRNAs modulation of innate and adaptive immune responses to viral infection. These findings highlight the complexity of host–pathogen networks determining the outcome of viral disease. Understanding the role of ncRNAs in these networks may offer novel antiviral therapy and diagnostic tools.


title: Public Health Lessons: Practicing and Teaching Public Health

text: The following four cases represent events that actually occurred at the local, statewide, national, and international levels. A general, succinct overview is provided of each case with references listed should the reader want to access additional resource materials. The concise format of these cases is intended to generate questions. Following the general overview of each case, I examine the lessons learned from the practitioner and educator perspective and I list the skills necessary to address the issues in the case. The reader will note that there are skills that are essential for the public health practitioner to master, whether one is in an internship, entry-level position, or the director of a public health organization and so these skills are consistently listed. I encourage the reader to regularly keep abreast of the news locally and abroad and to set aside time before a staff meeting or supervisory group meeting, or use the first few minutes of a class to discuss these issues. Ask your workforce or students, “Are we ready to handle such an event if it were to occur here?”; “What resources would we need to have accessible?”; “Have we partnered with the correct agencies in the community?”; “Do we have an established, trusted presence in the community?”; “Who else do we need on our team?”; “Do we need training in a specialty area, e.g., emergency preparedness?”; “What skills have we mastered and what skills do we need to obtain?” The discussion-based questions are endless but one runs the risk of not being prepared, either individually, or in their agency, should they not discuss how public health events are occurring around us daily. I encourage you to adapt these selected cases to use in your organization and/or classroom. Discussing these issues and reviewing the lessons learned will only help us to be better prepared public health practitioners and educators of public health students.


title: Herbonanoceuticals: A Novel Beginning in Drug Discovery and Therapeutics

text: The Indian pharmaceutical industry is the world’s second largest industry (by volume) that develops products and market drugs licensed for use as medications. Medicines manufactured in the modern era are associated with major controversies such as non–target specificity, resistance, repeated administration, immune rejection, and other adverse effects on the body. Thus, there is a great need to find drugs that do not raise the aforementioned issues. Nature is an excellent hub providing a diverse range of phytoconstituents that open the way to phototherapeutics, which need a scientific path to deliver the active elements in a supported way to increase patient compliance and reduce the need for repeated administration. To discover a novel phytochemical as a lead compound for a therapeutic purpose is a real challenge. In former times, drug discovery was a complex process, as it took several years to find a lead compound for use against a particular disease. Nowadays, however, virtual screening methods have been developed, which are target specific, time consuming, and cost effective. To avoid increased and repeated administration of a drug, nanosized drug delivery systems for herbal drugs have been developed to enhance the activity and overcome problems associated with synthetic medicines. This review summarizes three main fields: drug discovery, docking for drug design, and last—but not least—drug delivery systems. Nowadays, nanobased drug delivery systems are in demand for delivery of herbal medicines used for therapeutic purposes. Herbonanoceuticals—herbal drugs of a nanosize—have better remedial value and fewer detrimental effects than modern medicines. Therefore, herbonanoceuticals can be a boon in the field of therapeutics.


MedCERTAIN/MedCIRCLE: Using Semantic Web Technologies for Quality Management of Health Information on the Web


title: Histopathology

text: During the last 30 years, advances in intensive and critical care units, organ transplantation, concomitant use of immunosuppressive drugs, and increasing prevalence of chronic diseases, malnutrition, and other debilitating conditions, as well as the human immunodeficiency virus pandemic, have increased the incidence of systemic mycotic diseases, the most serious form of fungal diseases are the ones that comprise the central nervous system, representing the most dangerous clinical situations. In those cases, starting an adequate therapy through a rapid and assertive diagnosis is absolutely necessary. Considering the fastidious microbiological nature of some fungi (longtime requirement, specific culture conditions, and biohazard issues), as well as the lack of alternative testing availability, a rapid diagnosis is always challenging. When a tissue or liquid specimen is available, its pathological analysis constitutes a rapid and cost-effective way to provide a presumptive or definitive diagnosis of an invasive fungal infection; however, microbiologists, pathologists, and clinicians need to be aware of the limitations of microscopical diagnosis. In this chapter, we review the usual histological presentation of the most frequent central nervous system fungal infections.


title: A Farewell to the “Sick Man of East Asia”: The Irony, Deconstruction, and Reshaping of the Metaphor

text: Susan Sontag revealed how a disease could be turned into a metaphor in social evolution, from merely a disease of the body to moral judgment or even political oppression. In her article “AIDS and its Metaphors” written in 1989, she offers a plan to do away with the metaphor: “With this illness, one that elicits so much guilt and shame, the effort to detach it from these meanings, these metaphors, seems particularly liberating, even consoling. But the metaphors cannot be distanced just by abstaining from them. They have to be exposed, criticized, belabored, used up” (Songtag 2003). In Sontag’s terms, “metaphor” mainly refers to the symbolic social oppression of the diseases. For example, cancer is a metaphor for the defect of the sick person in personality. While diseases were a biological phenomenon, the “metaphor” was a social one. What I would like to demonstrate here was none other than the related “political metaphor” started by the “anti-germ warfare.”


title: Ear, Nose, and Throat

text: This chapter reviews otolaryngology conditions most commonly seen by pediatricians. Included are issues involving the ears, nose, and nasopharynx; the sinuses, throat, mouth, and oropharynx; and the neck. The most common surgical otolaryngologic procedures will also be discussed. Many of these conditions can be effectively identified, diagnosed, and treated by primary care physicians. However, for certain conditions, prompt identification and timely referral to an otolaryngologist is required.


title: Organoselenium in Nature

text: Selenium, among the naturally occurring elements, is nowadays considered the most relevant for the redox homeostasis of living systems. In this chapter, its role in plants, bacteria, and humans is scholarly discussed. Some plants have the possibility to accumulate this element, thus becoming a natural source for animals and humans, in which selenium is embedded in selenoproteins, as the 21(st) amino acid, selenocysteine (l-Sec). The main classes of selenoenzymes (glutathione peroxidase, thioredoxin reductase, and iodothyronine deiodinases) are reported here and the molecular mechanism that characterizes their physiological action is discussed.


title: Allergie, Mikrobiom und weitere epigenetische Faktoren

text: Die chinesische Medizin hat schon vor 2000 Jahren einen Zusammenhang zwischen Lunge und Dickdarm erkannt. Nach den Prinzipien der 5 Wandlungsphasen impliziert jegliche Behandlung des Yin-Organs Lunge (bzw. des Respirationstraktes) eine Regulation und Mitbehandlung des gekoppelten Yang-Organs, des Dickdarms. Nicht nur diese beiden Organe sind dem Element Metall zugeordnet, sondern auch die Haut als zugehörige Körperschichte und die Nase als Öffner (◘ Abb. 4.1).


title: Allgemeine Chirurgie

text: Die sechs klassischen Leitsymptome des Patienten erfordern eine sequenzielle Diagnostik.


Nanomicrobiology


title: Kardiologie

text: —. meist bakterielle (selten mykotische) Entzündung der Herzinnenhaut unter Beteiligung der Herzklappen; —. oft Vorbestehen einer prädisponierenden strukturellen Herzerkrankung, z. B. Klappenvitium oder kongenitaler Herzfehler; —. Befall der Mitralklappe und Aortenklappe am häufigsten, bei i.v. Drogenabusus Befall der Herzklappen des rechten Herzens durch Staphylokokken; —. Streptokokken (60–80% aller Fälle, davon >50% S. viridans), Staphylokokken (20–35%), Enterokokken, gramnegative Bakterien und andere seltene Erreger, z. B. Pilze (10%); —. —. Destruktionen und Vegetationen an gesunden Herzklappen (Endocarditis ulcerosa et polyposa) durch hochvirulente Erreger; —. Erregerspektrum: β-hämolysierende Streptokokken, Staphylococcus aureus, Pneumokokken, Gonokokken, gramnegative Bakterien; —. —. meist an vorgeschädigten Herzklappen, z. B. nach rheumatischer Endokarditis; —. Erregerspektrum: Streptococcus viridans, Enterokokken, gramnegative Bakterien der Darmflora, Staphylokokken, Pilze;


title: Engineering Ceramic Fiber Nanostructures Through Polymer-Mediated Electrospinning

text: Electrospinning is increasingly used as a simple and straightforward technique to fabricate one-dimensional fibers from both organic and inorganic materials. These one-dimensional fibers with controlled sizes possess some unique features such as large surface area to volume ratio, high porosity, and low density. Compared to other conventional materials, these features make them attractive for applications such as energy harvesting, energy storage, super-hydrophobic membranes, and sensors. This chapter provides an overview on the synthesis of inorganic fibers through polymer-mediated electrospinning. Some of the common techniques employed by many researchers, such as solgel combined with electrospinning, emulsion electrospinning, and electrospinning combined with solid–gas reaction, to fabricate metal oxide fibers are discussed. In addition, techniques to fabricate ceramic and metal oxide fibers having different morphologies and hierarchical structures are described. Recent applications of electrospun metal oxide fibers are finally highlighted with a focus on filtration, sensors, photocatalysis, and energy.


title: Neurochirurgie

text: Das Gebiet der Neurochirurgie umfasst die Erkennung, operative, perioperative und konservative Behandlung, Nachsorge und Rehabilitation von Erkrankungen, Verletzungen, Verletzungsfolgen und Fehlbildungen des zentralen Nervensystems, seiner Gefäße und seiner Hüllen, des peripheren und vegetativen Nervensystems (Bundesärztekammer 06/2010).


title: Health System in China

text: The health of China’s population improved dramatically during the first 30 years of the People’s Republic, established in 1949. By the mid-1970s, China was already undergoing the epidemiologic transition, years ahead of other nations of similar economic status, and by 1980, life expectancy (67 years) exceeded that of most similarly low-income nations by 7 years. Almost 30 years later, China’s 2009 health reforms were a response to deep inequity in access to affordable, quality healthcare resulting from three decades of marketization, including de facto privatization of the health sector, along with decentralized accountability and, to a large degree, financing of public health services. The reforms are built on earlier, equity-enhancing initiatives, particularly the reintroduction of social health insurance since 2003, and are planned to continue until 2020, with gradual achievement of overarching objectives on universal and equitable access to health services. The second phase of reform commenced in early 2012. China’s health reforms remain encouragingly specific but not prescriptive on strategy; set in the decentralized governance structure, they avoid the issue of reliance on local government support for the national equity objective, leaving the detailed design of health service financing, human resource distribution and accountability, essential drug lists and application of clinical care pathways, etc. to local health authorities answerable to local government, not the Ministry of Health. Community engagement in government processes, including in provision of healthcare, remains limited. This chapter uses the documentation and literature on health reform in China to provide a comprehensive overview of the current situation of the health sector and its reform in the People’s Republic.


title: The “City Operator” and the Tianyi Square Redevelopment Project

text: After describing today’s Tianyi Square, this chapter looks at the dilapidated conditions of this area before the redevelopment. Then it depicts the nation-wide fever of building Central Business Districts in Chinese cities since the late 1990s as the background. Afterward it analyzes the mechanism of the “city operator” (chengshi yunyingshang) in the Tianyi Square redevelopment project, which describes the role played by an entrepreneurial state and its subordinate urban development corporation in downtown redevelopment in Ningbo, as well as the origin of this mechanism back in the city of Dalian in the 1990s. It also analyzes the methods of compensating relocated residents, financing with land mortgage loans, historic conservation, promotion, and governance structure in the Tianyi Square project.


title: Mikrobiologie und Antiinfektiva

text: Bei einem 38-jährigen Patienten wurde eine Analfistel operiert. Am 3. postoperativen Tag kommt es zur akuten Verschlechterung des Gesundheitszustands mit hämodynamischer Instabilität und Fieber. Daraufhin wird der Patient in eine Klinik der Maximalversorgung verlegt. Beim Eintreffen im Schockraum ist der Patient somnolent und kaltschweißig. Der Blutdruck beträgt 70/40 mmHg, die Herzfrequenz 120/min und die Körpertemperatur 39,6°C. Das Hautkolorit ist blass-grau. Im Verlegungsbericht wird bei stark ödematös geschwollenem Skrotum der Verdacht auf eine Fournier-Gangrän nach Analfistel-OP gestellt. Der diensthabende Intensivmediziner muss nun parallel die hämodynamische Situation stabilisieren, mikrobiologisches Material gewinnen, eine kalkulierte antimikrobielle Therapie beginnen und weitere Maßnahmen zur Diagnosesicherung einleiten.


title: Makroamputationsverletzungen im Bereich der oberen Extremität

text: Alle Amputationsverletzungen im Bereich der oberen Extremität distal des Radiokarpalgelenks werden als Mikroamputationsverletzungen bezeichnet.


title: Advances in Gastrointestinal Surgery

text: Carcinoma of the stomach is a global disease with the highest incidence in Asia, South America and Eastern Europe. The disease is least common in USA and Western Europe [1]. The disease is common among smokers. Other risk factors are H. pylori infection, atrophic gastritis, Menetrier’s disease and previous gastrectomy. The disease can be genetic as in familial adenomatous polyposis, hereditary non-polyposis colorectal cancer, Peutz-Jegher’s syndrome, etc. [2]. Screening for gastric carcinoma is done in high incidence areas such as Japan, Korea and China.


title: Gastroenteritis and Intractable Diarrhea in Newborns

text: Gastroenteritis (GE) still represents a major cause of morbidity and mortality in children worldwide. Although the implementation of effective measures resulted in a significant decrease of global mortality, much remains to be done. The burden of GE in the neonatal age is generally reduced in relation to some protective factors (breastfeeding, minimal exposure to water and contaminated food, passive maternal immunity). In newborns, the contribution of the various causative agents could differ from that of the other pediatric age groups, nevertheless Rotavirus and pathogenic strains of E. coli remain the main etiologies. The acquisition of the pathogen generally occurs through the contaminated birth canal or by the use of contaminated tools, objects, or hands of the caregivers. The clinical presentation may vary widely from an acute, self-limiting disease to life-threatening complicated infections. The assessment of the dehydration and its rapid correction represent the cornerstones of the management of any GE. Antibiotic therapy should be reserved to cases with systemic symptoms, severe dehydration, or in the presence of bloody diarrhea. While the occurrence of diarrhea in the neonatal age is mainly caused by acute gastrointestinal infections, differential diagnosis with several other diseases including forms of severe congenital disorders should be considered.


title: Management of Peritoneal Malignancies

text: Peritoneal malignancies may result in a widespread disease process, peritoneal carcinomatosis (PC), which has significant morbidity and mortality for patients afflicted by this disease. Dissemination into the peritoneum and throughout the abdomen can be due to a primary peritoneal cancer or other primary malignancies that have metastasized, including (but not limited to) colorectal cancer, gastric cancer, pancreatic cancer, appendiceal cancer, ovarian cancer, and mesothelioma. Patients with gastrointestinal (GI) or gynecologic malignancies with peritoneal carcinomatosis may have dismal survival due to a high disease burden within the abdominal cavity. Some studies suggest the average survival for patients with peritoneal carcinomatosis of colorectal origin is 18–48 months, for high-grade appendiceal adenocarcinoma 12–36 months, and for low-grade appendiceal neoplasms >60 months. As the understanding of peritoneal malignancies and peritoneal carcinomatosis evolved, it may now be acceptable to treat this as locoregional disease.


Lung Biopsy in Acute Respiratory Distress Syndrome


title: Disaster Resilient Future in Korea

text: The Republic of Korea has not only monumentally progressed socially, economically, and politically since 1948, but has taken the arduous undertaking of reforming the way it reduces disaster risk, mitigates the impact, and prepares for and responds to disasters for a resilient future. The administrative and organizational reforms have not been without its setbacks or obstacles; however, they were not so insurmountable that they could not be overcome by one of Korea’s greatest assets: persisting endeavors to build back better and to enhance resilience. Starting with an independent national agency in 2004 to manage natural and human-caused disasters and preparedness, the government quickly realized, through focusing events, it was insufficient to handle the increasing complexity and intensifying of disasters striking the nation. Therefore, through political will and hindsight, it continuously coalesced pertinent disaster management responsibilities into newer and newer agencies until 2016, when it enacted a progressively more ubiquitous and self-propelling agency. However, although the agency is apt for current disasters, it will not be for future disaster, which needs the integration of resilience into Disaster Risk Management (DRM). Therefore, we suggest five tenets on how to make Korea’s resilient future as well as for other nations that are and will follow in Korea’s footsteps, especially for those nations in Asia and Africa. A future that is resilient against all types of disaster risks, especially being prepared well for “low probability and high impact” focusing events that are located in the long-tail of the Power-law Distribution.


title: Non-viral Vector for Muscle-Mediated Gene Therapy

text: Non-viral gene delivery to skeletal muscle was one of the first applications of gene therapy that went into the clinic, mainly because skeletal muscle is an easily accessible tissue for local gene transfer and non-viral vectors have a relatively safe and low immunogenic track record. However, plasmid DNA, naked or complexed to the various chemistries, turn out to be moderately efficient in humans when injected locally and very inefficient (and very toxic in some cases) when injected systemically. A number of clinical applications have been initiated however, based on transgenes that were adapted to good local impact and/or to a wide physiological outcome (i.e., strong humoral and cellular immune responses following the introduction of DNA vaccines). Neuromuscular diseases seem more challenging for non-viral vectors. Nevertheless, the local production of therapeutic proteins that may act distantly from the injected site and/or the hydrodynamic perfusion of safe plasmids remains a viable basis for the non-viral gene therapy of muscle disorders, cachexia, as well as peripheral neuropathies.


title: Childhood’s End

text: When things stop working in an organizational system—a firm, a nonprofit, or a political entity—people have two choices in addressing the failure: to leave or to protest. Both can be powerful. As the author of this thesis, economist Albert Hirschman, pointed out in his 1970 book Exit, Voice, and Loyalty, it is possible for even an entire country (e.g., the United States or Liberia) to be created by people who leave behind unhappy circumstances and start something new elsewhere. Likewise, examples of the success of protest (“voice” and related action) in achieving major changes are plentiful. Consider the French Revolution and the multitude of regime changes and coups d’état that dot human history—not to mention the many times that a regime has been replaced by popular demand of voters.


title: Stumpfe Wunderwaffe(3)

text: Bevor wir den Test für Krankheitserreger erklären, möchten wir noch eine andere Geschichte erzählen.


title: Sendungen: Nachrichten

text: Nachrichten sind knapp gefasste Informationen; sie enthalten nichts Überflüssiges. Nachrichten sind besonders glaubwürdig; sie unterscheiden sich grundsätzlich von meinungsbetonten journalistischen Beiträgen.


title: Communicable and Non-Communicable Diseases and Health Communication in Mainland China and Hong Kong

text: This chapter discusses how rapid development in China has caused a number of environmental hazards, food insecurity, and communicable health diseases. How the Chinese government has tackled pollution and major epidemics such as severe acute respiratory syndrome (SARS) and airborne diseases in major cities, and how Hong Kong has handled its major epidemics, are analyzed in depth. Also, non-communicable disease emerging from the change of lifestyle in China will be discussed. Health Communication Policies and Planning in China will be assessed with recommendations and lessons learned from China and Hong Kong. Political-economic policies will be considered together with health communication policies regarding communicable and non-communicable diseases.


Fakten auf einen Blick


The respiratory system


title: Severe Epigastric Pain with Nausea and Vomiting

text: A 41-year-old woman presents to the emergency department complaining of severe and continuous epigastric pain for the past 24 hours. The pain radiates straight through to her back. She has had progressive nausea with vomiting. The vomit is bile-stained and without blood. She has had similar but less severe episodes of abdominal pain in the past, usually after eating heavy meals, but they always resolved within a few hours. She is gravida two and para two, with last menses 2 weeks ago, and does not consume any alcohol. On exam, she is afebrile, heart rate is 115 beats/min, blood pressure of 128/86 mmHg, and respiratory rate is 18/min. Her abdomen is not distended. She has no surgical scars on her abdomen and no obvious masses visible. She has no bruising around her umbilicus or along her flank. Bowel sounds are hypoactive. She has marked tenderness to palpation in her epigastrium, without guarding or rebound. The remainder of her abdomen is soft and non-tender to palpation. No masses or organomegaly are appreciated. Laboratory examination reveals a white blood cell count of 17.2 × 10(3)cells/μL (normal 4.1–10.9 × 10(3) cells/uL), amylase of 1545 u/L (30–110 u/L), lipase of 1134 u/L (7–60 u/L), ALT of 245 u/L (7–56 u/L), AST of 263 u/L (5–35 u/L), serum glucose of 156 mg/dl (65–110 mg/dL), and LDH 180 u/L (0–250 u/L). An abdominal series demonstrates gas throughout the small and large bowel and a focal dilated loop of proximal small bowel without air fluid levels. There is no free air under the diaphragm.


title: Network Structures of Multiple Sequences Induced by Mutation

text: As fast multiple alignment (MA) algorithms become a reality, analyses and applications of their results become the central problem of genome research. In this chapter, we introduce the general methods of constructing the phylogenetic tree from multiple alignments, such as UPGMA, neighbor-joining, the maximum parsimony method, maximum-likelihood method and Bayesian methods. We then discuss the network structure theory of the multi-sequences induced by mutations. Using the distance matrix and the mutation information, we find the network structure of multi-sequences. Furthermore, we introduce the orthogonalization theorem for a mutation network. We may easily obtain the mutation relations for data structures among a multiple sequence from the network structure and the orthogonalization procedure of a mutation network. Finally, we give some examples of the network structure and explain the basic steps needed to analyze these multi-sequences.


title: Definition and Overview of Emerging Threats

text: The risks posed by bioterrorism and the proliferation of biological weapons capabilities have increased concern about how the rapid advances in genetic engineering and biotechnology could enable the production of biological weapons with unique and unpredictable characteristics. The nature of the biotechnology problem—indeed the nature of the biological research enterprise—is vastly different from that of theoretical and applied nuclear physics in the late 1930s. Evolving biotechnology presents an inextricably linked combination of opportunity and danger and that distinction turns on projected consequences and attributed intentions at the level of fundamental research. Matthew Meselson gave a stark warning of the potential dangers posed by the destructive applications of biotechnology at the annual meeting of the National Academy of Sciences in May 2000.


title: The Human Nature of Infectious Disease

text: Infectious disease raises questions about humans’ abilities to eliminate harm through the control of nature. People work to understand microbial life in order to manage the ways microbes mutate, adapt, and evolve, even while recognizing organisms’ essential nature. Public health practices from the past and present exemplify this ongoing quest to “solve” disease. Eradicating pathogens persists as a public health objective, even as new microbes emerge in the human environment. “Superbugs” and antibiotic resistance exemplify the problem-solution-problem cycle of disease. Moving from solutions-based thinking enables new imaginings of the microbial world in which humans reside.


title: Obstruktive Atemwegserkrankungen

text: In den folgenden Abschnitten werden die verschiedenen Formen der obstruktiven Atemwegserkrankungen erläutert, die je nach Alter, prädisponierenden Risikofaktoren und auch je nach Art der Auslöser verschiedenartige Ausprägungen und Verlaufsformen (Phänotypen) annehmen können.


title: Perception, Amplification and Communication: A Case Study of Food Safety Risks

text: In recent years, China has seen a rapid increase in public health incidents, among which food safety incidents have drawn the most attention. Every major food safety incident is a challenge to the safety warning line and leads to various social consequences in addition to economic losses. Food is the first necessity of the people, and food safety is of paramount importance. Any incident concerning food safety will spark public concern, and if not properly handled, may cause social panic.


title: Alveolar Diseases

text: Adenocarcinoma has surpassed squamous cell carcinoma as the leading histologic type, accounting for 30 % of all cases of lung cancer. The new 2015 WHO classification provided the basis for a multidisciplinary approach emphasizing the close correlation among radiologic and histopathologic pattern of lung adenocarcinoma. The term “bronchioloalveolar carcinoma” has been eliminated, introducing the concepts of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) and the use of descriptive predominant patterns in invasive adenocarcinomas (lepidic, acinar, papillary, solid, and micropapillary patterns). Invasive mucinous adenocarcinoma is the new definition for mucinous bronchioloalveolar carcinoma.


title: Behavioral Health Support for Patients, Families, and Healthcare Workers

text: During the 2014–2016 Ebola outbreak in West Africa, over 850 healthcare workers contracted Ebola, and over 500 died. These tragic numbers underscore the need for strict adherence to infection control precautions when caring for patients with Ebola and other diseases that are both highly infectious and potentially fatal. In addition to the use of personal protection equipment (PPE), such measures include source isolation of infected patients. In the process of confining infectious pathogens, however, it is essential that health systems do not overlook the psychological needs of patients nor that of the medical staff who care for them. This chapter is divided into two sections. The first explores the experiences of patients cared for in source isolation, highlighting the possible iatrogenic psychological consequences of treatment in a biocontainment unit. Strategies for mitigating the potentially harmful psychological effects of isolation are reviewed, including considerations for children. The second section considers the experiences of healthcare workers. The discussion outlines the psychological impact of treating patients with infectious diseases, risk factors for emotional distress, and strategies to promote psychological well-being and resilience.


title: Hightech in der Infektiologie: Diagnose und Therapie

text: Jeden Tag sterben weltweit etwa 13 Millionen Menschen an den Folgen viraler, bakterieller oder parasitärer Erkrankungen.


title: Respiratory Infections

text: The majority of respiratory tract infections (RTIs) are community acquired and are the single most common cause of physician office visits and among the most common causes of hospitalizations. The morbidity and mortality associated with RTIs are significant and the financial and social burden high due to lost time at work and school. The scope of clinical symptoms can significantly overlap among the respiratory pathogens, and the severity of disease can vary depending on patient age, underlying disease, and immune status, thereby leading to inaccurate presumptions about disease etiology. The rapid and accurate diagnosis of the causative agent of RTIs improves patient care, reduces morbidity and mortality, promotes effective hospital bed utilization and antibiotic stewardship, and reduces length of stay. This chapter focuses on the clinical utility, advantages, and disadvantages of viral and bacterial tests cleared by the Food and Drug Administration (FDA), and new promising technologies for the detection of bacterial agents of pneumonia currently in development or in US FDA clinical trials are briefly reviewed.


title: Recombinant poxvirus vaccines in biomedical research

text: In biomedical research recombinant poxviruses are investigated as important candidate medicines to derive advanced options for prevention and/or treatment of infectious diseases or cancer. Genetically engineered viruses can readily synthesize biologically active heterologous proteins, serve to determine relevant targets of cell-mediated and humoral immunity, and identify types of immune responses needed for protection against a multitude of different specific diseases. Substantial progress in vaccine development is based on the availability of exceptionally safe but efficient carrier viruses, on increasingly versatile vector technologies and on the feasibility of large scale manufacturing. Moreover, advances in deciphering the molecular pathways regulating poxvirus-host interactions will provide additional means to potently activate innate immune stimulation upon vaccination and to derive vectors with specifically targeted replicative capacity for experimental tumor therapy.


title: An Unexpected Diagnosis of Pulmonary Tuberculosis

text: Pulmonary tuberculosis is rare in critically ill cancer patients. We report the case of a man treated for Hodgkin’s lymphoma and admitted to the ICU for acute respiratory failure. All investigations were negative, and he died with a presumptive diagnosis of bleomycin-related pulmonary toxicity and Escherichia coli endocarditis. Several weeks after his death, cultures of sputum and BAL fluid samples were found positive for Mycobacterium tuberculosis. Postmortem pulmonary biopsies confirmed the diagnosis of pulmonary tuberculosis.


Infections in the PICU


title: Computer Network Vulnerabilities

text: System vulnerabilities are weaknesses in the software or hardware on a server or a client that can be exploited by a determined intruder to gain access to or shut down a network. Donald Pipkin defines system vulnerability as a condition, a weakness of or an absence of security procedure or technical, physical, or other controls that could be exploited by a threat [1].


title: Cytokines

text: Cytokines, currently known to be more than 130 in number, are small MW (<30 kDa) key signaling proteins that modulate cellular activities in immunity, infection, inflammation, and malignancy. Key to understanding their function is recognition of their pleiotropism and often overlapping and functional redundancies. Classified here into 9 main families, most of the 23 approved cytokine preparations (19 different cytokines and 4 pegylated), all in recombinant human (rh) form, are grouped in the hematopoietic growth factor, interferon (IFN), platelet-derived growth factor (PDGF), and transforming growth factor β (TGFβ) families. In the hematopoietin family, approved cytokines are aldesleukin (rhIL-2), oprelvekin (rhIL-11), filgrastim and tbo-filgrastim (rhG-CSF), sargramostim (rhGM-CSF), metreleptin (rh-leptin), ancestim (rh-SCF), and the rh-erythropoietins, epoetin and darbepoetin alfa. Anakinra, a recombinant receptor antagonist for IL-1, is in the IL-1 family; recombinant interferons alfa-1, alfa-2, beta-1, and gamma-1 make up the interferon family; palifermin (rhKGF) and becaplermin (rhPDGF) are in the PDGF family; and rhBMP-2 and rhBMP-7 represent the TGFβ family. The main physicochemical features, FDA-approved indications, modes of action and side effects of these approved cytokines are presented. Underlying each adverse events profile is their pleiotropism, potency and capacity to release other cytokines producing cytokine “cocktails.” Side effects, some serious, occur despite cytokines being endogenous proteins, and this therefore demands caution in attempts to introduce individual members into the clinic. This caution is reflected in the relatively small number of cytokines currently approved by regulatory agencies and by the fact that 15 of the FDA-approved preparations carry warnings, with 10 being black box warnings.


title: Role of Biomarkers in Health Care

text: Study of biomarkers of various diseases will help to improve the management in three ways: 1. By providing a better understanding of the disease pathomechanism 2. By improving the diagnosis and determining the prognosis 3. By providing a basis for development of therapeutics and monitoring the effect of therapeutics on the disease


title: Transmission of colds

text: Rhinorrhea, nasal congestion, and sore throat herald the beginning of the cold season for both children and adults. Although the common cold is a self-limited infection, there are no effective treatments presently available and complications, missed time from work and school, and overall discomfort are not insignificant. Understanding how infections are transmitted may lead to interventions to reduce rates of infection. In order to establish a route of transmission, certain conditions must be met. The virus must be produced and shed at the site of infection. The virus must be deposited in the environment and be able to survive there. The virus must then be able to reach the portal of entry. Finally, interruption of the proposed route of transmission must reduce the incidence of infection under natural conditions. Applying this framework, there is clear evidence in both experimental and home settings that colds can be transmitted via self-inoculation. A small amount of evidence is available relating to large and small particle aerosol transmission. Because rhinovirus is responsible for half of all colds, it has been used as the model to understand how virus is transmitted from one person to another in experimental settings. Rhinovirus has been shown to infect via self-inoculation following hand-to-hand contact with contaminated hands or hand-to-surface contact with contaminated objects in the environment. Similarly, there is convincing evidence that the self-inoculation method of cold virus transmission occurs in the home environment, where colds arre most often transmitted. Aerosol transmission has been studied in the experimental setting and may provide another, albeit less common method for transmission of rhinovirus infection. As more is understood about the transmission of cold viruses, effective methods to interrupt transmission may be devised.


title: Overview and Historical Review

text: This book investigates and scrutinizes the lessons learned in the Republic of Korea during a five-decade swath of disasters – from 1948 to 2015 – and results in the disaster response policy change model in the wake of major disasters for resilience building. This book is structured of power-law relation between disaster loss and frequency in Korea from 1948 to 2015, focusing events in the power-law distribution, Disaster-Triggered Policy Change Model, and suggestions for resilient future. To start with the historical review, how to understand disaster throughout the ages was investigated: from an Act of God to Mother Nature’s will to societies’ inherent risk. As we journey through disaster’s history, we start to see the categorization of disasters by cause, principle, and risk – drawing to an understanding of risk through hazard and vulnerability.


title: Rhinitis and Sinusitis

text: Rhinitis is defined as inflammation of the nose, which can extend into and affect the sinuses. The term rhinosinusitis is used to describe inflammation of both the nose and the sinuses. An example of rhinitis is allergic rhinitis, caused by sensitization and exposure to aeroallergens, which, along with other allergic diseases, such as asthma, affect up to one-third of women in the childbearing age. The most common type of rhinosinusitis is infectious, either acute or chronic, which commonly occurs secondarily to a viral respiratory tract infection. Both rhinitis and rhinosinusitis significantly affect the quality of life. The purpose of this chapter is to introduce and describe the differential diagnosis and treatment of these two common clinical entities during pregnancy.


title: The Effects of Network Relationships on Global Supply Chain Vulnerability

text: In this chapter, we analyze the effects of levels of social relationship on the global supply chain networks vulnerability. Relationship levels in our framework are assumed to influence transaction costs as well as risk for the decision-makers. We propose a network performance measure for the evaluation of the global supply chain networks efficiency and vulnerability. The measure captures risk, transaction cost, price, transaction flow, revenue, and demand information in the context of the decision-makers behavior the network. The network consists of manufacturers, retailers, and consumers. Manufacturers and retailers are multicriteria decisionmakers who decide about their production and transaction quantities as well as the level of social relationship they want to pursue in order to maximize net return and minimize risk. The model allows us to investigate the interplay of the heterogeneous decision-makers in the supply chain and to compute the resultant equilibrium pattern of product outputs, transactions, product prices, and levels of social relationship. The results show that high levels of relationship can lead to lower overall cost and therefore lower price and higher product transaction. Moreover, we use the performance measure to assess which nodes in the supply networks are themost vulnerable in the sense that their removal will impact the performance of the network in the most significant way.


title: Allografts in Anterior Cruciate Ligament Reconstruction

text: Usual allograft sources for anterior cruciate ligament (ACL) reconstruction are patellar ligament, Achilles tendon, tibialis anterior, and posterior. The advantages of the use of allograft include reduced donor-site morbidity, shorter operative time, smaller incisions, and no size restrictions. The disadvantages include increased cost, slower graft embodiment, and the risk of viral or bacterial infection, which may occur either by transmission from an infected donor or by contamination by the healthcare provider. Careful donor selection, aseptic graft procurement and processing, and tissue sterilization, by irradiation or proprietary chemical processing, are the three major steps of the graft preparation procedure. Successful allograft implantation depends on sterility, reduction of antigenicity, and preservation of the biomechanical properties of the graft. To date, reports on the clinical and functional outcomes of allograft compared to autograft ACL reconstruction are controversial. Overall, graft choice depends on surgeon and patient preference, since no graft can perfectly match the properties of the native ACL.


title: Pulmonary Manifestations of Predominantly Antibody Deficiencies

text: Predominantly antibody deficiencies (PADs) are the most frequent forms of primary immunodeficiency diseases (PIDs). Commonly accompanied with complications involving several body systems, immunoglobulin substitution therapy along with prophylactic antibiotics remained the cornerstone of treatment for PADs and related complications. Patients with respiratory complications should be prescribed an appropriate therapy as soon as possible and have to be adhering to more and longer medical therapies. Recent studies identified a gap for screening protocols to monitor respiratory manifestations in patients with PADs. In the present chapter, the pulmonary manifestations of different PADs for each have been discussed. The chapter is mainly focused on X-linked agammaglobulinemia, common variable immunodeficiency, activated PI3K-δ syndrome, LRBA deficiency, CD19 complex deficiencies, CD20 deficiency, other monogenic defects associated with hypogammaglobulinemia, immunoglobulin class switch recombination deficiencies affecting B-cells, transient hypogammaglobulinemia of infancy, and selective IgA deficiency.