title: The Biologics Revolution and Endotoxin Test Concerns

text: The advent of “at will” production of biologics in lieu of harvesting animal proteins (i.e. insulin) or human cadaver proteins (i.e. growth hormone) has revolutionized the treatment of disease. While the fruits of the biotechnology revolution are widely acknowledged, the realization of the differences in the means of production and changes in the manner of control of potential impurities and contaminants in regard to the new versus the old are less widely appreciated. This chapter is an overview of the biologics revolution in terms of the rigors of manufacturing required to produce them, their mechanism of action, and caveats of endotoxin control. It is a continulation of the previous chapter that established a basic background knowledge of adaptive immune principles necessary to understand the mode of action of both disease causation and biologics therapeutic treatment via immune modulation.


title: Intraoperativer Volumenersatz, Transfusion und Behandlung von Gerinnungsstörungen

text: Sowohl der operative Eingriff als auch die Narkose führen zu Veränderungen des intravasalen Volumenstatus des Patienten.


title: Modelling of Experimental Infections

text: This chapter aims to give a clear idea of how mathematical analysis for experimental systems could help in the process of data assimilation, parameter estimation and hypothesis testing.


title: Metaphernreflexion und -analyse in sozialwissenschaftlichen Disziplinen

text: Im vierten Kapitel erfolgt eine umfassende Rekonstruktion von Metaphernanalysen in den Disziplinen Soziologie, Erziehungswissenschaften, Soziale Arbeit, Politologie, Gesundheitswissenschaften und Psychologie sowie in einem Exkurs zur Geschlechterforschung. Metaphernanalysen haben sich in den verschiedenen Bereichen seit der Herausbildung des für sozialwissenschaftliche Forschungen anschlussfähigen Metaphernbegriffs in unterschiedlichem Tempo und mit heterogener Methodik entwickelt. Hier interessieren die bereits explorierten Fragestellungen, ihre Ergebnisse und die im Feld entwickelten methodische Besonderheiten.


title: Genotyping Arrays

text: Although the most common use of DNA microarrays is gene expression profiling, microarrays are also used for many other applications, including genotyping, resequencing, SNP analysis, and DNA methylation assays. Here we describe genotyping arrays for Influenza A subtype identification and for upper respiratory pathogen diagnostics using standard hybridization techniques and we also describe resequencing, SNP, and methylation assays using an enzyme-based strategy [25, 26].


title: Differential Diagnosis of Vasovagal Syncope: Postural Orthostatic Tachycardia

text: Postural tachycardia syndrome (POTS) is a syndrome defined as an increase in heart rate (HR) of ≥30 bpm within 10 min of assuming an upright posture in the absence of orthostatic hypotension (decrease in blood pressure (BP) >20/10 mmHg). The prevalence of POTS has been estimated as 500,000–3,000,000 patients in the USA. Because it affects mainly women between 13 and 50 years of age, the impact on productivity at work and lifestyle can be devastating. Considerable clinical overlap exists between POTS and vasovagal syncope (VVS) with patients experiencing similar orthostatic symptoms related to insufficient adaptation to blood volume shifts during upright posture. Nevertheless, differences emerge during head up tilt table testing. In patients with POTS, during upright tilt, sympathetic tone increases, there is an early and sustained tachycardia, and patients complain of presyncope without frank syncope. In contrast, patients with VVS experience delayed symptoms and abrupt drops in BP and HR and are more likely to lose consciousness. Treatment of POTS includes exercise and medications directed at decreasing sympathetic tone or increasing blood volume.


History Repeating? A Comparison of the Launch and Uses of Fixed and Mobile Phones


title: Health Effects of Changing Environment

text: Environment plays a crucial role in our economic, social and cultural behaviour as well as on health. However, since the beginning of industrialization era, focus on economic development has caused detrimental effects on the environment. Last two centuries have witnessed changes in global environmental factors such as rise in temperature leading to global warming, depletion of stratospheric ozone layer, loss of biodiversity and marked degradation in air and water quality due to atmospheric pollution, thereby causing upsurge in infectious and non-infectious diseases. Environmental health has emerged as an important part of medicine. The World Health Organization (WHO) estimates that 24% of global disease burden and 23% of all deaths can be attributed to environmental factors. Deaths from heart disease, cancer, respiratory disorders and many vector-borne diseases such as malaria, dengue, chikungunya and cholera have increased due to changes in climate, especially in developing countries. Besides limited attention to sanitation, hygiene, as well as quality of food and drinking water, factors such as deforestation, increasing vehicular traffic, migration from rural to urban areas, decreasing water resources and inadequate drainage systems contribute to increase incidence of diseases. The need of the hour is to sensitize ourselves about the way our ecology is being degraded and the health effects it is causing. A holistic view is needed to address the problem of environmental health where agriculture, animal husbandry, public health, water safety and air pollution need to be looked at in a combined manner for education, planning and resource allocation. Therefore, a close association between scientists, public health professionals and administrators is needed for integrated design and development of framework to attain harmony between man and nature.


title: Technical Annexes

text: This chapter provides guidance on technical issues in the health sector. The annexes contain selective compilations of frequently used reference information.


title: Challenges for the Application of GIS Interoperability in Emergency Management

text: This paper highlights application challenges for GIS interoperability for emergency management with emphasis on critical infrastructure sectors. In the first part, this paper provides a comparative analysis of emergency management operations in the City of Vancouver; the City of Toronto, the Kitchener Waterloo Region, and the Dufferin County. A variety of qualitative research methods were employed for gathering information from key decision-makers involved with emergency management. The second part of this paper presents a scenario-based case study, which aims to provide a demonstration of the utility of GIS interoperability, for disaster management. This paper also discusses the strengths and weaknesses of leveraging GIS interoperability for disaster management.


title: Rapid and Low-Cost Tools Derived from Plants to Face Emerging/Re-emerging Infectious Diseases and Bioterrorism Agents

text: Whether naturally occurring or man-made, biological threats pose a severe risk in an increasingly globalized world. The dual-use nature of biological research, with its most recent advances in biotechnology (‘synthetic biology’, gene editing, nanotechnologies etc.) and the rapid diffusion of knowledge, raise proliferation concerns of biological weapons by non-state actors. Thus, there is an urgent need to develop measures intended to enhance diagnostic, prophylactic and therapeutic capabilities and capacities to improve the ability of society to combat infectious diseases outbreaks, as well as to alleviate the effects of bioterrorism attacks. We present here two examples of biotechnology usage for biodefence purposes: (i) plants as biofactories for the rapid production of improved biopharmaceuticals (‘Plant Molecular Farming’), and (ii) plant sequences as immune-modulating agents to enhance the efficacy of genetic vaccines. These platforms represent two promising (and complementary) approaches for the rapid and low-cost production of countermeasures (diagnostics and vaccine candidates) against emerging, re-emerging and bioterrorism-related infections.


title: The molecular basis of paediatric malarial disease

text: Severe falciparum malaria is an acute systemic disease that can affect multiple organs, including those in which few parasites are found. The acute disease bears many similarities both clinically and, potentially, mechanistically, to the systemic diseases caused by bacteria, rickettsia, and viruses. Traditionally the morbidity and mortality associated with severe malarial disease has been explained in terms of mechanical obstruction to vascular flow by adherence to endothelium (termed sequestration) of erythrocytes containing mature-stage parasites. However, over the past few decades an alternative ‘cytokine theory of disease’ has also evolved, where malarial pathology is explained in terms of a balance between the pro- and anti-inflammatory cytokines. The final common pathway for this pro-inflammatory imbalance is believed to be a limitation in the supply and mitochondrial utilisation of energy to cells. Different patterns of ensuing energy depletion (both temporal and spatial) throughout the cells in the body present as different clinical syndromes. This chapter draws attention to the over-arching position that inflammatory cytokines are beginning to occupy in the pathogenesis of acute malaria and other acute infections. The influence of inflammatory cytokines on cellular function offers a molecular framework to explain the multiple clinical syndromes that are observed during acute malarial illness, and provides a fresh avenue of investigation for adjunct therapies to ameliorate the malarial disease process.


title: Use of Filgrastim (r-metHuG-CSF) in Human Immunodeficiency Virus Infection

text: In 2008, an estimated 33.4 million individuals worldwide were infected with the human immunodeficiency virus (HIV) [1]. Only a few years ago, infection with HIV almost invariably culminated in the development of the acquired immunodeficiency syndrome (AIDS), characterized by severe depletion of CD4(+) lymphocytes leading to derangements predominantly affecting cell-mediated immunity, but affecting humoral immunity as well [2]. In the later stages of AIDS, neutropenia and neutrophil functional deficits were common sequelae of HIV infection, other opportunistic infections, or HIV- or opportunistic infection-related treatment [3]. The care of the HIV-infected patient was palliative in nature, and the possibility that use of filgrastim (rHuG-CSF) might extend survival in late-stage AIDS patients with severe neutropenia or severe opportunistic infections, or might be a treatment for HIV infection itself, was explored [4]. Subsequently, however, the development of protease inhibitors and the widespread adoption of their use in multidrug regimens of highly active antiretroviral therapy (HAART) revolutionized the care of HIV-infected patients, and the number of patients dying from HIV decreased dramatically [5].


title: Evaluation Findings and Policy Suggestions

text: The foregoing Chaps. 10.1007/978-981-13-0644-0_3–10.1007/978-981-13-0644-0_7 have dealt with the five aspects of China’s Influenza A (H1N1) prevention and control efforts respectively, namely, strategies, systems and mechanisms, emergency response measures, costs and benefits, and social comments. This chapter will summarize the evaluation team’s findings in three respects of Influenza A (H1N1) prevention and control—main effects, basic experience, and inadequacies, and go on to raise issues worth further discussion and provide relevant policy suggestions.


title: Emerging Viral Zoonoses from Wildlife Associated with Animal-Based Food Systems: Risks and Opportunities

text: Zoonotic viruses of wildlife origin have caused the majority of recent emerging infectious diseases (EIDs) that have had significant impacts on human health or economies. Animal consumption-based food systems, ranging from the harvest of free-ranging wild species (hereafter, wild harvest systems) to the in situ stocking of domestic or farmed wild animals (hereafter, animal production systems), have been implicated in the emergence of many of these viruses, including HIV, Ebola, SARS, and highly pathogenic avian influenza (HPAI).


title: Infectious Diseases

text: This chapter introduces infectious diseases faced by many populations in the world. The role of the environment and how and why these diseases are transmitted as well as prevention strategies are also discussed. The story takes place at a disco funeral in Kenya, where HIV prevalence is high and risky sexual behavior takes place.


title: Local and Recurrent Regional Metastases of Melanoma

text: Up to 10% of patients with cutaneous melanoma will develop recurrent locoregional disease. While surgical resection remains the mainstay of treatment for isolated recurrences, locoregional melanoma can often present as bulky, unresectable disease and can pose a significant therapeutic challenge. This chapter focuses on the natural history of local and regionally recurrent metastases and the multiple treatment modalities which exist for advanced locoregional melanoma, including regional perfusion procedures such as hyperthermic isolated limb perfusion and isolated limb infusion, intralesional therapies, and neo-adjuvant systemic therapy strategies for borderline resectable regional disease. Hyperthermic limb perfusion (HILP) and isolated limb infusion (ILI) are generally well-tolerated and have shown overall response rates between 44% and 90%. Intralesional therapies also appear to be well-tolerated as adverse events are usually limited to the site of injection and minor transient flu-like symptoms. Systemic targeted therapies have shown to have response rates up to 85% when used as neoadjuvant therapy in patients with borderline resectable disease. While combination immunotherapy in the neoadjuvant setting has also shown promising results, this data has not yet matured.


title: Donor Evaluation for Hematopoietic Stem and Progenitor Cell Collection

text: With the increasing incidence of hematopoietic allogeneic cell transplantation (allo-HCT), the importance of securing a cellular product, safely from a donor, and ensuring that the product is without additional risk to the recipient, continues to be of paramount importance. The evaluation of the donor’s medical eligibility and suitability is designed to identify and limit the risk of transmitting infectious, genetic, or neoplastic diseases to the recipient through the product. It also aims to ensure a maximum level of safety for the donor and informs them of the risks of donation. Several regulatory agencies, national and international registries, and accreditation bodies have facilitated the availability and safe provision of human cells, tissues, and cellular- and tissue-based products not only at local institutions but also through international exchange.


title: Bluttransfusion

text: Bei einem 58-jährigen Patienten mit einem Hb-Wert von 6,5 g/dl, der nach operativer Ausschaltung eines Bauchaortenaneurysmas auf der Intensivstation unerwartet nachblutet, soll eine Bluttransfusion durchgeführt werden. Wenige Minuten nach der Anforderung aus der Blutbank treffen die bestellten Erythrozytenkonzentrate ein – es sind Erythrozytenkonzentrate der Blutgruppe A. Sie sind eindeutig auf den Namen des Patienten ausgezeichnet, die Identität des Patienten wird erneut überprüft. Der durchgeführte Bedside-Test zeigt aber die Blutgruppe B! Was muss der Intensivarzt nun tun?


title: Modern Patient Blood Management in Arthroplasty

text: One of the oldest and still commonest procedures in clinical practice, allogeneic blood transfusion (ABT), is not fully supported by available evidence. In the last few decades, increasing concerns about unfavorable outcomes associated with ABT, anticipation of future insufficient blood supply, and awareness of the cost (direct and indirect) of transfusion have led to the promotion of patient blood management (PBM) as a cost-effective strategy, beneficial for patients as well as for society (Shander et al. 2010). PBM programs utilize a series of measures with a proven ability to reduce ABT and to be cost-effective. Despite that the impact of PBM on patient clinical outcomes needs to be fully defined and future studies are needed, PBM should be adopted as a new standard of care.


title: Prediction of TGEV Spike Protein Secondary Structure and B Cell Epitopes

text: The spike gene of TGEV TH98 strain was translated into amino sequence by Editseq. The secondary structure and B cell epitope of spike protein of TGEV TH98 strain were predicted by Protean. Combining the results according to these methods, the spike protein of TGEV TH98 strain has complicated secondary structure. There are several epitopes of the B-cells in spike protein, including 43-56aa, 97-104aa, 117-128aa, 132-173aa, 238-257aa, 391-398aa, 535-706aa, 779-799aa, 918-987aa, 1165-1200aa, 1257-1266aa and 1430-1446aa.


title: Kidney-Organ Interaction

text: The practice of critical care nephrology demands an intimate understanding of the interactions and “crosstalk” that occurs between the kidney and multiple organ systems, in particular the heart, lung, gut, and brain. Accumulating evidence suggests that acute injury and dysfunction to the kidney can incite and propagate cardiac, pulmonary, gastrointestinal, and neurologic injury and dysfunction through a host of mechanisms.


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 Vordergrundstehen, lässt sich die medizinische Mikrobiologie am ehesten als Infektionslehre begreifen – als Lehre von der Auseinandersetzung des Wirtes mit den krankheitserzeugenden Eigenschaften des Erregers.


title: Lagos the Mega-City: A Report on How the Metropolis Handled an Outbreak of the Ebola Epidemic

text: Lagos State, Nigeria, is a mega-city with an estimated population of 16–21 million people. In the last ten years, the mega-city has made tremendous progress in terms of: sustained rapid economic growth, improved infrastructure and services, and a significant reduction in crime rates. This has provided an enabling environment for millions of Lagos state inhabitants to find their way out of poverty. The Lagos State Government has also made great strides in its quest to: increase value for money in public spending; improve the business climate in Lagos; maintain fiscal sustainability; and properly monitor and manage financial and health risks.


title: Modeling State Interventions

text: In the context of the modern nation state, the ecology of infectious diseases cannot be described by interacting populations alone, as much of the modeling literature implicitly presumes (Wallace and Wallace 2016). Modern states incorporate elaborate public health bureaucracies tasked with either containing or eliminating pathogen outbreaks. States are thus highly cognitive entities at the institutional level. It is then appropriate, indeed arguably necessary, to reconsider vector-borne infection from a control theory perspective.


title: Risks and Epidemiology of Infections After Lung or Heart–Lung Transplantation

text: Nowadays, lung transplantation is an established treatment option of end-stage pulmonary parenchymal and vascular disease. Post-transplant infections are a significant contributor to overall morbidity and mortality in the lung transplant recipient that, in turn, are higher than in other solid organ transplant recipients. This is likely due to several specific factors such as the constant exposure to the outside environment and the colonized native airway, and the disruption of usual mechanisms of defense including the cough reflex, bronchial circulation, and lymphatic drainage. This chapter will review the common infections that develop in the lung or heart–lung transplant recipient, including the general risk factors for infection in this population, and specific features of prophylaxis and treatment for the most frequent bacterial, viral, and fungal infections. The effects of infection on lung transplant rejection will also be discussed.


title: Future Directions in Food Safety

text: The recent success that the USDA Food Safety Inspection Service has had in 2003 and 2004 of reversing the steadily increasing trend in Class 1 recalls is welcomed. In agreement with those statistics are the FSIS microbiological results for Escherichia coli O157:H7 in raw ground beef, which also showed a decrease in 2003. But there is much work to be done in food safety and much more to achieve. It is imperative that while addressing food-safety issues, we should understand the role that the environmental microbiology, public health epidemiology, aerobiology, molecular microbial ecology, occupational health, industrial processes, municipal water quality, and animal health have on food safety. Although it is a difficult task, a concerted effort by industry, academic, and governmental researchers can accomplish the goal. Here we discuss the future directions and applications in the distribution and spread of foodborne hazards, methods for microbial detection and differentiation, intervention strategies for farm pathogen reduction, targeting waste at animal production sites, considerations on antimicrobial resistance, food-safety storage and preparation strategies, food irradiation, new and emerging food-safety hazards, and quantitative microbial food-safety risk assessment. Although this does not comprise an exhaustive list of food-safety issues, these are the areas that, we think, require considerable attention by researchers. Not only we need to strive to improve food safety through new strategies, processes, and applications, but we also need to be flexible and observant to readily handle the new and emerging food-safety problems, whether they are within our borders or global. At present, the United States has one of the safest food-safety systems in place. However, although this is not a time for complacency, our research endeavors should be designed to keep pace with the food-safety needs of the future.


title: Evaluation of the Person Under Investigation

text: A person under investigation (PUI) is defined as a patient who presents with both clinical and epidemiological risk factors for a specific infectious disease. In the case of infectious diseases that present risks of transmission to healthcare workers (HCWs) and patients, the use of the identify-isolate-inform framework is essential to protect staff and patients and the delivery of safe and effective care. This includes early identification of PUIs, institution of appropriate transmission-based precautions including use of specific personal protective equipment (PPE) and isolation, and prompt notification of relevant personnel, including relevant experts and authorities. Depending on the specific infection suspected, once appropriate infection control measures have been implemented, clinical evaluation of PUIs can vary in complexity. In the case of Ebola virus disease (EVD), the need for specialized PPE and training, well-developed procedures, and dedicated space can be extremely resource-intensive and costly for facilities. In addition, depending upon the need to reduce risks to other patients and HCWs, regular laboratory and imaging equipment may not be available (or available at the standard frequency or turnaround time) to support medical care. Lastly, diagnostic tests needed to confirm the diagnosis may not be available at the healthcare facility and may instead be accessible through public health authorities. This testing may take several days to confirm the diagnosis or rule out the presence of the suspected infection. Thus, the potential period of evaluation for a PUI can extend well beyond a typical clinic or emergency department (ED) visit. Thoughtful and coordinated planning efforts are required across the community and across the hospital to be able to adequately care for the PUI.


title: SARS and West Nile Virus

text: Clinical presentation of SARS is nonspecific; the important clinical findings in West Nile virus infection are those associated with neurological complications. Rapid and accurate diagnosis of SARS and West Nile virus infection remains an important clinical challenge. Older adults are at higher risk of complications, including death from SARS and West Nile virus. At present, there is no effective therapy for these infections. Although efforts are under way, there are presently no effective vaccines for SARS or West Nile virus.


title: Population Genomics of Human Viruses

text: Viruses, and a few RNA viruses in particular, represent one of the greatest threats for human health. High mutation rates, large population sizes, and short generation times contribute to their typically fast evolutionary rates. However, many additional processes operate on their genomes, often in opposite directions, driving their evolution and allowing them to adapt to diverse host populations and antiviral drugs. Until recently, the high levels of genetic variation of most viruses have been explored only at a few genes or genome regions. The recent advent and increasing affordability of next-generation sequencing techniques have allowed obtaining complete genome sequences of large numbers of viruses, mainly HIV, HCV, influenza A, and others associated with emerging infections, such as Zika, chikungunya, or dengue virus. This opens the possibility to explore the effects of the different processes affecting viral diversity and evolution at the genome level. Consequently, population genomics provides the conceptual and empirical tools necessary to interpret genetic variation in viruses and its dynamics and drivers and to transform these results into information that may complement the epidemiological surveillance of the virus and its disease. This chapter provides an overview of human viruses from a population genomics perspective, with a special emphasis on RNA viruses, and the potential benefits of “genomic surveillance” to establish public health policies that improve the control and monitoring of the diseases caused by these viruses.


title: Hämatologie

text: Die Hämatologie umfasst alle Erkrankungen, die das Blut, Blutbestandteile und die Blutfunktionen betreffen. In diesem Kapitel werden die Ätiologie, Pathologie, Klinik, Diagnostik und Therapie der wichtigsten Anämien (u. a. Eisenmangel-, Kugelzell-, Sichelzellänamie) und der akuten Leukämien (AML bzw. ALL) behandelt. Des Weiteren stehen maligne Lymphome und das multiple Myelom im Fokus. Darüber hinaus ist ein eigener Abschnitt den Gerinnungsstörungen gewidmet, darunter die Thrombozytopenien, Hämophilien und Koagulopathien. Abschließend wird auf Immundefizienzen und die Amyloidose eingegangen.


title: Public Health Disasters

text: Public health disasters reflect the uncharted conceptual, ethical, and pragmatic intersections between public health ethics and the emerging discourse on disaster bioethics. This novel concept reflects public health issues with calamitous social consequences such as infectious disease outbreaks, the attendant public health impacts of natural or man-made disasters, and currently latent or low prevalence public health issues with the potential to rapidly acquire pandemic capacities. The attendant moral dilemmas that PHDs generate have local and global dimensions. For this reason, they demand a multifaceted ethically grounded and pragmatically oriented approach. This chapter presents the conceptual foreground to the ethical and pragmatic dimensions of these issues.


title: Infection in Kidney Transplantation

text: Infection is an important cause of morbidity and mortality after kidney transplantation. It has been estimated that 70% of kidney transplant recipients will experience an infection episode within the first 3 years after transplantation (Dharnidharka et al. 2007). After cardiovascular disease, infection is the second leading cause of death in recipients with allograft function (Snyder et al. 2009). The immunosuppressive therapy required to prevent organ rejection places the kidney transplant recipient at increased risk for donor-derived, nosocomial, and community-acquired infections as well as reactivation of latent pathogens. Pretransplant screening, immunizations, and optimal antibacterial and antiviral prophylaxis can help to reduce the impact of infection. Awareness of the approach to infection in the transplant recipient including diagnostic and management strategies is essential to optimizing outcomes.


title: Control Strategies

text: This chapter studies control strategies. Control strategies are listed and explained. It focuses on modeling vaccination in single-strain and multistrain diseases. Different modes of introducing vaccination in models are shown. Imperfect vaccination as a mechanism leading to backward bifurcation and strain replacement is explained. Strain replacement with perfect vaccination is demonstrated. Quarantine and isolation are discussed and included in a model. Introduction to optimal control theory is incorporated and the theory is illustrated on a specific example with optimal control treatment. Matlab code for computing the optimal control is included.


title: Ecological Context of Epidemiology

text: This chapter is focused on ecoepidemiology. It introduces and studies a number of models related to infectious diseases in animal populations. Animals are typically subject to ecological interactions. The chapter first introduces SI and SIR models of species subject to a generalist predator and studies the impact of selective and indiscriminate predation. The classical Lotka–Volterra predator–prey and competition models are reviewed together with their basic mathematical properties. Furthermore, the chapter includes and discusses a Lotka–Volterra predator–prey model with disease in prey and a Lotka–Volterra competition model with disease in one of the species. Hopf bifurcation and chaos are found in some of the ecoepidemiological models.


title: Common respiratory infections diagnosed in general practice

text: Acute respiratory infections are one of the most common causes for presentation to a general practitioner. The range of symptoms associated with each infection can be wide ranging in both presentation and severity, depending on age of the patient, underlying co-morbidities and other confounding factors. In this chapter we describe the most common respiratory infections ranging from relatively mild infections such as the common cold, through to more serious presentations including pneumonia. Data are presented from a general practitioner morbidity surveillance system based in England and Wales. Each acute respiratory syndrome is described in respect of seasonality, secular trends and microbiological aetiology providing an insight into the complex nature of these acute respiratory episodes. The more serious endpoints of acute respiratory infections are hospitalisation and death. Many acute respiratory infections are mild in nature and generally self-limiting and therefore do not commonly require further medical interventions. However, despite major advances in the prevention and treatment of acute respiratory infections in recent years, hospitalisation and deaths continue to exert pressures on national health resources and provide an economic burden in countries across the world on an annual basis.


title: Quantitative Man-Made Risks’ Modelling

text: Catastrophe modelling began with earthquakes, then expanded to cover windstorms, floods, tsunamis, volcanic eruptions and other natural hazards, and has evolved in the twenty-first century to cover significant man-made risks like terrorism, and cyber crime. The modelling of man-made risks is reviewed, with particular attention given to the principles of terrorism risk modelling. Pandemic risk is also covered because of its historical linkage with political risk. The application of man-made risk modelling to financial risk transfer is discussed.


title: Gastroenterologie

text: —. : —. gastrointestinale Passagestörung, z. B. Magenausgangsstenose, Duodenalstenose, mechanischer Ileus; —. andere gastrointestinale Störungen, z. B. Gallenkolik, Gastroenteritis, Pankreatitis, Ulcus ventriculi/duodeni, Ileus, „Afferent-loop“-Syndrom nach Billroth-II-Magen, Achalasie, Zenker-Divertikel, obere GI-Blutung; —. zentralnervös, z. B. Meningitis, Enzephalitis, Hirntumor, Hirndrucksteigerung; —. vestibulär, z. B. M. Menière, Kinetosen; —. Stoffwechselentgleisungen, z. B. diabetische Ketoazidose, Urämie; —. schmerzbedingt, z. B. Nierenkolik, Myokardinfarkt; —. medikamentös-toxisch, z. B. Alkohol, Zytostatika; —. Schwangerschaft (β-HCG-assoziiert); —. Essstörungen, z. B. Anorexia nervosa, Bulimie;


title: Recent Developments in 3D QSAR and Molecular Docking Studies of Organic and Nanostructures

text: The development of quantitative structure–activity relationship (QSAR) methods is going very fast for the last decades. OSAR approach already plays an important role in lead structure optimization, and nowadays, with development of big data approaches and computer power, it can even handle a huge amount of data associated with combinatorial chemistry. One of the recent developments is a three-dimensional QSAR, i.e., 3D QSAR. For the last two decades, 3D-OSAR has already been successfully applied to many datasets, especially of enzyme and receptor ligands. Moreover, quite often 3D QSAR investigations are going together with protein–ligand docking studies and this combination works synergistically. In this review, we outline recent advances in development and applications of 3D QSAR and protein–ligand docking approaches, as well as combined approaches for conventional organic compounds and for nanostructured materials, such as fullerenes and carbon nanotubes.


title: Early disease management strategies in case of a smallpox outbreak

text: As a consequence of the threat of smallpox being potentially used as a means of bioterrorism, many countries have developed preparedness plans for smallpox in the past few years. This chapter summarizes some of the most important issues for the management of smallpox. Usually, the strategy for the management of clinical cases of poxviruses includes the early detection of cases, rapid laboratory diagnosis, an assessment of the risk of further spread and containment measures. For the early detection, different systems are being tested to identify suspected cases before a diagnosis is confirmed (e.g., syndromic surveillance). Also it is necessary to provide special training on the disease pattern, including differential diagnosis, to clinicians and practitioners. If a suspected case has been identified, rapid diagnostic tests are required. In addition to the national and international notifications based on given case definitions, certain measures are necessary to allow an initial risk assessment of the epidemic development. For a rapid risk assessment, the investigations should follow the algorithms of epidemiological outbreak investigation such as the tracing and identification of exposed contacts and the sources of infection. Further decisions have to be taken on the basis of a continuous risk assessment. Countermeasures can be divided into medical and non-medical ones. The choice of an adequate vaccination strategy as a medical countermeasure for the case of a re-emergence of smallpox very much depends on the epidemic scenario, and the general availability and quality of a vaccine. Logistic aspects of the vaccination strategies have to be considered in preparedness planning (e.g., resources necessary for the implementation of mass vaccinations), and also the prioritization of groups to be vaccinated. In addition non-medical measures to prevent the spread of infection, such as the isolation of cases and quarantining of exposed persons (e.g., contact persons of confirmed cases) have to be foreseen. The effectiveness of other measures like prohibition of mass gatherings or closure of institutions is often assessed in the light of historical events. However, they have to be considered within today’s ethical and societal context, taking into account, in particular, the increased number of people who are immunocompromised. Since our knowledge of how the virus would behave today is limited to extrapolations from historical data and is therefore imperfect, these measures are still under discussion. All relevant groups should be involved in exercises to assure the effective operation of the plan mainly regarding communication and cooperation.


title: Pulmonary System

text: Pulmonary disease is a highly prevalent cause of premature morbidity and mortality in long-term childhood cancer survivors. Pulmonary toxicity is frequently reported in survivors of Hodgkin lymphoma, germ cell tumors, acute lymphoblastic lymphoma and metastatic Wilms tumor survivors, as the chemotherapy, radiation and surgeries used to treat these pediatric cancer (among others) can result in permanent lung damage. This damage can manifest as acute pneumonitis, late onset fibrosis, and structurally induced dysfunction from developmental abnormalities due to impaired growth of the thorax attributable to surgery or radiation. The cumulative incidence of pulmonary problems after childhood cancer increases with time since diagnosis, as with other late-effects, suggesting that survivors are at an elevated risk of developing later-onset pulmonary morbidities as they age.


title: Promoting Universal Coverage of Basic Public Services Among Urban Residents

text: In 2012, China’s urbanization rate reached 52.57 % but, if we counted only people with urban hukous, this was only 35.29 %; there were 263 million migrant workers in China, where they have already been playing a leading role in urbanization. Nonetheless, governments are still managing applications for new permanent urban residents’ registration, demanded by rural migrant workers, by using the long-established hukou-based public service policies. This has constituted a big obstacle to the citizenization of rural migrant workers in China, caused a great deal of problems with urban management, and is contrary to social justice. In 2013, it was made clear in the Report on the Work of the Government that relevant authorities should accelerate reform of the household registration system and related institutions; that they should register eligible rural workers as permanent urban residents in an orderly manner, “progressively expand the coverage of basic public services in urban areas to include all their permanent residents and create an equitable institutional environment for freedom of movement and for people to live and work in contentment.” Accordingly, in order to protect the rights of migrants and improve the quality of the process of social urbanization in China, the most significant tasks involve investigating the current status of basic public services in Chinese towns and cities, especially the public services provided for potential new permanent migrant worker residents, and exploring methods to expand the coverage of these basic public services in urban areas to all their permanent residents.


title: Great Plains Societal Considerations: Impacts and Consequences, Vulnerability and Risk, Adaptive Capacity, Response Options

text: A variety of factors related to climate variability and change will impact the Great Plains across human and ecological communities. The changes and associated stress are triggering response strategies and other mitigation and adaptation measures from land managers, government officials and staff, and various industries. The impacts and responses address water, energy, and other essential resources for both human and environmental well-being.


All the techniques that we have discussed, flux measurements, steady-state and transient current measurements, as well as single-channel recordings and the corresponding analysis can be applied to the analysis of structure-function relationships. Such structure-function information can be obtained if we characterize and compare the function of wild-type and chemically or genetically modified transporters by using these techniques. The latter also includes naturally occurring mutations that are the source of various diseases; this is an important feature for the understanding and curing of such diseases. For many of the transporters the amino acid sequence and the possible orientation of the protein in the membrane, or even the three-dimensional structures have been determined. In this chapter on Examples of Applications of Electrophysiology, we will illustrate the strategy of an electrophysiologist in investigating structure, function and regulation of membrane transport using as an example the Na(+),K(+)-ATPase, the neurotransmitter transporter GAT (Na(+)-dependent GABA transporter), and the nucleotide receptors that form channels in the presence of extracellular ATP. For an understanding of drug action as well as the development of new drugs for the treatment of diseases, electrophysiology is a powerful method to elucidate drug receptor interaction. As an example, this will be illustrated for viral ion channels that are essential for virus reproduction.


title: Gastrointestinal Disorders

text: This chapter reviews extensively gastrointestinal bleeding that require intensive care unit admission. Its management, including with assessment of the airway, breathing, and circulation (ABCs), is emphasized as well as the use of proton pump inhibitors and H(2)-receptor blockers to prevent further hemorrhage. Acute mesenteric ischemia (AMI), an acute reduction in blood flow to the intestine leading to inadequate perfusion, is reviewed. Acute pancreatitis, an inflammatory process of the pancreas, having alcoholism, gallstones, hyperlipidemia, trauma, and infections as the most common etiologies, is also reviewed.


title: RNAi for Resistance Against Biotic Stresses in Crop Plants

text: RNA interference (RNAi)-based gene silencing has become one of the most successful strategies in not only identifying gene function but also in improving agronomical traits of crops by silencing genes of different pathogens/pests and also plant genes for improvement of desired trait. The conserved nature of RNAi pathway across different organisms increases its applicability in various basic and applied fields. Here we attempt to summarize the knowledge generated on the fundamental mechanisms of RNAi over the years, with emphasis on insects and plant-parasitic nematodes (PPNs). This chapter also reviews the rich history of RNAi research, gene regulation by small RNAs across different organisms, and application potential of RNAi for generating transgenic plants resistant to major pests(.) But, there are some limitations too which restrict wider applications of this technology to its full potential. Further refinement of this technology in terms of resolving these shortcomings constitutes one of the thrust areas in present RNAi research. Nevertheless, its application especially in breeding agricultural crops resistant against biotic stresses will certainly offer the possible solutions for some of the breeding objectives which are otherwise unattainable.


title: The Network Source Location Problem in the Context of Foodborne Disease Outbreaks

text: In today’s globally interconnected food system, outbreaks of foodborne disease can spread widely and cause considerable impact on public health. Food distribution is a complex system that can be seen as a network of trade flows connecting supply chain actors. Identifying the source of an outbreak of foodborne disease distributed across this network can be solved by considering this network structure and the dimensions of information it contains. The literature on the network source identification problem has grown widely in recent years covering problems in many different contexts, from contagious disease infecting a human population, to computer viruses spreading through the Internet, to rumors or trends diffusing through a social network. Much of this work has focused on studying this problem in analytically tractable frameworks, designing approaches to work on trees and extending to general network structures in an ad hoc manner. These simplified frameworks lack many features of real-world networks and problem contexts that can dramatically impact transmission dynamics, and therefore, backwards inference of the transmission process. Moreover, the features that distinguish foodborne disease in the context of source identification have not previously been studied or identified. In this article we identify these features, then provide a review of existing work on the network source identification problem, categorizing approaches according to these features. We conclude that much of the existing work cannot be implemented in the foodborne disease problem because it makes assumptions about the transmission process that are unrealistic in the context of food supply networks—that is, identifying the source of an epidemic contagion whereas foodborne contamination spreads through a transport network-mediated diffusion process, or because it requires data that is not available—complete observations of the contamination status of all nodes in the network.


title: Business Continuity Management (BCM)

text: This chapter elaborates on a review of BCM. As the background, it describes the historical development of BCM and its relationships with other concepts. It will be followed by reviews on BCM as a management system, BCM’s main principles, and Business Continuity Planning overview. The next section will describe the implementation of BCM, related with regulations or standards that support the concept and the development of BCM level of preparedness. Several reviews on BC plans from various sectors are elaborated in the final part of the chapter, followed by reviewing the need for BCM in organizations based on its benefits and challenges.


title: Care of the Patient with Liver Failure Requiring Transplantation

text: Patients undergo liver transplantation to address chronic liver failure, acute fulminant liver failure, or primary liver cancer. Depending on acuity, patients with decompensated chronic or acute fulminant liver failure generally require preoperative intensive care unit admission to manage organ dysfunction. Those with chronic liver failure are allocated an organ based on waiting list position determined by their local organ procurement organization (OPO). This position is dependent upon blood type and Model for End- Stage Liver Disease (MELD) score. These patients thus are critically ill and require preoperative ICU monitoring and care. Patients with hepatocellular carcinoma (HCC) who require liver transplantation are given a MELD exception and rarely require preoperative ICU care. The patient’s ability to undergo liver transplant in the setting of HCC is determined by the Milan criteria or the University of California, San Francisco (UCSF) criteria.


title: Secondary Metabolites of Plants

text: Orchid phytochemicals that have been studied include alkaloids, bibenzyls, phenanthrenes, stilbenoids, phenols, flavonoids, anthocyanins and polysaccharides. Many of these compounds exhibit antioxidant, anti-inflammatory, antimicrobial, antihelminthic, anticoagulant, antidiabetic and lipid-lowering properties. Some compounds are cytotoxic, prevent angiogenesis and tumour spread and promote programmed cell death of cancer cells. Some compounds protect nerve cells against chemicals and oxygen deprivation (stroke), promote nerve cell regeneration, protect the skin from ultraviolet damage, protect the liver against poisons such as carbon tetrachloride, prevent calcium loss from bone and enhance foetal lung maturation. This chapter provides a short account of the characteristics of the various groups of compounds, including their properties.


title: Fulfilling a Promise: Universal Care

text: Even before the extent of the epidemic became more reliably known, China’s leaders had signalled their renewed determination to tackle HIV in all of its dimensions, social and economic as well as medical. Because dedicated health officials and researchers had been running pilot programmes and building up evidence for well over a decade, there was a lot of information available about which approaches might work best. But most of these approaches went against the grain for many of the local politicians and senior bureaucrats who would have to implement them across the nation.


Genetic Variability in RNA Viruses: Consequences in Epidemiology and in the Development of New Stratgies for the Extinction of Infectivity


title: Influenza

text: Influenza is a highly contagious virus that causes an acute respiratory tract infection. Disease occurs in yearly outbreaks in humans, lasting 2–6 weeks in length. Influenza A and B predominate in these outbreaks, with more severe disease occurring with Influenza A. Additional infections with avian subtypes of influenza have also occurred in humans in the past decade, with notably increased morbidity and mortality. Vaccination is the mainstay for preventing disease. Antiviral drugs may be effective in decreasing duration and severity of disease, but evolving resistance has narrowed treatment options. This chapter provides a broad overview of influenza, from basic virology to epidemiology, disease, treatment, and prevention.


title: A Comprehensive Analytical Framework for Risks, Disasters and Crises

text: Early warning and emergency management is a comprehensive and integrated system that deals with all sorts of emergencies, risks and crises, and involves various sectors of society and government departments. A consistent and holistic approach, however, has previously been lacking in both research and practice.


title: Economic Implications of Influenza and Influenza Vaccine

text: The objective of this chapter is to review and summarize the current economic estimates of influenza and the cost-effectiveness of its vaccines. We reviewed the published assessments of the economic costs of human seasonal and pandemic influenza internationally. Seasonal influenza costs Germany, France, and the USA between $4 and $87 billion annually. Depending upon the intensity of transmission and severity of disease, pandemic influenza may cause as many as 350 million deaths and result in economic losses topping $1 trillion – an impact great enough to create a worldwide recession. We then reviewed 100 papers primarily from more than a dozen countries which studied the cost-effectiveness of influenza vaccine in children, adults, and the elderly. These studies demonstrate that influenza vaccination is quite cost-effective among children 6 months to 18 years old, in health care workers and pregnant women, and in high-risk individuals. Remarkably, compared with the other recently introduced vaccines for children, such as rotavirus and pneumococcal polysaccharide, vaccinating children and school attendees results in societal cost savings because it obviates lost productivity and wages among infected individuals and their caretakers. Vaccination for children is recommended in the USA and in Canada, but public health policy makers in Europe have undervalued this vaccine and not recommended it so widely.


title: Dengue

text: Dengue is one of the most important mosquito-borne viral infections caused by single-stranded RNA virus that are transmitted by the Aedes aegypti and Aedes albopictus mosquito species. Dengue is endemic in over 140 countries in Asia, the USA, the Eastern Mediterranean, and Africa. The World Health Organization (WHO) estimated that there are more than 2.5 billion people—mainly occurs in children living in tropical and subtropical countries—at risk of dengue infection with one or more dengue viruses. There are estimated nearly 100 million symptomatic dengue infections occurring worldwide annually, nearly 75% in Asia and the Western Pacific region [1]. During the past decades, the outbreaks of dengue infection have been reported throughout the world with increased severity. Ecologic and demographic changes are considered to be the contributing factors to the emergence of dengue infection in the past decades. Dengue has expanded into new countries and into urban settings associated with increased distribution of A. aegypti, population growth, urbanization, development of slums, migration of population, movement of dengue virus by infected travelers, trade development, and improved diagnostic capabilities in medical practice [2, 3]. Increased transmission of dengue virus in tropical urban areas has been created by substandard housing and crowding as well as deterioration in water, sewer, and waste management systems, all of which are intimately associated with unplanned urbanization [4–7]. So it is likely that dengue will expand its geographic reach and become an increasing burden on health resources in affected areas during the next decade. An effective vector-control management is the only means to reduce dengue infection in endemic areas. Because vector control has achieved only limited success so far in reducing the transmission of dengue, the usage of effective dengue vaccine in target population along with the preventive measures already used such as raising public awareness may be the means to effectively control of this disease in endemic area [8].


title: Hemostatic Resuscitation

text: Component therapy is useful for the majority of patients when blood requirements are minimal and there is no associated coagulopathy. Of concern are requirements for massive transfusion and resuscitation that absorb resources and create a short-fall for patients whose injuries are less severe. Additionally, the conventional massive transfusion model of packed RBCs, plasma and platelets actually further dilutes the patient compared to the blood he or she has lost and thus is not the ideal fluid for patients who require this massive transfusion of products. Fresh whole blood has three vital properties: oxygen carrying capacity, volume, and hemostatic effect. In the austere environment of combat the practice of fresh whole blood transfusion has proven beneficial to patients who are coagulopathic and require massive transfusion. Appropriate use following established guidelines can be beneficial and may even be superior to packed RBCs. A fluid containing the vital properties of fresh whole blood would serve as a bridge to allow a patient to be resuscitated without initiating the ‘bloody cycle of death’ that is seen all too often in our current paradigm of massive resuscitation.


title: Introduction: A Short History of Virology

text: Viral infections have been recorded unknowingly from the beginning of recorded history. The ancient Greeks and Romans described plagues of unknown origin. In general, infections were blamed on sins and punishment, balances of “vital humors” or on “miasma,” (rotten smells). In the sixteenth century, Girolamo Fracastoro suggested that infectious agents might spread disease, as did Agostino Bassi, studying diseases of silkworms. The development of the microscope by Hook and Van Leeuwenhoek in the seventeenth century led to the discovery of a new living world inhabited by very small creatures. Edward Jenner in England demonstrated that smallpox, a dreaded disease, could be prevented by inoculation with an organism that caused pockmarks on cows and dairymaids; this was the beginning of the concept of vaccination. Louis Pasteur proved that fermentation only occurred in the presence of air and was due to microorganisms. Pasteur and Pierre Roux, a colleague, as well as Jacob Henle and Robert Koch, proved that germs caused bacterial diseases such as anthrax and tuberculosis; Pasteur and Roux developed a vaccine against rabies by passaging the infectious material through rabbits. By the end of the nineteenth century it had been established that most infectious diseases were the result of germs. In parallel with this research, plant scientists had isolated material that passed through a low pore filter that was infectious to tobacco plants. This was called a “virus,” from the Latin for poison. Viruses were also found to be associated with leukemia and other cancers of chickens. The twentieth century saw the discovery of bacteriophage, viruses that attack bacteria, and the use of such bacteriophage to launch studies of molecular biology, and DNA and RNA structure.


title: Influenza Vaccines Have a Short but Illustrious History of Dedicated Science Enabling the Rapid Global Production of A/Swine (H1N1) Vaccine in the Current Pandemic

text: Vaccines for the swine flu pandemic of 2009 have been produced in an exquisitely short time frame. This speed of production comes because of 50 years of hard work by virologists worldwide in pharma groups, research laboratories, and government licensing units. The present chapter presents the background framework of influenza vaccine production and its evolution over 50 years. Isolation of the causative virus of influenza in 1933, followed by the discovery of embryonated hen eggs as a substrate, quickly led to the formulation of vaccines. Virus-containing allantoic fluid was inactivated with formalin. The phenomenon of antigenic drift of the virus HA was soon recognized and as WHO began to coordinate the world influenza surveillance, it became easier for manufacturers to select an up-to-date virus. Influenza vaccines remain unique in that the virus strain composition is reviewed yearly, but modern attempts are being made to free manufacturers from this yolk by investigating internal virus proteins including M2e and NP as “universal” vaccines covering all virus subtypes. Recent technical innovations have been the use of Vero and MDCK cells as the virus cell substrate, the testing of two new adjuvants, and the exploration of new presentations to the nose or epidermal layers as DNA or antigen mixtures. The international investment into public health measures for a global human outbreak of avian H5N1 influenza together with a focus of swine influenza H1N1 is leading to enhanced production of conventional vaccine and to a new research searchlight on T-cell epitope vaccines, viral live-attenuated carriers of influenza proteins, and even more innovative substrates to cultivate virus, including plant cells.


title: Impacts of Climate Change on the Environment, Economy, and Society of China

text: This chapter evaluates the characteristics and extent of impacts of modern climate change on the hydrology, ecology, agriculture, health, economy, and society of China. The impacts of climate change on water resources, hydrological processes, the cryosphere, and ocean hydrological processes are analyzed, as well as the impacts on land ecosystems, desertification, and soil erosion. The impact of global sea-level change on marine ecology and the coastal environment is comprehensively assessed. The chapter also summarized the impact of climate change on farming, animal husbandry, forestry, aquaculture, and fisheries.


title: A Mathematical Model of Cytokine Dynamics During a Cytokine Storm

text: Cytokine storms are a potentially fatal exaggerated immune response consisting of an uncontrolled positive feedback loop between immune cells and cytokines. The dynamics of cytokines are highly complex and little is known about specific interactions. Researchers at the Ontario Veterinary College have encountered cytokine storms during virotherapy. Multiple mouse trials were conducted where a virus was injected into mice whose leukocytes lacked expression of the type I interferon receptor. In each case a rapid, fatal cytokine storm occurred. A nonlinear differential equation model of the recorded cytokine amounts was produced to obtain some information on their mutual interactions. Results provide insight into the complex mechanism that drives the storm and possible ways to prevent such immune responses.


title: Environmental Risks

text: Production and consumption pose a number of burdens on our ecological systems. The risk of causing damage to human health by environmental contamination is called, in general, environmental risk. Climate changes and infection to new pandemic influenza are believed also to be caused by the global human activities affecting global environment and ecological systems; thus, they often make part of environmental risks in the broad sense. This chapter explains each of these risks and unveils our unique methods in counter them.


title: Infectious Complications

text: Infections remain a cause of significant morbidity and mortality following hematopoietic stem cell transplantation (HSCT). The conditioning regimen (chemotherapy, radiation therapy), mucosal damage, type of transplant, immune suppressive therapy, and graft-versus-host disease (GVHD) all predispose the HSCT recipient to infection. Abnormal B- and T-lymphocyte function results in impaired humoral and cellular immunity, respectively. Neutrophil function is impaired by the use of corticosteroids and other medications. Hypogammaglobulinemia and functional asplenia are common. The occurrence of infections in an individual patient varies according to the phase of the transplant process and reflects the type(s) of immune defect(s), underlying disease, endogenous host flora, exposure history, and pre-treatment infections.


title: Viral Pulmonary Disorders in Animals: Neoplastic and Nonneoplastic

text: Respiratory infections in animal species are as ubiquitous as they are in humans. Species that may be affected include mammals, birds, and reptiles. In these animal species some viruses primarily infect the respiratory tract, while other viruses infect non-respiratory organs. Viruses are generally classified according to the type of their nucleic acid, their protein structure, and whether or not they have a lipid-containing envelope surrounding the viral particle. In general, most viruses gain entry into the lungs via the conducting airways. In nonprimate mammalians these infections are most prominent in the cranioventral lung lobes because of their horizontal position. Table 24.1 lists some of the major viruses that cause pneumonia and other lung diseases in animals.


title: Akuttherapie

text: In Kürze: Die Anforderungen zum Monitoring und zur Basisdiagnostik nach stattgehabtem Schlaganfall wurden bereits ausführlich in 7 Abschn. 5.1 dargestellt. Ziel der Basistherapie auf der Stroke Unit ist vornehmlich eine allgemeine Stabilisierung der Vitalparameter, der Homöostase sowie die Verhinderung von Komplikationen. Sie schafft damit die Voraussetzung für spezifische Therapien und die frühe Erholung der Patienten. Die im Folgenden aufgeführten generellen Überlegungen orientieren sich an den Empfehlungen der Europäischen Schlaganfall Organisation (ESO) (Ringleb 2008, Schellinger 2008).


Avian Influenza


title: Application of Molecular Beacons in Real-Time PCR

text: Real-time PCR or quantitative PCR (QPCR) is a powerful technique that allows measurement of PCR product while the amplification reaction proceeds. It incorporates the fluorescent element into conventional PCR as the calculation standard to provide a quantitative result. In this sense, fluorescent chemistry is the key component in QPCR. Till now, two types of fluorescent chemistries have been adopted in the QPCR systems: one is nonspecific probe and the other is specific. As a brilliant invention by Kramer et al. in 1996, molecular beacon is naturally suited as the reporting element in real-time PCR and has been adapted for many molecular biology applications. In this chapter, we briefly introduce the working principle of QPCR and overview different fluorescent chemistries, and then we focus on the applications of molecular beacons-like gene expression study, single-nucleotide polymorphisms and mutation detection, and pathogenic detection.


title: The Pharmacological Activities of Glycyrrhizinic Acid (“Glycyrrhizin”) and Glycyrrhetinic Acid

text: Glycyrrhizin or, more correctly, Glycyrrhizinic acid is a triterpenoid saponin obtained from the root and rhizome extracts of Licorice (Glycyrrhiza glabra), being commonly used as a sweetener, being reported as – at least – 30 times sweeter than sucrose. This natural product, along with its aglycone glycyrrhetinic acid, is known in the literature for its several pharmacological and biological activities. This chapter summarizes the activities reported in the literature for the saponin and its aglycone since 2010.


title: Sociality, Parasites, and Pathogens in Bats

text: Little is known about the ecology of many of the parasites and pathogens affecting bats, but host social behavior almost certainly plays an important role in bat-parasite dynamics. Understanding parasite dynamics for bats is important from a human public health perspective because of their role as natural reservoirs for recent high-profile emerging zoonotic pathogens (e.g. Ebola, Hendra) and from a bat conservation perspective because of the recent emergence of white-nose syndrome (WNS) in North America highlighting the potential population impacts of parasites and pathogens. Although some bat species are among the most gregarious of mammals, species vary widely in terms of their social behavior and this variation could influence pathogen transmission and impacts. Here, we review the literature on links between bat social behavior and parasite dynamics. Using standardized search terms in Web of Science, we identified articles that explicitly tested or discussed links between some aspect of bat sociality and parasite transmission or host population impacts. We identified social network analysis, epidemiological modeling, and interspecific comparative analyses as the most commonly used methods to quantify relationships between social behavior and parasite-risk in bats while WNS, Hendra virus, and arthropod ectoparasites were the most commonly studied host-parasite systems. We summarize known host-parasite relationships in these three systems and propose testable hypotheses that could improve our understanding of links between host sociality and parasite-dynamics in bats.


title: Hydroids (Cnidaria, Hydrozoa): A Neglected Component of Animal Forests

text: Hydroids, one of the dominant components of the zoobenthic communities, share comparable growth patterns with higher plants because of their modular body organization, high potential of asexual reproduction, and phenotypic plasticity. These features, together with the ability to enter dormancy to overcome unfavorable conditions, make hydroids successful organisms adaptable to a wide range of environmental scenarios. Depending on their wide range of shapes and sizes, hydroids form three-dimensional forests at different dimensional scales, establishing both trophic and non-trophic relationships with several other organisms, from virus to vertebrates. Despite numerous researches conducted to study the hydroid ecology, the putative importance of hydroids in structuring zoobenthic communities is underestimated. Here, information available about hydroid ecology is summarized, in order to emphasize the role of hydroids as forest formers, as well as their function in the bentho-pelagic coupling.


title: Fremddarstellung – Selbstdarstellung: Über Grenzen der Medialisierung menschlichen Leidens

text: Der zwölfte Beitrag behandelt die Frage nach den Grenzen der Medialisierung menschlichen Leidens am Beispiel der Medialisierung von Aids. Während aber Aids als gesellschaftliche Metapher das endlose und globale Zirkulieren von Menschen, Bildern, Waren, Müll, Informationen und Kapital anzeigt, deutet inzwischen eine andere Krankheit, nämlich Alzheimer, sozusagen auf das Herz oder genauer gesagt auf das Gehirn der Informationsgesellschaft hin.


title: Pleuropulmonary Changes Induced by Drugs in Patients with Hematologic Diseases

text: Patients with hematologic diseases who are being treated with therapy drugs, or receive radiation therapy or blood transfusions may develop a host of potentially fatal infectious and noninfectious pulmonary complications [1]. The increased complexity of multimodality and high-dose treatment regimens with the intended benefit of augmented antineoplastic efficacy and prolonged disease-free survival, the use of a panel of novel drugs to treat malignant and nonmalignant hematologic conditions (e.g., azacytidine, bortezomib, cladribine, dasatinib, fludarabine, imatinib, lenalidomide, rituximab, and thalidomide), total body irradiation (TBI) and hematopietic stem cell transplantation (HSCT) have increased the incidence of severe sometimes life-threatening pulmonary complications.


title: Ziekten en afwijkingen die de zwangerschap compliceren

text: In dit hoofdstuk komen aan de orde: frequent voorkomende ziekten en afwijkingen die de zwangerschap kunnen compliceren, zoals


title: Sphingolipid Metabolism in Systemic Inflammation

text: The inflammatory response — induced and regulated by a variety of mediators such as cytokines, prostaglandins, and reactive oxygen species (ROS) — is the localized host’s response of the tissue to injury, irritation, or infection. In a very similar and stereotyped sequence, the mediators are thought to induce an acute phase response orchestrated by an array of substances produced locally or near the source or origin of the inflammatory response. Despite its basically protective function, the response can become inappropriate in intensity or duration damaging host tissues or interfering with normal metabolism. Thus, inflammation is the cause and/or consequence of a diversity of diseases and plays a major role in the development of remote organ failure. Better knowledge of the underlying mechanisms of these processes is, therefore, a fundamental pre-requisite fostering the molecular understanding of novel therapeutic targets or diagnostic variables.


title: Pathogenesis of Kingella kingae Disease

text: The pathogenesis of Kingella kingae disease begins with colonization of the oropharynx, a process facilitated by type IV pili and a non-pilus trimeric autotransporter adhesin called Knh, factors that mediate adherence to respiratory epithelial cells. A potent RTX cytotoxin with broad cellular specificity may play a role in disrupting the epithelial barrier and facilitating invasion of the bloodstream, possibly in concert with a viral coinfection. Once in the bloodstream, the organism can disseminate to sites of invasive disease, primarily the joints, bones, and endocardium. Survival in the bloodstream and dissemination are likely aided by expression of a capsular polysaccharide and an exopolysaccharide galactan. The evidence for antigenic diversity of K. kingae surface exposed protein epitopes and the observation that type IV pili are selected against during invasive disease suggest that immune system pressure plays an important role in K. kingae pathogenicity.


title: Biosensors for Security and Bioterrorism: Definitions, History, Types of Agents, New Trends and Applications

text: Biosensors are making a large impact in environmental, food, biomedical, and in many other applications. They provide many advantages. in comparison to standard analytical detection methods (i.e., chromatographic techniques) such as minimal sample preparation and handling, faster time analysis, simpler steps of analysis, rapid detection of the analytes of concern, use of non-skilled personnel, and portability for uses in the field applications. The aim of this chapter is to focus on novel research related to the rapid detection of agents and weapons of bioterrorism and provide a comprehensive review of the research topics most pertinent to advancing devices applicable to the rapid real-time detection of toxicants and bioterrorism weapons such as microbes, pathogens, toxins, virus, or nerve gases. The ongoing war on terrorism and the rising security concerns are driving the need for newer faster biosensing devices against bio-warfare agents for both military and civil defense applications. Readers of these review article will learn new schemes of biological weapons that can lead to the construction of devices that will minimize the risk of bio-terrorism.


title: The genetic transformation of plastids

text: Biolistic delivery of DNA initiated plastid transformation research and still is the most widelyused approach to generate transplastomic lines in both algae and higher plants. The principal designof transformation vectors is similar in both phylogenetic groups. Although important additions tothe list of species transformed in their plastomes have been made in algae and in higher plants, thekey organisms in the area are still the two species, in which stable plastid transformation was initiallysuccessful, i.e., Chlamydomonas reinhardtii and tobacco. Basicresearch into organelle biology has substantially benefited from the homologous recombination-basedcapability to precisely insert at predetermined loci, delete, disrupt, or exchange plastid genomesequences. Successful expression of recombinant proteins, including pharmaceutical proteins, hasbeen demonstrated in Chlamydomonas as well as in higher plants,where some interesting agronomic traits were also engineered through plastid transformation.


title: Holistic Integrative Medicine

text: Many people engaging in medical science asked me, “You’ve been working on the exploration of Holistic Integrative Medicine (HIM) for quite a while. What is the progress you have made in your research? Have you got your article published? May I be your first reader?” Each time I was confronted with such a situation, I felt embarrassed and speechless. Just as an old saying goes, it is easy to put the boat along with the current but it is difficult to sail against the current [1].


title: Open Source Chemoinformatics Software including KNIME Analytics

text: In this chapter, we present a brief description of compound datasets and programs developed to serve chemoinformatics as well as, more specifically, nanoinformatics purposes. Emphasis has been placed on publicly available tools and particularly on KNIME (Konstanz Information Miner), the most widely used freely available platform for data processing and analysis. Among a multitude of studies that have demonstrated the usefulness of chemoinformatics tools to chemical and medicinal applications, herein we present indicative cases of five successful KNIME-based approaches. The first two studies include the risk assessment of nanoparticles (NPs) through the Enalos InSilicoNano platform, namely, (1) the prediction of the toxicity of iron oxide NPs and (2) the cellular uptake prediction of computationally designed NPs with the aid of reliable quantitative nanostructure–activity relationships (QNAR) models. The third case study deals with the recognition of organic substances as corrosion inhibitors though the construction of predictive quantitative structure–property relationships (QSPR) models with Enalos KNIME nodes. Finally, two more cases are briefly described and involve the accurate prediction of yellow fever inhibitors from the ChEMBL database and the de novo design of compounds with the reaction vectors methodology. The aim of this work is to familiarize the interested reader with the freely available in silico tools in KNIME analytics platform and to demonstrate their value and effectiveness toward specific computational applications.


title: Dynamical Behavior of an SVIR Epidemiological Model with Two Stage Characteristics of Vaccine Effectiveness and Numerical Simulation

text: An SVIR epidemiological model with two stage characteristics of vaccine effectiveness is formulated. By constructing the appropriate Lyapunov functionals, it is proved that the disease free equilibrium of the system is globally stable when the basic reproduction number is less than or equal to one, and that the unique endemic equilibrium of the system is globally stable when the basic reproduction number is greater than one.


title: Context and Ethical Challenges During the Ebola Outbreak in West Africa

text: The philosophical discipline of ethics examines good, bad, right, wrong and how people live as individuals within a community. Bioethics investigates research in healthcare and medicine, examining public policy as it relates to healthcare and how resources are allocated. This includes: difficult, private, individual decisions, which occur in clinical settings; dilemmas during clinical trials; and controversies surrounding novel research. It is important to understand that ethical considerations related to health care ethics and those that pertain to public health are often seen from different perspectives. In public health, decisions are made within a context and a framework through principles which guide action that affect communities and populations. These decisions and actions are made with and involve, stakeholders to include: traditional, community and religious leaders; government officials; and private and commercial stake holders. The underlying principles of both public health ethics and bioethics are the same, namely equality, justice, beneficence, non-maleficence, veracity and fidelity. Health care ethics supports the rights of individuals. Under the same umbrella of health care ethics are medical ethics, clinical ethics and research ethics. These disciplines offer views that support the rights of individuals. Ethics in public health is very complex with a myriad of issues to include diverse groups of people in different situations, which have to be taken into account from the view of what is best for the population. Evaluating the components of a public health system, how resources are developed and the economic support available to communities is crucial. Access to care and the equitable and just allocation of resources are important factors; and questions about equal access for the poor, the socially disadvantaged and immigrants should be examined.


title: The Perioperative Use of Albumin

text: Human serum albumin (HSA) is the predominant product of hepatic protein synthesis and one of the more abundant plasma proteins. HSA is a monomeric multidomain macromolecule, representing the main determinant of plasma oncotic pressure and the main modulator of fluid distribution between body compartments. HSA displays an essential role in maintaining the integrity of the vascular barrier. HSA is the most important antioxidant capacity of human plasma, in addition to its ability to protect the body from the harmful effects of heavy metals such as iron and copper and reduce their ability to produce reactive oxygen radicals. HSA is the main depot for nitric oxide (NO) transport in the blood. HSA represents the main carrier for fatty acids, affects pharmacokinetics of many drugs, and provides the metabolic modification of some drugs and displays pseudo-enzymatic properties. HSA has been widely used successfully for more than 50 years in many settings of perioperative medicine including hypovolemia, shock, burns, surgical blood loss, sepsis, and acute respiratory distress syndrome (ARDS). Recently, the use of HSA has shown a promising neuroprotective effect in patients with subarachnoid hemorrhage. The most recent evidence-based functions and uses of HSA in the perioperative period are reviewed in this chapter.


title: Acute and Chronic Respiratory Failure in Cancer Patients

text: In 2016, there was an estimated 1.8 million new cases of cancer diagnosed in the United States. Remarkable advances have been made in cancer therapy and the 5-year survival has increased for most patients affected by malignancy. There are growing numbers of patients admitted to intensive care units (ICU) and up to 20% of all patients admitted to an ICU carry a diagnosis of malignancy. Respiratory failure remains the most common reason for ICU admission and remains the leading causes of death in oncology patients. There are many causes of respiratory failure in this population. Pneumonia is the most common cause of respiratory failure, yet there are many causes of respiratory insufficiency unique to the cancer patient. These causes are often a result of immunosuppression, chemotherapy, radiation treatment, or hematopoietic stem cell transplant (HCT). Treatment is focused on supportive care and specific therapy for the underlying cause of respiratory failure. Noninvasive modalities of respiratory support are available; however, careful patient selection is paramount as indiscriminate use of noninvasive positive pressure ventilation is associated with a higher mortality if mechanical ventilation is later required. Historically, respiratory failure in the cancer patient had a grim prognosis. Outcomes have improved over the past 20 years. Survivors are often left with significant disability.


title: Infectious Diseases in Pregnancy

text: Many infectious diseases have the potential to complicate pregnancy. Some illnesses may only impact maternal health, but others can infect the fetus with possible devastating or long-term sequelae. In this chapter we aim to review common infectious diseases such as urinary tract infections and influenza as well as those that can cause major neonatal morbidity and mortality including TORCH infections. We will also discuss the challenges that pregnancy creates for the management of these infectious diseases as some antibiotics that would typically be used may not be safe for the developing fetus depending on the stage of pregnancy.


title: Rethinking the financial network

text: On 16 November 2002, the first official case of Severe Acute Respiratory Syndrome (SARS) was recorded in Guangdong Province, China. Panic ensued. Uncertainty about its causes and contagious consequences brought many neighbouring economies across Asia to a standstill. Hotel occupancy rates in Hong Kong fell from over 80 % to less than 15 %, while among Beijing’s 5-star hotels occupancy rates fell below 2 %.


title: Neue Infektionserreger mit pandemischem Potential: Ursache – Verbreitung – Management

text: Die im vergangenen Jahrhundert errungenen Erfolge bei der Reduzierung der Mortalität durch Infektionskrankheiten können nicht verdecken, dass beständig neue Infektionskrankheiten mit weltweiter Verbreitung auftreten. Diese gehen entweder auf „neue“ Erreger zurück („emerging diseases“), oder sind durch bekannte Erreger bedingt, die neue Verbreitungsgebiete erobert haben. Bei der Expansion der endemischen Zirkulation von Infektionserregern spielen anthropogene Faktoren eine entscheidende Rolle, und eine große Zahl völlig unterschiedlicher Erreger kommt für solche Geschehen in Betracht (Kaufmann 2010).


title: Disaster Theory

text: To find a conclusive definition for contemporary purposes and uses, we look at many of the various definitions of disasters through cataclysmic events, historical records, public policies, laws, and organizational usage. Our natural progression leads us to modern theories of disaster and Disaster Risk Management (DRM) that have had to tackle new types of disasters that are being brought about by the interconnectivity of societies, people, diseases, technology, etc., increasing in magnitude and complexity like what was seen in Fukushima, Japan, in 2011 and on-setting disasters like climate change. After looking at all the historical evidence, we come to a definition for the term disaster for modern usage and what it means for policy implications.


title: Role of Immunoglobulin Therapy to Prevent and Treat Infections

text: Immunoglobulins have been used widely in medicine for a variety of diseases including infectious diseases. While the main clinical applications of immunoglobulin therapy concern their use as replacement for patients with primary immunodeficiencies, or as treatment for autoimmune and inflammatory disorders, their role in infectious disease is limited largely to viral and toxin neutralization and replacement therapy in patients with immunoglobulin deficiencies. Many aspects of the therapeutic regimen of immunoglobulins even in the established indications remain open. Recently, due to the worldwide surge of immunosuppression caused by AIDS, organ transplantation, cancer, and autoimmune therapies, as well as the emergence of multidrug-resistant bacteria, there has been renewed interest in the use of antibody preparation to prevent infections in high-risk groups. Knowing the limitations of the current anti-infective armamentarium, approaches that target the host through manipulations to augment the host immune response provide a helpful aid to conventional treatment options. A substantial body of evidence has demonstrated that strategies aiming to support or stimulate immune response could be feasible approaches that would benefit immunocompromised patients. In the present chapter, we present contemporary indications of immunoglobulin administration for therapy and prophylaxis of infections in the immunocompromised population.


title: Cryptococcosis

text: Infection with encapsulated yeast Cryptococcus neoformans or gattii. C. neoformans is found in bird and bat droppings and contaminated soil/dust; C. gattii colonizes trees/wood debris.


title: Vaccines

text: Since the introduction of smallpox vaccination more than two centuries ago, vaccines have been—and still are—instrumental in the prevention of infectious diseases. Nowadays vaccines form a heterogeneous group of pharmaceutical products that differ in several aspects from other biopharmaceuticals. In this chapter, after a brief introduction we first cover immunological principles that are important for vaccine design. Next, we give an overview of the different vaccine categories and current approaches to vaccine development, illustrated with representative examples. We also describe current trends in the field of vaccines against non-infectious diseases, such as therapeutic vaccines against cancer and other diseases. Moreover, routes of administration relevant to vaccination and pharmaceutical aspects of vaccines are briefly discussed.


Healthcare-Associated Infections in Pediatrics


title: Volume 3 Isolated Compounds (H-M)

text: Hemanthamine [466-75-1] C17H19NO4 (301.35). mp 203~203.5ºC, [a]D 25 = +19.7º (c = 3.8, methanol), [a]D 25 = +33 (c = 1.25, CHCl3). Pharm: Antihypertensive (mild); antiretroviral and cytotoxic (ID50 = 0.8µg/mL, TC50 = 1.0µg/mL, TI50 (TC50/ID50) = 1.3)[5026].


title: Gewinnung, Herstellung und Lagerung von Blut und Blutkomponenten

text: Blutspender leisten einen wertvollen Dienst für die Gemeinschaft: Die ständige Verfügbarkeit von Blutkomponenten ist zur unverzichtbaren Voraussetzung für viele Bereiche der Medizin geworden. Nicht nur die Gewinnung und Aufarbeitung von Blut und Blutbestandteilen zur Sicherstellung einer qualitativ wie quantitativ guten Versorgung, sondern auch die kompetente Betreuung der Spender ist eine der großen Aufgaben der Transfusionsmedizin.


title: Tonsillitis and Peritonsillar Abscess

text: Tonsillitis is one of the most common childhood infections. Occasionally, it can lead to one of the most common deep space head and neck infections, peritonsillar abscess. The epidemiology, microbiology and treatment of tonsillitis and peritonsillar abscess are similar and crucial for the primary care physician, infectious disease specialist, otolaryngologist, and emergency medicine physician to understand. The routine use of tonsillectomy as a treatment option for recurrent tonsillitis and peritonsillar abscess has decreased over the last decade and clearer indications for surgery have emerged. This chapter provides an overview of the most recent literature regarding the epidemiology, microbiology, diagnosis, complications and management of tonsillitis and peritonsillar abscess. It also discusses the indications for tonsillectomy along with its complications.


title: Applications of Infrared Thermography for Noncontact and Noninvasive Mass Screening of Febrile International Travelers at Airport Quarantine Stations

text: Infrared thermography (IRT), one of the most valuable tools, is used for noncontact, noninvasive, and rapid monitoring of body temperature; this has been used for mass screening of febrile travelers at places such as airport quarantine stations for over 10 years after the 2003 severe acute respiratory syndrome (SARS) outbreak. The usefulness of thermography for mass screening has been evaluated in many recent studies; its sensitivity varies from 40 to 89.4% under various circumstances. In this chapter, we perform IRT evaluations for detecting febrile international travelers entering Japan at Nagoya Airport, immediately after the SARS epidemic, from June 2003 to February 2004, and at Naha International Airport from April 2005 to March 2009. The correlation of body surface temperature measured via thermography with the axillary temperature was significant. Through IRT, febrile individuals were detected with good accuracy and the detection accuracy was improved by corroborating surveillance with self-reporting questionnaires. However, there are several limitations associated with the use of IRT for fever screening. For instance, taking antifebrile medications results in rapid modification of the body temperature and directly affects the efficiency of IRT. To solve this unreliability and obtain higher accuracy in mass screening, we have developed a novel infection screening system using multisensor data, i.e., heart and respiration rates are determined by microwave radar in noncontact manner and facial skin temperature is monitored through IRT. The detection accuracy of the system improved, which is notably higher compared to the conventional screening method using only IRT.


title: Mikrobiologische Schnelltests und molekularbiologische Analytik

text: Die meisten der derzeit am Markt verfügbaren mikrobiologischen Schnelltests basieren auf immunologischen Nachweisverfahren. Charakteristisch für alle immunologischen Verfahren ist, dass sie auf einer hochspezifischen Antigen-Antikörper-Reaktion beruhen. Mittels dieses immunologischen Prinzips ist sowohl der qualitative Nachweis eines Analyten als auch die quantitative Bestimmung seiner Konzentration möglich. Der Testaufbau eines immunchemischen Tests kann besonders hinsichtlich der Entstehung und Auswertung der Testsignale erheblich variieren. Bewährte und für mikrobiologische Schnelltests häufig benutzte Formate sind die Partikelagglutination und die Immunchromatographie sowie die daraus hervorgegangenen Weiterentwicklungen, beispielsweise der optische Immunoassay. Auf Basis von Nukleinsäure-Amplifikationstechniken (vor allem der Polymerase- Kettenreaktion, PCR) sind bislang nur wenige POC-Tests verfügbar; ihre Praktikabilität und Bewährung in der Praxis wird sich erst in den nächsten Jahren zeigen.


title: Interferons

text: Interferon was discovered by Alick Isaacs and Jean Lindenmann in 1957. It was originally thought that interferon could be used as a general anti-viral agent and in anti-cancer therapy. There are many different types of interferons, now known as interferons “alpha,” “beta,” “gamma” and “lambda,” with different cellular receptors and modes of action, and there are possibly 24 different types of alpha interferon. Independently and simultaneously, a group of Japanese scientists found an “interfering factor,” which upon subsequent analysis turned out to be interferon, probably of the alpha type. The interferon alpha gene was the first mammalian gene to be cloned in a bacterial system and became the prototype for gene cloning technology. Until the cloning of the interferons in Escherichia coli, and expression of the interferon genes in mammalian cells in culture, it was impossible to obtain enough material for clinical use. Interferon today is predominantly used in the treatment of hepatitis B and C, leukemia and Kaposi’s sarcoma. As an anti-viral agent, interferon has not lived up to its initial promise, since in vitro most viruses block the activity of interferon and clinical trials have given inconclusive results with severe side effects. Interferon induces hundreds of genes in vivo and in vitro, each interferon producing overlapping and distinct gene profiles. The mechanism of both interferon induction and anti-viral response is complicated and involves the interaction of many regulatory molecules. Interferon is now known to be a component of the large family of cytokines or interleukins.


Short- and Long-Term Reaction of European Airlines to Exogenous Demand Shifts


title: Carriage of Dangerous Goods by Air

text: The subject of carriage of dangerous goods by air is addressed in Annex 18 to the Chicago Convention. The material in this Annex was developed by the Air Navigation Commission in response to a need expressed by Contracting States for an internationally agreed set of provisions governing the safe transport of dangerous goods by air. In order to assist in achieving compatibility with the regulations covering the transport of dangerous goods by other modes of transport, the provisions of this Annex are based on the Recommendations of the United Nations Committee of Experts on the Transport of Dangerous Goods and the Regulations for the Safe Transport of Radioactive Materials of the International Atomic Energy Agency. More than half of the cargo carried by all modes of transport in the world is dangerous cargo—explosive, corrosive, flammable, toxic and even radioactive. These dangerous goods are essential for a wide variety of global industrial, commercial, medical and research requirements and processes. Because of the advantages of air transport, a great deal of this dangerous cargo is carried by aircraft.


title: National E-Commerce Strategy

text: Before discussing national e-commerce strategies in detail, we would like to explain why we determined to write this chapter in such a rich and colorful manner and the motivation for our further research at the national level. It is this point which makes this book different from others of the same kind.


title: Nanoparticles: Antimicrobial Applications and Its Prospects

text: Nowadays, nanomaterials [NPs; size, 1–100 nm] have emerged as unique antimicrobial agents. Specially, several classes of antimicrobial NPs and nanosized carriers for antibiotic delivery have proven their efficacy for handling infectious diseases, including antibiotic-resistant ones, in vitro as well as in animal models, which can offer better therapy than classical drugs due to their high surface area-to-volume ratio, resulting in appearance of new mechanical, chemical, electrical, optical, magnetic, electro-optical, and magneto-optical properties, unlike from their bulk properties. Thus, scientifically NPs have been validated to be fascinating in fighting bacteria. In this chapter, we will discuss precise properties of microorganisms and their modifications among each strain specifically. The toxicity mechanisms vary from one stain to another. Even the NP’s efficacy to treat against bacteria and drug-resistant bacteria and their defense mechanisms change according to strains in particular composition of cell walls, the enzymic composition, and so on. Thus, we provide an outlook on NPs in the microbial world and mechanism to overcome the drug resistance by tagging antibiotics in NPs and its future prospects for the scientific world.


title: Regulation of Neutrophil Serine Proteases by Intracellular Serpins

text: Neutrophil granules contain serine proteases that are central components of the antimicrobial weapons of the innate immune system. Neutrophil proteases also contribute to the amplification and resolution of inflammatory responses through defined proteolytic cleavage of mediators, cell surface receptors, and extracellular matrix proteins. In the blood and at mucosal surfaces, neutrophil serine proteases are regulated by serpins found in plasma and by non-serpin secreted inhibitors. Distinct mechanisms leading to neutrophil cell death have been described for the granule serine proteases, neutrophil elastase, cathepsin G, and proteinase-3. Granule leakage in neutrophils triggers death pathways mediated by cathepsin G and proteinase-3, and both proteases are tightly regulated by their inhibitor SERPINB1 in a cell intrinsic manner. Although stored in the same types of granules, neutrophil elastase does not significantly contribute to cell death following intracellular release from granules into the cytoplasm. However, heterozygous mutations in ELANE, the gene encoding elastase, are the cause of severe congenital neutropenia, a life-threatening condition characterized by the death of neutrophils at an early precursor stage in the bone marrow. This chapter focuses on recent work exploring the biology of clade B intracellular serpins that inhibit neutrophil serine proteases and their functions in neutrophil homeostasis and serine protease control at sites of inflammation.


title: Der Mann ohne Worte

text: Ein Patient sucht verwirrt die Notaufnahme auf. Er kann nicht mehr sprechen, hat Kopfschmerzen. Dann kommen epileptische Anfälle dazu. Das Ärzte-Team steht vor einem Rätsel. Nichts scheint die Symptome zu erklären, keine Therapie schlägt an. Endlich gibt es eine Spur. Doch wer ist der Kranke eigentlich? Als der Zustand des Patienten sich dramatisch verschlechtert, beginnt ein Wettlauf mit der Zeit.


title: Practice of Humidification During Noninvasive Mechanical Ventilation (NIV): Determinants of Humidification Strategies

text: 1. Who will benefit from humidification? 2. When to apply humidification? 3. How to incorporate humidification into NIV?


title: Bacterial Infections

text: Molecular techniques have revolutionized the detection and identification of microorganisms. Real-time PCR has allowed for the rapid and accurate detection of MRSA, VRE, and group B Streptococcus. The identification of difficult and slow-growing organisms has been expedited by sequence-based methods such as 16S rRNA gene sequencing. Rapid identification of organisms and detection of resistance markers directly from positive blood culture bottles has become a reality. Finally, a transformation is taking place with the introduction of MALDI-TOF into clinical laboratories that promises to improve the accuracy and speed of bacterial and fungal identifications by days. The advantages of these methodologies and their associated clinical applications, along with their inherent pitfalls and problems, are elucidated in this chapter.