title: Background Information: Isolation Routines

text: The isolation of patients with suspected or documented infections—to not spread to others—has been discussed for hundreds of years. Guidelines are many, methods are different, attitudes show vide variations, routines and procedures are still changing, regulations by law may be absent, and some healthcare professionals may be afraid of adverse outcomes of isolation [1–44]. Microbes that are spread in the environment, on the hands and equipment are invisible. The invisible agent does not call on attention before the infection; clinical disease, hospital infection or nosocomial infection is a factum that can be registered [23, 28, 29, 35–37]. How to stop the transmission is often “to believe and not believe” in infection control.


title: 3 Medische microbiologie

text: Microbiologie is de wetenschap die zich bezighoudt met de bestudering van micro-organismen. Dit zijn kleine organismen die niet met het blote oog waarneembaar zijn. Micro-organismen zijn van wezenlijk belang voor alle levensprocessen, ze zijn dan ook overal op aarde te vinden.


title: Diarrhea Leads to Pneumonia and Hematuria in the Intensive Care Unit

text: A 26-year-old man with a history of Crohn’s disease in remission presented to the Medical Intensive Care Unit with diarrhea, hematuria, left-sided pulmonary infiltrates, transaminitis, and rapid-onset respiratory failure with acute kidney injury. The patient was well until 7 days prior to admission, when he developed severe non-bloody diarrhea. Three days prior, he presented to an emergency department and was sent home after rehydration with normal saline with a reportedly normal chest x-ray. Two days prior, he presented to his primary care provider with continued diarrhea and fever to 39.4 °C, and he was sent home with antidiarrheal medications. One day prior, he returned to the emergency department with chest tightness, shortness of breath, and cough productive of dark sputum. He was found to have radiographic findings consistent with pneumonia. He also reported dark urine and anorexia, but he denied nausea, vomiting, abdominal pain, rash, or dysuria.


title: Biological Agents and Bioterrorism

text: For this very stimulating course, I want to share with you some of my studies and even some of my scientific and phylosophical considerations on biological agents living in the environment and their relations with humans, in the very wide concepts of ecological relationships, parasitism, immunolgical defenses and infectious disease mechanisms. All these concepts must be studied and considered in the event of criminal use of biological agents (bioterrorism) aimed at harming human populations in time and in geographical space.


title: Infektiöse Pneumonien

text: Definition, Ätiologie und Epidemiologie. Pneumonien sind akut- und chronisch-entzündliche Krankheiten des Lungenparenchyms. Man kann sie nach Ursache, Alter des Patienten sowie anatomischer Lokalisation bzw. dem Röntgenbefund einteilen. Sie werden vorwiegend von Infektionserregern verursacht. Seltenere Auslöser von Pneumonien sind allergische, chemische und physikalische Noxen sowie Autoimmunkrankheiten, die an anderer Stelle abgehandelt werden. Die Pneumonien des Neugeborenen werden in ▸ Kap. 60 besprochen. Unter den ambulant erworbenen Pneumonien dominieren in den ersten Lebensjahren virale Erreger, die vorwiegend eine Entzündung des Lungeninterstitiums hervorrufen. Am häufigsten werden Respiratory-syncytial-Viren (RSV), Parain-fluenza-, Influenza-, Adeno- und humane Metapneumoviren gefunden. Gelegentlich sind sie Wegbereiter für nachfolgende bakterielle Sekundärinfektionen (unbekapselte Haemophilus influenzae, Staphylococcus aureus, Pneumokokken u. a.). Im späteren Kleinkind- und Schulalter überwiegen Bakterien, insbesondere Pneumokokken und Haemophilus influenzae, als Pneumonieerreger. Zunehmend treten in diesem Alter auch Mykoplasmen in Erscheinung (Abb. 139.1).


title: General Pulmonary Question and Answer Items

text: An overview of the general pediatric pulmonary topics necessary for ward knowledge, clinical acumen, and board examination preparation is presented in an easy-to-study question-and-answer format.


docid: foenmbqi

title: Role of Proteases in Inflammatory Lung Diseases

text: Proteases are enzymes that have the capacity to hydrolyze peptide bonds and degrade other proteins. Proteases can promote inflammation by regulating expression and activity of different pro-inflammatory cytokines, chemokines and other immune components in the lung compartment. They are categorized in three major subcategories: serine proteases, metalloproteases and cysteine proteases especially in case of lung diseases. Neutrophil-derived serine proteases (NSPs), metalloproteases and some mast cell-derived proteases are mainly focused here. Their modes of actions are different in different diseases for e.g. NE induces the release of IL-8 from lung epithelial cells through a MyD88/IRAK/TRAF-6-dependent pathway and also through EGFR MAPK pathway. NSPs contribute to immune regulation during inflammation through the cleavage and activation of specific cellular receptors. MMPs can also influence the progression of various inflammatory processes and there are many non-matrix substrates for MMPs, such as chemokines, growth factors and receptors. During lung inflammation interplay between NE and MMP is an important significant phenomenon. They have been evaluated as therapeutic targets in several inflammatory lung diseases. Here we review the role of proteases in various lung inflammatory diseases with emphasis on their mode of action and contribution to immune regulation during inflammation.


title: Current and Future Issues in Global Health Diplomacy

text: This chapter provides an overview of the issues that are addressed by global health diplomacy and are discussed in more detailed case studies in the remaining chapters of this book. These are health issues that transcend national boundaries to affect the health of people in rich and poor countries and require concerted international effort to address them. Many such issues arise from the impact of globalization on health, which serves to accelerate not only the transmission of communicable disease but also the spread of unhealthy products and lifestyles. Health in fragile states poses complex challenges for global health diplomacy, requiring even greater engagement with all parties. This need for wider engagement to create a global movement for health and to establish pathways through which multiple actors can work together is the common theme that emerges at many different levels. It heralds a new era of global health governance recognizing the voice and contribution of all parties.


title: Novel Therapeutics Against West Nile Virus

text: No effective therapy is currently available for clinical treatment of flavivirus infections. Recent advances in the structural and molecular biology of flaviviruses have provided new opportunities for the development of antiviral therapies. This chapter summarizes the current status of West Nile virus (WNV) therapeutics. First, strategies for identifying and characterizing small molecular inhibitors are reviewed. These strategies include structure-based rational design, biochemical enzyme-based screening, and reverse genetic system-based screening. Second, known WNV inhibitors are summarized. Both small and macromolecular inhibitors have been identified to inhibit WNV. The macromolecular inhibitors include WNV antibodies, interferon, and nucleic acid-based agents (i.e., antisense oligomer and siRNA). Since the antibody-based therapy is reviewed elsewhere in this book, this chapter emphasizes the nonantibody macromolecular and small molecular inhibitors. Finally, new potential antiviral targets and issues related to WNV therapeutics are discussed.


Microfluidic Applications in Biodefense


title: Spleen and Liver

text: In liver cirrhosis, the spleen is a source of nitric oxide which affects a hyperdynamic state typical of portal hypertension. It is generally accepted that pancytopenia results predominantly from the increased phagocytosis and destruction of hemocytes in splenic macrophages. In addition, liver fibrosis is amplified by migrated Th2 lymphocytes and transforming growth factor beta from the spleen. There is a possibility that increase of the spleen stiffness is the primary factor of idiopathic portal hypertension. Spleen stiffness is caused by bleeding, fibrosis, and calcareous deposits after increase in red pulp pressure due to venous congestion. In nonalcoholic steatohepatitis, macrophage activity in the spleen is upregulated. In addition, high levels of inflammatory cytokines are produced and T cell shows increased proliferation in the spleen. In autoimmune hepatitis model, CD4(+) T cells are differentiated into follicular helper T cells (T(FH)) in the spleen. T(FH) cells promoted hypergammaglobulinemia and antinuclear antibodies production. T(FH) cells migrate from the spleen to the liver, triggering induction of autoimmune hepatitis in this model. IgM-positive B cells localize in the CD21-positive lymph follicle in the spleen of primary biliary cholangitis. These findings prove that the spleen influences on the pathogenesis and severity of several kinds of liver disease.


title: Infection Control and the Need for Family-/Child-Centered Care

text: Patient- and family-centered care (FCC) has become central to the delivery of medical care over the last 20 years and has been shown to improve patient outcomes. Infection control practices have the potential to greatly influence family centeredness and care providers, and hospital personnel must consider the potential impacts of isolation and the use of personal protective equipment (PPE). Approaching infection control with the perspective of FCC requires balancing patient safety and overall patient well-being. In this chapter, authors consider infection control and the benefits of FCC, family and sibling visitation, the use of playrooms, animals in healthcare settings including animal-assisted interventions, the potential adverse effects of infection control practices, and strategies to mitigate these impacts.


Diseases


title: Microbes, Transmission and Protection

text: This chapter is a short survey—in table form—concerning clinical types of infections, the most important microbes in medicine, recommended methods to isolate patients with infections and recommended use of personal protective equipment.


title: Antibody-Capture Enzyme-Linked Immunosorbent Assay for Detection of Antibody to Turkey Coronavirus Using Infectious Bronchitis Virus or Recombinant Nucleocapsid Protein as Coating Antigen

text: Turkey coronavirus (TCoV) infection continues to threaten turkey industry. Because specific treatment and effective vaccination program are not available, rapid and cost-effective detection of antibodies to TCoV infection is an important control measure to monitor the disease status in the fields. Two antibody-capture enzyme-linked immunosorbent assay (ELISA) procedures for detection of antibodies to TCoV are outlined in this chapter. One ELISA method uses chicken infectious bronchitis coronavirus (IBV) as the coating antigen based on antigenic cross-reactivity between TCoV and IBV. The other method relies on a recombinant TCoV nucleocapsid protein. Both methods are useful for serological diagnosis of TCoV infection in the turkey flocks.


title: The Role of Managerial Epidemiology in Infection Prevention and Control

text: 1. Understand the roles and responsibilities of health care managers in infection prevention and control in health care organizations. 2. Apply epidemiologic principles to manage an outbreak of a transmissible disease in a health care setting. 3. Develop a strategy for infection prevention in a health care setting.


title: Dominant Risks and Risk Management Practices in Supply Chains

text: Supply chains are inherently susceptible to risky events. Earlier articles in supply chain management by Kraljic (1983) and Treleven, and Schweickhart (1988) stressed the importance to consider the risks arising from interconnected flows of material, information and funds in inter-organizational networks. However, during the last several years, the interest in this topic has significantly gained momentum. A large body of recent literature reports on events that disrupted supply chains and on their negative impact on businesses. These reports are paralleled by numerous articles from researchers and practitioners proposing best practices, guidelines, and concepts for risk management strategies that aim to ultimately create resilient supply chains. But what actually fuelled this recent attention to supply chain risks and their management? There are arguably at least two significant factors.


title: The Human Coronaviruses

text: The human coronaviruses have been shown to be a major player in clinical microbiology and frequently occur as pathogens responsible for mild to severe respiratory infections. Moreover, two of the most dangerous viral respiratory infections are caused by novel coronaviruses, namely, the SARS and the MERS coronavirus. This chapter briefly summarizes the most important facts and knowledge required for the appropriate laboratory diagnostics of infections caused by the human coronaviruses.


title: A Web-Based System for Infectious Disease Data Integration and Sharing: Evaluating Outcome, Task Performance Efficiency, User Information Satisfaction, and Usability

text: To better support the surveillance of infectious disease and epidemic outbreaks by public health professionals, we design and implement BioPortal, an advanced Web-based system for cross-jurisdictional information sharing and integration. In this paper, we report two empirical studies that evaluate the outcomes, task performance efficiency, user information satisfaction, and usability associated with BioPortal. Overall, our results suggest that the use of BioPortal can improve users’ surveillance performance as measured by analysis accuracy and efficiency (i.e., the amount of time required to complete an analysis task). Our subjects were highly satisfied with the information support of BioPortal and considered it reasonably usable. Our evaluation findings show the effectiveness and value of BioPortal and, at the same time, shed light on several areas where its design can further improve.


title: Viral Infections of the Respiratory Tract

text: Viral infections of the respiratory tract are common events in all age groups and are the leading cause of mortality in children under 5 years of age in developing countries [1]. These infections cause significant economic burden, with estimated direct and indirect medical costs in the US exceeding $70 billion annually [2, 3]. Children under the age of 5 have an average incidence rate of four to six viral respiratory infections/year and the rate gradually decreases to one to two/year in most adults [4].


title: Forced Migration and Refugee Policy

text: This chapter focuses on international, regional and national legal norms, policies, organizational roles and relations and good practices that are applicable to a broad range of humanitarian crises that have migration consequences. These crises and the resulting displacement differ by their causes, intensity, geography, phases and affected populations. The chapter examines movements stemming directly and indirectly from: persecution, armed conflict, extreme natural hazards that cause extensive destruction of lives and infrastructure; slower onset environmental degradation, such as drought and desertification, which undermine livelihoods; manmade environmental disasters, such as nuclear accidents, which destroy habitat and livelihoods; communal violence, civil strife and political instability; and global pandemics that cause high levels of mortality and morbidity. Demographic trends are themselves drivers of displacement in conjunction with other factors. This can play out in two ways—demography as a macro-level factor and demographic composition as a micro-level driver of movement. The chapter compares the paucity of legal, policy and institutional frameworks for addressing crisis-related movements with the more abundant frameworks for addressing the consequences of refugee movements. The chapter discusses the policy implications of the findings, positing that State-led initiatives such as the Nansen and Migrants in Countries in Crisis initiatives are useful mechanisms to fill protection gaps in the absence of political will to adopt and implement more binding legal frameworks. It also argues that, in the context of slow onset climate change, in particular, there is a need for better understanding of how population density, distribution and growth as well as household composition affect vulnerability and resilience to the drivers of displacement.


title: Intestinal/Multivisceral Transplantation

text: Intestinal/multivisceral transplantation has evolved from an experimental procedure to the treatment of choice for patients with irreversible intestinal failure and serious complications related to long-term parenteral nutrition. Children who are likely to suffer permanent intestinal failure and benefit from intestinal transplantation include those with a remaining small bowel length of less than 30–40 cm, absence of the ileocecal valve, colonic resection and malabsorptive syndromes. Indications for transplant include frequent severe bouts of catheter associated sepsis, threatened loss of vascular access and the development of liver cirrhosis from cholestasis. Children who are more likely to experience cholestasis from total parenteral nutrition include those who experience persistent hyperbilirubinemia (greater than 6 mg/dl despite enteral nutrition), those with recurrent sepsis and/or bacterial overgrowth and those with minimal tolerance of any enteral feeds in the first few months post resection. The 1 year survival rate after intestinal transplantation has markedly improved over the last several years but long term survival rates have remained unchanged. The improved short term survival rates have led to an increased prevalence of this patient population in intensive care units. Management of intestinal and multivisceral transplant recipients is uniquely challenging because of complications arising from the high incidence of transplant rejection and its treatment. In the ICU, the complexity of medical care for the transplant recipient requires a multidisciplinary approach with coordination by an intensivist in collaboration with the transplant surgeon, gastroenterologist, and other specialists.


Genetics and Severe Sepsis


title: RMSF and Serious Tick-Borne Illnesses (Lyme, Ehrlichiosis, Babesiosis and Tick Paralysis)

text: Rocky Mountain spotted fever (RMSF) and other tick-borne illnesses, a burden predominantly in the summer season, produce symptoms ranging from fever to paralysis. Although often benign, sequela can range from chronic arthritis to neurologic or cardiac illness. Especially in the areas of the North America where tick-borne illnesses are more prevalent, tick-borne illnesses require vigilance on the provider’s part to inquire about recent outdoor activity. Prevention is paramount including the use of protective clothing and tick repellent.


Pegylated Interferons: Clinical Applications in the Management of Hepatitis C Infection


title: Nucleic Acid Extraction Techniques

text: Since thermostable Taq DNA polymerase was discovered in 1987, nucleic acid amplification techniques have made great strides and contributed greatly to progress in the life sciences. These techniques were introduced into the clinical laboratory and have produced great changes in diagnostic tools and tests. In particular, there have been many innovative molecular testing developments in the field of diagnostic microbiology.


title: Infectious Diseases

text: Infectious disease agents include viruses, bacteria, fungi, protozoa, parasites, and proteins called prions. Some patients are asymptomatic from their infection, whereas in other patients, clinical or subclinical illness affects the patient during the perioperative period. Transmission of the agents can occur through airborne inhalation, through contact with contaminated body fluids, via food, through physical contact, or through vector organisms. Additionally, patient-patient and patient-healthcare worker (HCW) transmission of infectious diseases remain a high concern. The perioperative period represents a unique challenge in the prevention of transmission. While diligent hand washing remains a staple in the standard of care, other measures must be implemented with certain infectious agents. Several of the major infectious diseases will be reviewed in this section, and universal precautions will be examined. Careful perioperative planning and situational awareness should be practiced by the healthcare worker taking care of patients with transmissible diseases.


title: Application and evaluation of entomopathogens for control of livestock and poultry pests

text: The control of livestock and poultry pests presents unique challenges. The hosts are warmblooded vertebrate animals, capable of a wide range of behaviors and movement. Range cattle and sheep in arid environments, for example, may occupy sparse grassland regions of thousands of hectares and move freely over many kilometers in search of forage. In these situations, pest management strategies must be effective and sustainable with minimal human input or supervision.


title: The Role of Infections and Autoimmune Diseases for Schizophrenia and Depression: Findings from Large-Scale Epidemiological Studies

text: An immunologic component to schizophrenia and depression has been increasingly recognized, which has led to extensive research into the associations with infections and autoimmune diseases. Large-scale nationwide epidemiological studies have displayed an increased prevalence of both autoimmune diseases and infections among persons with schizophrenia and depression. Autoimmune diseases, and especially the number of infections requiring hospitalization, increase the risk of schizophrenia and depression in a dose–response relationship. Infections are a common exposure and a broad spectrum of infections are associated with schizophrenia and depression. Particularly the autoimmune diseases with a potential presence of brain-reactive antibodies were associated with psychiatric disorders. However, the associations seem to be bidirectional, since the risk of autoimmune diseases and infections is also increased after diagnosis with schizophrenia and depression. The risk of autoimmune diseases was particularly increased in individuals with prior hospital contacts for infections. It has been suggested that inflammation and autoimmunity could be involved in the etiology and pathogenesis of some patients with symptoms of schizophrenia and depression. The psychiatric symptoms can be directly triggered by immune components, such as brain-reactive antibodies and cytokines, or infections reaching the central nervous system (CNS), or be secondary to systemic inflammation indirectly affecting the brain. However, the associations could also be caused by shared genetic factors, other environmental factors, or common etiological components. Nonetheless, autoimmune diseases and infections should be considered by clinicians in the treatment of individuals with psychiatric symptoms, since treatment would probably improve the psychiatric symptoms, quality of life, and the survival of the individuals.


docid: jkhvcjcb

title: Modeling Brain Tumors Using Avian Retroviral Gene Transfer

text: RCAS/tv-a is a system for postnatal cell-type-specific gene transfer. It is used for the modeling of gliomas and medulloblastomas. This system provides a combination of lineage tracing from the cell origin with oncogenesis induced by mis-expression of specific genes. The genes that are most potent at inducing tumors are those that encode components of signal transduction and undifferentiated cells are most capable of serving as the cell of origin. The system effectively generates tumors with the histologic characteristics of human disease. Mice bearing RCAS/tv-a-induced brain tumors are currently being used for preclinical trials to understand the biology of therapeutic response in the various cell types that make up gliomas and medulloblastomas.


docid: opipmdjf

title: Intestinal Transplantation from Living Donors

text: Intestinal transplantation (ITx) represents the physiologic alternative to total parenteral nutrition (TPN) for patients suffering from life-threatening complications of irreversible intestinal failure. The number of transplants performed worldwide has been increasing for several years until recently. ITx has recently become a valid therapeutic option with a graft survival rate between 80 % and 90 % at 1 year, in experienced centers. These results have been achieved due to a combination of several factors: better understanding of the pathophysiology of intestinal graft, improved immunosuppression techniques, more efficient strategies for the monitoring of the bowel graft, as well as control of infectious complications and posttransplant lymphoproliferative disease (PTLD). In fact, this procedure is associated with a relatively high rate of complications, such as infections, acute rejection, graft versus host disease (GVHD), and PTLD, if compared to the transplantation of other organs. These complications may be, at least in part, the consequence of the peculiarity of this graft, which contains gut-associated lymphoid tissue and potentially pathogenic enteric flora. Furthermore, in these patients, the existing disease and the relative malnutrition could predispose them to infectious complications. Additionally, other factors associated with the procedure, such as laparotomy, preservation injury, abnormal motility, and lymphatic disruption, could all be implicated in the development of complications.


title: Shellfish-Associated Enteric Virus Illness: Virus Localization, Disease Outbreaks and Prevention

text: Numerous outbreaks of shellfish-borne enteric virus illness have been reported worldwide. Most notable among the outbreaks are those caused by NoV and HAV. Lessons learned from outbreak investigations indicate that most outbreaks are preventable. Anthropogenic sources of contamination will continue to invade shellfish growing waters. Shellfish, by their very nature, will continue to bioconcentrate these contaminants, including enteric viruses. There is no quick fix for enteric virus contamination of shellfish; however, vigilance on behalf of the industry, regulatory agencies, and the consumer could substantially reduce the incidence of illness. Enhanced monitoring in all areas of shellfish production, harvesting, distribution, and processing would help to reduce viral illnesses. Pollution abatement and improved hygienic practices on behalf of the industry and consumers are needed. Improved analytical techniques for the detection of enteric viruses in shellfish will lead to enhanced shellfish safety and better protection for the consumer and the industry. Better reporting and epidemiological follow-up of outbreaks are keys to reducing the transmission of foodborne viral infections. It is anticipated that recent advances in analytical techniques, particularly for NoV, will lead to better monitoring capabilities for food and water and a reduction in the incidence of enteric virus illness among shellfish consumers.


docid: dvxrwzqw

title: Viral Proteins that Enhance Membrane Permeability


title: Article 11 Applicability of Air Regulations

text: Subject to the provisions of this Convention, the laws and regulations of a contracting State relating to the admission to or departure from its territory of aircraft engaged in international air navigation, or to the operation and navigation of such aircraft while within its territory, shall be applied to the aircraft of all contracting States without distinction as to nationality, and shall be complied with by such aircraft upon entering or departing from or while within the territory of that State.


title: Disease Outbreaks Caused by Emerging Paramyxoviruses of Bat Origin

text: Newly emerging and re-emerging infections are recognized as a global problem and 75% of these are potentially zoonotic (Woolhouse & Gowtage-Sequeria, 2005). Emergence of a new “killer” disease in any part of the world is likely to be a threat world wide in today’s society with very rapid means of transportation of both human and animal/animal products. Recent examples include the global outbreaks of severe acute respiratory syndrome (SARS), H5N1 avian influenza, and the outbreaks of West Nile virus in United States. The rapid economic development in the Asian region during the last few decades was accompanied by massive urbanization and environmental changes, which are believed to be one of the triggers leading to the emergence of new zoonotic diseases. Wildlife animals play an ever-increasing role in the emergence of zoonotic diseases, and bats have been identified as natural reservoir host of several lethal zoonotic viruses that emerged in recent times. This review will focus on the disease outbreaks caused by emerging bat viruses in the family Paramyxoviridae.


title: Viral Hemorrhagic Fever Preparedness

text: The 2014–2016 outbreak of Ebola virus disease (EVD) in West Africa marked the 25th such occurrence but was noteworthy in its massive scope, causing more human morbidity and mortality than the previous 24 recorded outbreaks combined. As of April 2016, there were 28,652 cases resulting in at least 11,325 deaths, nearly all in the three nations of Guinea, Liberia, and Sierra Leone (Centers for Disease Control and Prevention. http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html. Accessed 2 June 2016). Moreover, the 2014–2016 outbreak was the first in which patients, albeit few in number, were afforded sophisticated intensive care in the United States and in Europe. This “high-level containment care” (HLCC) was provided in specially designed purpose-built biocontainment units (BCUs). In this chapter, we explore the history and evolution of biocontainment, discuss its unique engineering and infection control modalities, and offer recommendations for the clinical and operational management of Ebola and other viral hemorrhagic fevers (VHFs).


title: Becoming a Successful Corporate Communication Practitioner in International Business Consultancy

text: Corporate communication practitioners have a very wide range of professional responsibilities ranging from the almost ubiquitous, for example, media relations, public relations, communication strategy, crisis communications and public policy, to those that are less common, such as investor relations, government relations, technical communications and ethics (Goodman MB, Hirsch PB, Corporate communication: strategic adaptation for global practice. Peter Lang, New York, 2010). This chapter examines how the most frequently encountered of these responsibilities are discharged and highlights the skills and technical practices that are necessary for their successful execution. It further examines the leadership roles of corporate communication professionals in the corporation, among the more commonly encountered of which include counsel to the CEO and the corporation, manager of the company’s reputation, driver of the company’s publicity and manager of the company’s image (Goodman MB, Hirsch PB, Corporate communication: strategic adaptation for global practice. Peter Lang, New York, 2010). It is these leadership roles of corporate communicators that highlight their importance both internally and externally in protecting, maintaining and enhancing the company’s reputation. It also conditions the relationship of corporate communicators with those executives who have primary responsibility for critical programmes, such as investor and government relations, where corporate communicators have a secondary role. It is the task of corporate communicators working as a team with directors and senior managers to formulate and agree a coherent narrative that best represents the company’s activities, aspirations and strategy. In undertaking this work, corporate communicators may call on the support of communication consultancies (and they may themselves choose to spend part of their careers in consultancy), and the chapter discusses their differing roles and how optimum results can be achieved from their combined efforts.


title: Conidiobolus

text: Conidiobolus coronatus, C. incongruus, C. lamprauges


Transfusionshepatitis


title: Utilising Media and Text-Based Sources

text: An often-underestimated, valuable source of naturally occurring data is that of media sources, such as television programmes, documentaries, newspapers, and magazines. Often in traditional textbooks these are positioned as secondary sources. We argue that they can be considered primary data, as well as naturally occurring data. This type of naturally occurring data is of interest for qualitative research, and in this chapter, we focus on the use of policy documents, medical notes, health guidelines, as well as other data sources such as police transcripts, court transcripts, and social care reports whereby health is invoked, to illustrate the value of analysing texts that occur naturally in the field of health.


title: Bat-Related Zoonoses

text: The many emerging infectious diseases associated with Chiropteran species can have major impacts on both ecosystem and public health. As such, the scope of this chapter is to provide an overview of those potential bat-related zoonoses and their clinical relevance to people. With increased disease surveillance and a trend toward more human contact with bat populations, it is likely that additional zoonotic diseases will continue to be identified. Bat infection dynamics are driven by a complex interplay of ecological, immunological, behavioral, and anthropogenic factors. Interdisciplinary work will be needed in the future to better understand the drivers of disease emergence in bat populations and ultimately mitigate the threats that face both people and bats themselves.


title: Dangerous Microbes

text: The most dangerous microbes for humans are those that are easily transmitted, virulent and invasive to central organs like the blood and lung, robust survivors in the environment, have a low infection dose and are without any specific treatment or vaccine. Most of them are zoonoses transmitted from animals and often with insects as vectors. The most dangerous microbes cause a very high mortality, are identified as high-risk agents or “biohazard-level 4” agents and are treated at the highest level of infection protection with strict isolation measures. Dangerous microbes occur as a problem mostly in countries with low hygiene standards/high population density and in tropical-subtropical areas. Infection control must always be based on hygienic measures and strict infection protection. This chapter is a short information about the most virulent and pathogenic agents, geographic area and severity of disease.


title: Neuropeptidases

text: Neuropeptides are neurotransmitters and modulators distributed in the central nervous system (CNS) and peripheral nervous system. Their abnormalities cause neurological and mental diseases. Neuropeptidases are enzymes crucial for the biosynthesis and biodegradation of neuropeptides. We here focus on the peptidases involved in the metabolism of the well-studied opioid peptides. Bioactive enkephalins are formed from propeptides by processing enzymes—prohormone thiol protease, prohormone convertase 1 and 2 (PC 1 and 2), carboxypeptidase H/E, and Arg/Lys aminopeptidase. After they exert their biological effects, enkephalins are likely to be inactivated by degrading enzymes—angiotensin-converting enzyme (ACE), aminopeptidase N (APN), puromycin-sensitive aminopeptidase (PSA), and endopeptidase 24.11. Recently, a neuron-specific aminopeptidase (NAP), which was a putative enkephalin-inactivating enzyme at the synapses, was found. Neuropeptidases are useful drug targets and their inhibitors can be therapeutic. Synthetic anti-enkephalinases and anti-aminopeptidases are being developed. They are potent analgesics but have fewer side effects than the opiates.


title: Infecties van de onderste luchtwegen en tuberculose

text: Tot de onderste luchtwegen behoren alle onderdelen van de luchtwegen en de longen onder de stembanden (trachea, bronchi en bronchioli). Onder normale omstandigheden zijn de onderste luchtwegen vrij van micro-organismen. Deze situatie wordt gehandhaafd door de continue activiteit van de trilharen, die zorgen voor eliminatie van de partikels. De deeltjes die toch in de alveoli terechtkomen, worden door de macrofagen gefagocyteerd en verwijderd. Ontstaat er toch een ontsteking, dan vindt vanuit de bloedbaan toestroom plaats van granulocyten en lymfocyten om pathogenen te verwijderen. Daarnaast bevatten de luchtwegen nog een aantal beschermende eiwitten die de gastheer beschermen tegen kolonisatie. Bij patiënten met chronische obstructieve longaandoeningen (COPD) treedt vernauwing en deformatie van de luchtwegen op, wat kan leiden tot een lokale afvloedbelemmering en kolonisatie met micro-organismen. Ook zijn er zeldzame aandoeningen zoals mucoviscidose (taaislijmziekte/cystische fibrose), het immotieleciliasyndroom en hypo- of agammaglobulinemie die predisponeren tot luchtweginfecties. ELEKTRONISCH AANVULLEND MATERIAAL: De online versie van dit hoofdstuk (doi:10.1007/978-90-368-1117-0_3) bevat aanvullend materiaal, dat beschikbaar is voor geautoriseerde gebruikers.


title: Thorax, Mediastinum

text: Für die Analyse der normalen Topographie müssen in der Thoraxaufnahme p.a. die Organsysteme der Trachea, des Mediastinums, des Zwerchfells, der Fissuren, der Lunge, der Hiluskonfigurationen, der Weichteilstrukturen und der ossären Strukturen evaluiert werden (◘ Abb. 19.1). Wichtige Kriterien sollen für jedes dieser Organsysteme dezidiert vorgestellt werden.


title: Transgenic Vegetables and Fruits for Control of Insects and Insect-Vectored Pathogens

text: Fruits and vegetables are major components of a healthy diet, but are subject to severe pest pressure. Approximately 30% of all insecticides applied worldwide are used to control insects affecting vegetables and fruits. Transgenic, or more commonly referred to as genetically modified (GM), vegetables and fruits offer unique opportunities for controlling insects and the pathogens they transmit. Aphid transmitted viruses have been particularly difficult to manage by tactics aimed at reducing aphid populations and in many cases there has not been virus resistant plant germplasm. Farmers in the USA have benefited from having GM virus resistant squash and papaya available to them as tools in their overall IPM programs. In the USA, Bt sweet corn has proven effective for control of Lepidoptera and continues to be accepted in the fresh market. However, the best opportunities for GM vegetables and fruits are in developing countries where 83% of the world’s population lives, the majority of vegetables and fruits are produced and pest problems are most acute.


title: Distribution Theory, Stochastic Processes and Infectious Disease Modelling

text: The occurrence of a major outbreak, the shape of the epidemic curves, as well as the final sizes of outbreaks, are realizations of some stochastic events with some probability distributions. These distributions are manifested through some stochastic mechanisms. This chapter divides a typical outbreak in a closed population into two phases, the initial phase and beyond the initial phase. For the initial phase, this chapter addresses several aspects: the invasion (i.e. the risk of a large outbreak); quantities associated with a small outbreak; and characteristics of a large outbreak. In a large outbreak beyond the initial phase, the focus is on its final size. After a review of distribution theories and stochastic processes, this chapter separately addresses each of these issues by asking questions such as: Are the latent period and/or the infectious period distributions playing any role? What is the role of the contact process for this issue? Is the basic reproduction number R (0) sufficient to address this issue? How many stochastic mechanisms may manifest observations that may resemble a power-law distribution, and how much detail is really needed to address this specific issue? etc. This chapter uses distribution theory and stochastic processes to capture the agent–host–environment interface during an outbreak of an infectious disease. With different phases of an outbreak and special issues in mind, modellers need to choose which detailed aspects of the distributions and the stochastic mechanisms need to be included, and which detailed aspects need to be ignored. With these discussions, this chapter provides some syntheses for the concepts and models discussed in some proceeding chapters, as well as some food for thought for following chapters on case studies.


title: Respiratory Diseases of Pregnancy

text: Pregnant patients can suffer from the same respiratory diseases as the general population in addition to unique syndromes of pregnancy (such as pre-eclampsia and tocolytic induced pulmonary edema, and pregnancy induced cardiomyopathy). Pregnancy by itself may add certain challenges such as difficult intubation. The critically ill pregnant patient requires a multidisciplinary approach and early inclusion of obstetrical expertise is paramount in managing these patients especially in the third trimester.


title: Regional Therapy of Cancer

text: Surgical resection is the primary treatment and typically the only curative therapy for most solid malignancies. Throughout this surgical textbook, virtually all chapters dealing with individual organs have some portion of that chapter devoted to the surgical treatment of primary cancer at that site. For example, Chapter 96 on breast disease primarily discusses the treatment of cancer because this is by far the predominant surgical disease in that organ. On the other hand, Chapter 49 on the small intestine has a much smaller proportion dealing with cancer as primary malignancies comprise a smaller fraction of the surgical diseases involving the small intestine. A specialized type or category of surgical treatment for cancer can be categorized as regional therapy. As opposed to straightforward surgical resection, in this type of therapy a specific region or area of the body is treated. Regional therapy is primarily applicable to metastatic disease limited to one site or area of the body. There are two broad categories of regional therapy of cancer: (1) vascular-based treatments and (2) intracavitary treatments. The most successfully treated areas of the body by vascular means are the extremities and the liver.


title: Infectious Diseases: Need for Targeted Drug Delivery

text: Infectious diseases are a leading cause of death worldwide, with the constant fear of global epidemics. It is indeed an irony that the reticuloendothelial system (RES), the body’s major defence system, is the primary site for intracellular infections which are more difficult to treat. Pro-inflammatory M1 macrophages play an important role in defence. However, ingenious pathogen survival mechanisms including phagolysosome destruction enable their persistence. Microbial biofilms present additional challenges. Low intracellular drug concentrations, drug efflux by efflux pumps and/or enzymatic degradation, emergence of multi-drug resistance (MDR), are serious limitations of conventional therapy. Targeted delivery using nanocarriers, and passive and active targeting strategies could provide quantum increase in intracellular drug concentration. Receptor mediated endocytosis using appropriate ligands is a viable approach. Liposomes and polymeric/lipidic nanoparticles, dendrimers micelles and micro/nanoemulsions could all be relied upon. Specialised targeting approaches are demonstrated for important diseases like tuberculosis, HIV and Malaria. Application of targeted delivery in the treatment of veterinary infections is exemplified and future possibilities indicated. The chapter thus provides an overview on important aspects of infectious diseases and the challenges therein, while stressing on the promise of targeted drug delivery in augmenting therapy of infectious diseases.


title: Selecting Genotyping Oligo Probes Via Logical Analysis of Data

text: Based on the general framework of logical analysis of data, we develop a probe design method for selecting short oligo probes for genotyping applications in this paper. When extensively tested on genomic sequences downloaded from the Lost Alamos National Laboratory and the National Center of Biotechnology Information websites in various monospecific and polyspecific in silico experimental settings, the proposed probe design method selected a small number of oligo probes of length 7 or 8 nucleotides that perfectly classified all unseen testing sequences. These results well illustrate the utility of the proposed method in genotyping applications.


Role of ACE, ACE2 and Neprilysin in the Kidney


title: Environmental Influences in Experimental Autoimmune Encephalomyelitis

text: Environmental factors, in particular infectious agents, are thought to have a major influence on the development and course of MS. Some of these influences are also reflected in the animal model, EAE. In this chapter, the role of infectious agents in the development and course of autoimmunity in EAE is discussed. Other environmental agents including trauma, solar radiation exposure, temperature, stress, toxins, are discussed in terms of their relevance to MS and EAE.


title: Characterization of Proprotein Convertases and Their Involvement in Virus Propagation

text: Proprotein convertases (PCs), also known as eukaryotic subtilases, are a group of serine proteases comprising furin (PACE), PC1 (PC3), PC2, PC4, PACE4, PC5 (PC6), and PC7 (LPC, PC8) that generate bioactive proteins and peptides, such as hormones, receptors, and growth factors by cleaving precursor proteins at multibasic motifs. Two other family members, SKI-1/S1P and PCSK9, cleave regulator proteins involved in cholesterol and fatty acid homeostasis at nonbasic peptide bonds. Furin is ubiquitous in eukaryotic tissues and cells. PACE4, PC5, and PC7 are also widespread, whereas the expression of the other PCs is more restricted. PCs are synthesized as multi-segmented zymogens which are autocatalytically activated. The prodomains have regulatory and inhibitory functions. The catalytic domains are the most conserved domains among the PCs. The architecture of the catalytic active furin domain is known in different binding states. The C-terminal parts of the PCs differ in length and structure and contain encoded peptide signatures guiding the PCs to the subcellular destinations on the secretory pathways: SKI-1/S1P to the cis-Golgi, furin, PC5B, and PC7 to the TGN region but also to the plasma membrane. PACE4, PC5A, and PCSK9 are attached at the cell surface. Truncated, soluble furin and SKI-1/S1P, as well as PC1 and PC2, are released into the extracellular matrix. Many enveloped viruses are activated by furin and furin-like PCs and arenaviruses and a few bunyaviruses by SKI-1/S1P. The PCs cleave the viral fusion glycoprotein to trigger fusion of viral envelopes with cellular membranes to deliver the viral genome into host cells. Cleavage by PCs, occasionally in concert with other endoproteases, enables conformational changes in the viral membrane proteins needed for correct oligomerization of glycoprotein spikes and their effective incorporation into virions. Mutational alterations of PC cleavage sites can reduce the fusion potential of viral surface proteins and thus facilitate the development of secure live attenuated vaccines. Alternatively, agents preventing cleavage of viral surface (glyco)proteins block fusion capacity and multicyclic virus replications. PC inhibitors are suggested as promising antiviral drugs for quite a number of viruses causing severe infections.


title: Conclusion: Ethnographic Data as Medical Evidence

text: The Conclusion returns to the larger question of the role of ethnography in the development of plague science during the third pandemic. Discussing the challenges of rendering ethnographic data into epidemiological evidence within the context of epistemological entropy, it is argued that epidemiological reasoning developed on the basis of plague ethnographies entailed a two-way process: on the one hand, the ethnographic configuration of plague, as an infectious disease whose decipherment relied on the medical objectification of ethnographic data; and on the other hand, the representation of native societies in terms of being either cultural vectors of or culturally immune to the disease. It is hence argued that, in the case of the north-east Chinese-Russian frontier, this interpretive strategy condemned Mongol and Buryat societies to a static condition of functional unreason. Discussing how this form of ontological and epistemological enclosure continues to inform our postcolonial world, the Conclusion underscores the need for a critical and relational understanding of infectious disease.


title: Bioterrorism—a clear and present danger

text: Until a few years ago, the thought of anyone highjacking a crowded airliner and deliberately crashing it into skyscraper buildings in one of the world's major cities would have been dismissed as fantasy. The event would have been unthinkable. But then, on September 11, 2001 fantasy was turned into chilling fact.


title: A SIS Epidemiological Model Based on Cellular Automata on Graphs

text: The main goal of this work is to introduce a new SIS epidemic model based on a particular type of finite state machines called cellular automata on graphs. The state of each cell stands for the fraction of the susceptible and infected individuals of the cell at a particular time step and the evolution of these classes is given in terms of a local transition function.


title: Modeling the Spread of Preventable Diseases: Social Culture and Epidemiology

text: This paper uses multiagent simulation to examine the effect of various awareness interventions on the spread of preventable diseases in a society. The work deals with the interplay between knowledge diffusion and the spreading of these preventable infections in the population. The knowledge diffusion model combines information acquisition through education, personal experiences, and the spreading of information through a scale-free social network. A conditional probability model is used to model the interdependence between the risk of infection and the level of health awareness acquired. The model is applied to study the spread of HIV/Aids, malaria, and tuberculosis in the South African province Limpopo. The simulation results show that the effect of various awareness interventions can be very different and that a concerted effort to spread health awareness through various channels is more likely to control the spread of these preventable infections in a reasonable time.


title: Curtailing Agriculture Projects’ Practices That Can Harm Urban Food Security and Public Health

text: Many old and “modern” cities have been built on terrain that was previously vegetated and part of biologically diverse ecosystems. This was often on productive farmland that was not protected from encroachment as municipalities expanded and opened pristine areas to development. The encroachment continues as rural citizens and their families are attracted to urban centers for the way of life they seemed to offer. This starts with employment possibilities, education for workers children, and family health services as manufacturing/industrial operations and large and small businesses that serviced them spurs economic development. Agricultural projects are located mainly away from population centers, be they major metropolises or smaller cities. They provide food security for urban citizens through “brought into markets” in-ground crops, bush crops, and tree crops they cultivate, and through animal husbandry (e.g., beef and dairy cattle, poultry, hogs, sheep). The last chapter described how manufacturing/industrial endeavors can present potential harm to the health of urban and rural citizens and to natural resource rich ecosystems that help sustain them, and how to find solutions to the problems. This chapter will discuss the problems that food production methods present, the threats they pose to urban populations that are generally distant from them, and possible solutions to such problems.


title: Risks

text: Risk is our daily work and often our obsession – as risk researchers we are working on research projects which are intended to increase our knowledge about all aspects of risks. Being a “risk researcher” means looking at things through a specific perspective – the perspective of what negative consequences a natural or man-made event, a technology, a decision could probably have on the world we live in. Our perspective is a socio-scientific one. This means, we are analyzing what consequences do risks have on the society and what can we do to decrease or prevent them. This includes the possible actions of a single consumer as well as strategies of whole governments to manage risks. How are risks perceived by people? What kinds of knowledge are needed to deal with different kinds of risks? Who should be involved, and when? What to do if conflicts evolve about how to handle risks? How to communicate risks? It is our job to answer questions like these. We are dealing with these questions in many different thematic areas: food safety, climate change, chemicals, nanotechnology, electromagnetic fields, etc. These risks pose very different problems and it seems difficult to find general strategies to deal with them.


title: Zukunftsszenarien für die Logistikdienstleistung im Jahr 2025

text: Die Logistik hat die Zukunftsforschung und ihre Möglichkeiten für sich noch nicht entdeckt. Die Logistikdienstleistungsbranche liegt im Bereich der Zukunftsforschung deutlich hinter der Pharma-, Automobil- und Telekommunikationsbranche, die die langfristige Zukunft ihrer Branchen schon seit vielen Jahren sehr systematisch analysieren, um Veränderungen zu antizipieren und Wettbewerbsvorteile zu erzielen (Darkow, von der Gracht, 2006). Warum sollte dies nicht auch in der Logistikdienstleistung möglich sein? Das Supply Management Institute (SMI) und die FutureManagementGroup AG haben aus diesem Anlass eine Studie zur Zukunft der Logistikdienstleistungsbranche in Deutschland 2025 durchgeführt, die im Februar 2008 gemeinsam mit der Bundesvereinigung Logistik (BVL) veröffentlicht wurde (Von der Gracht et al., 2008). Mit diesem Projekt sollen die Bedeutung und Möglichkeiten der Zukunftsforschung in der Logistik herausgestellt und ein weiter Blick in die Zukunft geworfen werden.(1)


title: Nanomaterials – the Next Great Challenge for Qsar Modelers

text: In this final chapter a new perspective for the application of QSAR in the nanosciences is discussed. The role of nanomaterials is rapidly increasing in many aspects of everyday life. This is promoting a wide range of research needs related to both the design of new materials with required properties and performing a comprehensive risk assessment of the manufactured nanoparticles. The development of nanoscience also opens new areas for QSAR modelers. We have begun this contribution with a detailed discussion on the remarkable physical–chemical properties of nanomaterials and their specific toxicities. Both these factors should be considered as potential endpoints for further nano-QSAR studies. Then, we have highlighted the status and research needs in the area of molecular descriptors applicable to nanomaterials. Finally, we have put together currently available nano-QSAR models related to the physico-chemical endpoints of nanoparticles and their activity. Although we have observed many problems (i.e., a lack of experimental data, insufficient and inadequate descriptors), we do believe that application of QSAR methodology will significantly support nanoscience in the near future. Development of reliable nano-QSARs can be considered as the next challenging task for the QSAR community.


title: Molecular Mechanism of Drug Resistance

text: The treatment of microbial infections has suffered greatly in this present century of pathogen dominance. Inspite of extensive research efforts and scientific advancements, the worldwide emergence of microbial tolerance continues to plague survivability. The innate property of microbe to resist any antibiotic due to evolution is the virtue of intrinsic resistance. However, the classical genetic mutations and extrachromosomal segments causing gene exchange attribute to acquired tolerance development. Rampant use of antimicrobials causes certain selection pressure which increases the resistance frequency. Genomic duplication, enzymatic site modification, target alteration, modulation in membrane permeability, and the efflux pump mechanism are the major contributors of multidrug resistance (MDR), specifically antibiotic tolerance development. MDRs will lead to clinical failures for treatment and pose health crisis. The molecular mechanisms of antimicrobial resistance are diverse as well as complex and still are exploited for new discoveries in order to prevent the surfacing of “superbugs.” Antimicrobial chemotherapy has diminished the threat of infectious diseases to some extent. To avoid the indiscriminate use of antibiotics, the new ones licensed for use have decreased with time. Additionally, in vitro assays and genomics for anti-infectives are novel approaches used in resolving the issues of microbial resistance. Proper use of drugs can keep it under check and minimize the risk of MDR spread.


title: Application of Ionic Liquids in Multicomponent Reactions

text: This chapter reports the applicability of ionic liquids in the formation of different types of multicomponent reactions. Easy work-up, relatively short reaction times, good to high yields of the desired products, mild reaction conditions, low cost, availability, and reusability of the employed ionic liquids are the striking features of the reported methodologies.


title: Managing risk

text: recognize the omnipresence of risk of various kinds; identify the main strategic responses to the existence of risk; understand when avoidance is the best form of risk management; distinguish between the management and mitigation of risk; understand how diversification is one way of managing risk; consider how, using scenario building and planning, risk management can be made part of the overall strategic orientation of those making strategy.


title: Dealing with Global Infectious Disease Emergencies

text: The microbes that cause human infectious diseases are complex, dynamic, and constantly evolving. They reproduce rapidly, mutate frequently, adapt with relative ease to new environments and hosts, and frequently breach the species barrier between animals and humans. Social, economic, and environmental factors linked to a host of human populations and activities can accelerate and amplify these natural phenomena. The ability of infectious diseases to spread internationally—carried by humans, insect vectors, food and food products, and livestock—has been greatly augmented by the pressures of a crowded, closely interconnected, and highly mobile world. When they spread internationally, infectious diseases often lead to global emergencies.


title: Infektionen

text: Trotz Weiterentwicklung moderner Antibiotika in den letzten Jahren sind die Letalitätszahlen der bakteriellen (eitrigen) Meningitis weiterhin hoch; Überlebende haben häufig neurologische Residuen. Die ungünstigen klinischen Verläufe der bakteriellen Meningitis sind meist Folge intrakranieller Komplikationen, wie z. B. eines generalisierten Hirnödems, einer zerebrovaskulären arteriellen oder venösen Beteiligung oder eines Hydrozephalus. Als Folge dieser Komplikationen kommt es häufig zu einem Anstieg des intrakraniellen Drucks. Bei schweren, komplizierten klinischen Verläufen der bakteriellen Meningitis kommen oft adjuvante Therapiemaßnahmen (z. B. intravenöse Gabe von hyperosmolaren Substanzen, externe Ventrikeldrainage) zum Einsatz. Bei Nachweis einer meningitisassoziierten septischen Sinus-/Venenthrombose erfolgt die dosisadaptierte intravenöse Heparintherapie.


title: Alcohol and Cancer Epidemiology

text: In a comprehensive worldwide assessment of cancer risk related to food and nutrition, the American Institute for Cancer Research (AICR 2007) identified alcohol consumption as a “convincing” or “probable” risk factor for esophageal, mouth, and laryngeal cancers, for liver cancer, for breast cancer in women, and for colorectal cancer especially in men. The World Health Organization’s Global Burden of Disease Project concluded that “A total of 390,000 cases of cancer are attributable to alcohol drinking worldwide, representing 3.6% of all cancers (5.2% in men, 1.7% in women)” each year, with a corresponding annual mortality rate of 233,000, representing 3.5% of all cancer deaths (Boffetta et al. 2006). For the USA, the Alcohol-Related Disease Impact (ARDI) report indicates an annual rate of 2,464 deaths in six different alcohol-related cancer categories for the period 2001–2006 (CDC 2010).


docid: yaubmffq

title: Parasites and Their World Records in Their Fight for Survival

text: Parasites are animals that enter plants, animals and humans – but are not welcome. Therefore they had to develop strategies for invasion and survival – outside and inside of hosts. For this purpose they developed amazing, often unbelievable skills during evolution. Thirteen of them are presented in this chapter showing that they are fit for the future thus threatening mankind, if there are no precautions in the future.


title: Acute Liver Failure in Children

text: “Acute liver failure” (ALF) and “fulminant liver failure” are terms used interchangeably to describe severe and sudden onset of liver cell dysfunction leading on to synthetic and detoxification failure across all age groups. Considerable variations exist between ALF in children and adults, in terms of aetiology and prognosis. Encephalopathy is not essential to make a diagnosis of ALF in children but when present has a bad prognosis. Early recognition of ALF and initiation of supportive management improve the outcome. Liver transplantation remains the only definitive treatment when supportive medical management fails.


docid: ezfiqxqz

title: A Stakeholder Approach to Risk Management

text: In crisis management, risk management has been conceived mainly as a proactive pre-crisis management effort where it is deployed for crisis prevention and preparedness efforts. This chapter argues that risk management extends into the entire crisis management continuum, as crises ignite new types of risks with their associated stakeholders. Organizations should continually identify, manage and communicate risks to key stakeholders during the different phases of crisis management. A stakeholder orientation demands that organizations seek and involve risk stakeholders in the risk management process. The level of involvement will depend on both the identified risks and how stakeholders are expected to be affected by the proposed solutions and decision-making processes.


docid: prumutes

title: Acute Liver Failure

text: Acute liver failure is a highly unpredictable disease that can evolve to a life-threatening situation within few hours. In a simplified manner, acute liver failure is the acute liver dysfunction with multiorgan damaging associated with numerous complications, and very poor prognosis, being caused by varied etiologies. Despite the numerous advances on pathophysiology, intensive care treatment, and transplantation techniques from the last decades, is still characterized by increased mortality. At present, the patients with acute liver failure should be managed in Intensive Care Unit where the therapy should be applied based on the specific etiology of the acute liver failure and it should be started as early as possible.


title: Drug-Induced Delayed Multi-organ Hypersensitivity Syndrome

text: Drug-induced delayed multi-organ hypersensitivity syndrome (DIDMOHS), also known as drug reaction (or rash) with eosinophilia and systemic symptoms (DRESS), drug-induced hypersensitivity syndrome (DIHS), or drug hypersensitivity syndrome (DHS) is a rare, potentially fatal, drug-induced hypersensitivity reaction characterized by cutaneous eruption, fever, lymphadenopathy, hematologic abnormalities, and visceral manifestations. Anticonvulsants such as carbamazepine, phenytoin, lamotrigine, and phenobarbital as well as allopurinol and sulfonamides, are the most common causes of DIDMOHS. Impaired drug detoxification and herpes virus reactivation play a key role in DIDMOHS pathogenesis. Human leukocyte antigen (HLA) haplotypes also contribute. Early cutaneous findings generally include a morbilliform eruption characterized by diffuse, erythematous, pruritic macules across the face, upper trunk, and upper extremities with later extension to the lower extremities. Rapid confluence and progression are characteristic. DIDMOHS frequently involves the lymphatic, hematologic, and hepatic systems. Renal, pulmonary, and cardiac dysfunction may also ensue. Early recognition and diagnosis with prompt withdrawal of the culprit drug is paramount. Corticosteroid therapy is widely accepted as the cornerstone of DIDMOHS management. Moving forward, haplotyping and assays such as the lymphocyte transformation test (LTT) will aid in the primary prevention and diagnosis of DIDMOHS. Novel steroid-sparing immunomodulatory agents also have significant therapeutic potential.


title: Virus Glycoproteins Tagged with the Human Fc Domain as Second Generation Vaccine Candidates

text: Traditional vaccines such as inactivated or live attenuated vaccines, are gradually giving way to more biochemically defined vaccines that are most often based on a recombinant antigen known to possess neutralizing epitopes. Such vaccines can offer improvements in speed, safety and manufacturing process but an inevitable consequence of their high degree of purification is that immunogenicity is reduced through the lack of the innate triggering molecules present in more complex preparations. Targeting recombinant vaccines to antigen presenting cells (APCs) such as dendritic cells however can improve immunogenicity by ensuring that antigen processing is as efficient as possible. Immune complexes, one of a number of routes of APC targeting, are mimicked by a recombinant approach, crystallizable fragment (Fc) fusion proteins, in which the target immunogen is linked directly to an antibody effector domain capable of interaction with receptors, FcR, on the APC cell surface. A number of virus Fc fusion proteins have been expressed in insect cells using the baculovirus expression system and shown to be efficiently produced and purified. Their use for immunization next to non-Fc tagged equivalents shows that they are powerfully immunogenic in the absence of added adjuvant and that immune stimulation is the result of the Fc-FcR interaction.


docid: rydmolif

title: TLR Signaling and Tumour-Associated Macrophages

text: The role that Toll-like receptor (TLR) signaling may have in stimulating macrophages to become tumor promoting is not yet clearly defined. However, given the role macrophages play in restoring tissue homeostasis such as in the tissue repair response, it is likely that tumor-induced TLR signaling provides macrophages with signals of persistent injury. In this chapter, we review the molecular determinants of TLR signaling, the role TLR signaling plays in infection, wound healing, and tumorigenesis and discuss how TLR signaling in tumor-associated macrophages may result in tumor progression.


title: Methods for Testing Immunological Factors

text: Hypersensitivity reactions can be elicited by various factors: either immunologically induced, i.e., allergic reactions to natural or synthetic compounds mediated by IgE, or non-immunologically induced, i.e., activation of mediator release from cells through direct contact, without the induction of, or the mediation through immune responses. Mediators responsible for hypersensitivity reactions are released from mast cells. An important preformed mediator of allergic reactions found in these cells is histamine. Specific allergens or the calcium ionophore 48/80 induce release of histamine from mast cells. The histamine concentration can be determined with the o-phthalaldehyde reaction.


title: Blastomycosis in Mammals

text: Blastomycosis is a serious fungal disease of dogs, humans, and occasionally other mammals caused by geographically restricted, thermally dimorphic Blastomyces species. Blastomycosis is primarily a canine disease, with approximately ten dogs diagnosed for every human case. Dogs also develop disease more rapidly, thus becoming sentinels for possible human disease. Human and canine blastomycosis may differ according to epidemiology/epizoology, clinical features, performance and use of diagnostics, and management.


title: Power Shifts in Global Health Diplomacy and New Models of Development: South–South Cooperation

text: South–South cooperation represents an alternative ideal to the model of rich northern countries providing aid to the poor countries of the southern hemisphere. It offers the prospect of mutual advantages for developing and emerging countries as well as a stronger voice in global diplomacy on social and economic issues. This chapter sets out to provide a balanced view of opportunities and challenges of South–South cooperation, outlining pertinent questions that emerge from this new dynamic of global governance. In the following sections, we briefly outline the history of South–South cooperation and describe its main mechanism and its application to health. We then discuss the paradigm shift from the former bipolar system during the Cold War to today’s global multipolar system. We demonstrate how the consolidation of multipolarity is particularly reflected in the (re)formation of regional blocks, notably in terms of their spheres of coordination and their engagement in different South–South cooperation mechanisms. The African Union (AU), the Association of Southeast Asian Nations (ASEAN), and the Union of South American Nations (UNASUR in its official Spanish acronym) serve as key examples to illustrate both the current state of South–South cooperation and emerging challenges that need to be addressed if South–South cooperation is to be effective and viable in the long term.


title: New Concepts and Emerging Issues in Sepsis

text: Severe sepsis and septic shock are manifestations of the host's immune uncontrolled response to infection. The term sepsis is a poorly defined, but commonly used term in the medical literature, and it is derived from the Greek word “Sépsis” meaning decay. Sepsis is best defined as a life-threatening condition or complex caused by overwhelming inflammatory response to infection associated with dysregulation of the body's immune mechanism. Sepsis is the leading cause of death in critically ill patients in most intensive care units (ICUs). It has been estimated that in the United States sepsis develops in 750,000 people annually, and more then 210,000 of those die(1,2)! Infants and children in >42,000 cases of severe sepsis occur annually in the United States and millions worldwide.(2) The incidence of septicemia and sepsis have been increasing in the past 3 decades in many countries because of several factors, including longer lifespan with a greater population of the elderly; treatment with immunosuppressives with a greater number of subjects with organ transplantations and cancers; use of invasive and novel treatment with prosthesis, long-term or permanent catheters; and the expanding acquired immunodeficiency syndrome (AIDS) epidemic. In national hospital discharge surveys in the United States, the incidence of septicemia had increased from 73.6 per 100,000 patients in 1979 to 175.9 per 100,000 patients in 1987.(3) Surveys in the United States and Europe have estimated that severe sepsis accounts for 2–11& of all admission to hospital or ICUs.(1) Observational studies indicate that 30–50& of the cases are admitted through the emergency department, rather than developing in hospitals.(4,5) The incidence of sepsis appears to continue to increase by 8.7& annually (with an adjusted rate of increase of nearly 300& from 1979 to 2000),(6) but may be greater in the United States (US) with an incidence of 240–300 per 100,000 populations, compared to some European countries (Austria, Germany) with rates of 54–116 per 100,000 population.(7) Despite progress in our understanding of the pathophysiology of sepsis, the mortality rate is still high (in those with severe sepsis and septic shock). Although the mortality rate overall has fallen in the United States from 27.8& to 17.9& in septic patients over 2 decades, the mortality rate was 30& in those with any organ failure and 70& in those with multiple organ failure.(6) Patients with infections and severe sepsis require prolonged stay in ICU and hospital, resulting in increase health care costs. Estimates of direct costs per sepsis patient in the United States are about $50,000 whereas European costs are lower, $26,450–33,350.(7) Thus a crude estimate of the direct annual cost of severe sepsis in the United States is about $17.0 billion.(1)


title: Coronavirus Receptors

text: The major receptor for murine coronavirus, mouse hepatitis virus (MHV), is identified as a protein, cell-adhesion molecule 1 in the carcinoembryonic antigen family (CEACAM1), which is classified in the immunoglobulin superfamily. There are four CEACAM1 isoforms, with either four or two ectodomains, resulting from an alternative splicing mechanism. CEACAM1 is expressed on the epithelium and in endothelial cells of a variety of tissues and hemopoietic cells, and functions as a homophilic and heterophilic adhesion molecule. It is used as a receptor for some bacteria as well. The N terminal domain participates in mediating homophilic adhesion. This domain is also responsible for binding to the MHV spike (S) protein; the CC’ face protruding in this domain interacts with an N terminal region of the S protein composed of 330 amino acids (called S1N330). The binding of CEACAM1 with MHV S protein induces S protein conformational changes and converts fusion-negative S protein to a fusion-positive form. The allelic forms of CEACAM1 found among mouse strains are thought to be an important determinant for mouse susceptibility to MHV.


Travel in a small world


title: Food Security in an Insecure Future

text: Food security in the Middle East is directly affected by a challenging combination of ongoing destructive conflicts, a global economic downturn, widespread poverty, high population growth, corruption, intolerance, and the potentially damaging consequences of climate change. Many Arab countries demonstrate nearly all the features of those countries classified as poor, less developed, or failing to achieve the eight Millennium Goals. Even the economies of the richer oil-exporting countries in the Region have been seriously damaged by the downturn in oil and gas prices as new sources come on stream elsewhere and demand falls as a result of renewable sources of energy becoming available.


docid: ekfjmnsn

title: Structure, Immunopathogenesis and Vaccines Against SARS Coronavirus

text: A new disease, severe atypical respiratory syndrome (SARS), emerged in China in late 2002 and developed into the first epidemic of the 21st century. The disease was caused by an unknown animal coronavirus (CoV) that had crossed the species barrier through close contact of humans with infected animals, and was identified as the etiological agent for SARS. This new CoV not only became readily transmissible between humans but also was also more pathogenic. The disease spread across the world rapidly due to the air travel, and infected 8096 people and caused 774 deaths in 26 countries on 5 continents. The disease is characterized by flu-like symptoms, including high fever, malaise, cough, diarrhea, and infiltrates visible on chest radiography. The overall mortality was about 10%, but varied profoundly with age; the course of disease seemed to be milder in the pediatric age group and resulted rarely in a fatal outcome, but the mortality in the elderly was as high as 50%. Aggressive quarantine measures taken by the health authorities have successfully contained and terminated the disease transmission. As a result there are no SARS cases recorded recently. Nevertheless there is a possibility that the disease may emerge in the population with high vigor. Significant progress has been made in understanding the disease biology, pathogenesis, development of animal models, and design and evaluation of different vaccines, and these are the focus of this chapter.


title: Traveler to Uganda

text: A 25-year-old, otherwise healthy woman traveled to Uganda. Two weeks after her return, she complained of dyspnea on exertion and cough. Several people who traveled with her displayed similar symptoms, and she suspected that she had an infection.


title: Pneumonia

text: Hospital-acquired pneumonia (HAP) is usually caused by bacterial, viral, or fungal pathogens that occur ≥48 h after hospital admission.(1,2) Overall, more than 80% of HAP episodes are related to invasive airway management (in patients with endotracheal intubation or tracheostomy) with mechanical ventilation, which is known as ventilator-associated pneumonia (VAP).(3) VAP is defined as pneumonia developing more than 48 h after intubation and mechanical ventilation. Healthcare-associated pneumonia (HCAP) is part of the continuum of pneumonia, which includes patients who were hospitalized in an acute-care hospital for ≥2 days within 90 days of the infection; resided in a long-term care facility; received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; or attended a hospital or hemodialysis clinic.(1,2) Although this document focuses more on HAP and VAP, many of the principles are also relevant to the management of HCAP. HAP, VAP, and HCAP are the second most common nosocomial infections after urinary tract infection, but are the leading causes of mortality due to hospital-acquired infections.(4,5)


title: Epidemiology and Etiology of Mental Retardation

text: Mental retardation (MR) is a manifestation of a heterogeneous set of impairments and conditions that result in cognitive limitation. It is a condition of medical, educational, and social importance. Physicians identify profound, severe, and moderate MR but rarely diagnose mild MR unless it is associated with a genetic or medical syndrome. From a medical perspective, the quest for etiology and the possibility of medical or surgical intervention to minimize deterioration are paramount. Educators, on the other hand are less concerned with causation than with academic achievement and school success. The majority of cases of mild MR is identified in school settings. Finally, the public uses the label to describe poor adaptive skills. Adults with MR who hold jobs, live independently, and participate in society are not always described as having MR. Thus some individuals characterized in childhood or adolescence as having mild MR become indistinguishable from the general population in adulthood.


title: Toxicity Evaluation and Human Health Risk Assessment of Surface and Ground Water Contaminated by Recycled Hazardous Waste Materials

text: Prior to the 1970s, principles involving the fate and transport of hazardous chemicals from either hazardous waste spills or landfills into ground water and/or surface water were not fully understood. In addition, national guidance on proper waste disposal techniques was not well developed. As a result, there were many instances where hazardous waste was not disposed of properly, such as the Love Canal environmental pollution incident. This incident led to the passage of the Resource Conservation and Recovery Act (RCRA) of 1976. This act gave the United States Environmental Protection Agency regulatory control of all stages of the hazardous waste management cycle. Presently, numerous federal agencies provide guidance on methods and approaches used to evaluate potential health effects and assess risks from contaminated source media, i.e., soil, air, and water. These agencies also establish standards of exposure or health benchmark values in the different media, which are not expected to produce environmental or human health impacts. The risk assessment methodology is used by various regulatory agencies using the following steps: i) hazard identification; ii) dose-response (quantitative) assessment; iii) exposure assessment; iv) risk characterization. The overall objectives of risk assessment are to balance risks and benefits; to set target levels; to set priorities for program activities at regulatory agencies, industrial or commercial facilities, or environmental and consumer organizations; and to estimate residual risks and extent of risk reduction. The chapter will provide information on the concepts used in estimating risk and hazard due to exposure to ground and surface waters contaminated from the recycling of hazardous waste and/or hazardous waste materials for each of the steps in the risk assessment process. Moreover, this chapter will provide examples of contaminated water exposure pathway calculations as well as provide information on current guidelines, databases, and resources such as current drinking water standards, health advisories, and ambient water quality criteria. Finally, specific examples of contaminants released from recycled hazardous waste materials and case studies evaluating the human health effects due to contamination of ground and surface waters from recycled hazardous waste materials will be provided and discussed.


title: Case Study – Greece

text: Biological terrorism and the need for biological defence is a relatively new concept for Greece. Although defence against weaponized pathogens was part of CBRN training in the military, it was the 9/11 massacre followed by the anthrax letters horror that triggered a more active involvement of the Greek public health sector. In that historical moment a third bullet was added to the already existing disease outbreak classification – naturally, accidental and now deliberate. These incidents and the subsequent 2004 Olympic Games in Athens drove the Greek government to focus on biodefence and revise existing civil emergency planning by inclusion of new emerging threats.


title: Cryptosporidiosis in Farmed Animals

text: Cryptosporidiosis was first identified as a disease of veterinary, rather than human medical, importance, and infection of farmed animals with different species of Cryptosporidium continues to be of veterinary clinical concern. This chapter provides insights into Cryptosporidium infection in a range of farmed animals – cattle, sheep, goats, pigs, cervids, camelids, rabbits, water buffalo and poultry – presenting not only an updated overview of the infection in these animals, but also information on clinical disease, infection dynamics and zoonotic potential. Although extensive data have been accrued on, for example, Cryptosporidium parvum infection in calves, and calf cryptosporidiosis continues to be a major veterinary concern especially in temperate regions, there remains a paucity of data for other farmed animals, despite Cryptosporidium infection causing significant clinical disease and also, for some species, with the potential for transmission of infection to people, either directly or indirectly.


title: Acute Exacerbation of Idiopathic Pulmonary Fibrosis

text: Acute exacerbation (AEx) of idiopathic pulmonary fibrosis (IPF) is a clinically important complication of IPF that carries a high morbidity and mortality. In the last decade we have learned much about this event, but there are many remaining questions: What is it? Why does it happen? How can we prevent it? How can we treat it? This chapter attempts to summarize and update our current understanding of the epidemiology, etiology, and management of acute exacerbation of IPF and point out areas where additional data are needed.


docid: jmqpjzvx

title: The Role of Angiotensin–(1-7) in Cancer

text: The rationale to investigate the role of angiotensin-(1-7) [Ang-(1-7)] in cancer relies on the fact that the heptapeptide inhibits the growth of several cell lines. The first studies showed that Ang-(1-7) accelerated hematopoietic recovery in the peripheral blood and bone marrow after chemotherapy and inhibits lung cancer cell growth through the activation of Mas receptor. In this chapter, we summarize studies on the role of Ang-(1-7) in different types of cancer, especially lung, breast, prostate, hepatocellular cancers and in gliobalstoma multiforme (GBM). The antitumor effect of Ang-(1-7) was due to reduction of angiogenesis, cancer-associated fibrosis, osteoclastogenesis, tumor-induced inflammation, and metastasis as well as inhibition of cancer cell growth and proliferation. In clinical trials, Ang-(1-7) was well tolerated with limited toxic or quality-of-life side effects and showed clinical benefit in cancer patients with solid tumors. Further clinical trials are needed to confirm safety, to determine doses and clinical indications.


title: Die Ökologie des Menschen: Bevölkerungswachstum, Krankheiten und Versorgung mit Nahrung

text: In diesem Kapitel werden wir erörtern, wie wir mithilfe der Ökologie besser verstehen können, welche Probleme das menschliche Bevölkerungswachstums, Krankheiten, die Landwirtschaft und der Ressourcenverbrauch mit sich bringen. Selbstverständlich hat alleine schon das Wachstum der menschlichen Bevölkerung Auswirkungen auf die Umwelt und die natürlichen Ökosystemfunktionen, genauso wesentlich sind aber der beträchtliche Anstieg des Pro-Kopf-Verbrauchs und der diesem zugrunde liegende stetige Ausbau neuer Technologien (Abb. 14.1). In der ersten Hälfte des 20. Jahrhunderts ist die Weltbevölkerung um 40 % angewachsen – von 1,8 auf 2,5 Mrd. Menschen. Seither hat sich Bevölkerung beinahe verdreifacht auf über 7 Mrd. Menschen. Das globale Bruttoinlandsprodukt (engl. gross domestic production) ist in der ersten Hälfte des 20. Jahrhunderts um 75 % angestiegen – von 3 auf 5,3 Bio. US-Dollar – und seitdem sogar um mehr als das Zehnfache auf 55 Bio. US-Dollar. Welche Konsequenzen hat dieser Wohlstand? Der Verbrauch von Nahrung, Energie und materiellen Gütern hat erheblich zugenommen – mit entsprechend gravierenden Folgen auf lokaler und globaler Ebene. Die Ökologie kann als Wissenschaft dazu beitragen, diese Folgen besser zu verstehen und Möglichkeiten für einen nachhaltigeren Fortschritt zu finden.


title: Severe Infections in the Returning Traveler

text: The ease of air travel has made spread of infectious agents a global problem. There are a multitude of tropical diseases ranging from benign viral illnesses to highly contagious and life-threatening diseases and it is important to take a detailed clinical and travel history from the ill returning traveller, especially in the fi rst 4 weeks of return.


title: Adverse Transfusion Reactions in Critically Ill Patients

text: Although transfusion therapy in the past 30 years has achieved high levels of safety, severe adverse reactions can still complicate a red blood cell, plasma, or platelet transfusion. Adverse events can be either of infectious nature (Infectious Adverse Reactions to Transfusion–IARTs) or noninfectious (NIARTs). The former are due to viruses, bacteria, or protozoa present in the transfused component. Medical doctors faced with an infectious disease in a hospitalized patient should always collect an accurate clinical history that must include transfusion of blood components and take into consideration that the viral/bacterial/protozoan infection could be related to a transfusion event. If a transfusion-transmitted infection is suspected, the clinician must contact the transfusion center that will provide a look-back of the blood products and a follow-up of the involved donors. NIARTs may be of immunological and nonimmunological nature. This chapter provides an overview of pathogenesis, presentation, therapy, and prevention of the main NIARTs. Finally, organizational measures for the management of NIARTs are presented, in order to ensure the highest possible level of safety for the patients.


title: Autoimmune Encephalitis in the Intensive Care Unit

text: Autoimmune encephalitis is a rapid, progressive encephalopathy due to an autoimmune response directed against the brain parenchyma. It is associated with significant morbidity, often necessitating evaluation and treatment in the intensive care unit (ICU). Patient management centers on rapid diagnosis of the autoimmune encephalitis syndrome with careful assessment for other etiologies of acute encephalopathy, the initiation of immunosuppressive therapy, and the management of associated sequelae including status epilepticus, respiratory failure, elevated intracranial pressure, and dysautonomia.


title: Epitope-Based Immunome-Derived Vaccines: A Strategy for Improved Design and Safety

text: Vaccine science has extended beyond genomics to proteomics and has come to also encompass ‘immunomics,’ the study of the universe of pathogen-derived or neoplasm-derived peptides that interface with B and T cells of the host immune system. It has been theorized that effective vaccines can be developed using the minimum essential subset of T cell and B cell epitopes that comprise the ‘immunome.’ Researchers are therefore using bioinformatics sequence analysis tools, epitope-mapping tools, microarrays, and high-throughput immunology assays to discover the minimal essential components of the immunome. When these minimal components, or epitopes, are packaged with adjuvants in an appropriate delivery vehicle, the complete package comprises an epitope-based immunome-derived vaccine. Such vaccines may have a significant advantage over conventional vaccines, as the careful selection of the components may diminish undesired side effects such as have been observed with whole pathogen and protein subunit vaccines. This chapter will review the pre-clinical and anticipated clinical development of computer-driven vaccine design and the validation of epitope-based immunome-derived vaccines in animal models; it will also include an overview of heterologous immunity and other emerging issues that will need to be addressed by vaccines of all types in the future.


docid: uznffmtg

title: 1 Zorgvuldig en verantwoord handelen in de basiszorg

text: In dit hoofdstuk besteden we aandacht aan zorgvuldig en verantwoord handelen, veiligheid, vrijheidsbeperkende maatregelen, hygiëne en infectiepreventie en ergonomisch werken. Deze belangrijke onderwerpen zijn van toepassing op zorgsituaties van de gezondheidspatronen van Gordon die in de diverse hoofdstukken aan de orde komen. Kennis hiervan is van belang voor de basisverpleegkunde.


title: Norovirus and Other Viral Gastroenteritis

text: New and old entero-pathogenic viruses are increasing in the society and in the healthcare, like the Calicivirus family (Norovirus, Sapovirus, Astrovirus), Reovirus family (Rotavirus) (especially infant, toddler and elderly) and rarely other viral types such as adenovirus (especially serotype 40, 41), bocavirus, parechovirus, enterovirus and a variety of other types. In all types of gastroenteritis, infection prevention measures are performed as with norovirus, described below. The following chapter is focused on practical measures to detect and prevent transmission of entero-pathogenic viruses in healthcare institutions.


title: Supply Chain Risk Management: A Neural Network Approach

text: Effective supply chain risk management (Hallikas et al. 2002; Harland et al. 2003; Henke et al. 2006) requires the identification, assessment and monetization of risks and disruptions, as well as the determination of the probability of their occurrence and the development of alternative action plans in case of disruptions (cf. Zsidisin 2003; Zsidisin et al. 2004; Zsidisin et al. 2000; Vidal a. Goetschalckx, 2000). Companies traditionally use multiple sources for material procurement and/or hold safety stocks to avoid vulnerability. However, these strategies can negatively impact the supply chain performance, leading to higher purchase and logistics costs. The aim of this chapter is to illustrate how the implementation of the supply chain risk management concept can be improved by using a neural network approach.


title: Automated Knowledge Extraction from Internet for a Crisis Communication Portal

text: This paper describes the development of an Automated Knowledge Extraction Agent (AKEA) which was designed to acquire online news and document from the internet for the establishment of a knowledge based crisis communication portal. It was recognized that in times of crisis, an effective communication mechanism is essential to maintain peace and calmness in the community by providing timely and appropriate information. It is proposed that the incorporation of software agents into the crisis communication portal will be capable to send alert news to subscribed users via internet and mobile services. The proposed system consists of crawler, wrapper, name-entity tagger, AIML (Artificial Intelligence Markup language) and an animated character is used in the front-end for human computer communication.


title: Infectious Disease Epidemiology

text: The following chapter intends to give the reader an overview of the current field of applied infectious disease epidemiology. Prevention of disease by breaking the chain of transmission has traditionally been the main purpose of infectious disease epidemiology. While this goal remains the same, the picture of infectious diseases is changing. New pathogens are identified and already known disease agents are changing their behavior. The world population is aging; more people develop underlying disease conditions and are therefore more susceptible to certain infectious diseases or have long term sequelae after being infected.


title: Chirurgische Infektionen

text: Der menschliche Organismus ist von einer unzähligen Menge von Mikroorganismen umgeben. Dringen diese Krankheitserreger in uns ein, dann laufen Wechselbeziehungen zwischen dem Eindringling und dem Wirtsorganismus ab. Krankheit resultiert, wenn die Mikroorganismen aufgrund ihrer verschiedenen Determinanten der Pathogenität und Virulenz den Wettlauf mit der Infektabwehr des Makroorganismus gewonnen haben. Mit diesem Problem hatten sich Chirurgen zu allen Zeiten auseinanderzusetzen—und es hat bis heute nicht an Aktualität verloren.


title: The Antiviral Potential of Host Protease Inhibitors

text: The replication of numerous pathogenic viruses depends on host proteases, which therefore emerged as potential antiviral drug targets. In some cases, e.g., for influenza viruses, their function during the viral propagation cycle is relatively well understood, where they cleave and activate viral surface glycoproteins. For other viruses, e.g., Ebola virus, the function of host proteases during replication is still not clear. Host proteases may also contribute to the pathogenicity of virus infection by activating proinflammatory cytokines. For some coronaviruses, human proteases can also serve in a nonproteolytical fashion simply as receptors for virus entry. However, blocking of such protein-protein contacts is challenging, because receptor surfaces are often flat and difficult to address with small molecules. In contrast, many proteases possess well-defined binding pockets. Therefore, they can be considered as well-druggable targets, especially, if they are extracellularly active. The number of their experimental crystal structures is steadily increasing, which is an important prerequisite for a rational structure-based inhibitor design using computational chemistry tools in combination with classical medicinal chemistry approaches. Moreover, host proteases can be considered as stable targets, and their inhibition should prevent rapid resistance developments, which is often observed when addressing viral proteins. Otherwise, the inhibition of host proteases can also affect normal physiological processes leading to a higher probability of side effects and a narrow therapeutic window. Therefore, they should be preferably used in combination therapies with additional antiviral drugs. This strategy should provide a stronger antiviral efficacy, allow to use lower drug doses, and minimize side effects. Despite numerous experimental findings on their antiviral activity, no small-molecule inhibitors of host proteases have been approved for the treatment of virus infections, so far.


title: Preventie, gezondheidsbescherming en -bevordering

text: Preventieve voorzieningen kunnen, voor zover ze bij menselijk gedrag aanknopen, op het individu of op collectiviteiten zijn gericht.(1) Individuele preventie vindt onder andere plaats in het kader van de relatie tussen de patiënt en de behandelend arts, bijvoorbeeld als er een dieet wordt voorgeschreven, een leefadvies of erfelijkheidsadvisering wordt gegeven. Maar ook curatieve activiteiten kunnen een individueel preventief aspect hebben, voor zover ze verergering van ziekte of de gevolgen van een ziekte beogen te voorkomen. Deze individuele preventieve activiteiten blijven in dit hoofdstuk buiten beschouwing.