title: Policy Innovations for Health

text: We are at a turning point in health policy. It has become increasingly clear that changes in the existing health care system will not be sufficient to maintain and improve our health at this historical juncture. Both our extensive knowledge on what creates health as well as the exponentially rising rates of chronic disease obesity, and mental health problems indicate that we need to shift course and apply a radically new mind-set to health and health policy. This is what we mean by policy innovations for health. The boundaries of what we call the “health system” are becoming increasingly fluid and health has become integral to how we live our everyday life. Health itself has become a major economic and social driving force in society. This shifts the pressure for policy innovation from a focus on the existing health system to a reorganization of how we approach health in 21st century societies. The dynamics of the health society challenge the way we conceptualize and locate health in the policy arena and the mechanisms through which we conduct health policy. They also redefine who should be involved in the policy process. This concern is beginning to be addressed within government through Health in All Policy approaches and beyond government through new partnerships for health. Most importantly, the role of citizen and patient is being redefined – a development that will probably lead to the most significant of the policy innovations for health in the 21st century.


title: Diagnostic Radiology in Hematological Patients with Febrile Neutropenia

text: Radiologists have a special role in the management of neutropenic patients. The appropriate investigational technique, specific differential diagnoses, and particular risks of these patients need to be understood by referring physicians as well as by radiologists. Thus, communication and cooperation, also including other clinical disciplines such as pulmonology, are required. Early detection of an infectious focus is the major goal in febrile neutropenic patients. As pneumonia is the most common focus, chest imaging is a special radiological task. The sensitivity of chest x-ray, especially in supine position, is low. Therefore, the very sensitive thin-section multislice CT became a gold standard in neutropenic hosts and might be cost effective in comparison to antibiotic treatment. CT-based localization can be used to guide invasive procedures in order to obtain samples for microbiological workup. Furthermore, the radiological characterization of infiltrates gives a first and rapid hint to discriminate between infectious (viral, typical bacterial, atypical bacterial, fungal) and noninfectious etiologies. Radiological follow-up has to take into account aspects according to disease, immune recovery, and treatment modalities. Due to a high incidence of fungal-related lung infiltrates, interpretation of follow-up findings must include further parameters besides lesion size. Apart from the lungs, also other organ systems such as the brain, liver, and paranasal sinuses need attention and are to be imaged with the appropriate technique.


title: Community-Acquired Pneumonia

text: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in the world, with an annual incidence ranking from 1.6 to 10.6 per 1.000 people in Europe. The incidence is age related, peaking over 65 years. Up to 75 % of CAP patients with pulmonary diseases need hospitalization, and up to a 10 % of these are admitted to an intensive care unit (ICU) due to complications like sepsis, septic shock, and acute respiratory distress syndrome (ARDS) [1–3]. Up to 8 % of CAP patients die within 90 days of disease onset; 21 % die within a year [4] making CAP the most frequent cause of death from infection in Europe and the third most common cause of death in general [5]. Mortality is highest in ICU patients.


title: The Peritoneal Cavity, Retroperitoneum, and Abdominal Wall

text: Early detection of peritoneal changes is essential for the management of several neoplastic and non-neoplastic conditions in veterinary patients. The peritoneal and retroperitoneal spaces are normally included in abdominal MDCT examination. Contrast-enhanced MDCT scans with near-isotropic or isotropic resolution are necessary for fine evaluation of the abdominal cavity in dogs and cats. Isotropic imaging and post-processing with dorsal and sagittal reformation can fully delineate the peritoneal and retroperitoneal spaces and extent of diseases.


title: Optimal Time Delay in the Control of Epidemic

text: A mathematical model to address the efficiency of the isolation and quarantine strategies in the containment of epidemics is constructed based on the SIR model with time delay. The model is investigated with numerical simulation that demonstrates the importance of quick measure in identifying the infected and the subsequent quarantine of his/her neighbors. The model also provides a theoretical framework for the estimation of the cost involved in the containment of the epidemics. Based on a general estimate of the cost, we demonstrate the procedure for the calculation of the optimal set of parameters in our isolation and quarantine strategy through numerical simulation on a model social network. We find an important parameter π which is a combination of several general parameters for the SIR model so that when π> 0, the isolation and quarantine strategy will fail to contain the outbreak. The procedure outlined provides some general guidance in the selection of strategies in the containment of real epidemics, where the balance between social cost and risk must be carefully handled.


title: Erreger

text: Das Erregerspektrum von Pneumonien unter Immunsuppression ist breit und umfasst definierte bakterielle Erreger (Rhodococcus spp. und Nokardien), Mykobakterien (M. tuberculosis und nichttuberkulöse Mykobakterien), Pilze, Pneumocystis jirovecii, Viren (respiratorische Viren und Herpesviren) und Parasiten. Mikrobiologie, Übertragungsmechanismen, Risikofaktoren, Pathogenese, klinische Präsentation, Diagnostik, antimikrobielle Therapie und Prävention dieser Erreger werden im Einzelnen vorgestellt. Die Kenntnis dieser Zusammenhänge eröffent eine frühe und rationelle Diagnostik sowie eine gezielte Therapie auf dem Boden valider Erregernachweise.


title: Reducing Costs – Increasing the Efficiency and Effectiveness through IT

text: There is a natural limit to how IT can generate economic benefits and increase corporate value: It’s IT cost. Many value-oriented IT projects are discontinued, not because the resulting benefits cannot be quantified but because the company’s focus has shifted. And this shift does not necessarily have to include changes in the long-term corporate strategy, as would be caused by external developments in market and competition: To produce less-than-positive effects, all a company needs to do is shift its focus from IT growth drivers to IT-driven cost reductions, as often happens in times of economic downturns or internal restructuring.


title: Decision-Making

text: Chapter 7 focuses on decision-making. It introduces and discusses the relevant actors and agents responsible for identifying health risks, and developing and ordering responses at the local, national, and international levels. Then it delves into the functions of trust and history in disordering (and potentially re-ordering) health: such as the role of reactance and the ostensible reclaiming of rights by refusing vaccination(s). The latter has been the case in the former East Germany for example, which experienced a large measles outbreak in 2015, as well as in California. The chapter explores ways and means for overcoming such political and policy gaps to promote health rights and responsibilities. Finally, the chapter explores ways in which decision-makers and decision-making respond to health threats that can(not) be contained.


title: Cell and Tissue Reactions

text: Similar types of tissue reaction result as a final common pathway from a wide array of different internal brain pathophysiological states and external insults. Since these cellular and tissue reactions are largely independent of the specific type of insults, they are, therefore, non-specific. The tissue reactions are to be differentiated according to their specific pathogenetic mechanisms, though these mechanisms as well as the phenomena are overlapping as demonstrated in Fig. 4.1; brain ischemia as a type of metabolic disturbance, edema, intracranial pressure, necrosis, herniation and inflammation are influencing themselves and are dependent on each other. Some will be mentioned again in later chapters as viewed from different forensic aspects; therefore, a certain redundancy is unavoidable. Immediately following, we offer a survey of the individual types of reaction and their fundamental pathophysiological principles and morphology.


title: Populations, Patients, Germs and Genes: Ethics Of Genomics and Informatics in Communicable Disease Control

text: This chapter will explore the ways in which genomics (and the informatics tools needed to analyze and interpret them) could, potentially, transform our understanding of infectious disease epidemiology, improve disease management and prevention and save lives. The integration of microbiological, clinical and environmental data into personalized clinical decision support and risk assessment tools will improve both the care of patients with infectious diseases and public health protection. Integrated electronic health information systems will be faster, safer and more cost-effective than the current inefficient miscellany of individual medical records and disease surveillance systems. Technical, commercial and economic barriers to system implementation are unlikely to be insurmountable, but the largely uncharted ethical hazards are potentially more challenging. Prospective evaluation of clinical and public health impact and cost-effectiveness of new diagnostic and surveillance methods and information systems, designed to protect privacy and security of health data without placing unnecessary restrictions on access to essential public health data, will be needed. The interests, priorities and concerns of all stakeholders, including patients and potential patients, health professionals and administrators, public health officials and politicians, must be openly debated and addressed. Otherwise, unnecessary delays or a failure to implement better systems will allow unnecessary suffering and preventable mortality to continue.


title: Forensic Histopathology

text: Forensic histopathology is the application of histological techniques and examination to forensic pathology practice. It is a unique and specialised aspect of pathology practice. This chapter highlights several differences in forensic histopathology practice compared to clinical and surgical histopathology practice. The various roles of microscopic tissue examination in forensic pathology practice are categorised and discussed. These are in relation to definitive pathological diagnosis, confirmation of equivocal and occult pathology, serving as a form of permanent record, and providing invaluable material for education and research. Case examples are included to illustrate the impact of routine histological examinations, special stain techniques, as well as immunohistochemistry where appropriate, towards relevant pathological diagnoses, which may or may not be directly relevant to the establishment of the cause of death. Lastly, the chapter also aims to highlight some recent advances as well as the challenges ahead in this field.


title: Using Viral-Mediated Gene Transfer to Study Depressive-Like Behavior

text: The use of viral-mediated gene transfer in animal behavioral experiments has become very popular over the last decade. Altering gene regulation and assessing subsequent behavior can be a useful tool in unraveling a specific gene’s contributions to complex behavioral processes such as depressive-like behavior. However, these types of experiments require detailed planning and designs to avoid pitfalls associated with issues such as surgical procedure or the peak of viral expression. This chapter is intended to be a primer on the design of such experiments and aims to discuss factors that must be considered in the early phases of experimental planning.


title: Our World as a Learning System: A Communities-of-Practice Approach

text: We live in a small world, where a rural Chinese butcher who contracts a new type of deadly flu virus can infect a visiting international traveller, who later infects attendees at a conference in a Hong Kong hotel, who within weeks spread the disease to Vietnam, Singapore, Canada, and Ireland. Fortunately, the virulence of the Severe Acute Respiratory Syndrome (SARS) was matched by the passion and skill of a worldwide community of scientists, health care workers, and institutional leaders who stewarded a highly successful campaign to quarantine and treat those who were infected while identifying the causes of the disease and ways to prevent its spread. In such a world, we depend on expert practitioners to connect and collaborate on a global scale to solve problems like this one – and to prevent future ones.


title: Microbial Agents in the Indoor Environment: Associations with Health

text: There is international consensus that damp buildings and indoor mould can increase the risk of asthma, rhinitis, bronchitis and respiratory tract infections but we do not know which types of microbial agents that are causing the observed adverse health effects. Microbial indoor exposure is a broader concept than microbial growth in buildings. Other sources of indoor microbial exposure include the outdoor environment, humans (crowdedness) and furry pet keeping. Microbial exposure can have different health effects depending on the dose, different exposure route, genetic disposition and the timing of exposure. Microbial stimulation linked to large microbial diversity in early life can protect against disease development, especially for allergic asthma and atopy. Protective effects are more often reported for bacterial exposure and adverse health effects are more often linked to mould exposure. There are many studies on health associations for indoor exposure to endotoxin, mainly from homes. The risk of getting atopic asthma may be less if you are exposed to endotoxin in childhood but the risk of non-atopic asthma may increase if exposed to endotoxin especially in adulthood. Moreover, genetic disposition modifies health effects of endotoxin. Epidemiological studies on muramic acid (from gram-positive bacteria) or ergosterol (from mould) are few. Studies on health effects of indoor exposure to beta-1-3-glucan (from mould) have conflicting results (positive as well as negative associations). Epidemiological studies on health effects of indoor exposure to mycotoxins are very few. Some studies have reported health associations for MVOC, but it is unclear to what extent MVOC has microbial sources in indoor environments. Many studies have reported health associations for fungal DNA, especially as a risk factor for childhood asthma at home. Since most studies on health effects of indoor exposure to mould, bacteria and microbial agents are cross-sectional, it is difficult to draw conclusions on causality. More prospective studies on indoor microbial exposure are needed and studies should include other indoor environments than homes, such as day care centers, schools, hospitals and offices.


title: Aspects of Microparticle Utilization for Potentiation of Novel Vaccines: Promises and Risks

text: Many recombinant vaccines against novel (HIV, HCV) or ever-changing (influenza) infectious agents require the presence of adjuvants/delivery vehicles to induce strong immune responses. The necessity of their improvement led to the major effort towards development of vaccine delivery systems that are generally particulate (e.g., nano- and microparticles) and have comparable dimensions to the pathogens (viruses or bacteria). The mode of action of these adjuvants is not fully understood but implies the stimulation of the innate or antigen-specific immune responses, and/or the increase of antigen uptake or processing by antigen-presenting cells (APC). Moreover, enhancement of adjuvant activity through the use of micro- and nanoparticulate delivery systems often resulted from the synergistic effects producing immune responses stronger than those elicited by the adjuvant or delivery system alone. Among particulate adjuvants, biodegradable micro- and nanoparticles of poly(D,L-lactide-co-glycoside) (PLGA) or poly(D,L-lactide) (PLA) have been reported to enhance both humoral and cellular immune responses against an encapsulated protein antigen. Cationic and anionic polylactide co-glycolide (PLG) microparticles have been successfully used to adsorb a variety of agents, which include plasmid DNA, recombinant proteins and adjuvant active oligonucleotides and are also currently tested in several vaccine applications. Another approach envisions specific targeting of APC, especially peripheral DC and exploitation of particulate systems that are small enough for lymphatic uptake (polystyrene nanobeads). Micro- and nanoparticles offer the possibility of enhancement of their uptake by appropriate cells through manipulation of their surface properties. Still, questions regarding toxicity and molecular interaction between micro- and nano-particles and immune cells, tissues and whole organisms remain to be addressed. These risks and other possible side effects should be assessed in detail especially if mass-production and massive administration of such preparations is to be considered.


title: Complex Situations in Patients with Adult-Onset Still’s Disease

text: Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology, characterized by quotidian or double quotidian fever, a peri-febrile cutaneous eruption, polyarthritis, and multiorgan involvement. AOSD is a challenging disease with protean disease manifestations and rare, albeit potentially life-threatening, complications. In such cases, prompt diagnosis and treatment may prove life-saving. The purpose of this chapter is to review the diagnosis and management of challenging clinical situations in AOSD patients that are associated with significant morbidity and mortality and to provide the readers with information that could aid their decision-making process.


title: Chemokine Actions in the CNS: Insights from Transgenic Mice

text: Historically the central nervous system (CNS) has been viewed as a relatively immune sheltered tissue. Under physiological conditions the CNS is devoid of leukocytes, including professional antigen presenting cells (APC), is deficient in key immune accessory molecules such as major histocompatibility molecules (MHC) and is protected by an effective blood brain barrier. Significantly, however, in numerous pathological states including infectious diseases and autoimmune disorders (e.g. multiple sclerosis) immune cells are effectively recruited to and infiltrate in the CNS. This immune response can be a two-edged sword required on the one hand to control infection and facilitate tissue repair and regeneration but on the other causing tissue injury that can result in life threatening complications. Therefore, understanding the mechanisms that control the trafficking of leukocytes to the CNS and the subsequent interactions between these cells that contribute to tissue injury has significant implications.


title: Hepadnaviruses have a narrow host range — do they?

text: Host range describes the range of species that a virus can infect to productively propagate itself. Productive infection requires compatibility between virus and host molecules. Thus host range may be restricted by lack of appropriate permissivity factors;alternatively, hosts may actively counteract infection using restriction factors. Incompatibility between virus and host can manifest on the level of individual cells,of tissues or organs,and of the entire organism. All hepatitis B viruses are hepatotropic,but individual viruses infect the livers of only selected mammalian (orthohepadnaviruses) and avian (avihepadnaviruses) hosts. Hence a narrow host range is thought to be a salient feature of hepadnaviruses. Here we briefly review general mechanisms of host range restriction,and summarise older as well as recent data pertaining to hepadnaviral host range. Clearly,the term species-specific is inadequate for many hepadnaviruses because they can infect different species from one genus,and even species from different genera. For a few others,only a single species,or genus,has been identified that supports efficient infection;however,this could as well relate to the restricted number of experimentally addressable test species. Together with the uncertainty about quantitative phylogenetic relationships between species,still largely based on morphological rather than molecular criteria,this leaves the term narrow open to interpretation. Finally,few if any of the host molecules enabling productive infection by a hepadnavirus have unambiguously been identified,the role of restriction factors has not yet been assessed,and even on the virus side the so-called host determining regions in the PreS domains of the large envelope proteins appear to be relevant only under specialised experimental conditions. Hence this important aspect of hepadnavirus biology is still far from being understood.


title: Metal-Based Drugs for Treatment of Malaria

text: Despite the incessant efforts to decrease exorbitant number of daily deaths, malaria remains a major threat to the public health in many countries. Transmitted by Anopheles mosquitoes, it is caused by infection with Plasmodium parasites that have become resistant to many antimalarial drugs. In this context, series of metal-based compounds have been screened for optimal activity against different Plasmodium species and strains. This chapter briefly reviews current and potential uses of metal complexes (such as iron, cobalt, nickel, gallium, copper, gold, and silver), metal chelators, and organometallic compounds, as interesting medicinal agents that greatly benefits the fight against malaria.


title: Identifying Multiple Propagation Sources

text: The global diffusion of epidemics, computer viruses and rumors causes great damage to our society. One critical issue to identify the multiple diffusion sources so as to timely quarantine them. However, most methods proposed so far are unsuitable for diffusion with multiple sources because of the high computational cost and the complex spatiotemporal diffusion processes. In this chapter, we introduce an effective method to identify multiple diffusion sources, which can address three main issues in this area: (1) How many sources are there? (2) Where did the diffusion emerge? (3) When did the diffusion break out? For simplicity, we use rumor source identification to present the approach.


title: Fabrication of Nanostructures with Bottom-up Approach and Their Utility in Diagnostics, Therapeutics, and Others

text: Nanofabrication has been a critical area of research in the last two decades and has found wide-ranging application in improvising material properties, sensitive clinical diagnostics, and detection, improving the efficiency of electron transport processes within materials, generating high energy densities leading to pulse power, novel therapeutic mechanisms, environmental remediation and control. The continued improvements in the various fabrication technologies have led to realization of highly sensitive nanostructure-based devices. The fabrication of nanostructures is in principle carried out primarily using top-down or bottom-up approaches. This chapter summarizes the important bottom-up nanofabrication processes for realizing nanostructures and also highlights the recent research conducted in the domain of therapeutics and diagnostics.


title: The Phytochemical Composition, Biological Effects and Biotechnological Approaches to the Production of High-Value Essential Oil from Geranium

text: Geraniaceae family plants are highly reputed aromatic and medicinal perennial branched herbs. The high economic value of these plants is due to their secondary metabolites, especially essential oil of foliage, which is a complex mixture of volatile phytochemicals, such as terpenes, esters, aldehydes, alcohols, ketones and phenols. The main phytoconstituents of the essential oil belong to the terpenoid group of metabolites, such as monoterpenes, sesquiterpenes, diterpenes and their esters. Of these, geraniol, linalool, citronellol and their esters (50–70%) generally constitute a major portion of essential oil, responsible for its fragrance. Essential oil is biosynthesized in specialized tissues known as glandular trichomes present in leaves, green branches and fresh flowers. Geraniaceae family plants have been highly useful in the perfumery, cosmetics, aromatherapy, pharmaceuticals and food industries. Several pharmacological properties such as antifungal, anti-inflammatory, anti-cancerous, anti-depressant, antibacterial, antioxidant, antiseptic, anti-dysentery, and antidiabetic properties are attributed to the presence of geranium oil. Further, it improves blood circulation, treats congestion, cleans the lymphatic system, strengthens the immune system, and is effective in combating nervousness, constipation, insomnia, anxiety and high blood pressure. The chapter discusses the phytochemical composition, pharmacological properties, genomics of essential oil biosynthetic pathway, enhancement of essential oil yield, and several biotechnological approaches to enhance the quantity as well as quality of essential oil in geranium.


Akutes und chronisches Leberversagen


Severe acute respiratory syndrome: clinical features


title: Fluorescence In Situ Hybridization (FISH) and Its Applications

text: Fluorescence in situ hybridization (FISH) is the most convincing technique for locating the specific DNA sequences, diagnosis of genetic diseases, gene mapping, and identification of novel oncogenes or genetic aberrations contributing to various types of cancers. FISH involves annealing of DNA or RNA probes attached to a fluorescent reporter molecule with specific target sequence of sample DNA, which can be followed under fluorescence microscopy. The technique has lately been expanded to enable screening of the whole genome simultaneously through multicolor whole chromosome probe techniques such as multiplex FISH or spectral karyotyping or through an array-based method using comparative genomic hybridization. FISH has completely revolutionized the field of cytogenetics and has now been recognized as a reliable diagnostic and discovery tool in the fight against genetic diseases.


title: Kutane Lymphome

text: Kutane Lymphome (cutaneous lymphomas: CL) umfassen die Gruppe der kutanen T-Zell-Lymphome (cutaneous T-cell lymphomas: CTCL), kutanen B-Zell-Lymphome (cutaneous B-cell lymphomas: CBCL) und die sog. hämatodermischen Neoplasien (HN). CL gehören zur Gruppe der Non-Hodgkin-Lymphome (NHL) und stellen in der Subgruppe der extranodalen NHL die zweithäufigste Gruppe hinter den gastrointestinalen Lymphomen dar (Jaffe et al. 2009). Man unterscheidet zwischen primären und sekundären CL. Primäre CL haben ihren Ursprung in der Haut und bleiben in der Regel darauf auch längere Zeit beschränkt, während sekundäre Lymphomekutane CL kutane Manifestationen von primär nodalen oder extranodalen Lymphomen darstellen (Willemze 2005). Die primären CL unterscheiden sich hinsichtlich klinischem Verlauf, Therapieoptionen und Prognose erheblich von nodalen und extrakutanen Lymphomen. So zeigen z. B. die primär kutanen CD30(+) Lymphome einen gutartigen Verlauf, wogegen die nodalen Varianten als aggressiv eingestuft werden. Da die CL zumeist weniger aggressiv sind, werden sie weniger aggressiv behandelt.


Infectious Disease


title: Spread-of-Disease Modeling in a Microbiology Course

text: Microbiology is the study of microorganisms. Most college courses in microbiology emphasize the biology of bacteria and viruses, including those that are human pathogens. One challenging aspect of the course is to introduce students to epidemiology, which considers the causes, dispersal, and control of disease. Although disease transmission models have helped develop successful strategies for managing epidemics, most science students are unaware of their advantages and complexities. To address this challenge, the microbiology course at Wofford College has incorporated a sequence of three or four laboratories on modeling the spread of disease. Emphasis in Computational Science students who have studied modeling and simulation in depth serve as laboratory assistants and mentors. Evidence from test scores and self-assessment support the hypothesis that the sequence of laboratories has improved student understanding of human disease dynamics and demonstrated the utility of computational models.


title: Non-poisson Processes of Email Virus Propagation

text: Email viruses are one of the main security problems in the Internet. In order to stop a computer virus outbreak, we need to understand email interactions between individuals. Most of the spreading models assume that users interact uniformly in time following a Poisson process, but recent measurements have shown that the intercontact time follows heavy-tailed distribution. The non-Poisson nature of contact dynamics results in prevalence decay times significantly larger than predicted by standard Poisson process based models. Email viruses spread over a logical network defined by email address books. The topology of this network plays important role in the spreading dynamics. Recent observations suggest that node degrees in email networks are heavy-tailed distributed and can be modeled as power law network. We propose an email virus propagation model that considers both heavy-tailed intercontact time distribution, and heavy-tailed topology of email networks.


title: Characteristics of B Cells and B Cell Responses in Aged Individuals

text: Ageing individuals are immunologically characterized by loss of immunological protection and responsiveness, and autoimmunity occurs with increased incidence. Here we review studies on specific age-related changes in B cell generation, activation, and maintenance as well as characteristics of B cell responses and antibody levels during ageing in relation to other cells and factors that are interwoven with B cell biological processes. In the elderly, fewer new B cells are generated, B cell responsiveness to antigens is impaired, and smaller and fewer germinal centers are formed within an immune response with participation of less potent T cells and follicular dendritic cells, leading to the production of reduced, often insufficient plasma cell numbers. Recall responses in the elderly appear to be limited by the cells’ proliferative capacity. Hence, vaccine responsiveness is often insufficient and autoantibody production emerges in the elderly. In total, B cells appear to be less affected by age as compared with T cells. Recently, new concepts have been developed to counteract immunosenescence beyond active vaccination, comprising the generation of specific monoclonal antibodies for passive vaccination, immune rejuvenation by immunoablation followed by autologous stem cell transplantation, and modulation of lifestyle.


title: Growth Factors

text: Any cell needs extracellular signals for its growth, proliferation, and survival, among other events. Chemical, mechanical, electrical, and other physical interactions of cells with the extracellular matrix yield functional and structural signals for normal cellular activity as well as formation and maintenance of three-dimensional tissues. Environmental chemical signals are transmitted by hormones (Sect. 1.4) and growth factors (Table 3.1), in addition to nervous cues (Sect. 1.1).


title: SARS Epidemic: SARS Outbreaks in Inner-land of China

text: Severe Acute Respiratory Syndrome (SARS), also known in China as Infectious Atypical Pneumonia (IAP), is the 21st century’s first infectious disease to severely threaten the public health of the human population (WHO, 2003a). A respiratory transmitted disease caused by a virus, SARS is highly infectious and is rapidly transmitted, inflicting severe complications and a high case fatality rate. The first round of the SARS pandemic led to global panic and billions of dollars economic losses, for due to lack of effective SARS drugs, governments throughout the world had to take rigid steps toward prevention and treatment of the disease. The SARS epidemic began with the first reported case in Guangzhou, China (Wang et al., 2004), on 16 November 2002. Eight months later, the disease had spread to 26 countries in Asia, America, and Europe, resulting in a reported 8,096 cases and 774 deaths (WHO, 2004). In this global epidemic, China, with 7,429 cases and 685 deaths, accounted for 91.8% of the world’s reported cases and 88.5% of the deaths (5,327 SARS cases and 349 deaths were reported in 24 provinces in the inner-land of China – mostly in Beijing and Guangzhou, which, with a combined 4,033 cases, accounted for 75.7% of the total number in the inner-land of China; Hong Kong had 1,755 cases, 299 deaths; Taiwan: 346 cases, 37 deaths; Macao: 1 case, 0 deaths) (He et al., 2003; Peng et al., 2003; Yang et al., 2003; Leadership Group of SARS Prevention and Control in Beijing, 2003; Chinese Center for Disease Control and Prevention, 2003).


title: Historical Overview

text: “Poisons” were originally considered as the causative agents of illnesses that we know as viral diseases today. At that time, there were no standard methods to detect pathogenic (disease-causing) organisms such as bacteria and protozoa in the supposed “poisonous materials”. Only animal experiments performed by Louis Pasteur at the end of the nineteenth century, in which no dilution of the poisonous properties was achieved even after several passages, suggested that the disease-causing agent was able to multiply in the organism. Therefore, there was talk of a reproducible “virus” (Latin for “poison” or “slime”) in living organisms, and later also in cells. In St. Petersburg in 1892, Dimitri I. Ivanovski demonstrated that tobacco mosaic disease is caused by an “ultrafilterable” agent, whose size is significantly smaller than that of bacteria: tobacco mosaic virus (bacteria filters have a pore size of approximately 0.2 μm, however, most viruses are smaller than 0.1 μm). Soon afterwards, Martinus Willem Beijerinck came to the same conclusion: he developed, for the first time, the notion of a self-replicating, “liquid” agent (contagium vivum fluidum). The discovery of foot-and-mouth disease virus by Friedrich Loeffler and Paul Frosch in Greifswald in 1898 was the first evidence of an animal pathogenic virus.


title: Hypoxemic Respiratory Failure: Evidence, Indications, and Exclusions

text: ECMO is increasingly being used to manage severe ARDS with refractory hypoxemia and hypercapnia, and to facilitate lung-protective ventilation and minimize ventilator-associated lung injury. However, there is limited high-level evidence to support its use. Early randomized trials did not show a benefit, though these studies were hampered by high mortality rates, limited experience with ECMO, and antiquated technology. Since the advent of more advanced circuit components and increased experience with the use of this technology, survival rates with ECMO for ARDS have improved. There is only one randomized trial to date which used a more modern ECMO circuit. This trial, which has significant limitations, demonstrated a survival benefit from referral to a specialized center for consideration for ECMO. However, a prospective randomized trial comparing ECMO, using modern equipment, to standard-of-care mechanical ventilation has yet to be performed. There are no universally accepted guidelines for initiation of ECMO for ARDS, however suggested criteria include PaO(2) to FIO(2) ratio less than 80, uncompensated respiratory acidosis, and excessively high plateau airway pressures despite optimal ventilator management. Relative contraindications include prolonged ventilation at high airway pressures or high FIO(2), contraindications to anticoagulation, and concurrent severe, irreversible comorbidities.


title: One Health: From Concept to Practice

text: One Health (OH) is an approach, focusing on emergent infectious diseases, which looks at health in the context of human, animal and environment relationships. Governments worldwide through the International Ministerial Conferences on Avian and Pandemic Influenza (IMCAPI) meetings have made a commitment to OH. There is unanimous agreement from the international organizations to the community level that this is a necessary approach in an increasingly populous world. It is a world, however, in which professions have moved to specialization and expertise within their own realm rather than in collaboration and cross discipline. This chapter reports on the operationalization of OH to date and consideration of the forward path in examination of the key areas of: leadership, relationships, infrastructure, skills and capacity, communication and technology, and resources.


title: Antiviral Probiotics: A New Concept in Medical Sciences

text: In recent decades, probiotics have shown beneficial effects on animal and human health. Probiotics can protect the host against several health threats, including infectious diseases. Before 1995, researchers believed that the effect of probiotics was only on gut microbiota which can restore the gut flora and thus prevent pathogenic bacteria from triggering gastroenteritis. Recent studies have shown that the immunomodulatory activity is the most important mechanism of action of probiotics. From this information, researchers started to evaluate the effect of some immunobiotics, not only on pathogenic bacteria but also on viruses, including enteric and respiratory viruses. Several studies have confirmed the potential antiviral activity of some probiotics due to the immunomodulatory effect. These studies were conducted on humans (clinical trials) and in animal models. In this chapter, probiotics with antiviral effect against respiratory and enteric viruses will be presented and discussed, as well as their mechanisms of action.


Global Governance


Caspase-6


title: How to Choose the Right Journal

text: Authors of a scientific manuscript wish their paper to be published in a journal and then read, used and cited by their peers. However, there can be many stumbling blocks in this process. One such impediment is submitting the manuscript to an inappropriate journal. At one extreme, it may result in a journal editor summarily rejecting the manuscript without even commissioning an external peer review; this results in the need to resubmit the manuscript to another journal and a consequent delay in publication. At the other extreme, the paper may be published in a journal that is rarely accessed or read by those interested in the work. Either way, the authors’ efforts to disseminate their knowledge have been frustrated.


title: Respiratory Emergencies

text: Causes of cough: Acute cough (<3 weeks): Respiratory tract infections: viral upper respiratory tract infection, viral rhinosinusitis, common cold, acute bacterial sinusitis, acute bronchitis, pneumonia, acute exacerbation of COPD; pertussis. Inhalation of direct irritants: dust, smoke, ozone, air pollutants. Inhalation of specific allergen in the asthmatic: pollen, or low concentration of non-specific irritants: cigarette smoke, perfume; house dust mites. Allergic rhinitis. Chemical exposure: chloramines in swimming pools. Medication: ACE inhibitors. Subacute cough (3–8 weeks): Post-infectious cough: prior viral upper respiratory tract infection. Bordetella pertussis infection. Subacute bacterial sinusitis. Asthma. Neoplasm. Chronic cough (>8 weeks): Persistent airway inflammation: COPD, asthma, bronchiectasis. Smoking. Neoplasm. Interstitial lung disease: pulmonary fibrosis. Persistent infection: tuberculosis; bronchiectasis. Raised left atrial pressure: mitral stenosis, left ventricular failure. Inhaled foreign body. Iatrogenic: ACE inhibitors, radiation pneumonitis, steroid aerosols. Aspiration syndrome: gastro-oesophageal reflux disease; bulbar dysfunction; oesophageal dysmotility. Psychogenic. Post-nasal drip syndrome (posterior nasal discharge and night cough): sinusitis; rhinitis (allergic; non-allergic; vasomotor). Primary ciliary dyskinesia.


title: Refugee Crisis As a Potential Threat to Public Health

text: The refugee crisis in Europe continues to persist despite recent data, showing a drop in the number of refugees seeking asylum. The EU has called this as “an unprecedented displacement crisis” and has aimed at devising a comprehensive approach to tackle it, which has been widely criticized. Concerns about public healthcare aspects of the crisis have permanently entered the media and policy discourse even though no systematic association between migration and the importation of infectious diseases has been recorded. In this context, the literature has not filled the existing gap between discourse and evidence, and almost no publications with reliable empirical data exist, both thematic (epidemiology) and geographical (Eastern Europe and Bulgaria). Among the existing publications, the focus has been on TB and HIV (Odone et al., Euro J Public Health 25(3):506–512, 2015). In light of this, the aim of this research is to contribute to the debate by providing an overview of the refugee situation in Bulgaria, as a primary entry-point for refugees entering the EU. In order to achieve this, the article analyses the case of the refugee camp in city of Harmanly, close to the Bulgarian-Turkish border, and assesses the public health risks related to this specific situation. Based on a study of 128 patients with different symptoms we aim to draw wider implications about the linkages between public health and migration. The in-depth review of this specific case shows that both the probability and impact of migration on public health increases when the hosting country is relatively poor, the domestic public healthcare system is not efficient, and there is lack of trust in the government and public services. The study contributes to understanding better these risks in order to identify potential mitigation strategies in the region and the EU as a whole.


title: Community Acquired Pneumonia

text: Early identification of patients with severe community-acquired pneumonia (CAP) who require ICU care is important as delayed transfer is associated with increased mortality. In such patients, aggressive diagnostic testing is warranted given the increased probability of detecting a pathogen resistant to usual empirical therapy. In the absence of risk factors for healthcare-associated pneumonia or drug resistant pathogens, adequate coverage of Streptococcus pneumoniae and Legionella pneumophila is crucial. When Pseudomonas is suspected, dual anti-pseudomonal therapy is required. When methicillin-resistant Staphylococcus aureus is suspected, linezolid is superior to vancomycin. Several aspects of managing severe CAP remain without consensus and include the risks associated with multidrug resistant pathogens, antibiotic use to suppress toxin formation in the setting of pneumonia caused by S. aureus, and adjuvant assessment tools such as procalcitonin.


title: Probing Biology with Small Molecule Microarrays (SMM)

text: In the continuous drive to increase screening throughput and reduce sample requirement, microarray-based technologies have risen to the occasion. In the past 7 years, a number of new methodologies have been developed for preparing small molecule microarrays from combinatorial and natural product libraries with the goal of identifying new interactions or enzymatic activities. Recent advances and applications of small molecule microarrays are reviewed.


title: Pulmonology

text: Respiratory conditions are very common among children. This chapter aims to provide a quick review of common respiratory conditions with which the general pediatrician preparing for the certifying board exam should be familiar. The chapter begins with a review of common diagnostic testing methods used in the evaluation of respiratory diseases. Subsequently, the reader will find a description as well as recommended evaluation, differential diagnosis, and management of general signs and symptoms frequently encountered in respiratory medicine. Summaries of specific conditions follow, which provide brief high-yield facts on background, clinical presentation, evaluation, and management. Specific conditions are grouped similarly to the content outline for the ABP into conditions of the upper airway, lower airway, pulmonary parenchyma, chest wall disease, and disorders in breathing. More extensive summaries regarding asthma and cystic fibrosis are also included.


title: Human Insecurity in the People’s Republic of China: The Vulnerability of Chinese Women to HIV/AIDS

text: HIV/AIDS has become one of the world’s leading causes of human insecurity for both men and women. In addition to physiological factors, women’s vulnerability to HIV transmission is primarily fuelled by gender inequality and gender-based discrimination and violence. Therefore, women’s vulnerability to HIV transmission is closely linked to issues of empowerment and gender-based power relations. Even with this realization however, women are still sometimes overlooked in many HIV/AIDS prevention and treatment campaigns, such as those in the People’s Republic of China (PRC), and responses to HIV/AIDS do not always actively seek to empower women. Therefore, a deficiency in women’s human security increases their HIV/AIDS vulnerability. This chapter examines the intersection of gender inequality and HIV vulnerability as it applies to women in the PRC. The unequal status of many women in China, and the privileged position accorded to Chinese men, strongly indicates that Chinese women face a heightened vulnerability to HIV transmission. While many of these vulnerabilities are similar to women elsewhere in the world and certainly are not unique to China, by overlooking the many social, cultural, economic and political factors that contribute to HIV/AIDS vulnerability and transmission of the virus, particularly those faced by women, China has a long way to go before Chinese women are protected from HIV transmission. Given that HIV/AIDS heightens human insecurity, the stage is set for Chinese women (and men) to face an insecure future if the Chinese government does not fully implement international best practice, meaning a gendered response, into its overall HIV/AIDS response.


title: Antiviral Resistance in Influenza Viruses: Clinical and Epidemiological Aspects

text: Two classes of anti-viral agents, the M2 ion channel inhibitors (amantadine, rimantadine) and neuraminidase (NA) inhibitors (oseltamivir, zanamivir) are available for treatment and prevention of infl uenza in most countries of the world. The principle concerns about emergence of antiviral resistance in infl uenza viruses are loss of drug effi cacy, transmission of resistant variants, and possible increased virulence or transmissibility of resistant variants (1). Because seasonal infl uenza is usually an acute, self-limited illness in which viral clearance occurs rapidly due to innate and adaptive host immune responses, the emergence of drug-resistant variants would be anticipated to have modest effects on clinical recovery, except perhaps in immunocompromised or immunologically naïve hosts, such as young infants or during the appearance of a novel strain. In contrast to the limited impact of resistance emergence in the treated immunocompetent individual, the epidemiologic impact of resistance emergence and transmission could be considerable, including loss of both prophylactic and therapeutic activity for a particular drug, at the household, community, or perhaps global level. Infl uenza epidemiology in temperate climates is expected to provide some protection against widespread circulation of resistant variants, as viruses do not persist between epidemics but rather are re-introduced each season and new variants appear often (2, 3).


title: Cell and Tissue Gene Targeting with Lentiviral Vectors

text: One of the main advantages of using lentivectors is their capacity to transduce a wide range of cell types, independently from the cell cycle stage. However, transgene expression in certain cell types is sometimes not desirable, either because of toxicity, cell transformation, or induction of transgene-specific immune responses. In other cases, specific targeting of only cancerous cells within a tumor is sought after for the delivery of suicide genes. Consequently, great effort has been invested in developing strategies to control transgene delivery/expression in a cell/tissue-specific manner. These strategies can broadly be divided in three; particle pseudotyping (surface targeting), which entails modification of the envelope glycoprotein (ENV); transcriptional targeting, which utilizes cell-specific promoters and/or inducible promoters; and posttranscriptional targeting, recently applied in lentivectors by introducing sequence targets for cell-specific microRNAs. In this chapter we describe each of these strategies providing some illustrative examples.


title: Gastroenterologie

text: Dieses Kapitel behandelt die wichtigsten diagnostischen Möglichkeiten, die man im Bereich der Gastroenterologie mittels Auskultation, Palpation und Perkussion hat, und gibt klinisch-praktische Beispiele sowie Hilfen für die Umsetzung. Ferner wird durch die Vertiefung der Pathologien (Welche Begleitsymptome können auftreten? An welche Differenzialdiagnosen sollte gedacht werden?) der ganzheitlich-medizinische Blick geschult.


title: Krankheiten des Herz-Kreislauf-Systems

text: Definition. Basale Regulationsmechanismen des Kreislaufs, die von der übergeordneten nervalen und humoralen Steuerung unabhängig sind.


title: Gryphon: A Hybrid Agent-Based Modeling and Simulation Platform for Infectious Diseases

text: In this paper we present Gryphon, a hybrid agent-based stochastic modeling and simulation platform developed for characterizing the geographic spread of infectious diseases and the effects of interventions. We study both local and non-local transmission dynamics of stochastic simulations based on the published parameters and data for SARS. The results suggest that the expected numbers of infections and the timeline of control strategies predicted by our stochastic model are in reasonably good agreement with previous studies. These preliminary results indicate that Gryphon is able to characterize other future infectious diseases and identify endangered regions in advance.


title: Molecular Biology

text: Genetic information is passed with high accuracy from the parental organism to the offspring and its expression governs the biochemical and physiological tasks of the cell. Although different types of cells exist and are shaped by development to fill different physiological niches, all cells have fundamental similarities and share common principles of organization and biochemical activities. This chapter gives an overview of general principles of the storage and flow of genetic information. It aims to summarize and describe in a broadly approachable way, from the point of view of molecular biology, some general terms, mechanisms and processes used as a base for the molecular computing in the subsequent chapters.


title: The Airway and Lungs

text: Extremely useful and relevant information can be obtained when analysing the position assumed by patients with dyspnoea. Relief of breathlessness in a sitting or standing position compared to the recumbent position is referred to as orthopnoea. While increased venous return in the supine patient is well tolerated in individuals with a preserved heart function, this leads to pulmonary venous congestion, an increase in interstitial lung water and a subsequent reduction of lung capacities with resultant shortness of breath in patients with impaired heart function. Accordingly, patients with heart failure prefer to sit upright (e.g. supporting their back with pillows to achieve a maximum upright position) (Fig. 5.1). Conversely, placing the patient into a supine position may be used as a stress test to exclude respiratory distress due to heart failure or (pulmonary) fluid overload. A history of paroxysmal nocturnal dyspnoea characterized by repeated awakening due to breathlessness while sleeping in the recumbent position is a typical symptom of heart failure.


Coronavirus infections in veterinary medicine


Evaluation of current strategies to inhibit HIV entry, integration and maturation


title: Hematologic Disorders

text: This chapter reviews hematologic disorders which are conditions that affect millions of people each year in the United States. From malignancies to acquired coagulopathies, this chapter covers common and uncommon disorders found in this area in patients admitted to the ICU. Special consideration is given to conditions that are related to therapeutic interventions such as heparin-induced thrombocytopenia.


title: Unequal Vulnerability to Social Risks: Analysis of Hong Kong’s Social Strata (1993–2013)

text: This chapter demonstrates the vulnerability to social risks of varying social strata in Hong Kong. We consolidate and compare the income, occupational statistics and employment conditions vis-à-vis key economic indicators from 1993 to 2013. The study period covers several global economic crises with which Hong Kong significantly afflicted since its handover to China—notably the Asian financial storm (1998), the epidemic crisis of Severe Acute Respiratory Syndrome (SARS) (2003), and the global financial tsunami (2008–09). Despite the recovery of Hong Kong’s economy since the aftermath of the financial tsunami, data show divergent employment conditions between the ‘haves’ and ‘have-nots’ throughout the study period. The findings are indicative of unequal vulnerability to social risks of different social strata. This study thus echoes to the scholarly dialogue surrounding risk society theory, in particular the unequal distribution of social risk to those with varying socio-economic conditions.


title: Levels and Stability of Expression of Transgenes

text: It is well known that in a given cell, at a particular time, only a fraction of the entire genome is expressed. Expression of a gene, nuclear, or organellar starts with the onset of transcription and ends in the synthesis of the functional protein. The regulation of gene expression is a complex process that requires the coordinated activity of different proteins and nucleic acids that ultimately determine whether a gene is transcribed, and if transcribed, whether it results in the production of a protein that develops a phenotype. The same also holds true for transgenic crops, which lie at the very core of insert design. There are multiple checkpoints at which the expression of a gene can be regulated and controlled. Much of the emphasis of studies related to gene expression has been on regulation of gene transcription, and a number of methods are used to effect the control of gene expression. Controlling transgene expression for a commercially valuable trait is necessary to capture its value. Many gene functions are either lethal or produce severe deformity (resulting in loss of value) if over-expressed. Thus, expression of a transgene at a particular site or in response to a particular elicitor is always desirable.


title: Herpesvirus

text: Name: Herpesvirus


title: Global Health Security and Weapons of Mass Destruction Chapter

text: The global proliferation of weapons of mass destruction (WMD) presents a clear and present danger to global health security. Unlike conventional weapons that confine themselves to a defined and targeted area, WMD’s cross international boundaries and borders. Moreover, the release of WMDs can be achieved using a low technology approach resulting in a transformation and redefinition of the mission of global health providers. This chapter will focus on the ease of access to WMDs, the impact biological weapons and bioterrorism plays on global health security, United States global policies on public health, and the role actors and non-state actors play in the global health landscape. In addition, this chapter will focus on global WMD proliferation prevention to include international efforts, treaties, and conventions. The chapter will conclude with a discussion of ongoing research initiatives, identification of emerging threats, and additional recommended readings.


title: Ecological and Environmental Monitoring After Reservoir Impoundment

text: The Three Gorges reservoir began to store water in June 2003. By November 5, the water level had risen to El.139 meters.


Ischemia-reperfusion Injury of the Lung: Role of Surfactant


title: Human Metapneumovirus

text: Name of Virus: Human metapneumovirus


title: The Notion of a Health Good in China and Elsewhere

text: Is the intervention of the state in the healthcare market legitimate and efficient? To answer this question, a clear definition of a health good and its implications is needed. Can we just apply the general definition of a public good for all health goods? Should we consider different types of health goods? If yes, how do we delimit the frontier between a public good and a private good? With a rapid glance at the diversity of organizations in the healthcare system that exist in the world, it appears there is little consensus on what can and should be defined as a public good. Generally speaking, all countries have a mixed health system, combining pro-market elements with welfare state safeguards, and China is no exception: all reforms of the healthcare system implemented since the 1980s have swung between both. To understand the Chinese health system and its recent evolution, we need to start by defining the global framework in which the “health good” is set.


title: Influenza Virus: The Biology of a Changing Virus

text: Influenza viruses are members of the family Orthomyxoviridae and include influenza virus types A, B, and C. This introduction provides an overview of influenza virus classification, structure, and life cycle. We also include a brief review of the clinical manifestations of influenza and the molecular determinants for virulence. The genetic diversity of influenza A viruses and their capability to successfully infect an array of hosts, including avian and mammalian species, are highlighted in a discussion about host range and evolution. The importance of viral receptor-binding hemagglutinins and host sialic acid distribution in species-restricted binding of viruses is underscored. Finally, recent advances in our understanding of the seasonality and transmission of influenza viruses are described, and their importance for the control of the spread of these viruses is discussed.


title: Size Effect in Physical and Other Properties of Nanostructured Coatings

text: This chapter starts the discussion about size effect in physical and other (except electrochemical and mechanical) properties of nanocoatings and its real usage through different examples. It starts from the usage of nanostructured materials in microelectronics and goes through different reported papers in this field. Size effect in nanometric scale has been compared with larger scales by some examples. Detailed discussions about some methods with enough examples were presented in this chapter. Different parts of this chapter include discussions about microelectronics, silicides specifications, size effect in sensing characterization, size effect in optical properties of nanostructured films, self-cleaning glasses, using nanocomposite coating for food packaging and using polarizer nano-layers to produce LCD monitors.


title: Structure–Activity Relationship Study of PD 404182 Derivatives for the Highly Potent Anti-HIV Agents

text: Using facile synthetic approaches to pyrimido[1,2-c][1,3]benzothiazin-6-imines and related tricyclic derivatives, the parallel structural optimizations were investigated for the central 1,3-thiazin-2-imine core, the benzene part, and the cyclic amidine part of PD 404182. Replacement of the 6-6-6 pyrimido[1,2-c][1,3]benzothiazin-6-imine framework with 5-6-6 or 6-6-5 derivatives led to a significant loss of anti-HIV activity, and introduction of a hydrophobic group at the 9- or 10-positions improved the potency. The most potent PD 404182 derivative exerts anti-HIV effects at an early stage of viral infection including binding and fusion.


title: Leitsymptomorientierte Sonographie

text: Symptomenkomplex bestehend aus akutem Beginn und akuter Funktionsstörung intra-, aber auch extraabdomineller Organe mit möglicherweise lebensbedrohlichen Folgen.


title: Building Porosity for Better Urban Ventilation in High-Density Cities

text: Given that building typology is one of the key elements in architectural design and that the drag force of surface roughness on airflow directly depends on building typologies, it is important to expand our understandings on wind environment from urban and neighborhood scale to the building scale. In this chapter, CFD simulation was conducted to provide the detailed understandings on pedestrian-level wind environment and building typologies. First, [Formula: see text] SST turbulence model was validated by comparing modeling results with data from the wind tunnel experiment. Second, the impact of various building typologies on pedestrian-level airflow were investigated in a parametric study, in which various parametric cases with different wind porosities were designed, and wind speed was classified based on PET to evaluate outdoor thermal comfort. Subsequently, critical design issues were identified, and the corresponding mitigation strategies were developed. From both the accuracy and practical point of view, this chapter introduces a study that allows architects to improve building porosity efficiently for better pedestrian-level urban ventilation.


title: Laboratory Processing of Specimens

text: Although not always the first topic discussed when preparing for a bioemergency, the availability of a competent clinical laboratory is vital for the optimal care of a patient with a risk group 4 (RG-4) high-consequence pathogen. The recent development of highly specialized facilities in the United States to assess and treat patients with highly hazardous communicable diseases has led to the design of dedicated laboratories or the redesign of laboratory space to safely process and test specimens that might contain one of these pathogens. For frontline and other acute care facilities to be prepared, safety practices need to be assessed and reviewed as necessary as pertaining to all laboratory activities, to include the pre-analytical (specimen collection and processing), analytical (specimen testing), and post-analytical (specimen disposal/waste management and reporting) processes. Laboratorians and administrative personnel need to consider the risks in handling specimens containing these pathogens and subsequently develop or revise processes to mitigate risks. In addition, issues such as scalability to handle large volume testing, the availability of trained staff, and long-term sustainability to meet the requirements of regulatory agencies need to be adopted within a fiscally responsible budget setting. This chapter provides generalized information on how clinical laboratories, from those supporting small frontline medical facilities to highly specialized laboratories supporting acute care treatment centers, can safely manage specimens from a patient known or potentially infected with a high-consequence pathogen.


title: Major Issues of Air Pollution

text: Environmental issues change from place to place and time to time. The issues include local as well as global issues. The understanding of issues is necessary to find solution. Air pollution issues have changed over a period of time. Issues like atmospheric brown cloud, climate change, hazardous air pollutants, black/muddy snow which are hardly discussed few decades back have now gaining importance. This chapter elaborates major issues due to air pollution.


title: Respiratory Infections

text: Respiratory infections are the most frequent cause of athletes’ visits in medical practices. Simultaneously, contradictory beliefs are generally held regarding influence of repeated exercise on immunity reflected in susceptibility to infections. Many tend to claim that exercise weakens the immunity and renders regular exercisers more prone to develop airway infections. On the other hand, voices are heard in favor of the possible beneficial influence of regular exercise on immune system efficiency. This chapter focuses on the associations of various kinds of exercise with respiratory infection susceptibility. Influence of exercise, in particular associated with competitive performance, on selected innate and acquired immune response mechanisms is also addressed.


title: The HCV Replicase Complex and Viral RNA Synthesis

text: Replication of hepatitis C virus (HCV) is tightly linked to membrane alterations designated the membranous web, harboring the viral replicase complex. In this chapter we describe the morphology and 3D architecture of the HCV-induced replication organelles, mainly consisting of double membrane vesicles, which are generated by a concerted action of the nonstructural proteins NS3 to NS5B. Recent studies have furthermore identified a number of host cell proteins and lipids contributing to the biogenesis of the membranous web, which are discussed in this chapter. Viral RNA synthesis is tightly associated with these membrane alterations and mainly driven by the viral RNA dependent RNA polymerase NS5B. We summarize our current knowledge of the structure and function of NS5B, the role of cis-acting replication elements at the termini of the genome in regulating RNA synthesis and the contribution of additional viral and host factors to viral RNA synthesis, which is still ill defined.


title: Fettsenker gegen Grippe

text: In China sind an der Vogelgrippe mit dem H7N9-Erreger nach offiziellen Angaben bisher zehn Menschen gestorben. Die Zahl der neuen Fälle geht zurück. Zum einen hat China aus der SARS-Pandemie 2002 gelernt und zum anderen scheint das Grippevirus keine Sommerhitze zu vertragen.


title: History and Philosophy of Science and the Teaching of Macroevolution

text: Although macroevolution has been the subject of sustained attention in the history and philosophy of science (HPS) community, only in recent years have science educators begun to more fully engage with the topic. This chapter first explores how science educators have conceptualized macroevolution and how their perspectives align with the views from HPS. Second, it illustrates how science educators’ limited engagement with HPS scholarship on macroevolution has influenced construct delineation, measurement instrument development, and educational arguments about which aspects of macroevolution are most important for students to learn. Third, it discusses how scientific debates about the causal factors responsible for macroevolutionary patterns have been exploited by creationists and have impacted the teaching of evolution. Finally, it emphasizes that the rich perspectives that HPS has to offer on the important topic of macroevolution have yet to be integrated into science education scholarship.


title: Demyelination

text: Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease that affects all ages, except children less than 2 years. It occurs during the course of various infections, particularly the acute exanthematous diseases of childhood (measles, rubella, chickenpox, and smallpox immunization), other common viral infections (i.e., Epstein-Barr virus, adenovirus, cytomegalovirus, influenza, rhinoviruses, coronaviruses), and following vaccination against smallpox, measles, and rabies. The clinical features are the same regardless of the inciting event. The symptoms develop days to weeks after the onset of the predisposing cause. The symptoms and signs of acute disseminated encephalomyelitis are related to the portion of the central nervous system (CNS) that is most severely damaged. Death occurs in 20%–30%. There are neurological deficits in survivors.


title: Disease Outbreaks: Critical Biological Factors and Control Strategies

text: Disease outbreaks remain a major threat to human health and welfare especially in urban areas in both developed and developing countries. A large body of theoretical work has been devoted to modeling disease emergence, and critical factors that predict outbreak occurrence and severity have been proposed. In this chapter, we focus on biological factors that underlie both theoretical models and urban planning. We describe the SARS 2002–2003 pandemic as a case study of epidemic control of a human infectious disease. We then describe theoretical analyses of disease dynamics and control strategies. An important conclusion is that epidemic control will be strongly dependent on particular aspects of pathogen biology including host breadth, virulence, incubation time, and/or mutation rate. The probability, and potential cost, of future outbreaks, may be high and lessons from both past cases and theoretical work should inform urban design and policy. Interdisciplinary collaboration in planning, swiftness of information dissemination and response, and willingness to forgo personal liberties during a crisis may be key factors in resilience to infectious disease outbreaks.


title: Besmettingsbronnen

text: Infectieziekten kunnen zich op twee manieren voordoen (Van Furth e.a., 1992): endemisch en epidemisch. Een endemische infectie komt over een langere tijd in constante frequentie in een bevolkingsgroep voor. Van een epidemie wordt gesproken indien er in relatief korte tijd een sterke toename is van het aantal ziektegevallen. Wat nog endemisch heet en wat een epidemie is, hangt af van de aard van de ziekte en de omstandigheden.


title: Prediction of Ribosomal -1 Frameshifts in the Escherichia coli K12 Genome

text: Ribosomal frameshifting at a particular site can yield two protein products from one coding sequence or one protein product from two overlapping open reading frames. Many organisms are known to utilize ribosomal frameshifting to express a minority of genes. However, finding ribosomal frameshift sites by a computational method is difficult because frameshift signals are diverse and dependent on the organisms and environments. There are few computer programs available for public use to identify frameshift sites from genomic sequences. We have developed a web-based application program called FSFinder2 for predicting frameshift sites of general type. We tested FSFinder2 on the Escherichia coli K12 genome to detect potential -1 frameshifting genes. From the genome sequence, we identified 18,401 frameshift sites following the X XXY YYZ motif. 11,530 frameshift sites out of the 18,401 sites include secondary structures. Comparison with the GenBank annotation produced 11 potential frameshift sites, including 3 known frameshift sites. The program is useful for analyzing frameshifts of various types and for discovering new genes expressed by frameshifts.


title: Danger in Paradise

text: A 31-year-old man presented to the Student Health Center for evaluation 3 days after departing Hong Kong. On the last day of his 3-week-long trip to Southeast Asia, he developed sudden onset of fever, arthralgia, and headache. He initially attributed his symptoms to exhaustion, but the symptoms persisted. He also had several loose, non-bloody stools, a problem that resolved without intervention.


title: Preoperative Evaluation and Arrangements for Multiorgan Donation: General Principles and Contraindications

text: In this chapter we discuss these points:1) Donor coordinator’s duties. Promote and facilitate the entire donation process. Provide support to families regarding organ and tissue donation. Ensure that donation proceeds in line with national legislation, policies, and procedures. Obtain all information to allow transplant centers to assess the suitability of potential donors. Assist in the optimization of organs for transplant through appropriate donor management. Maximize the placement of organs for transplant. Train donation services’ team members.Collect data for organ donation-related audits. Facilitate and support the education of healthcare professionals and the general public.2) Exclusion criteria for infection transmission of organ donors.3) Donor exclusion criteria for hearth, lung, liver, kidney, pancreas and intestine.


title: Mental Health Care for Survivors and Healthcare Workers in the Aftermath of an Outbreak

text: When pandemics sweep across communities, they leave behind tremendous suffering in their wake. It is not only the illness that becomes a pandemic, but the same can be inferred about fear, mourning, and despair. The reverberations of loss are felt in a multitude of ways by those left behind. Often times, the mental health issues of affected persons and entire communities do not receive the attention they deserve in the light of other competing, immediate needs imparted by the devastation of the pandemic. This chapter aims to develop strategies for providing psychiatric care to survivors and their families, in the aftermath of a pandemic outbreak. Lastly, special considerations in the application of psychopharmacological interventions are reviewed.


title: Defense Against Biological Weapons (Biodefense)

text: Biological warfare (germ warfare) is defined as the use of any disease-causing organism or toxin(s) found in nature as weapons of war with the intent to destroy an adversary. Though rare, the use of biological weapons has occurred throughout the centuries.


title: Emerging and Rare Viral Infections in Transplantation

text: Immunocompromised patients such as those undergoing solid organ or hematopoietic stem cell transplantation are at substantial risk for infection with numerous pathogens. Infections with cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein–Barr virus (EBV), and human herpesvirus-6 (HHV-6) are well-described complications of transplantation. As viruses previously believed to be quiescent through widespread vaccination (e.g., measles and mumps) reemerge and molecular diagnostic techniques are refined, rare and emerging viral infections are increasingly diagnosed in transplant recipients. This chapter will review the clinical manifestations, diagnosis, and potential antiviral therapies for these viruses in the transplant population.


title: Immunology

text: The immune defence mechanisms by which an organism combats viral infections can be divided into two systems. On the one hand, there are the unspecific, non-adaptive immune reactions, which recognize and eliminate invading foreign pathogens. This so-called natural or innate immune system becomes primarily active after a virus has overcome the external physical protection barriers of the body (skin, mucous membranes). It consists of dendritic cells, granulocytes, monocytes, macrophages and natural killer cells (NK cells). They have proteins that serve as receptors, e.g. Toll-like receptors (TLRs) and complement receptors, for specific structures of pathogens and for the soluble products of the innate immune system (acute-phase proteins, factors of the complement system, cytokines, chemokines and interferons). The effects and functions of cytokines, chemokines and interferons will be discussed separately in Chap. 8. The specific, adaptive immune response is the second line of defence, and is developed only during or after the establishment of an infection. It includes antibody-producing B cells – the humoral immune system – as well as T-helper (T(H)) cells and cytotoxic T lymphocytes, which collectively constitute the cellular defence system. The adaptive immune reactions can selectively recognize certain pathogen types or subtypes, and in the case of a reinfection, they are able to recognize the pathogens again and eliminate them. They are long-lasting and a subset of stimulated lymphocytes transform into memory cells during their development, which confers on the organism an efficient protective immunity against infections with the same pathogen. The systems of the specific and non-specific immune responses are in close contact with each other, particularly via cytokines, chemokines and interferons. An immune response is generally triggered by antigens. These may be the infectious pathogens, individual protein components or sugar structures. The immune system recognizes these as foreign, and thus can distinguish between endogenous and exogenous components. However, the antigens must be of a certain size to trigger different immune responses. Molecules with a molecular mass of less than 3–4 kDa are usually incapable of doing that.


title: Inner Ear

text: Herpes zoster oticus, herpes zoster cephalicus, Ramsay Hunt syndrome.


title: Emergency Care

text: Children less than 6 years have the greatest risk for accidental ingestion and poisoning.


title: The Safety Profile of Filgrastim and Pegfilgrastim

text: The discovery of endogenous proteins that regulate hematopoiesis led to the identification of human granulocyte colony-stimulating factor (G-CSF). With the advent of recombinant DNA technology, it became possible to manufacture bioactive recombinant proteins for medicinal use. Since the approval of recombinant human G-CSF (rHuG-CSF), such as filgrastim in 1991 and pegfilgrastim in 2002, millions of patients at risk for severe myelosuppression have received these products. Overall, filgrastim and pegfilgrastim have a high margin of safety for short-term use; however, rare severe adverse events have emerged and questions remain regarding the long-term safety and consequences of use of these products. This chapter primarily focuses on the safety and adverse event profile of the most widely used commercially available rHuG-CSF, Neupogen (filgrastim) and Neulasta [a modified (pegylated) filgrastim, pegfilgrastim]. As safety information can change rapidly, we suggest readers consult the latest package inserts for any changes that have occurred from the time of this writing. Other chapters in this volume discuss key studies in specific disease settings in greater detail than is the purview of this chapter, and we encourage the interested reader to reference them for further information.


title: Virus-Induced Demyelination: The Case for Virus(es) in Multiple Sclerosis

text: Multiple Sclerosis (MS) is the most common demyelinating disease of man with over 400,000 cases in the United States and over 2.5 million cases worldwide. There are over 64,000 citations in Pubmed dating back as far as 1887. Much has been learned over the past 129 years with a recent burst in therapeutic options (mostly anti-inflammatory) with newer medications in development that are neuroprotective and/or neuroreparative. However, with all these advancements the cause of MS remains elusive. There is a clear interplay of genetic, immunologic, and environmental factors that influences both the development and progression of this disorder. This chapter will give a brief overview of the history and pathogenesis of MS with attention to how host immune responses in genetically susceptible individuals contribute to the MS disease process. In addition, we will explore the role of infectious agents in MS as potential “triggers” of disease. Models of virus-induced demyelination will be discussed, with an emphasis on the recent interest in human herpesviruses and the role they may play in MS disease pathogenesis. Although we remain circumspect as to the role of any microbial pathogen in MS, we suggest that only through well-controlled serological, cellular immune, molecular, and animal studies we will be able to identify candidate agents. Ultimately, clinical interventional trials that either target a specific pathogen or class of pathogens will be required to make definitive links between the suspected agent and MS.


title: Hepatobiliäre Funktionsstörungen und Leberversagen

text: Als »sepsisinduzierte Cholestase« bezeichnet man das Auftreten einer konjugierten Hyperbilirubinämie als Folge einer extrahepatischen bakteriellen Infektion ohne direkte Invasion der Leber durch Erreger.


title: Harnessing T-Cell Immunity to Target Brain Tumors

text: T-cell mediated immunotherapy is a conceptually attractive treatment option to envisage for glioma, since T lymphocytes can actively seek out neoplastic cells in the brain, and they have the potential to safely and specifically eliminate tumor. Some antigenic targets on glioma cells are already defined, and we can be optimistic that more will be discovered from progress in T-cell epitope identification and gene expression profiling of brain tumors. In parallel, advances in immunology (regional immunology, neuroimmunology, tumor immunology) now equip us to build upon the results from current immunotherapy trials in which the safety and feasibility of brain tumor immunotherapy have already been confirmed. We can now look to the next phase of immunotherapy, in which we must harness the most promising basic science advances and existing clinical expertise, and apply these to randomized clinical trials to determine the real clinical impact and applicability of these approaches for treating patients with currently incurable malignant brain tumors.


Surveillance and Control of Communicable Disease in Conflicts and Disasters


title: Viral Infections

text: Despite major advances in basic and applied research and the availability of several vaccines, viral diseases still account for a large proportion of the human infectious disease burden. Many viruses cause self-limiting and relatively mild infections, but several, including human immunodeficiency virus and influenza virus, are responsible for millions of deaths every year throughout the world. Several factors contribute to the enormous impact that viruses have on human health. For example, there are very few therapeutic options available for the treatment of viral infections, and many of those that are available possess a limited spectrum of activity or are designed for the treatment of diseases caused by specific viruses (e.g., oseltamivir is intended for the treatment of influenza only). In addition, the rapid evolution of viruses has led to the emergence of drug-resistant strains against which no currently available therapeutics are effective. Coupled with these and other issues are the appearance of never before seen viruses and the emergence of known but previously underappreciated viruses. Since the beginning of the twenty-first century, numerous “new” viruses, including the coronaviruses responsible for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), the 2009 pandemic influenza A virus, and Lujo hemorrhagic fever virus, have made their debut and have proved to be formidable threats to human health. Recently, the appearance of Ebola virus (Zaire ebolavirus) in West Africa, a region that has not previously seen an outbreak of this virus, was marked by an epidemic that afflicted nearly 30,000 individuals and killed more than 11,000 of those who were infected. Most recently, the far-reaching and rapid spread of Zika virus, a mosquito-borne virus that was discovered in the 1940s in Uganda, in the Western Hemisphere has invoked considerable public and scientific attention and has given rise to perhaps the largest concerted effort by scientists to rapidly develop a vaccine to halt the transmission of a virus. Each of these points underscores the importance of further research into improved surveillance, diagnosis, treatment, and prevention of viral diseases.


title: Protein Microarrays for the Detection of Biothreats

text: Although protein microarrays have proven to be an important tool in proteomics research, the technology is emerging as useful for public health and defense applications. Recent progress in the measurement and characterization of biothreat agents is reviewed in this chapter. Details concerning validation of various protein microarray formats, from contact-printed sandwich assays to supported lipid bilayers, are presented. The reviewed technologies have important implications for in vitro characterization of toxin–ligand interactions, serotyping of bacteria, screening of potential biothreat inhibitors, and as core components of biosensors, among others, research and engineering applications.


title: DC-SIGN Family of Receptors

text: In the immune system, C-type lectins and CTLDs have been shown to act both as adhesion and as pathogen recognition receptors. The Dendritic cell-specific ICAM-3 grabbing non-integrin (DC-SIGN) and its homologs in human and mouse represent an important C-type lectin family. DC-SIGN contains a lectin domain that recognizes in a Ca(2+)-dependent manner carbohydrates such as mannose-containing structures present on glycoproteins such as ICAM-2 and ICAM-3. DC-SIGN is a prototype C-type lectin organized in microdomains, which have their role as pathogen recognition receptors in sensing microbes. Although the integrin LFA-1 is a counter-receptor for both ICAM-2 and ICAM-3 on DC, DC-SIGN is the high affinity adhesion receptor for ICAM-2/-3. While cell–cell contact is a primary function of selectins, collectins are specialized in recognition of pathogens. Interestingly, DC-SIGN is a cell adhesion receptor as well as a pathogen recognition receptor. As adhesion receptor, DC-SIGN mediates the contact between dendritic cells (DCs) and T lymphocytes, by binding to ICAM-3, and mediates rolling of DCs on endothelium, by interacting with ICAM-2. As pathogen receptor, DC-SIGN recognizes a variety of microorganisms, including viruses, bacteria, fungi and several parasites (Cambi et al. 2005). The natural ligands of DC-SIGN consist of mannose oligosaccharides or fucose-containing Lewis-type determinants. In this chapter, we shall focus on the structure and functions of DC-SIGN and related CTLDs in the recognition of pathogens, the molecular and structural determinants that regulate the interaction with pathogen-associated molecular patterns. The heterogeneity of carbohydrate residues exposed on cellular proteins and pathogens regulates specific binding of DC-expressed C-type lectins that contribute to the diversity of immune responses created by DCs (van Kooyk et al. 2003a; Cambi et al. 2005).


title: Risks and Safety Aspects of MR-PET

text: The introduction of MR-PET systems into medical practice not only may lead to a gain in clinical diagnosis as compared to PET-CT imaging due to the superior soft tissue contrast of the MR technology but can also substantially reduce exposure of patients to ionizing radiation. On the other hand, there are also risks and health effects associated with the use of diagnostic MR devices that have to be considered carefully. In this chapter, the biophysical and biological aspects relevant for the assessment of health effects related to the use of ionizing radiation in PET and (electro)magnetic fields in MR are summarized. On this basis, the current safety standards will be presented – which, however, do not address the possibility of synergistic effects of ionizing radiation and (electro)magnetic fields. In the light of the developing MR-PET technology, it is of utmost importance to investigate this aspect in more detail for exposure levels that will occur at MR-PET systems. Finally, some considerations concerning the justification and optimization of MR-PET examination will be made.


title: The Aliens in Us and the Aliens Out There: Science Fiction in the Movies

text: The notion and images of aliens are for the most part an outcome of collective societal occurrences that often consists of personalized accounts of encounters with other beings, and in many ways are like our own dreams which are based on our life experiences. Cinematic portrayals of aliens can tell us much about what is going on in human minds. And it works the other way around as well: just as movies can reflect social distress, they also have the capacity to add to, or exacerbate social distress. Movies are similar to dreams and nightmares in that they employ the language of dreams to powerful effect. Aliens appear in human folklore because they are equipped by us with traits and characteristics we secretly desire such immortality. There are as many types of aliens as there are social dreams. During the Cold War era some of the prevailing social dreams were haunted by the specter of nuclear annihilation, and the idea of alien threat continues to make up the majority of film science fiction productions. Yet aliens are not always treated as malevolent beings that have come to usurp our societies, seize control of the planet, and pilfer our resources: the human/alien crews in Star Trek represent a social dream that society perceives as desirable.


title: Health Policy, Programmes and Initiatives

text: Environment as an input for good health and wellbeing should be protected and preserved. Reflecting on the growing urban spaces associated with increasing number of city inhabitants, it becomes imperative to plan for particularly urban health. Keeping in mind the future needs and demands, the government plans to build 100 new smart cities in India. This is in cognizance with the Sustainable Cities and Human Settlements and Sustainable Development Goals to build planned resilient sustainable cities that are prepared for disasters and promote health and wellbeing. The present chapter encapsulates landmark policies, acts and programmes undertaken by the government of India to promote good health and wellbeing and pave way for bringing sustainable urban development.


title: Grundlagen der Zellbiologie

text: Die Vorstellung, dass Lebewesen aus einer oder mehreren Zellen bestehen, die alle mehr oder weniger nach dem gleichen Prinzip funktionieren, existiert bereits seit langer Zeit und konnte sich infolge der Entdeckung der Mikroskopie nach und nach durchsetzen. Der Engländer R. Hooke (1635–1703) führte Untersuchungen von Pflanzengewebe mithilfe eines relativ einfachen Gerätes durch. Das Korkgewebe erschien ihm als eine Aneinanderreihung von Kästen, die er als „Zellen“ bezeichnete (Abb. 1.1). Der Holländer A. van Leeuwenhoeck (1632–1723) entwickelte etwas später das erste Mikroskop. Es handelte sich um eine einfache Anordnung von schmalen Lupen, die zusammen mit dem Objekt vor dem Auge platziert wurden. Leeuwenhoeck konnte auf diese Weise eine Vergrößerung auf das 200-Fache erreichen. Er führte zahlreiche Beobachtungen und Beschreibungen einzelliger Organismen wie Protozoen und Bakterien durch. Erst viel später kam mit den Zoologen und Botanikern T. Schwann (1810–1882) und M. Schleiden (1804–1881) die Theorie von der Zelle auf. Sie bestätigten, dass alle Lebewesen, auch die hoch Entwickelten, aus Zellen und deren Zellprodukten aufgebaut sind. R. Virchow (1821–1902) ergänzte diese Theorie 1855 durch eine zweite Behauptung: Omnis cellula e cellula – „Jede Zelle entsteht aus einer anderen Zelle“.


title: Mers-CoV and Zika Virus

text: Chapter 6 analyses the recent emergence of Mers-CoV and the spread of Zika virus around the globe. With a glace into the future, especially with regard to emerging infectious diseases (EID), it explores the most important indicators of such emergence and spread, asking which local, national, and international characteristics come to the fore to heighten or mitigate such threats. It further initially evaluates how these might interact with accelerators such as climate change and migration, exploring in particular the allocation of health rights and responsibilities across borders. Between the timelines of response and the anticipation of new outbreaks, the chapter offers some pointers on what decision-makers need to take into account to prepare for EIDs.


title: Work, Health, Safety and Well-Being: Current State of the Art

text: This introductory chapter will present a review of the current state of the art in relation to employee health, safety and well-being (HSW). The work environment and the nature of work itself are both important influences on HSW. A substantial part of the general morbidity of the population is related to work. It is estimated that workers suffer 270 million occupational accidents and 160 million occupational diseases each year. The chapter will first define HSW. It will then review the current state of the art by outlining key HSW issues in the contemporary world of work, identifying key needs. It will then discuss the evolution of key theoretical perspectives in this area by linking theory to practice and highlighting the need for aligning perspectives and integrating approaches to managing HSW in the workplace.


title: Psoriasis: Overview and Diagnosis

text: Psoriasis is a chronic, common, inflammatory skin disease. The classic skin lesions can be described as sharply demarcated, scaly, erythematous plaques often found on the extensor surfaces. Several variants of psoriasis have also been described, including palmoplantar, pustular, erythrodermic, and guttate forms. Although psoriasis is usually diagnosed clinically, characteristic histologic findings include hyperkeratosis, parakeratosis, and acanthosis of the epidermis with dilated blood vessels and a lymphocytic infiltrate. Psoriasis is an immune-mediated disease, and although the etiology is not fully understood, genetic and environmental factors have been implicated. Importantly, psoriasis is associated with a number of systemic complications and comorbidities that have a high impact on affected patients.


title: Biosensors in Tissue and Organ Fabrication

text: We begin this chapter by looking at the role of sensors during tissue and organ fabrication. We provide a working model for sensor technology to support different parts of the tissue fabrication pathway. We next look at biological sensors in nature, with IGF-1 signaling as an example and study the intracellular signaling events which take place in response to IGF-1 signaling. Next, we look at the design requirements for sensors to support the culture and fabrication of 3D artificial tissue. The next three sections are dedicated to three specific sensing mechanisms, which include acoustic sensors, magnetic sensors and optical sensors. For each of the three sensor mechanism, we provide an overview of the theory, along with some applications to illustrate the principles of operation. We then look at flexible sensors and how they have been used for various applications and the potential role of flexible sensors in tissue engineering. We conclude this chapter by providing a case study from the Artificial Heart Laboratory; the case study is focused on the development of novel sensors to record the EKG properties of 3D artificial heart muscle.


title: Obstetric Medicine

text: —to maintain adequate uterine perfusion, fetal oxygenation, and nutrient delivery. May potentially mask serious illness


title: Thermal investigation on whole plants and plant tissues

text: In recent years, plant calorimetry has finished its sleeping beauty dormancy that lasted more or less continuously since the beginning of last century and realizes quite a number of scientifically attractive princes around it. They appeared with new armours and weapons and are eager to dedicate their life to her beauty. New sophisticated calorimeter allow investigations that were excluded before, combination with other highly specific instruments renders more information than gathered earlier by calorimetry alone, rigid and flexible light guides illuminate the otherwise dark vessels and open the field to photosynthesis experiments, infrared thermography provides a means to determine temperature distributions without injuring or even only touching the object. Imagination and technical skill are asked for further developments in plant calorimetry that will for sure come. A special issue of Thermochimica Acta in 2004 will be dedicated to the outcomes of the XIII(th) Conference of the International Society for Biological Calorimetry Energetics of Adaptation and Development — From Molecular Mechanisms to Clinical Practice that took place in Würzburg / Germany 2003. Many contributions deal with photocalorimetry and its application to plant systems as well as with conventional heat flow and combustion calorimetry for plant cells. Among other, topics like A new calorespirometric instrument, Calorespirometric ratios and metabolic efficiency, Energy processes in model plant cells, Heat production and respiration of wheat roots, Calorimetric studies of vegetable tissue wounding, Life zones for key plant species can be predicted with calorespirometry and temperature measurements; Photo-Bio-Calorimetry of Chlorella vulgaris growth, Energetic evaluation of forest formations by bomb calorimetry will be approached. This issue is recommended for further information.


Lymphocyte trafficking and chemokine receptors during pulmonary disease


Disease Surveillance in Georgia: Benefits of International Cooperation


title: An Evaluation of China’s Influenza A (H1N1) Emergency Response Measures

text: In order to stay up to date on epidemic trends and monitor possible mutations of the virus in the wake of an outbreak, China invested nearly 400 million RMB on testing large amounts of specimens and expanding the influenza monitoring network to include 411 influenza monitoring network laboratories and 556 sentinel hospitals - a network which covered all prefectural-level cities and some priority districts and counties. All of these laboratories and hospitals were in operation by September, 2009 (see Fig. 5.1).


title: Bioinformatics

text: Why is sequence, structure, and biological pathway information relevant to medicine? Where on the Internet should you look for a DNA sequence, a protein sequence, or a protein structure? What are two problems encountered in analyzing biological sequence, structure, and function? How has the age of genomics changed the landscape of bioinformatics? What two changes should we anticipate in the medical record as a result of these new information sources? What are two computational challenges in bioinformatics for the future?


title: Pneumonia

text: This chapter describes the imaging patterns of pneumonia (lobar, lobular, interstitial, round) and its complications (abscess, empyema, pneumatocele); bacterial, fungal, and viral infections; and the many manifestations of pulmonary tuberculosis. ELECTRONIC SUPPLEMENTARY MATERIAL : The online version of this chapter (10.1007/978-3-030-16826-1_6) contains supplementary material, which is available to authorized users.