Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

The large number of microbials in the intestine that overrides the total human cells alludes to significant contribution of the microbiota to human health. This is vivid in enteric and some systemic diseases emanating from disruption of the microbiota. A balanced microbiota influences the development and functioning of both innate and acquired immune systems to foster intestinal immunity and to prevent disease. It does this by interacting with intestinal immune system at all levels, from the "primitive non-specific pattern recognition receptors (PRR) to most specific adaptive T cell responses". Commensal microbes are recognised by PRRs, which in turn transduce signals to activate transcription factors like nuclear factor kappa B that induce production of immune mediators to regulate mucosal innate immunity and inflammatory responses. The microbiota also influences leukocytes like natural killer cells, mast cells, eosinophils, basophils and phagocytic cells including macrophages, neutrophils and dendritic cells to generate responses protective to the gut. This could involve allergic, inflammatory and infectious processes. It is interesting to understand that the putatively known antigen presentation carried out by professional macrophages and dendritic cells to link innate and adaptive gut immune systems is also driven by macrobiota. These commensals drive or polarize macrophage- and dendritic cell-mediated responses adaptive immune responses during health and disease. As to how this occurs, this book will highlight recent findings. The adaptive immunity of the gut, both humoral and cellular, is also influenced by the microbiota. These commensals drive the development and differentiation of gut-associated lymphoid tissue (GALT) which is the key structure to humoral immune system. In germ free animals and those with disrupted microbita, GALT functioning is heavily compromised leading to diseases. All these facts are discussed by the author. In addition, the book highlights the involvement of microbiota to the correction of diseases that emanate from disrupted microbiota. It is expected that the insight gained could help design therapeutics against gastrointestinal diseases caused by disruption of the microbiota.

This issue of Emergency Medicine Clinics, guest edited by Joshua Joseph and Benjamin White, focuses on Emergency Department Operations and Administration. Topics include: Emergency Department Operations Overview; Queuing Theory and Modeling ED Resource Utilization; Factors Affecting ED Crowding; Staffing and Provider Productivity in the ED; Patient Assignment Models in the ED; ED Layout and Organization; Lean Processes in the ED; ED Observation and Alternatives to Admission; Quality Assurance in the ED; Information Management in the ED; Best Practices in Communication and Patient Safety; Optimizing Patient Experience in the ED; Management of the Academic ED; and Strategies for Provider Well-being in the ED.

This is a reproduction of a book published before 1923. This book may have occasional imperfections such as missing or blurred pages, poor pictures, errant marks, etc. that were either part of the original artifact, or were introduced by the scanning process. We believe this work is culturally important, and despite the imperfections, have elected to bring it back into print as part of our continuing commitment to the preservation of printed works worldwide. We appreciate your understanding of the imperfections in the preservation process, and hope you enjoy this valuable book.