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Critical care medicineprinciples of diagnosis and management in the adult /

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Critical care medicine[edited by] Joseph E. Parrillo, R. Phillip Dellinger.
其他題名:	principles of diagnosis and management in the adult /
其他作者:	Parrillo, Joseph E.
出版者:	Philadelphia, PA :Mosby Elsevier,c2008.
面頁冊數:	xix, 1776 p. :ill. (some col.) ;29 cm.
標題:	Critical care medicine.
電子資源:	An electronic book accessible through the World Wide Web; click for information
ISBN:	9780323048415

Critical care medicineprinciples of diagnosis and management in the adult /
Critical care medicineprinciples of diagnosis and management in the adult /[electronic resource] :[edited by] Joseph E. Parrillo, R. Phillip Dellinger. - 3rd ed. - Philadelphia, PA :Mosby Elsevier,c2008. - xix, 1776 p. :ill. (some col.) ;29 cm.

Includes bibliographical references and index.

Part I CRITICAL CARE PROCEDURES, MONITORING, -- AND PHARMACOLOGY -- 1 Cardiac Arrest and Cardiopulmonary Resuscitation, Wanchun Tang and Max Harry Weil -- 2 Airway Management in the Critically Ill Adult, G.G. Lavery and C.A. Jamison -- 3 Assessment of Cardiac Filling and Blood Flow, Amish Patel, Andrew Rhodes, and Richard Beale -- 4 Arterial, Central Venous, and Pulmonary Artery Catheters, Jean-Louis Vincent -- 5 Temporary Cardiac Pacing, Lawrence J. Gessman and Joseph E. Parrillo -- 6 Pericardial Tamponade: Clinical Presentation, -- Diagnosis, and Catheter-Based Therapies, Hani Jneid, Andrew O. Maree, and Igor F. Palacios -- 7 Intra-aortic Balloon Counterpulsation, Zoltan G. Turi -- 8 Echocardiography, Sherif F. Nagueh and Priscilla J. Peters -- 9 General Principles of Mechanical Ventilation, Ismail Cinel, Smith Jean, and R. Phillip Dellinger -- 10 Ventilatory Management of Obstructive Airway Disease, John Marini -- 11 Mechanical Ventilation in Acute Respiratory Distress Syndrome, Luciano Gattinoni, Eleonora Carlesso, and Pietro Caironi -- 12 Bronchoscopy and Lung Biopsy in Critically Ill Patients, Thaddeus Bartter and Melvin R. Pratter -- 13 Noninvasive Respiratory Monitoring, Amal Jubran and Martin J. Tobin -- 14 Arterial Blood Gas Measurements, Robin Gross and William Peruzzi -- 15 Tracheostomy, Yaakov Friedman and Sabine Sobek -- 16 Chest Tube Thoracostomy, Vincent E. Lotano -- 17 Intracranial Monitoring, Alan R. Turtz -- 18 Gastrointestinal Endoscopy, Jack T. Dinh and Adam B. Elfant -- 19 Continuous Renal Replacement Therapy, Boon Wee Teo, Nigel S. Kanagasundaram, and -- Emil P. Paganini -- 20 Use of Sedatives, Analgesics, and Neuromuscular Blockers, Michael J. Murray, Lance J. Oyen, and William T. Browne -- 21 Principles of Drug Dosing in Critically Ill Patients, John W. Devlin and Jeffrey F. Barletta -- Part II CRITICAL CARE CARDIOVASCULAR DISEASE -- 22 Shock: Classifi cation, Pathophysiology, and Approach to Management, Anand Kumar and Joseph E. Parrillo -- 23 Cardiogenic Shock, Steven M. Hollenberg and Joseph E. Parrillo -- 24 Septic Shock, Stephen Trzeciak, R. Phillip Dellinger, and Joseph E. Parrillo -- 25 Cardiac Tamponade, Zoltan G. Turi -- 26 Severe Sepsis and Multiple Organ Dysfunction, Sergio L. Zanotti-Cavazzoni, -- R. Phillip Dellinger, and Joseph E. Parrillo -- 27 Hypovolemic Shock, A.B.J. Groeneveld -- 28 Traumatic Shock and Tissue Hypoperfusion: Nonsurgical Management, David J. Dries -- 29 Anaphylaxis and Anaphylactic Shock, Marilyn T. Haupt -- 30 Severe Heart Failure, Fredric Ginsberg and Joseph E. Parrillo -- 31 Acute Coronary Syndromes and Acute Myocardial Infarction, Steven Werns -- 32 Cardiac Arrhythmias, Lawrence J. Gessman and Richard Trohman -- 33 Valvular Heart Disease in Critical Care, Zoltan G. Turi -- 34 Acute Aortic Dissection, Jonathan H. Cilley, Jr., and Robert J. March -- 35 Hypertensive Crises, Sergio L. Zanotti-Cavazzoni -- 36 General Principles of Postoperative Intensive -- Care Unit Care, Michael J. Hockstein and Philip S. Barie -- 37 Management of the Patient after Cardiac Surgery, Robert G. Johnson and C. Allen Bashour -- Part III CRITICAL CARE PULMONARY DISEASE -- 38 Acute Respiratory Failure, David P. Gurka and Robert A. Balk -- 39 Life-Threatening Asthma, S. Sujanthy Rajaram and R. Phillip Dellinger -- 40 Chronic Obstructive Pulmonary Disease, Guillermo Do�mnguez-Cherit, Juan Gabriel Posadas-Calleja, and Delia Borunda -- 41 Hypoventilation and Respiratory Muscle Dysfunction, Franco Laghi -- 42 Nonpulmonary Causes of Respiratory Failure, Ramya Lotano -- 43 Pneumonia: Considerations for the Critically Ill Patient, Michael S. Niederman -- 44 Weaning from Mechanical Ventilation, Martin J. Tobin -- 45 Pulmonary Embolism, John D. Buckley, Daniel R. Ouellette, and John Popovich, Jr. -- 46 Pulmonary Hypertension, Lewis J. Rubin -- 47 Massive Hemoptysis, Susan Garwood, Charlie Strange, and Steven A. Sahn -- 48 Pneumothorax and Barotrauma, Ankur A. Karnik and Ashok M. Karnik -- 49 Toxic Gas, Fume, and Smoke Inhalation, M. Sean Kincaid, Sam R. Sharar, and Leonard D. Hudson -- 50 Immunologic Lung Disease in the Critically Ill, Gregory A. Schmidt and Gary W. Hunninghake -- Part IV CRITICAL CARE INFECTIOUS DISEASE -- 51 Nosocomial Infection in the Intensive Care Unit, Dennis G. Maki, Christopher J. Crnich, and Nasia Safdar -- 52 Principles Governing Antimicrobial Therapy in the Intensive Care Unit, John Godke and George Karam -- 53 Antifungal and Antiviral Therapy, Luis Ostrosky-Zeichner and John H. Rex -- 54 Critically Ill Immunosuppressed Host, Henry Masur -- 55 Specifi c Infections with Critical Care Implications, Henry S. Fraimow and Annette C. Reboli -- Part V RENAL DISEASE AND METABOLIC DISORDERS IN THE CRITICALLY ILL -- 56 Acute Renal Failure, Robert J. Anderson -- 57 Chronic Renal Failure, Robert J. Anderson -- 58 Acid-Base, Electrolyte, and Metabolic Abnormalities, Ahmad Bilal Faridi and Lawrence S. Weisberg -- 59 Acute Diabetic Emergencies, Hypoglycemia, and Glycemic Control, Michael Chansky and Ghada Haddad -- 60 Adrenal Insuffi ciency in the Critically Ill Patient, Robert W. Taylor -- 61 Thyroid Disorders, Susan S. Braithwaite -- Part VI NEUROLOGIC DISEASE IN THE CRITICALLY ILL -- 62 Coma, Igor Ougorets and John J. Caronna -- 63 Neurologic Criteria for Death in Adults, Joseph A. Karam and John M. Luce -- 64 Stroke, Thomas R. Mirsen -- 65 Acute Neuromuscular Respiratory Failure in Myasthenia Gravis and Guillain-Bar�r Syndrome, Osman Samil Kozak and Eelco F.M. Wijdicks -- 66 Seizures in the Critically Ill, Thomas P. Bleck -- 67 Head Injury, Alan R. Turtz and H. Warren Goldman -- Part VII PHYSICAL AND TOXIC INJURY IN THE CRITICALLY ILL -- 68 Critical Care Management of the Severely Burned Patient, Jeffery R. Saffle -- 69 Poisonings, Janice L. Zimmerman and Maria Rudis -- 70 Hypothermia, Hyperthermia, and Rhabdomyolysis, Sanjay Subramanian, J. Christopher Farmer, and Christopher McFadden -- Part VIII ADMINISTRATIVE, ETHICAL, AND PSYCHOLOGICAL ISSUES IN CARE OF THE -- CRITICALLY ILL -- 71 Intensive Care Unit Administration and Performance Improvement, Sean Townsend and Carolyn Bekes -- 72 Ethical Considerations in Managing Critically Ill Patients, Marion Danis, Ezekial Emanuel, and Henry Silverman -- 73 Delirium, Sleep, and Mental Health Disturbances in Critical Illness, Pratik Pandharipande, James Jackson, and E. Wesley Ely -- 74 Severity Scoring Systems: Tools for the Evaluation of Patients and Intensive Care Units, Rui P. Moreno and Philipp G.H. Metnitz -- 75 Education and Training in Critical Care, Nandan Gautam, Hannah Reay, and Julian Bion -- Part IX OTHER CRITICAL CARE DISORDERS AND ISSUES IN CARE OF THE CRITICALLY ILL -- 76 Diagnosis and Management of Liver Failure in the Adult, Nick Murphy -- 77 Gastrointestinal Bleeding, Louis Chaptini and Steven Peikin -- 78 Acute Pancreatitis, John C. Marshall -- 79 Hemorrhagic and Thrombotic Disorders, Neil A. Lachant -- 80 Use of Blood Components in the Intensive Care Unit, Judith A. Luce -- 81 Intensive Care of the Cancer Patient, Brendan D. Curti and Dan L. Longo -- 82 Critical Care Medicine in Pregnancy, Stephen E. Lapinsky -- 83 Nutrition Support, Richard G. Barton.

Here b2 ss the most clinically oriented critical care text focusing on the adult patient. In full-color and superbly illustrated with clinical photographs, imaging studies, and management algorithms, and with a broad multidisciplinary focus, this text will help you enhance your skills at any level of training. Stands alone as a clinically oriented comprehensive reference. Completely updated and authorship expanded to reflect the evolution in critical care practice. In color for the first time, with new color schematics and treatment algorithms for greater ease of reference. Utilizes key points lists at the end of chapter, to help you make decisions rapidly and easily. Delivers key references that list other useful resources for information.

Electronic reproduction.
Amsterdam :
Elsevier Science & Technology,
2009.

Mode of access: World Wide Web.

ISBN: 9780323048415

Source: 135178:135313Elsevier Science & Technologyhttp://www.sciencedirect.comSubjects--Topical Terms:

281334
Critical care medicine.
Index Terms--Genre/Form:

214472
Electronic books.

LC Class. No.: RC86.7 / .C744 2008

Dewey Class. No.: 616/.028

National Library of Medicine Call No.: 2008 B-638

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245 0 0 $a Critical care medicine $h [electronic resource] : $b principles of diagnosis and management in the adult / $c [edited by] Joseph E. Parrillo, R. Phillip Dellinger.
250 $a 3rd ed.
260 $a Philadelphia, PA : $b Mosby Elsevier, $c c2008.
300 $a xix, 1776 p. : $b ill. (some col.) ; $c 29 cm.
504 $a Includes bibliographical references and index.
505 0 $a Part I CRITICAL CARE PROCEDURES, MONITORING, -- AND PHARMACOLOGY -- 1 Cardiac Arrest and Cardiopulmonary Resuscitation, Wanchun Tang and Max Harry Weil -- 2 Airway Management in the Critically Ill Adult, G.G. Lavery and C.A. Jamison -- 3 Assessment of Cardiac Filling and Blood Flow, Amish Patel, Andrew Rhodes, and Richard Beale -- 4 Arterial, Central Venous, and Pulmonary Artery Catheters, Jean-Louis Vincent -- 5 Temporary Cardiac Pacing, Lawrence J. Gessman and Joseph E. Parrillo -- 6 Pericardial Tamponade: Clinical Presentation, -- Diagnosis, and Catheter-Based Therapies, Hani Jneid, Andrew O. Maree, and Igor F. Palacios -- 7 Intra-aortic Balloon Counterpulsation, Zoltan G. Turi -- 8 Echocardiography, Sherif F. Nagueh and Priscilla J. Peters -- 9 General Principles of Mechanical Ventilation, Ismail Cinel, Smith Jean, and R. Phillip Dellinger -- 10 Ventilatory Management of Obstructive Airway Disease, John Marini -- 11 Mechanical Ventilation in Acute Respiratory Distress Syndrome, Luciano Gattinoni, Eleonora Carlesso, and Pietro Caironi -- 12 Bronchoscopy and Lung Biopsy in Critically Ill Patients, Thaddeus Bartter and Melvin R. Pratter -- 13 Noninvasive Respiratory Monitoring, Amal Jubran and Martin J. Tobin -- 14 Arterial Blood Gas Measurements, Robin Gross and William Peruzzi -- 15 Tracheostomy, Yaakov Friedman and Sabine Sobek -- 16 Chest Tube Thoracostomy, Vincent E. Lotano -- 17 Intracranial Monitoring, Alan R. Turtz -- 18 Gastrointestinal Endoscopy, Jack T. Dinh and Adam B. Elfant -- 19 Continuous Renal Replacement Therapy, Boon Wee Teo, Nigel S. Kanagasundaram, and -- Emil P. Paganini -- 20 Use of Sedatives, Analgesics, and Neuromuscular Blockers, Michael J. Murray, Lance J. Oyen, and William T. Browne -- 21 Principles of Drug Dosing in Critically Ill Patients, John W. Devlin and Jeffrey F. Barletta -- Part II CRITICAL CARE CARDIOVASCULAR DISEASE -- 22 Shock: Classifi cation, Pathophysiology, and Approach to Management, Anand Kumar and Joseph E. Parrillo -- 23 Cardiogenic Shock, Steven M. Hollenberg and Joseph E. Parrillo -- 24 Septic Shock, Stephen Trzeciak, R. Phillip Dellinger, and Joseph E. Parrillo -- 25 Cardiac Tamponade, Zoltan G. Turi -- 26 Severe Sepsis and Multiple Organ Dysfunction, Sergio L. Zanotti-Cavazzoni, -- R. Phillip Dellinger, and Joseph E. Parrillo -- 27 Hypovolemic Shock, A.B.J. Groeneveld -- 28 Traumatic Shock and Tissue Hypoperfusion: Nonsurgical Management, David J. Dries -- 29 Anaphylaxis and Anaphylactic Shock, Marilyn T. Haupt -- 30 Severe Heart Failure, Fredric Ginsberg and Joseph E. Parrillo -- 31 Acute Coronary Syndromes and Acute Myocardial Infarction, Steven Werns -- 32 Cardiac Arrhythmias, Lawrence J. Gessman and Richard Trohman -- 33 Valvular Heart Disease in Critical Care, Zoltan G. Turi -- 34 Acute Aortic Dissection, Jonathan H. Cilley, Jr., and Robert J. March -- 35 Hypertensive Crises, Sergio L. Zanotti-Cavazzoni -- 36 General Principles of Postoperative Intensive -- Care Unit Care, Michael J. Hockstein and Philip S. Barie -- 37 Management of the Patient after Cardiac Surgery, Robert G. Johnson and C. Allen Bashour -- Part III CRITICAL CARE PULMONARY DISEASE -- 38 Acute Respiratory Failure, David P. Gurka and Robert A. Balk -- 39 Life-Threatening Asthma, S. Sujanthy Rajaram and R. Phillip Dellinger -- 40 Chronic Obstructive Pulmonary Disease, Guillermo Do�mnguez-Cherit, Juan Gabriel Posadas-Calleja, and Delia Borunda -- 41 Hypoventilation and Respiratory Muscle Dysfunction, Franco Laghi -- 42 Nonpulmonary Causes of Respiratory Failure, Ramya Lotano -- 43 Pneumonia: Considerations for the Critically Ill Patient, Michael S. Niederman -- 44 Weaning from Mechanical Ventilation, Martin J. Tobin -- 45 Pulmonary Embolism, John D. Buckley, Daniel R. Ouellette, and John Popovich, Jr. -- 46 Pulmonary Hypertension, Lewis J. Rubin -- 47 Massive Hemoptysis, Susan Garwood, Charlie Strange, and Steven A. Sahn -- 48 Pneumothorax and Barotrauma, Ankur A. Karnik and Ashok M. Karnik -- 49 Toxic Gas, Fume, and Smoke Inhalation, M. Sean Kincaid, Sam R. Sharar, and Leonard D. Hudson -- 50 Immunologic Lung Disease in the Critically Ill, Gregory A. Schmidt and Gary W. Hunninghake -- Part IV CRITICAL CARE INFECTIOUS DISEASE -- 51 Nosocomial Infection in the Intensive Care Unit, Dennis G. Maki, Christopher J. Crnich, and Nasia Safdar -- 52 Principles Governing Antimicrobial Therapy in the Intensive Care Unit, John Godke and George Karam -- 53 Antifungal and Antiviral Therapy, Luis Ostrosky-Zeichner and John H. Rex -- 54 Critically Ill Immunosuppressed Host, Henry Masur -- 55 Specifi c Infections with Critical Care Implications, Henry S. Fraimow and Annette C. Reboli -- Part V RENAL DISEASE AND METABOLIC DISORDERS IN THE CRITICALLY ILL -- 56 Acute Renal Failure, Robert J. Anderson -- 57 Chronic Renal Failure, Robert J. Anderson -- 58 Acid-Base, Electrolyte, and Metabolic Abnormalities, Ahmad Bilal Faridi and Lawrence S. Weisberg -- 59 Acute Diabetic Emergencies, Hypoglycemia, and Glycemic Control, Michael Chansky and Ghada Haddad -- 60 Adrenal Insuffi ciency in the Critically Ill Patient, Robert W. Taylor -- 61 Thyroid Disorders, Susan S. Braithwaite -- Part VI NEUROLOGIC DISEASE IN THE CRITICALLY ILL -- 62 Coma, Igor Ougorets and John J. Caronna -- 63 Neurologic Criteria for Death in Adults, Joseph A. Karam and John M. Luce -- 64 Stroke, Thomas R. Mirsen -- 65 Acute Neuromuscular Respiratory Failure in Myasthenia Gravis and Guillain-Bar�r Syndrome, Osman Samil Kozak and Eelco F.M. Wijdicks -- 66 Seizures in the Critically Ill, Thomas P. Bleck -- 67 Head Injury, Alan R. Turtz and H. Warren Goldman -- Part VII PHYSICAL AND TOXIC INJURY IN THE CRITICALLY ILL -- 68 Critical Care Management of the Severely Burned Patient, Jeffery R. Saffle -- 69 Poisonings, Janice L. Zimmerman and Maria Rudis -- 70 Hypothermia, Hyperthermia, and Rhabdomyolysis, Sanjay Subramanian, J. Christopher Farmer, and Christopher McFadden -- Part VIII ADMINISTRATIVE, ETHICAL, AND PSYCHOLOGICAL ISSUES IN CARE OF THE -- CRITICALLY ILL -- 71 Intensive Care Unit Administration and Performance Improvement, Sean Townsend and Carolyn Bekes -- 72 Ethical Considerations in Managing Critically Ill Patients, Marion Danis, Ezekial Emanuel, and Henry Silverman -- 73 Delirium, Sleep, and Mental Health Disturbances in Critical Illness, Pratik Pandharipande, James Jackson, and E. Wesley Ely -- 74 Severity Scoring Systems: Tools for the Evaluation of Patients and Intensive Care Units, Rui P. Moreno and Philipp G.H. Metnitz -- 75 Education and Training in Critical Care, Nandan Gautam, Hannah Reay, and Julian Bion -- Part IX OTHER CRITICAL CARE DISORDERS AND ISSUES IN CARE OF THE CRITICALLY ILL -- 76 Diagnosis and Management of Liver Failure in the Adult, Nick Murphy -- 77 Gastrointestinal Bleeding, Louis Chaptini and Steven Peikin -- 78 Acute Pancreatitis, John C. Marshall -- 79 Hemorrhagic and Thrombotic Disorders, Neil A. Lachant -- 80 Use of Blood Components in the Intensive Care Unit, Judith A. Luce -- 81 Intensive Care of the Cancer Patient, Brendan D. Curti and Dan L. Longo -- 82 Critical Care Medicine in Pregnancy, Stephen E. Lapinsky -- 83 Nutrition Support, Richard G. Barton.
505 0 $a Cardiac arrest and cardiopulmonary resuscitation -- Airway management in the critically ill adult -- Assessment of cardiac filling and blood flow -- Arterial, central venous, and pulmonary artery catheters -- Temporary cardiac pacing -- Pericardial tamponade: clinical presentation, diagnosis, and catheter-based therapies -- Intra-aortic balloon counterpulsation -- Echocardiography -- General principles of mechanical ventilation -- Ventilatory management of obstructive airway disease -- Mechanical ventilation in acute respiratory distress syndrome -- Bronchoscopy and lung biopsy in critically ill patients -- Noninvasive respiratory monitoring -- Arterial blood gas measurements -- Tracheostomy -- Chest tube thoracostomy -- Intracranial monitoring -- Gastrointestinal endoscopy -- Continuous renal replacement therapy -- Use of sedatives, analgesics, and neuromuscular blockers -- Principles of drug dosing in critically ill patients -- Shock: classification, pathophysiology, and approach to management -- Cardiogenic shock -- Septic shock -- Cardiac tamponade -- Severe sepsis and multiple organ dysfunction -- Hypovolemic shock -- Traumatic shock and tissue hypoperfusion: nonsurgical management -- Anaphylaxis and anaphylactic shock -- Severe heart failure -- Acute coronary syndromes and acute myocardial infarction -- Cardiac arrhythmias -- Valvular heart disease in critical care -- Acute aortic dissection -- Hypertensive crises -- General principles of postoperative intensive care unit care -- Management of the patient after cardiac surgery -- Acute respiratory failure -- Life-threatening asthma -- Chronic obstructive pulmonary disease -- Hypoventilation and respiratory muscle dysfunction.
505 0 $a Nonpulmonary causes of respiratory failure -- Pneumonia: considerations for the critically ill patient -- Weaning from mechancial ventilation -- Pulmonary embolism -- Pulmonary hypertension -- Massive hemoptysis -- Pneumothorax and barotrauma -- Toxic gas, fume, and smoke inhalation -- Immunologic lung disease in the critically ill -- Nonsocomial infection in the intensvie care unit -- Principles governing antimicrobial therapy in the intensive care unit -- Antifungal and antiviral therapy -- Critically ill immunosuppressed host -- Specific infections with critical care implications -- Acute renal failure -- Chronic renal failure -- Acid-base, electrolyte, and metabolic abnormalities -- Acute diabetic emergencies, hypoglycemia, and glycemic control -- Adrenal insufficiency in the critically ill patient -- Thyroid disorders -- Coma -- Neurologic criteria for death in adults -- Stroke -- Acute neuromuscular respiratory failure in myasthenia gravis and Guillain-Barr�e Syndrome -- Seizures in the critically ill -- Head injury -- Critical care management of the severely burned patient -- Poisonings -- Hypothermia, hyperthermia, and rhabdomyolysis -- Intensive care unit adminstration and performance improvement -- Ethical considerations in managing critically ill patient -- Delirium, sleep, and mental health disturbances in critical illness -- Severity scoring systems: toos for the evaluation of patients and intensive care units -- Education and training in critical care -- Diagnosis and management of liver failure in the adult -- Gastrointestinal bleeding -- Acute pancreatitis -- Hemorrhagic and thrombotic disorders -- Use of blood components in the intensive care unit -- Intensive care of the cancer patient -- Critical care medicine in pregnancy -- Nutrition support.
520 $a Here b2 ss the most clinically oriented critical care text focusing on the adult patient. In full-color and superbly illustrated with clinical photographs, imaging studies, and management algorithms, and with a broad multidisciplinary focus, this text will help you enhance your skills at any level of training. Stands alone as a clinically oriented comprehensive reference. Completely updated and authorship expanded to reflect the evolution in critical care practice. In color for the first time, with new color schematics and treatment algorithms for greater ease of reference. Utilizes key points lists at the end of chapter, to help you make decisions rapidly and easily. Delivers key references that list other useful resources for information.
533 $a Electronic reproduction. $b Amsterdam : $c Elsevier Science & Technology, $d 2009. $n Mode of access: World Wide Web. $n System requirements: Web browser. $n Title from title screen (viewed on Dec. 9, 2009). $n Access may be restricted to users at subscribing institutions.
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