The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the ...Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals.
•Early life stress (ELS) can overwhelm an individual’s capacity to adapt to a stressor, thus leading to harmful effects on the cardiovascular system in adulthood. Cohort studies have demonstrated a ...strong link between ELS experiences and cardiovascular disease.•Toxic stress defined as “the excessive or prolonged activation of physiologic stress response systems in the absence of buffering protection afforded by stable responsive relationships” includes poverty, physical and sexual abuse, neglect, neighborhood violence, or the substance abuse or mental illness of a caregiver.•Maternal separation (MatSep) is a well-established animal model of ELS and provides a paradigm to test the correlation between ELS and cardiovascular disease.•This review focus on the roles of the central nervous system, the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system, the renin-angiotensin-aldosterone system, the immune system and epigenetics.•We conclude that ELS emerges as an independent risk factor for cardiovascular disease. This review reveals the need for further investigation in the ELS-induced mechanisms underlying future risk of premature CVD morbidity and mortality.
The Developmental Origins of Health and Disease (DOHaD) hypothesizes that environmental insults during childhood programs the individual to develop chronic disease in adulthood. Emerging epidemiological data strongly supports that early life stress (ELS) given by the exposure to adverse childhood experiences is regarded as an independent risk factor capable of predicting future risk of cardiovascular disease. Experimental animal models utilizing chronic behavioral stress during postnatal life, specifically maternal separation (MatSep) provides a suitable tool to elucidate molecular mechanisms by which ELS increases the risk to develop cardiovascular disease, including hypertension. The purpose of this review is to highlight current epidemiological studies linking ELS to the development of cardiovascular disease and to discuss the potential molecular mechanisms identified from animal studies. Overall, this review reveals the need for future investigations to further clarify the molecular mechanisms of ELS in order to develop more personalized therapeutics to mitigate the long-term consequences of chronic behavioral stress including cardiovascular and heart disease in adulthood.
We analyze a case study of output-feedback stabilization of an unobservable equilibrium. The problem involves achieving two conflicting goals: to estimate the unmeasured states, for which the system ...must a priori operate in an oscillatory regime, and to stabilize an equilibrium asymptotically. To overcome this quandary we propose a novel hybrid controller that generates a piecewise constant dwindling reference designed to make the system operate in an oscillatory, yet asymptotically stable, regime. The controller relies on a previously proposed switching observer, for which we provide an original analysis of exponential convergence.
This status report focuses on specific products of two γ-TiAl alloys that are advancing toward structural applications for 550–750°C service in advanced turbine engines. These are low-pressure ...turbine blade, transition-duct beam and radial diffuser castings for engine components, and corner-beam and closeout beam castings for the outlet-nozzle of a very large engine. Also included are current development of sheet corrugations for formed subcomponents and the perfection of cast turbine wheels for automotive turbochargers. In the current implementation stage, alloy composition, desired process and component definition are the important introductory issues. Then, the engineering technology that must be developed is discussed for the desired final product and a match of cost and benefit. Balancing better performance with the acceptance constraints is the key. Cost is a major constraint along with real and perceived risk. Within five to ten years, systematic reduction of certain hardware costs will occur as familiarity builds and enters into the production stage.
We solve the problem of set-point (respectively, tracking) control of a permanent-magnet synchronous motor via linear time-invariant (respectively, time varying) control. Our control approach is ...based on the physical properties of the machine: inherent stability and robustness to external disturbances. Our analysis is carried out under mild conditions, using cascaded systems theory. For all cases: constant operating point, trajectory tracking, and with known and unknown load, we show uniform global asymptotic stability of the closed-loop system with a linear controller that uses only velocity measurements. Furthermore, we explore natural extensions of our results to improve robustness with respect to external ldquodisturbancesrdquo and parametric uncertainties.
Early origins of adult disease may be defined as adversity or challenges during early life that alter physiological responses and prime the organism to chronic disease in adult life. Adverse ...childhood experiences or early life stress (ELS) may be considered a silent independent risk factor capable of predicting future cardiovascular disease risk. Maternal separation (MatSep) provides a suitable model to elucidate the underlying molecular mechanisms by which ELS increases the risk to develop cardiovascular disease in adulthood. The aim of this review is to describe the links between behavioural stress early in life and chronic cardiovascular disease risk in adulthood. We will discuss the following: (i) adult cardiovascular outcomes in humans subjected to ELS, (ii) MatSep as an animal model of ELS as well as the limitations and advantages of this model in rodents and (iii) possible ELS‐induced mechanisms that predispose individuals to greater cardiovascular risk. Overall, exposure to a behavioural stressor early in life sensitizes the response to a second stressor later in life, thus unmasking an exaggerated cardiovascular dysfunction that may influence quality of life and life expectancy in adulthood.
The prevalence of vector-associated parasitic infections is high in central-southern Italy. The deltaic coastal plain of the Volturno River has been suspected, by veterinary practitioners, to have a ...high accidental incidence of Dirofilaria repens. Thus, the goal of this study was to evaluate the prevalence of dirofilariasis and other coinfections frequently described in dogs living in the Volturno area. Blood samples of 100 clinical asymptomatic dogs were examined using a Knott's technique and polymerase chain reaction in order to identify microfilariae. Other vector-borne coinfections were also investigated using ELISA kits. The results were analysed using statistical and Geographic Information System (GIS) software. Microfilariae of D. repens were detected in 10% of the dogs surveyed, with a presence of antibodies against Ehrlichia canis (4/10) and Dirofilaria immitis (1/10). Such high incidence should be considered in light of the zoonotic potential for D. repens and the support for more regular use of repellents to prevent the spread of this disease. The GIS analyses indicated that the study area provides suitable conditions to sustain populations of mosquito vectors and D. repens parasites throughout much of the year.
Abstract
Slot-scanning technology is nowadays a valid solution for the follow-up of chronic musculoskeletal disorders on children and adolescent patients, but there is no commercial software designed ...for simulating this X-ray beam geometry. PC Program for X-ray Monte Carlo (PCXMC) is a widespread Monte Carlo software developed for dose computation in projection radiography. In this study, experimental measurements were performed to evaluate its applicability in examinations with a slit-beam device. Physical phantoms corresponding to an adult and a 5-y-old child with calibrated thermoluminescent dosemeters were used for experiments. Different simulation approaches were investigated. Differences between measured and calculated organ doses ranged from −95 to 67% and were statistically significant for almost all organs. For both patients, PCXMC underestimated the effective dose of about 25%. This study suggests that PCXMC is not suited for organ dose evaluation in examinations with slot-scanning devices. It is still a useful tool for effective dose estimation when a proper correction factor is applied.
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