| 1. |
- Falcone, Marco, et al.
(författare)
-
Considerations for the optimal management of antibiotic therapy in elderly patients
- 2020
-
Ingår i: Journal of Global Antimicrobial Resistance. - : ELSEVIER SCI LTD. - 2213-7165 .- 2213-7173. ; 22, s. 325-333
-
Forskningsöversikt (refereegranskat)abstract
- Objectives: To maximise efficacy and minimise toxicity, special considerations are required for antibiotic prescription in elderly patients. This review aims to provide practical suggestions for the optimal management of antibiotic therapy in elderly patients. Methods: This was a narrative review. A literature search of published articles in the last 15 years on antibiotics and elderly patients was performed using the Cochrane Library and PubMed electronic databases. The three priority areas were identified: (i) pharmacokinetics/pharmacodynamics (PK/PD) for optimising dosage regimens and route of administration; (ii) antibiotic dosages in some special subpopulations; and (iii) treatment considerations relating to different antibiotic classes and their adverse events. Results: Clinicians should understand the altered PK/PD of drugs in this population owing to co-morbid conditions and normal physiological changes associated with ageing. The body of evidence justifies the need for individualised dose selection, especially in patients with impaired renal and liver function. Clinicians should be aware of the major drug-drug interactions commonly observed in the elderly as well as potential side effects. Conclusion: Antibiotic therapy in the elderly requires a comprehensive approach, including strategies to improve appropriate antibiotic prescribing, limit their use for uncomplicated infections and ensure the attainment of an optimal PK/PD target. To this purpose, further studies involving the elderly are needed to better understand the PK of antibiotics. Moreover, it is necessary to assess the role therapeutic drug monitoring in guiding antibiotic therapy in elderly patients in order to evaluate its impact on clinical outcome.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Del Ferraro, Simona, et al.
(författare)
-
A potential wearable solution for preventing heat strain in workplaces : The cooling effect and the total evaporative resistance of a ventilation jacket
- 2022
-
Ingår i: Environmental Research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 212
-
Tidskriftsartikel (refereegranskat)abstract
- The increase in average seasonal temperatures has an impact in the occupational field, especially for those sectors whose work activities are performed outdoors (agricultural, road and construction sectors). Among the adaptation measures and solutions developed to counteract occupational heat strain, personal cooling garments represent a wearable technology designed to remove heat from the human body, enhancing human performance. This study aims to investigate the effectiveness and the cooling power of a specific cooling garment, i.e. a ventilation jacket, by quantifying the evaporative heat losses and the total evaporative resistance both when worn alone and in combination with a work ensemble, at three adjustments of air ventilation speed. Standardised "wet" tests in a climatic chamber were performed on a sweating manikin in isothermal conditions considering three clothing ensembles (single jacket, work ensemble and a combination of both) and three adjustments of fan velocity. Results showed a significant increase (p < 0.001) in evaporative heat loss values when the fan velocity increased, particularly within the trunk zones for all the considered clothing ensembles, showing that fans enhanced the dissipation by evaporation. The cooling power, quantified in terms of percent changes of evaporative heat loss, showed values exceeding 100% when fans were on, in respect to the condition of fans-off, for the trunk zones except for the Chest. A significant (p < 0.01) decrease (up to 42.3%) in the total evaporative resistance values of the jacket, coupled with the work ensemble, was found compared to the fans-off condition. Results confirmed and quantified the cooling effect of the ventilation jacket which enhanced the evaporative heat losses of the trunk zones, helping the body to dissipate heat and showing the potential for a heat adaptation measure to be developed.
|
|
| 5. |
- Del Ferraro, Simona, et al.
(författare)
-
Cooling garments against environmental heat conditions in occupational fields : measurements of the effect of a ventilation jacket on the total thermal insulation
- 2021
-
Ingår i: International Journal of Industrial Ergonomics. - : Elsevier BV. - 0169-8141. ; 86
-
Tidskriftsartikel (refereegranskat)abstract
- Personal cooling garments (PCGs) can represent an adaptation solution to counteract heat strain and to improve worker's health and productivity (especially for some outdoor work activities as in agriculture and in the construction industry). The cooling effect of a ventilation jacket was preliminarily investigated carrying out “dry” tests in a climatic chamber on a thermal manikin. A standardized condition with air temperature, ta = 22.4 °C, three different adjustments of the fan velocity (vf= 0, vf = 2 and vf = 4), and three different ensembles (the single jacket, a work ensemble and a combination of both) were considered. Results showed significant increases in dry heat losses (through convection) for the trunk thermal zones, higher when the fans were on, for all the ensembles considered. Percent changes greatly exceeded 100 % for the thermal zones close to the fans. The air ventilation determined significant decreases of the total thermal insulation (IT) values (up to 35 %) compared to the fans-off condition, confirming and quantifying the cooling effect of the ventilation jacket.
|
|
| 6. |
- Del Ferraro, Simona, et al.
(författare)
-
Mitigating heat effects in the workplace with a ventilation jacket : simulations of the whole-body and local human thermophysiological response with a sweating thermal manikin in a warm-dry environment
- 2024
-
Ingår i: Journal of Thermal Biology. - 0306-4565. ; 119
-
Tidskriftsartikel (refereegranskat)abstract
- Climate change is increasingly affecting human well-being and will inevitably impact on occupational sectors in terms of costs, productivity, workers' health and injuries. Among the cooling garment developed to reduce heat strain, the ventilation jacket could be considered for possible use in workplaces, as it is wearable without limiting the user's mobility and autonomy. In this study, simulations with a sweating manikin are carried out to investigate the effects of a short-sleeved ventilation jacket on human thermophysiological responses in a warm-dry scenario. Simulations were performed in a climatic chamber (air temperature = 30.1 °C; air velocity = 0.29 m/s; relative humidity = 30.0 %), considering two constant levels of metabolic rate M (M 1 = 2.4 MET; M 2 = 3.2 MET), a sequence of these two (Work), and three levels of fan velocities (l f = 0; l f=2; l f=4). The results revealed a more evident impact on the mean skin temperature (T sk) compared to the rectal temperature (T re), with significant decreases (compared to fan-off) at all M levels, for T sk from the beginning and for T re from the 61 st minute. Skin temperatures of the torso zones decreased significantly (compared to fan-off) at all M levels, and a greater drop was registered for the Back. The fans at the highest level (l f=4) were significantly effective in improving whole-body and local thermal sensations when compared to fan-off, at all M levels. At the intermediate level (l f=2), the statistical significance varied with thermal zone, M and time interval considered. The results of the simulations also showed that the Lower Torso needs to be monitored at M 2 level, as the drop in skin temperature could lead to local overcooling and thermal discomfort. Simulations showed the potential effectiveness of the ventilation jacket, but human trials are needed to verify its cooling power in real working conditions.
|
|
| 7. |
- Hult, Robert, 1984, et al.
(författare)
-
Design and experimental validation of a cooperative driving control architecture for the Grand Cooperative Driving Challenge 2016
- 2018
-
Ingår i: IEEE Transactions on Intelligent Transportation Systems. - 1524-9050 .- 1558-0016. ; 19:4, s. 1290-1301
-
Tidskriftsartikel (refereegranskat)abstract
- In this paper, we present the cooperative driving sys- tem developed by the Chalmers Car team for the Grand Cooper- ative Driving Challenge 2016. The paper gives an overview of the system architecture and describes in detail the communication, signal processing and decision-making sub-systems. Experimental results demonstrate the system’s performance and operation according to the rules and requirements of the competition.
|
|
| 8. |
- Perez-Nadales, Elena, et al.
(författare)
-
Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales : The impact of cytomegalovirus disease and lymphopenia
- 2020
-
Ingår i: American Journal of Transplantation. - : WILEY. - 1600-6135 .- 1600-6143. ; 20:6, s. 1629-1641
-
Tidskriftsartikel (refereegranskat)abstract
- Treatment of carbapenemase-producing Enterobacterales bloodstream infections in solid organ transplant recipients is challenging. The objective of this study was to develop a specific score to predict mortality in solid organ transplant recipients with carbapenemase-producing Enterobacterales bloodstream infections. A multinational, retrospective (2004-2016) cohort study (INCREMENT-SOT, ClinicalTrials.gov NCT02852902) was performed. The main outcome variable was 30-day all-cause mortality. The INCREMENT-SOT-CPE score was developed using logistic regression. The global cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score >= 8 (8 points), no source control (3 points), inappropriate empirical therapy (2 points), cytomegalovirus disease (7 points), lymphopenia (4 points), and the interaction between INCREMENT-CPE score >= 8 and CMV disease (minus 7 points). This score showed an area under the receiver operating characteristic curve of 0.82 (95% confidence interval [CI] 0.76-0.88) and classified patients into 3 strata: 0-7 (low mortality), 8-11 (high mortality), and 12-17 (very-high mortality). We performed a stratified analysis of the effect of monotherapy vs combination therapy among 165 patients who received appropriate therapy. Monotherapy was associated with higher mortality only in the very-high (adjusted hazard ratio [HR] 2.82, 95% CI 1.13-7.06, P = .03) and high (HR 9.93, 95% CI 2.08-47.40, P = .004) mortality risk strata. A score-based algorithm is provided for therapy guidance.
|
|
| 9. |
- Raffel, Simon, et al.
(författare)
-
Quantitative proteomics reveals specific metabolic features of Acute Myeloid Leukemia stem cells
- 2020
-
Ingår i: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 136:13, s. 1507-1519
-
Tidskriftsartikel (refereegranskat)abstract
- Acute myeloid leukemia is characterized by the accumulation of clonal myeloid blast cells unable to differentiate into mature leukocytes. Chemotherapy induces remission in the majority of patients, but relapse rates are high and lead to poor clinical outcomes. Because this is primarily caused by chemotherapy-resistant leukemic stem cells (LSCs), it is essential to eradicate LSCs to improve patient survival. LSCs have predominantly been studied at the transcript level, thus information about posttranscriptionally regulated genes and associated networks is lacking. Here, we extend our previous report on LSC proteomes to healthy age-matched hematopoietic stem and progenitor cells (HSPCs) and correlate the proteomes to the corresponding transcriptomes. By comparing LSCs to leukemic blasts and healthy HSPCs, we validate candidate LSC markers and highlight novel and potentially targetable proteins that are absent or only lowly expressed in HSPCs. In addition, our data provide strong evidence that LSCs harbor a characteristic energy metabolism, adhesion molecule composition, as well as RNA-processing properties. Furthermore, correlating proteome and transcript data of the same individual samples highlights the strength of proteome analyses, which are particularly potent in detecting alterations in metabolic pathways. In summary, our study provides a comprehensive proteomic and transcriptomic characterization of functionally validated LSCs, blasts, and healthy HSPCs, representing a valuable resource helping to design LSC-directed therapies.
|
|
| 10. |
|
|
| 11. |
- Thornhill, John P, et al.
(författare)
-
Human monkeypox virus infection in women and non-binary individuals during the 2022 outbreaks: a global case series.
- 2022
-
Ingår i: Lancet (London, England). - 1474-547X. ; 400:10367, s. 1953-1965
-
Tidskriftsartikel (refereegranskat)abstract
- Between May and November, 2022, global outbreaks of human monkeypox virus infection have been reported in more than 78000 people worldwide, predominantly in men who have sex with men. We describe the epidemiological and clinical characteristics of monkeypox virus infection in cisgender (cis) and transgender (trans) women and non-binary individuals assigned female sex at birth to improve identification and understanding of risk factors.International collaborators in geographical locations with high numbers of diagnoses of monkeypox virus infection were approached and invited to contribute data on women and non-binary individuals with confirmed monkeypox virus infection. Contributing centres completed deidentified structured case-report spreadsheets, adapted and developed by participating clinicians, to include variables of interest relevant to women and non-binary individuals assigned female at birth. We describe the epidemiology and clinical course observed in the reported infections.Collaborators reported data for a total of 136 individuals with monkeypox virus infection who presented between May 11 and Oct 4, 2022, across 15 countries. Overall median age was 34 years (IQR 28-40; range 19-84). The cohort comprised 62 trans women, 69 cis women, and five non-binary individuals (who were, because of small numbers, grouped with cis women to form a category of people assigned female at birth for the purpose of comparison). 121 (89%) of 136 individuals reported sex with men. 37 (27%) of all individuals were living with HIV, with a higher proportion among trans women (31 [50%] of 62) than among cis women and non-binary individuals (six [8%] of 74). Sexual transmission was suspected in 55 (89%) trans women (with the remainder having an unknown route of transmission) and 45 (61%) cis women and non-binary individuals; non-sexual routes of transmission (including household and occupational exposures) were reported only in cis women and non-binary individuals. 25 (34%) of 74 cis women and non-binary individuals submitted to the case series were initially misdiagnosed. Overall, among individuals with available data, rash was described in 124 (93%) of 134 individuals and described as anogenital in 95 (74%) of 129 and as vesiculopustular in 105 (87%) of 121. Median number of lesions was ten (IQR 5-24; range 1-200). Mucosal lesions involving the vagina, anus, or oropharynx or eye occurred in 65 (55%) of 119 individuals with available data. Vaginal and anal sex were associated with lesions at those sites. Monkeypox virus DNA was detected by PCR from vaginal swab samples in all 14 samples tested. 17 (13%) individuals were hospitalised, predominantly for bacterial superinfection of lesions and pain management. 33 (24%) individuals were treated with tecovirimat and six (4%) received post-exposure vaccinations. No deaths were reported.The clinical features of monkeypox in women and non-binary individuals were similar to those described in men, including the presence of anal and genital lesions with prominent mucosal involvement. Anatomically, anogenital lesions were reflective of sexual practices: vulvovaginal lesions predominated in cis women and non-binary individuals and anorectal features predominated in trans women. The prevalence of HIV co-infection in the cohort was high.None.
|
|
| 12. |
- Vaio, Marco Di, et al.
(författare)
-
Design and Experimental Validation of a Distributed Interaction Protocol for Connected Autonomous Vehicles at a Road Intersection
- 2019
-
Ingår i: IEEE Transactions on Vehicular Technology. - 0018-9545 .- 1939-9359. ; 68:10, s. 9451-9465
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents a fully distributed interaction protocol for connected self-driving cars negotiating the access a traffic junction. The vehicles coordination has been reformulated as an equivalent virtual platoon control problem. The desired vehicles spacing within the platoon is chosen so to avoid the side and rear-end collisions and is controlled by a cooperative non-linear control algorithm, based on potential functions. The asymptotic stability of the closed-loop system has been analytically proved by leveraging the LaSalle's Invariance Principle. The analysis of the convergence rate has resulted in an effective tuning tool ensuring that the desired formation is achieved before vehicles reach the intersection. Most notably, results from an in-vehicle experimental validation are presented. The experiments were carried out on three self-driving cars connected through a V2V communication infrastructure based on the IEEE 802.11p protocol. The experimental results confirm the theoretical analysis and reveal the effectiveness of the control approach for autonomously and safely negotiating a generic traffic junction.
|
|
