Review: Role of antibiotic stewardship in extending the age of modern medicine

Antibiotic resistance is threatening modern medicine. Overuse and misuse of antibiotics is driving resistance to such an extent that we have entered the post-antibiotic era, where some multidrug- and pandrug-resistant  bacterial infections are no longer treatable. If the situation is not reversed, 10 million people will die annually of  drug-resistant infections by 2050. More than just a question of mortality, such infections are causing the clo ure of wards, cancellation of operations, and interference with other common medical procedures that rely on antibiotics for their success. The response to this crisis requires co-ordinated international action with  increased surveillance of bacterial resistance, infection prevention, and antibiotic stewardship, i.e. access to affordable, quality-assured antibiotics prescribed appropriately. This review describes antibiotic stewardship at the individual patient and programmatic level, which must be adopted by every prescriber if we are to  preserve modern medicine for future generations

A chain rule for the expected suprema of Gaussian processes

The expected supremum of a Gaussian process indexed by the image of an index set under a function class is bounded in terms of separate properties of the index set and the function class. The bound is relevant to the estimation of nonlinear transformations or the analysis of learning algorithms whenever hypotheses are chosen from composite classes, as is the case for multi-layer models

Velocity Anisotropy Of Two Deep Crystalline Samples

Using ultrasonic velocity measurements taken over a multiplicity of directions we show that samples exhibit weak to moderate anisotropy of seismic velocities. We further define the anisotropic geometry with high resolution scanning electron microscopy. Our data indicate that one sample, a granite, is transversely anisotropic, and that the presence of fine to moderately fine microcracks is the most important factor effecting the velocities. We model the angular velocity dependence using 5 elastic constants and show that all 9 observed velocities fit these predictions to within 0.1 km/s. We are unable to obtain similar fits to a second sample, a mica-schist, in the same fashion. SEM observations indicate this rock displays orthorhombic symmetry. We made additional velocity measurements in order to calculate 9 elastic constants, and found that the predicted angular velocity dependence agreed much better with our velocity observations.Massachusetts Institute of Technology. Full Waveform Acoustic Logging ConsortiumEnte nazionale per l'energia elettric

Atypical pneumonia in adults in southern Africa

The true incidence of Legionella pneumophilia, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Coxiella burnetti, the so-called atypical pathogens that cause adult community-acquired pneumonia in southern Africa, is unknown. Although there are a lack of community-based studies, hospital-based studies suggest that the incidence may be as high as 30% in patients admitted to, but not requiring, an intensive care unit. A lack of specific clinical features that differentiate atypical pathogens, plus the lack of reliable, simple diagnostics, compound the uncertainty regarding the contribution of atypical pathogens to the sum total of community-acquired pneumonia in southern Africa. Without reliable diagnostic tests, macrolide or azalide antibiotics are widely used for in-patients with pneumonia, potentially fuelling the rise of antibiotic resistance to macrolides in other bacteria

Food, Freedom, Fairness, and the Family Farm

The concept of the “family farm” holds powerful sway within the American narrative, embodying both nostalgia for an imagined past and anxiety for a future perceived to be under threat. Since the founding of the United States, this cultural ideal has been invoked in support of a rosy vision of agrarian democracy while obscuring the ways in which the U.S. Department of Agriculture’s codified definition of “family farm” has unfairly aggregated advantages for the benefit of a particular kind of family (nuclear) and farmer (white, male, straight). At the same time, consumers are misled by an under-interrogated conflation of family farming with “good” farming practices. There exists a pervasive fear among Americans that the family farm is at risk of disappearing, and that something must be done to save it. This Essay analyzes the history of family farms in the United States and contends that reclaiming, not rescuing, is what needs to be done. As an alternative to preserving an institution whose benefits have always been constrained by gender, race, and wealth, we propose instead re-orienting efforts toward three concepts rooted in the family farm ideal but which we believe to possess greater transformative potential: fairness—the distribution of benefits along the agrifood chain to ensure adequate compensation and access; self-determination—the ability for communities to make their own decisions within the food system; and “good” farming—the specific practices that could lead to a more just, humane, and sustainable food system

The Evolution of Multi-component Visual Signals in Darters (genus Etheostoma)

As complex traits evolve, each component of the trait may be under different selection pressures and could respond independently to distinct evolutionary forces. We used comparative methods to examine patterns of evolution in multiple components of a complex courtship signal in darters, specifically addressing the question of how nuptial coloration evolves across different areas of the body. Using spectral reflectance, we defined 4 broad color classes present on the body and fins of 17 species of freshwater fishes (genus Etheostoma) and quantified differences in hue within each color class. Ancestral state reconstruction suggests that most color traits were expressed in the most recent common ancestor of sampled species and that differences among species are mostly due to losses in coloration. The evolutionary lability of coloration varied across body regions; we found significant phylogenetic signal for orange color on the body but not for most colors on fins. Finally, patterns of color evolution and hue of the colors were correlated among the two dorsal fins and between the anterior dorsal and anal fins, but not between any of the fins and the body. The observed patterns support the hypothesis that different components of complex signals may be subject to distinct evolutionary pressures, and suggests that the combination of behavioral displays and morphology in communication may have a strong influence on patterns of signal evolution [Current Zoology 57 (2): 125–139, 2011]

Addendum: One‐Speed Neutron Transport in Two Adjacent Half‐Spaces

The interface current for the problem of two half‐spaces with a constant source in one half‐space is obtained in closed form.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/70010/2/JMAPAQ-5-12-1804-1.pd