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Background: Feedback reports summarizing clinician performance are effective tools to improve antibiotic stewardship in the ambulatory setting, but few studies have evaluated their effectiveness for pediatric inpatients. We developed and implemented feedback reports reflecting electronically-derived measures of appropriate antibiotic choice and duration for community acquired pneumonia (CAP) and measured their impact on appropriate antibiotic use in children hospitalized for CAP. Methods: We performed a single center quasi-experimental study including children 6 months to 17 years hospitalized for CAP between 12/1/2021-11/30/2023. Children with chronic medical conditions, ICU stays >48 hours, and outside transfers were excluded. The intervention occurred in 11/2022 and included clinician education, a monthly group-level feedback report disseminated by email (Figure 1), and a monthly review of clinician performance during a virtual quality improvement meeting. Patient characteristics were compared using chi-square or Wilcoxon rank sum tests. Interrupted time series analysis (ITSA) was used to measure the immediate change in the proportion of CAP encounters receiving both the appropriate antibiotic choice and duration, as well as the change in slope from the preintervention to the postintervention periods. Choice and duration were analyzed separately using ITSA as a secondary analysis. Results: There were 817 CAP encounters, including 420 preintervention and 397 postintervention. Patients admitted in the postintervention period were older (median age 2 years vs 3 years, P=0.03), but otherwise there were no differences in race, ethnicity, sex, ICU admission, or complicated pneumonia. Preintervention, 52% of encounters received both the appropriate antibiotic choice and duration; 96% of encounters received the appropriate antibiotic choice and 54% received the appropriate duration. The ITSA demonstrated an immediate 16% increase in the proportion of patients receiving both appropriate antibiotic choice and duration (95% confidence interval, 1-31%; P = 0.047) and no significant further increase over time following the intervention (P = 0.84) (Figure 2). When antibiotic choice was analyzed separately by ITSA, there was no immediate change or change over time in the proportion of patients receiving the appropriate antibiotic choice. In the ITSA of duration alone, there was an immediate 17% increase in the proportion receiving the appropriate duration (95% confidence interval, 2-33%; P = 0.03) and no change over time. Conclusion: Feedback reports generated from electronically-derived metrics of antibiotic choice and duration, combined with ongoing clinician education, increased the proportion of children with CAP treated with the appropriate antibiotic duration. Electronic feedback reports are a scalable and impactful intervention to improve antibiotic use in children hospitalized with CAP.

Abstract To explore the interplay of NLO matching and next-to-leading logarithmic (NLL) parton showers, we consider the simplest case of γ * and Higgs-boson decays to q q ¯ $$ q\overline{q} $$ and gg respectively. Not only should shower NLL accuracy be retained across observables after matching, but for global event-shape observables and the two-jet rate, matching can augment the shower in such a way that it additionally achieves next-to-next-to-double-logarithmic (NNDL) accuracy, a first step on the route towards general NNLL. As a proof-of-concept exploration of this question, we consider direct application of multiplicative matrix-element corrections, as well as simple implementations of MC@NLO and POWHEG-style matching. We find that the first two straightforwardly bring NNDL accuracy, and that this can also be achieved with POWHEG, although particular care is needed in the handover between POWHEG and the shower. Our study involves both analytic and numerical components and we also touch on some phenomenological considerations.

Abstract We carry out extensive tests of the next-to-leading logarithmic (NLL) accuracy of the PanScales parton showers, as introduced recently for colour-singlet production in hadron collisions. The tests include comparisons to (semi-)analytic NLL calculations of a wide range of hadron-collider observables: the colour-singlet boson transverse momentum distribution; global and non-global hadronic energy flow variables related to jet vetoes and analogues of jettiness distributions; (sub)jet multiplicities; and observables sensitive to the DGLAP evolution of the incoming momentum fractions. In the tests, we also include an implementation of a standard transverse-momentum ordered dipole shower, to establish the size of missing NLL effects in such showers, which, depending on the observable, can reach 100%. This paper, together with [1], constitutes the first step towards process-independent NLL-accurate parton showers for hadronic collisions.

Background: Inappropriate antibiotic use for community-acquired pneumonia (CAP) is common. Although antibiotic stewardship activities require real-time, accurate identification of patients being treated for CAP, there are few reliable methods to identify such patients using the electronic health record (EHR). We conducted a retrospective study to assess the performance of provider-selected antibiotic indication in identifying patients being treated for CAP among a cohort of hospitalized adults. Methods: We randomly selected 440 patients from a cohort of patients who received at least 1 systemic antibiotic within 48 hours of admission between January 1, 2019, and December 31, 2021, at 3 acute-care hospitals. The reference standard for treatment of CAP was defined as intention to treat for pneumonia by inpatient provider(s) within 48 hours of admission, as assessed by chart review of provider notes. Treatment for pneumonia using any terminology except with “hospital-acquired pneumonia” (HAP) or “ventilator-associated pneumonia” (VAP) were counted. Provider-selected indication of CAP (in an antibiotic order) was compared against this reference standard; sensitivity, specificity, and positive and negative predictive values were calculated. Performance characteristics of International Classification of Disease, Tenth Revision (ICD-10) codes for pneumonia in identifying CAP patients were assessed against the same reference standard. A secondary analysis including terms HAP and VAP in the reference standard was performed. Results: Provider-selected antibiotic indication for CAP had a sensitivity of 64.4%, specificity of 96.3%, positive predictive value (PPV) of 73.1%, and negative predictive value (NPV) of 96.1%, giving comparable performance to ICD-10 codes (Table 1). Of those with 21 false-negative results, 13 (61.9%) had a healthcare-associated lower respiratory tract infection and 14 (66.7%) had sepsis indicated in at least 1 antibiotic order. Conclusions: Provider-selected antibiotic indication showed moderate sensitivity and high specificity for identifying CAP-treated cases. Importantly, use of this method can be deployed for real-time antibiotic stewardship interventions for CAP.

Background: Community-acquired pneumonia (CAP) is a common indication for antibiotic use in hospitalized children and is a key target for pediatric antimicrobial stewardship programs (ASPs). Building upon prior work, we developed and refined an electronic algorithm to identify children hospitalized with CAP and to evaluate the appropriateness of initial antibiotic choice and duration. Methods: We performed a cross-sectional study including children 6 months to 17 years hospitalized for CAP between January 1, 2019, and October 31, 2022, at a tertiary-care children’s hospital. CAP was defined electronically as an International Classification of Disease, Tenth Revision (ICD-10) code for pneumonia, a chest radiograph or chest computed tomography scan (CT) performed within 48 hours of admission, and systemic antibiotics administered within the first 48 hours of hospitalization and continued for at least 2 days. We applied the following exclusion criteria: patients transferred from another healthcare setting, those who died within 48 hours of hospitalization, children with complex chronic conditions, and those with intensive care unit stays >48 hours. Criteria for appropriate antibiotic choice and duration were defined based on established guidelines. Two physicians performed independent medical record reviews of 80 randomly selected patients (10% sample) to evaluate the performance of the electronic algorithm in (1) identifying patients treated for clinician-diagnosed CAP and (2) classifying antibiotic choice and duration as appropriate. A third physician resolved discrepancies. The electronic algorithm was compared to this medical record review, which served as the reference standard. Results: Of 80 children identified by the electronic algorithm, 79 (99%) were diagnosed with CAP based on medical record review. Antibiotic use was classified as the appropriate choice in 75 (94%) of 80 cases, and appropriate duration in 16 (20%) of 80 cases. The sensitivity of the electronic algorithm for identifying appropriate initial antibiotic choice was 94%; specificity could not be calculated because no events of inappropriate antibiotic choice were identified based on chart review. The sensitivity and specificity for determining appropriate duration were 88% and 97%, respectively (Table 1).

Abstract We introduce a simple procedure that resolves the long-standing question of how to account for single-logarithmic spin-correlation effects in parton showers not just in the collinear limit, but also in the soft wide-angle limit, at leading colour. We discuss its implementation in the context of the PanScales family of parton showers, where it complements our earlier treatment of the purely collinear spin correlations. Comparisons to fixed-order matrix elements help validate our approach up to third order in the strong coupling, and an appendix demonstrates the small size of residual subleading-colour effects. To help probe wide-angle soft spin correlation effects, we introduce a new declustering-based non-global spin-sensitive observable, the first of its kind. Our showers provide a reference for its single-logarithmic resummation. The work in this paper represents the last step required for final-state massless showers to satisfy the broad PanScales next-to-leading logarithmic accuracy goals.

Animal health laboratories are an increasingly important part of safeguarding animal and public health due to their role in surveillance and diagnostics of animal diseases, food safety, and in the development and production of medicinal products, vaccines, and diagnostic tools. Despite their importance, the global distribution of veterinary laboratory expertise is uneven, with greater concentration of reference laboratories in wealthier countries. To address this issue, the World Organization for Animal Health (WOAH, founded as OIE) created a Laboratory Twinning Programme in 2006. The paper will briefly review this Programme in the context of an increasingly populated global health security field, based on a literature review and on a combination of public and internal WOAH data and describe the implementation of the Programme in the past 16 years, noting the drivers for project implementation, its links with the global livestock biomass distribution and with the current distribution of veterinary laboratory expertise. There has been broad uptake and diversity in the focus of the twinning projects implemented in WOAH Member Countries. The Laboratory Twinning Programme would benefit from an evaluation that looks at its outcomes and quantifiable impact in beneficiary countries. A case is made for the development of a monitoring and evaluation system tailored to the Programme's specificities.

Abstract Standard dipole parton showers are known to yield incorrect subleading-colour contributions to the leading (double) logarithmic terms for a variety of observables. In this work, concentrating on final-state showers, we present two simple, computationally efficient prescriptions to correct this problem, exploiting a Lund-diagram type classification of emission regions. We study the resulting effective multiple-emission matrix elements generated by the shower, and discuss their impact on subleading colour contributions to leading and next-to-leading logarithms (NLL) for a range of observables. In particular we show that the new schemes give the correct full colour NLL terms for global observables and multiplicities. Subleading colour issues remain at NLL (single logarithms) for non-global observables, though one of our two schemes reproduces the correct full-colour matrix-element for any number of energy-ordered commensurate-angle pairs of emissions. While we carry out our tests within the PanScales shower framework, the schemes are sufficiently simple that it should be straightforward to implement them also in other shower frameworks.

Abstract The World One Health Congresses are biennial gatherings of approximately 1500 professionals from relevant international organisations, OIE, FAO, WHO, World Bank, leading scientific experts and researchers in the field of One Health, animal production and trade, food safety, animal health, human health and environmentology/ecology, government representatives in public health, human health, food safety, environmental health and global health security. The Congress is organized by the One Health Platform. This white paper summarizes highlights of the 5th International One Health Congress in Saskatoon, Canada, June 2018 and serves as a roadmap for the future, detailing several concrete action points to be carried out in the run-up to the 6th World One Health Congress in Edinburgh, Scotland, June 2020.

The conclusions are unchanged.

Abstract We formulate some first fundamental elements of an approach for assessing the logarithmic accuracy of parton-shower algorithms based on two broad criteria: their ability to reproduce the singularity structure of multi-parton matrix elements, and their ability to reproduce logarithmic resummation results. We illustrate our approach by considering properties of two transverse-momentum ordered final-state showers, examining features up to second order in the strong coupling. In particular we identify regions where they fail to reproduce the known singular limits of matrix elements. The characteristics of the shower that are responsible for this also affect the logarithmic resummation accuracies of the shower, both in terms of leading (double) logarithms at subleading N C and next-to-leading (single) logarithms at leading N C .

Abstract We present a next-to-leading order accurate simulation of t-channel single-top plus jet production matched to parton showers via the Powheg method. The calculation underlying the simulation is enhanced with a process-specific implementation of the multi-scale improved NLO (Minlo) method, such that it gives physical predictions all through phase space, including regions where the jet additional to the t-channel single-top process is unresolved. We further describe a tuning procedure for the Minlo Sudakov form factor, fitting the coefficient of the first subleading term in its exponent using an artificial neural-network. The latter tuning, implemented as a straightforward event-by-event reweighting, renders the Minlo simulation NLO accurate for t-channel single-top observables, in addition to those of the analogous single-top plus jet process.

Some aerobic bacteria contain a biotin-independent malonate decarboxylase (MDC), which allows them to use malonate as the sole carbon source. Here, the authors present the crystal structure of a Pseudomonas MDC and give insights into its catalytic mechanism and function.

Steep declines in North American monarch butterfly (Danaus plexippus) populations have prompted continent-wide conservation efforts. While monarch monitoring efforts have existed for years, we lack a comprehensive approach to monitoring population vital rates integrated with habitat quality to inform adaptive management and effective conservation strategies. Building a geographically and ecologically representative dataset of monarchs and their habitat will improve these efforts. These data will help track long-term changes in the distribution and abundance of monarchs and their habitats, refine population and habitat models, and illuminate how conservation activities affect monarchs and their habitats. The Monarch Conservation Science Partnership developed the Integrated Monarch Monitoring Program (IMMP) to profile breeding habitats and their use by monarchs in North America. A spatially balanced random sampling framework guides site selection, while also allowing opportunistic inclusion of sites chosen by participants, such as conservation areas. The IMMP weaves new protocols together with those from existing monitoring programs to improve data compatibility for assessing milkweed (Asclepias spp.) density, nectar resources, monarch reproduction and survival, and adult monarch habitat use. Participants may select a protocol subset according to interests or local monitoring objectives, thereby maximizing contributions. Conservation partners, including public and private land managers, academic researchers, and citizen scientists contribute data to a national dataset available for analyses at multiple scales. We describe the program and its development, implementation elements that make the program robust and feasible, participation to date, and how IMMP data can advance research and conservation for monarchs, pollinators, and their habitats.

In 2011, the world was declared free from rinderpest, one of the most feared and devastating infectious diseases of animals. Rinderpest is the second infectious disease, after smallpox, to have been eradicated. However, potentially infectious rinderpest virus material remains widely disseminated among research and diagnostic facilities across the world and poses a risk for disease recurrence should it be released. Member Countries of the World Organisation for Animal Health and the Food and Agricultural Organization of the United Nations are committed to destroying remaining stocks of infectious material or ensuring that it is stored under international supervision in a limited number of approved facilities. To facilitate this commitment and maintain global freedom from rinderpest, World Organisation for Animal Health Member Countries must report annually on rinderpest material held in their countries. The first official surveys, conducted during 2013–2015, revealed that rinderpest material was stored in an unacceptably high number of facilities and countries.

Assessing progression of disease or response to treatment remains a major challenge in the clinical management of nontuberculous mycobacterial (NTM) infections of the lungs. Serial assessments of validated measures of treatment response address whether the current therapeutic approach is on track toward clinical cure, which remains a fundamental question for clinicians and patients during the course of NTM disease treatment. The 2015 NTM Research Consortium Workshop, which included a patient advisory panel, identified treatment response biomarkers as a priority area for investigation. Limited progress in addressing this challenge also hampers drug development efforts. The Biomarker Qualification Program at the FDA supports the use of a validated treatment response biomarker across multiple drug development programs. Current approaches in clinical practice include microbiologic and radiographic monitoring, along with symptomatic and quality-of-life assessments. Blood-based monitoring, including assessments of humoral and cell-mediated NTM-driven immune responses, remain under investigation. Alignment of data collection schemes in prospective multicenter studies, including the support of biosample repositories, will support identification of treatment response biomarkers under standard-of-care and investigational therapeutic strategies. In this review, we outline the role of treatment monitoring biomarkers in both clinical practice and drug development frameworks.

Wild birds play a major role in the evolution, maintenance, and spread of avian influenza viruses. However, surveillance for these viruses in wild birds is sporadic, geographically biased, and often limited to the last outbreak virus. To identify opportunities to optimize wild bird surveillance for understanding viral diversity, we reviewed responses to a World Organisation for Animal Health–administered survey, government reports to this organization, articles on Web of Knowledge, and the Influenza Research Database. At least 119 countries conducted avian influenza virus surveillance in wild birds during 2008–2013, but coordination and standardization was lacking among surveillance efforts, and most focused on limited subsets of influenza viruses. Given high financial and public health burdens of recent avian influenza outbreaks, we call for sustained, cost-effective investments in locations with high avian influenza diversity in wild birds and efforts to promote standardized sampling, testing, and reporting methods, including full-genome sequencing and sharing of isolates with the scientific community.

We report a case of Lassa fever in a US traveler who visited rural Liberia, became ill while in country, sought medical care upon return to the United States, and subsequently had his illness laboratory confirmed. The patient recovered with supportive therapy. No secondary cases occurred.

Aims: Current data suggest that SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) emerged from an animal source. However, to date, there is insufficient scientific evidence to identify the source of SARS‐CoV‐2 or to explain the original route of transmission to humans. A wide range of mammalian species have been shown to be susceptible to the virus through experimental infection, and in natural environments when in contact with infected humans. The main objective of this work was to provide a summary of the official data shared by countries on SARS‐CoV‐2 in animals with the World Organisation for Animal Health (WOAH), to highlight the role of WOAH as an international organization in coordinating scientific information actions and to discuss the implications and impact of these activities. Methods and Results: Between January 2020 and December 2022, 36 countries in Europe, the Americas, Asia and Africa officially reported SARS‐CoV‐2 identification in 26 animal species. Affected countries were generally responsive in confirming the pathogen (median of 5 days after onset) and reporting to WOAH (median of 7 days after confirmation). Conclusions: During the pandemic, WOAH, supported by its network of experts, played a crucial role in collecting, analysing and disseminating veterinary scientific information, acting as the reference organization on these issues, thus avoiding misinformation and disinformation. Future perspectives to avoid new emerging threats are discussed. [ABSTRACT FROM AUTHOR]