Advancement of antimicrobial stewardship (AS) programs requires partnership with clinicians, quality assurance teams, and laboratorians. Inevitably, AS programs also practice diagnostic stewardship (DS), as stewards are aptly placed to connect key stakeholders and help steer processes toward higher value care for pediatric patients. In this review, we illustrate five moments of collaboration between stakeholders in the interplay between AS and DS in pediatrics. These moments include (1) Observation, (2) Reflection, (3) Exploration, (4) Enactment and (5) Evaluation. We offer a targeted narrative of examples in current literature using common relatable scenarios (ie, endotracheal aspirates, blood cultures, gastrointestinal samples, and urine testing) including impact on financial and environmental waste.

Patent ductal arteriosus stenting is an alternative procedure in patients with pulmonary-ductal-dependent circulation. Stent embolization is one of the major acute complications of ductal stenting procedure. We describe the case of a stent embolization into the abdominal aorta during the deployment of ductal stent in a premature low-weight infant (1.850 kg), affected by critical pulmonary stenosis and duct-dependent pulmonary circulation. The stent was successfully retrieved through a 4F Flexor catheter without vascular complication by using a new approach.

This article focuses on the problem of the categorization of the adverb sans doute as an epistemico-modal marker or an evidential marker. Starting from a critical appraisal of an analysis proposed by Bourmayan et Ashino, in which sans doute is considered fundamentally epistemico-modal, three hypotheses are presented, which depart from theirs. First, sans doute has as its main lexical element an inferential evidential value: it signals that the content qualified by the adverb is the result of a defeasible type of inference from clues/premises. Second, due to the defeasibility of the inference, the statement containing the adverb takes on, invariably, a pragmatic value of non-certainty, not lexically coded, however. Sans doute is thus not an epistemico-modal marker by itself in contemporary French. Third, the adverb combines these values with an epistemic value of what we call “posture of certainty”. Different from epistemic modality, which refers to an evaluation in terms of certainty, and/or to the epistemic cognitive state linked to that, posture of certainty refers to what can be called the tone or epistemic behavior of confidence the speaker shows. Sans doute therefore indicates without contradiction, a defeasible and, thus, uncertain hypothesis, presented with a tone of full confidence.

Basal bark application involves applying an oil-soluble herbicide in an oil carrier to the lower 0 to 45-cm of woody stems. For triclopyr, basal bark application typically requires the butoxyethyl ester formulation; however, this cannot be applied when standing water is present, which is common in seasonally flooded wetlands. Recently, the intermediate oil and water-soluble triclopyr acid formulation was registered for use in aquatic sites, allowing for basal bark applications in wetlands where standing water is present. Recent studies indicated that flooding after basal bark treatment can result in triclopyr release to surface waters and subsequent non-target injury. Elevated band application height (i.e., treating a higher band on each stem) may reduce non-target injury potential; however, this modified application technique has not been well tested on woody invasive species. To evaluate this approach, a field study on Schinus terebinthifolia was conducted near Melbourne and Wimauma, FL on well-established and juvenile rootstocks. Treatments included triclopyr acid at 17, 34, and 69 g L-1 applied in an oil carrier and treatment band heights of 0 to 45-cm and 61 to 107-cm from the ground line. At Melbourne, both band heights treated with 34 or 69 g L-1 resulted in 75 to 100% mortality of mature rootstocks. However, triclopyr applied at 17 g L-1 to the low and elevated band heights resulted in 70 and 11% mortality, respectively. All treatments resulted in 90 to 100% mortality at Wimauma, where the rootstocks were juvenile and much smaller. These findings indicate elevated band heights may be a useful approach for woody plant control and may support an effective management strategy in inundated wetlands that provides better prevention of non-target injury.

How do sociolegal scholars who liken monetary sanctions to “bleeding a turnip” or “drawing blood from stones” reconcile these idioms with the fact that fines and fees constitute a growth industry? We take up this puzzle by turning our attention to perhaps the most relatable experience with monetary sanctions among the population: parking tickets. Much of the available law and society literature on fines and fees documents how these sanctions disproportionately impact communities subjugated by race and class. Because parking tickets are adjudicated within a legal domain so fundamentally different from fines and fees that dominate the academic focus, we ask whether these insights extend outside criminal counts to municipal ones. Using Chicago as a case study, our inquiry measures the structural determinants of 11.3 million tickets issued between 2013 and 2017. We use a series of count models to predict the incidence rates of tickets at the tract level as well as how many were subject to reprimands for nonpayment. What we find are disparate patterns of racialization in terms of who is targeted by these sanctions versus who is devastated by them. We synthesize key ideas from empirical critical race theory and developing work on predation theory to make sense of these findings.

This Article draws upon and connects three different developments: the ‘internationalisation’ of tax law and EU tax law, specifically; the increasing digitalisation of the economy, and the European Union’s need for more revenue to deal with the financial consequences of the COVID-19 pandemic and other policy priorities. It is explained why the taxation of data per se cannot be addressed at the global level at present and why the focus of research has to lie on the taxation of the different business models of the digital economy. In the absence of a global agreement as to how the digital economy should be taxed, the reaction of the European Union to such a fundamental undertaking remains uncertain and politically contingent on the outcomes of negotiation at the OECD level. Most particularly, on the so-called Pillar One agreement. A seemingly temporal solution to the taxation of the digital economy, the so-called DSTs (Digital Services Taxes) have been adopted by Member States of the EU and third countries, but their future remains uncertain. Amidst these developments, the EU has also looked for ways to increase its resources and to finance its post-Covid ambitious recovery plan. This need has led to a reconsideration of whether EU taxes could finance the EU budget (next to the Union’s own resources, which remain for the main part transfers from Member States). In this Article, I argue that beyond tax design considerations and potential constitutional impediments, the EU revenue side should be emphasised in the discussion. Therefore, I suggest that the Union should ensure that at least part of the revenue arising from digital taxation should be channeled to the supranational budget. Whether Pillar One gets adopted or not, the potential introduction of an EU digital levy, ideally by way of an EU tax, could help overcoming several shortcomings of the present tax status quo and could result in an increase of the resources at the disposal of the EU in a fashion compatible with the imperatives of democratic legitimacy.

Adults have an interconnected lexicon in which two words are related because their referents belong to the same semantic category, because they occur in the same context, or both. This interconnection has been explored by means of the priming effect, in which people respond more rapidly to related than to unrelated words and benefit from the lexical boost when the two types of interconnections are combined. Although substantial research has reported on the memory problems of people diagnosed with Alzheimer’s disease (AD), it remains unknown whether they experience problems with related words at these levels of comprehension. This study analyzed the lexical networks of older adults with AD and typically aging (TA) adults to understand their semantic memory related to word associations. We tested combined taxonomic-thematic, purely taxonomic, and purely thematic relationships using an eye tracker to analyze fixations to a named target picture preceded by a related or unrelated prime word. Participants with TA showed a priming effect in all three types of relationships, but those with AD showed this effect only with purely thematic pairs. Words that share more than one level of relationship seem to create competition, revealing a deficit in the lexical networks of people with AD.

We aimed to identify risk factors related to COVID-19 reinfection in Hong Kong. We performed a population-based retrospective cohort study and reviewed case-based data on COVID-19 infections reported to the Centre for Health Protection from 8 January 2020 to 29 January 2023. We analyzed the epidemiology of COVID-19 infections and performed a Cox regression analysis. In this period, 3.32% (103,065/3,106,579) of COVID-19 infections recorded were classified as reinfection. Compared with primarily infected cases, a higher proportion of re-infected cases had chronic diseases (33.54% vs. 27.27%) and were residents of residential care homes (RCH) (10.99% vs. 1.41%). The time interval between the two episodes ranged from 31 to 1,050 days (median 282 days). Cox regression analysis of Omicron cases with the adjustment of covariates showed that being female (Hazard Ratio [HR] 1.12, 95% CI 1.11–1.13), chronic diseases (HR 1.18, 95% CI 1.16–1.20) and RCH residents (HR 6.78, 95% CI 6.61–6.95) were associated with reinfection, while additional vaccination after primary infection was protective (HR 0.80, 95% CI 0.79–0.81). Further analytical studies on the risk factors and protectors of COVID-19 reinfection are needed to guide targeted interventions.

Many historians continue to regard the killing of prisoners and potential prisoners on the battlefield as having been an absolute exception during the Great War, something that was ‘episodic’ and happened only ‘in isolated cases’. One reason for this assessment might be the fact that the subject has rarely been examined empirically. This article is the first study directly to compare the actions of the British and the Canadians, the Empire’s two largest armies on the western front. Drawing on a wide range of primary source material, including, for the first time, unit war diaries and after-action reports, this article reveals that documentary evidence exists for scores of separate instances of prisoner killing by British and Canadian troops deployed against German forces between August 1914 and November 1918, with the number of dead ranging from individual enemy soldiers to several hundred victims at once. Examples are recorded of prisoner killing by enlisted men, NCOs and officers, acting either in groups or alone, and furthermore of officers at platoon, battalion, regimental and even corps level either encouraging prisoner killing or issuing explicit ‘take no prisoners’ orders. The level of acceptance that commanders showed for these practices, the openness with which soldiers discussed them in their letters home to mothers, sisters and wives, and the almost complete absence of any disciplinary action against the perpetrators indicate that – on some level – they were regarded as legitimate.

The article analyses how Russian state-controlled media adapt narratives across their language versions to speak to specific national audiences. These media support the Kremlin by echoing its strategic narratives in the international arena. Our article stems from the assumption that the media tailor the narratives and do not deliver homogenous news. Texts published since the initial days of the Russian invasion of Ukraine were analyzed from Sputnik Czech Republic, Germany, and Sputnik World, known to spread the Russian regime’s propaganda. The central question was how the Russian regime depicted and explained the invasion of Ukraine in 2022 in the chosen languages. Qualitative coding based on a predefined codebook, modified with codes inductively acquired during the analysis, was used to deeply understand strategic narratives and identify key differences among the Russian regime’s influence campaigns in various national contexts. Some narratives were found to differ based on the national contexts, strengthening the initial assumption. However, analyzed texts also consistently depict Russia as a victim and the West as a threat across the language versions.

Toxocara canis is a widespread parasite of canids with a wide range of paratenic hosts, but also one of the overlooked agents causing nervous system infections of humans. Previous experimental infections of mice demonstrated the impact of high infection doses of larvae on neurobehavioral disorders and pathological changes. In contrast to previous studies, we aimed to investigate the long-term (up to 100 weeks) impact of low- to high-dose infection in mice. We focused on their physical condition, motor skills, and the accompanying pathologies in the brain. Three groups of BALB/c mice were infected with 10, 100, and 1000 T. canis larvae/mouse and specific anti-T. canis excretory-secretory antigens immunoglobulin G antibody response, general condition, and motor skills were tested in defined intervals within 100 weeks after infection. The number of larvae in selected organs was assessed and the pathological changes in the brain were studied histologically. As a result, subtle to severe impairments in general condition and motor skills were detected, with generally earlier onsets occurring the higher the infection dose was. The specific immunoglobulin G antibody levels corresponding to the infection dose were detected in all infected groups. Necrosis, cellular infiltrations, and foamy cells developed in moderate- and high-infection dose mice, in contrast with hemorrhages detected in all groups. This study demonstrated the long-term negative impact of T. canis infection on the paratenic host, particularly at moderate and high infectious doses. Although pathological changes in the brain were observed even in low-infection dose mice, their physical and motor condition was comparable to the control group.

Analysing hierarchical design processes is difficult due to the technical and organizational dependencies spanning over multiple levels. The V-Model of Systems Engineering considers multiple levels. It is, however, not quantitative. We propose a model for simulating hierarchical product design processes based on the V-Model. It includes, first, a product model which structures physical product properties in a hierarchical dependency graph; second, an organizational model which formalizes the assignment of stakeholder responsibility; third, a process model which describes the top-down and bottom-up flow of design information; fourth, an actor model which simulates the combination of product, organization and process by using computational agents. The quantitative model is applied to a simple design problem with three stakeholders and three separate areas of responsibility. The results show the following phenomena observed in real-world product design: design iterations occur naturally as a consequence of the designers’ individual behaviour; inconsistencies in designs emerge and are resolved. The simple design problem is used to compare point-based and interval-based requirement decomposition quantitatively. It is shown that development time can be reduced significantly by using interval-based requirements if requirements are always broken down immediately.

Growing evidence highlights the critical role of patient choice of treatment, with significant benefits for outcomes found in some studies. While four meta-analyses have previously examined the association between treatment choice and outcomes in mental health, robust conclusions have been limited by the inclusion of studies with biased preference trial designs. The current systematic review included 30 studies across three common and frequently comorbid mental health disorders (depression N = 23; anxiety, N = 5; eating disorders, N = 2) including 7055 participants (Mage 42.5 years, SD 11.7; 69.5% female). Treatment choice most often occurred between psychotherapy and antidepressant medication (43.3%), followed by choice between two different forms of psychotherapy, or elements within psychotherapy (36.7%). There were insufficient studies with stringent designs to conduct meta-analyses for anxiety or eating disorders as outcomes, or for treatment uptake. Treatment choice significantly improved outcomes for depression (d = 0.17, n = 18) and decreased therapy dropout, both in a combined sample targeting depression (n = 12), anxiety (n = 4) and eating disorders (n = 1; OR = 1.46, 95% CI: 1.17, 1.83), and in a smaller sample of the depression studies alone (OR = 1.65, 95% CI: 1.05, 2.59). All studies evaluated the impact of adults making treatment choices with none examining the effect of choice in adolescents. Clear directions in future research are indicated, in terms of designing studies that can adequately test the treatment choice and outcome association in anxiety and eating disorder treatment, and in youth.

As a result of analysis of the ice cover, geological structure and tectonics of the underlying rocks in the Lake Vostok area of Antarctica, a layered sub-horizontal structure of the ice cover and a distribution of the parameters of the ice composition were established. The physical and mechanical properties of the underlying rocks were determined experimentally. Complex tectonics revealed an increase in geothermal flow in the Vostok Basin region, which plays a role in the evolution of the Earth's crust and in shaping the morphology of its physical properties. A three-dimensional geomechanical model of the unified system ‘glacier-Lake Vostok-bedrock ’ was constructed and investigated. Regularities in the changes to the stress-strain state were revealed. Zones of development of plastic deformation in the ice cover along the perimeter of Lake Vostok and their distribution over the lake were established, which were confirmed by results from field observations. Modelling of geomechanical processes shows that the change in the mechanical state of the Earth's crust, taking into account the creep deformation of the ice sheet, relates more to nonlinear dynamic systems, which are characterized by unstable changes and should be considered as fractal systems.