The Friend Who Helps You Move, but Is Really Only There for the Free Beer and Pizza: An Update on Antimicrobial Susceptibility Testing (AST) and Breakpoints for Companion Animal Dermatology.

Antimicrobial resistance is a significant public health threat and a major challenge for treatment of companion animal skin infections. Antimicrobial susceptibility testing (AST) is a critical tool which clinicians should employ when a patient may need antimicrobials beyond those deemed "first-tier." Clinicians may have noted that many more isolates of Staphylococcus sp.

A model of occupational stress to assess impact of COVID-19 on critical care and redeployed nurses: a mixed-methods study.

Objective: To use the job demands-resources model of occupational stress to quantify and explain the impact of working in critical care during the COVID-19 pandemic on nurses and their employing organisation.

Design: Two-phase mixed methods: a cross-sectional survey (January 2021-March 2022), with comparator baseline data from April to October 2018 (critical care nurses only), and semistructured interviews.

Participants: Critical care nurses ( = 461) and nurses redeployed to critical care ( = 200) who worked in the United Kingdom National Health Service (primarily Scotland) between January 2021 and March 2022.

Canine Multidrug-Resistant Pseudomonas aeruginosa Cases Linked to Human Artificial Tears-Related Outbreak.

We report 2 canine cases of carbapenemase-producing Pseudomonas aeruginosa within a United States veterinary hospital associated with a human outbreak linked to over-the-counter artificial tears. We investigated veterinary hospital transmission. Veterinary antimicrobial resistance surveillance and infection prevention and control enhancements are needed to reduce transmission of carbapenemase-producing organisms.

A causal inference framework for leveraging external controls in hybrid trials.

We consider the challenges associated with causal inference in settings where data from a randomized trial are augmented with control data from an external source to improve efficiency in estimating the average treatment effect (ATE). This question is motivated by the SUNFISH trial, which investigated the effect of risdiplam on motor function in patients with spinal muscular atrophy. While the original analysis used only data generated by the trial, we explore an alternative analysis incorporating external controls from the placebo arm of a historical trial.

Initial Validation of a Survey Instrument to Evaluate Veterinary Student Self-Efficacy for Antimicrobial Selection in the United States.

Antimicrobial resistance (AMR) is a major threat to human and animal health, and antimicrobial use selects for AMR. Appropriate selection of antimicrobial drugs is an important part of veterinary education, but many veterinary students report that they have knowledge gaps in this area. Students with greater self-efficacy, the belief that one can perform the individual steps that comprise a task, tend to expend more effort and motivation in learning new skills.

A Multicenter Evaluation of a Metacognitive Framework for Antimicrobial Selection Education.

Antimicrobial selection is a complex task for veterinary students there is a need for both assessment tools and novel strategies to promote the proper use of antimicrobials. SODAPOP (Source-Organism-Decided to treat-Antimicrobials-Patient- Option-Plan) is a mnemonic previously designed to aid in developing antimicrobial selection skills by promoting metacognition. To assess the effect of this tool, we enrolled veterinary students ( = 238) from five veterinary teaching institutions in a study that consisted of an online survey that contained a video-based intervention.

Development of a Competency-Based Veterinary Education Diversity, Equity, Inclusion, and Justice Domain.

A group of veterinary educators with diverse backgrounds and interests from five universities in the northeastern region of the United States convened in December 2020 to address challenges in diversity, equity, inclusion, and justice (DEIJ) in veterinary education. It was elected to develop a DEIJ-specific competency domain to supplement the nine domains previously described in the Competency-Based Veterinary Education framework. The domain that we created provides a detailed but flexible roadmap that can be used to guide curriculum-development initiatives that support learner development in DEIJ and, as a result, enhance their impact in working teams and the communities in which they will live and practice.

EXPOSURE EFFECTS ON COUNT OUTCOMES WITH OBSERVATIONAL DATA, WITH APPLICATION TO INCARCERATED WOMEN.

Causal inference methods can be applied to estimate the effect of a point exposure or treatment on an outcome of interest using data from observational studies. For example, in the Women's Interagency HIV Study, it is of interest to understand the effects of incarceration on the number of sexual partners and the number of cigarettes smoked after incarceration. In settings like this where the outcome is a count, the estimand is often the causal mean ratio, i.

Empirical Sandwich Variance Estimator for Iterated Conditional Expectation g-Computation.

Iterated conditional expectation (ICE) g-computation is an estimation approach for addressing time-varying confounding for both longitudinal and time-to-event data. Unlike other g-computation implementations, ICE avoids the need to specify models for each time-varying covariate. For variance estimation, previous work has suggested the bootstrap.

Clinical course and radiographic resolution of pneumonia in dogs treated with a shorter versus longer course of antimicrobials: a randomized, double-masked, placebo-controlled study.

Objective: To describe clinical and radiographic outcomes in dogs with uncomplicated pneumonia receiving a shorter (2-week) versus longer (4-week) duration of antimicrobial therapy.

Animals: 30 client-owned dogs with radiographic evidence of pneumonia.

Methods: Dogs were randomly assigned to either a 2-week course of antimicrobials followed by a 2-week course of placebo medication (2-week group) or a 4-week course of antimicrobials (4-week group).

Bacterial Prostatitis Secondary to Salmonella enterica serovar Enteritidis in an Immunocompetent Dog.

Salmonella is a rod-shaped gram-negative bacterium of the family Enterobacteriaceae, commonly present in the gastrointestinal tract in humans and animals. Salmonella-associated bacteriuria and prostatitis are rare but have been reported in humans, predominantly older patients with underlying diseases, including urinary tract obstructions, diabetes mellitus, and compromised immunity. In dogs, Salmonella bacteriuria and prostatitis have only been described in patients on immunosuppressive medications.

Bridged Treatment Comparisons: an Illustrative Application in HIV Treatment.

Comparisons of treatments, interventions, or exposures are of central interest in epidemiology, but direct comparisons are not always possible due to practical or ethical reasons. Here, we detail a fusion approach to compare treatments across studies. The motivating example entails comparing the risk of the composite outcome of death, AIDS, or greater than a 50% CD4 cell count decline in people with HIV when assigned triple versus mono antiretroviral therapy, using data from the AIDS Clinical Trial Group (ACTG) 175 (mono versus dual therapy) and ACTG 320 (dual versus triple therapy).

Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps.

Importance: Accurate assessment of gestational age (GA) is essential to good pregnancy care but often requires ultrasonography, which may not be available in low-resource settings. This study developed a deep learning artificial intelligence (AI) model to estimate GA from blind ultrasonography sweeps and incorporated it into the software of a low-cost, battery-powered device.

Objective: To evaluate GA estimation accuracy of an AI-enabled ultrasonography tool when used by novice users with no prior training in sonography.

Semiparametric g-computation for survival outcomes with time-fixed exposures: An illustration.

Purpose: Generalized (g-) computation is a useful tool for causal inference in epidemiology. However, in settings when the outcome is a survival time subject to right censoring, the standard pooled logistic regression approach to g-computation requires arbitrary discretization of time, parametric modeling of the baseline hazard function, and the need to expand one's dataset. We illustrate a semiparametric Breslow estimator for g-computation with time-fixed treatments and survival outcomes that is not subject to these limitations.

M-estimation for common epidemiological measures: introduction and applied examples.

M-estimation is a statistical procedure that is particularly advantageous for some comon epidemiological analyses, including approaches to estimate an adjusted marginal risk contrast (i.e. inverse probability weighting and g-computation) and data fusion.

Clinical Differences in Dogs with Enterococcal Bacteriuria Compared with Other Bacteriuria: A Retrospective, Case-Control Study.

A retrospective case-control study was performed to determine the clinical differences between dogs with enterococcal bacteriuria (n = 96 cases) and control dogs with any other bacteriuria (n = 288). More dogs with nonenterococcal bacteriuria demonstrated lower urinary tract clinical signs such as hematuria, pollakiuria, and stranguria (40% versus 27%, P = .02).

A One Health perspective on the use of genotypic methods for antimicrobial resistance prediction.

Antimicrobial resistance is a global One Health concern with critical implications for the health of humans, animals, and the environment. Phenotypic methods of bacterial culture and antimicrobial susceptibility testing remain the gold standards for the detection of antimicrobial resistance and appropriate patient care; however, genotypic-based methods, such as PCR, whole genome sequencing, and metagenomic sequencing, for detection of genes conferring antimicrobial resistance are increasingly available without inclusion of appropriate standards for quality or interpretation. Misleading test results may lead to inappropriate antimicrobial treatment and, in turn, poor patient outcomes and the potential for increased incidence of antimicrobial resistance.

Current state and future directions for veterinary antimicrobial resistance research.

Antimicrobial resistance (AMR) is a critical One Health concern with implications for human, animal, plant, and environmental health. Antimicrobial susceptibility testing (AST), antimicrobial resistance testing (ART), and surveillance practices must be harmonized across One Health sectors to ensure consistent detection and reporting practices. Veterinary diagnostic laboratory stewardship, clinical outcomes studies, and training for current and future generations of veterinarians and laboratorians are necessary to minimize the spread of AMR and move veterinary medicine forward into an age of better antimicrobial use practices.

Higher-order evidence.

Higher-order evidence is evidence about evidence. Epidemiologic examples of higher-order evidence include the settings where the study data constitute first-order evidence and estimates of misclassification comprise the second-order evidence (e.g.

The PRotective Effect of Maternal Immunisation on preTerm birth: characterising the Underlying mechanisms and Role in newborn immune function: the PREMITUR study protocol.

Maternal immunisation, a low cost and high efficacy intervention is recommended for its pathogen specific protection. Evidence suggests that maternal immunisation has another significant impact: reduction of preterm birth (PTB), the single greatest cause of childhood morbidity and mortality globally. Our overarching question is: how does maternal immunisation modify the immune system in pregnant women and/or their newborn to reduce adverse pregnancy outcomes and enhance the newborn infant's capacity to protect itself from infectious diseases during early childhood? To answer this question we are conducting a multi-site, prospective observational cohort study collecting maternal and infant biological samples at defined time points during pregnancy and post-partum from nulliparous women.

Estimating SARS-CoV-2 seroprevalence.

Governments and public health authorities use seroprevalence studies to guide responses to the COVID-19 pandemic. Seroprevalence surveys estimate the proportion of individuals who have detectable SARS-CoV-2 antibodies. However, serologic assays are prone to misclassification error, and non-probability sampling may induce selection bias.

Fusing trial data for treatment comparisons: Single vs multi-span bridging.

While randomized controlled trials (RCTs) are critical for establishing the efficacy of new therapies, there are limitations regarding what comparisons can be made directly from trial data. RCTs are limited to a small number of comparator arms and often compare a new therapeutic to a standard of care which has already proven efficacious. It is sometimes of interest to estimate the efficacy of the new therapy relative to a treatment that was not evaluated in the same trial, such as a placebo or an alternative therapy that was evaluated in a different trial.