A Quality Assessment of a Collaborative Model of a Pediatric Antimicrobial Stewardship Program

BACKGROUND: Infectious Diseases Society of America guidelines recommend that key antimicrobial stewardship program (ASP) personnel include an infectious disease (ID) physician leader and dedicated ID-trained clinical pharmacist. Limited resources prompted development of an alternative model by using ID physicians and service-based clinical pharmacists at a pediatric hospital. The aim of this study was to analyze the effectiveness and impact of this alternative ASP model. METHODS: The collaborative ASP model incorporated key strategies of education, antimicrobial restriction, day 3 audits, and practice guidelines. High-use and/or high-cost antimicrobial agents were chosen with audits targeting vancomycin, caspofungin, and meropenem. The electronic medical record was used to identify patients requiring day 3 audits and to communicate ASP recommendations. Segmented regression analyses were used to analyze quarterly antimicrobial agent prescription data for the institution and selected services over time. RESULTS: Initiation of ASP and day 3 auditing was associated with blunting of a preexisting increasing trend for caspofungin drug starts and use and a significant downward trend for vancomycin drug starts (relative change -12%) and use (-25%), with the largest reduction in critical care areas. Although meropenem use was already low due to preexisting requirements for preauthorization, a decline in drug use (-31%, P = .021) and a nonsignificant decline in drug starts (-21%, P = .067) were noted. A 3-month review of acceptance of ASP recommendations found rates of 90%, 93%, and 100% for vancomycin, caspofungin, and meropenem, respectively. CONCLUSIONS: This nontraditional ASP model significantly reduced targeted drug usage demonstrating acceptance of integration of service-based clinical pharmacists and ID consultants

Cultivating Resilience in the Biodiversity Heritage Library During the Global Pandemic: Improving access to existing content

The events of 2020, including the COVID-19 pandemic and social justice demonstrations around the world, helped the Biodiversity Heritage Library (BHL) refocus our priorities for implementing our 2020–2025 Strategic Plan, which was adopted in April 2020. BHL’s natural ecosystem relies on virtual coordination across our global community. For this reason, much of the work of the consortium could continue during lockdowns and telework mandates at many of our partner institutions. Though most digitization projects were placed on hold, staff were able to shift priority to metadata enhancements to improve access and discoverability of existing content. Long-planned improvements in the use of persistent identifiers were pushed to the forefront of technical development. Improvements to the data model and user interface to better support born-digital content and articles were also prioritized in the 2021 Technical Priorities. Back-end improvements to the BHL website, currently under development, will also facilitate easier metadata import and updates, making it faster and easier to add article-level metadata, which will improve search and discoverability for articles within the collection. These technical improvements will continue to define BHL as a tool to connect biodiversity data. Part of our collaborative resilience is our ability to adapt and adjust to changing priorities. Over the past year, BHL has been working to review and update our Collection Development Policy. Social justice movements and discussions concerning the harmful content in BHL’s collection are helping to inform the review of our collection development policy in ways we wouldn’t have anticipated prior to 2020. Our review now includes strategies to identify gaps in and improve representation of biodiversity information from underrepresented regions, languages, cultures, and perspectives. We are also working with colleagues to support larger efforts within the library profession to improve and broaden metadata such as subject headings. We will continue to address the problematic historical legacy of natural history collections through actions defined in our strategic plan. The isolation and work from home orders of 2020 and early 2021 provided opportunities for some to expand into deep research and contribute to collaborative projects as work assignments became digital and thus more versatile. For example, transcription projects were accelerated because staff had more time to contribute to these resource-intensive activities. One result of this work is that more handwritten materials such as field notes and correspondence are now available for full-text searching and taxonomic name recognition within BHL.   Another strategic goal of BHL is to grow consortial partnerships and alliances to foster cross-institutional collaboration. BHL sought new partnerships that would integrate BHL data into existing and emerging biodiversity projects. This cross-institutional collaboration is another way to cultivate resilience and sow the seeds of sustainability.In this talk, we will describe how BHL shifted its focus to reflect on and respond to global events of 2020. We will share discussions around acknowledging and addressing the harmful legacy content in BHL collections, new technical developments, and examples of collaborative telework projects

Safeguarding Access to 500 Years of Biodiversity Data: Sustainability planning for the Biodiversity Heritage Library

The Biodiversity Heritage Library (BHL) is the world's largest open access digital library for biodiversity literature and archives. Headquartered at Smithsonian Libraries and Archives (SLA), BHL is a global consortium of research institutions working together to build and maintain a critical piece of biodiversity data infrastructure. BHL provides free access to over 60 million pages of biodiversity content from the 15th–21st centuries. BHL works with the biodiversity community to develop tools and services to facilitate greater access, interoperability, and reuse of content and data. Through taxonomic intelligence tools developed by Global Names Architecture, BHL has indexed more than 230 million instances of taxonomic names throughout its collection, allowing researchers to locate publications about specific taxa. BHL also works to bring historical literature into the modern network of scholarly research by retroactively assigning DOIs (digital object identifiers) and making this historical content more discoverable and trackable. Biodiversity databases such as the Catalogue of Life, International Plant Names Index, Tropicos, World Register of Marine Species, and iNaturalist, rely on literature housed in BHL. Locked within its 60 million pages are valuable species occurrence data and observations from expeditions. To make this data FAIR (findable, accessible, interoperable, and reusable), BHL and its partners are working on a data pipeline to transform textual content into actionable data that can be deposited into data aggregators such as the Global Biodiversity Information Facility (GBIF).BHL's shared vision began in 2006 among a small community of passionate librarians, technologists, and biodiversity researchers. Uniting as a consortium, BHL received grant funding to build and launch its digital library. BHL partners received additional grant funding for further technical development and targeted digitization projects. When initial grant funding ended in 2012, BHL established an annual dues model for its Members and Affiliates to help support central BHL operating expenses and technical development. This dues model continues today, along with in-kind contributions of staff time from Members and Affiliates. Significant funding is also provided by the Smithsonian in the form of an annual U.S. federal allocation, endowment funds, and SLA cost subvention, to host the technical infrastructure and Secretariat staff. BHL also relies on user donations to support its program.Though BHL has diversified funding streams over the years, it relies heavily on a few key institutions to cover operating costs. Though these institutions have overarching open access, research, and sustainability goals, priorities and resources to achieve these goals shift over time. Without long-term commitments, institutions may choose to prioritize new projects over established programs. Many BHL contributors have experienced funding loss for digitization projects, reducing the rate at which new content is added to BHL. Further loss of funding for central staff and technical infrastructure would reduce BHL from a data-rich technology project to an unsupported and deprecated platform. Without a long-term commitment to maintain and improve the technical infrastructure, BHL's termination would result in countless broken links from biodiversity databases, library catalogs, Wikidata, and other aggregators across the web; detrimental impact on existing third-party projects relying on BHL citation and species data; and the elimination of more equitable and free access to biodiversity knowledge.To continue its mission, BHL must increase and improve its data integration with the wider biodiversity infrastructure and secure a sustainable future. Securing that future will require external expertise to diversify funding sources, re-engage support from existing partners, and identify new stakeholders for support. During the founding discussions of BHL, stakeholders agreed that the only way to do biodiversity science globally is through collaboration. One institution could not lead alone. Going forward, this imperative must also include collaborative funding models. Partnering with initiatives such as the Global Biodata Coalition (GBC) can lead to a stronger and more resilient biodiversity infrastructure. With ongoing collaboration, innovation, and an unwavering commitment to open access, BHL will continue to transform research on a global scale and provide researchers with the tools they need to study, explore, and conserve life on Earth

Safeguarding Access to 500 Years of Biodiversity Data: Sustainability planning for the Biodiversity Heritage Library

The Biodiversity Heritage Library (BHL) is the world’s largest open access digital library for biodiversity literature and archives. Headquartered at Smithsonian Libraries and Archives (SLA), BHL is a global consortium of research institutions working together to build and maintain a critical piece of biodiversity data infrastructure. BHL provides free access to over 60 million pages of biodiversity content from the 15th–21st centuries. BHL works with the biodiversity community to develop tools and services to facilitate greater access, interoperability, and reuse of content and data. Through taxonomic intelligence tools developed by Global Names Architecture, BHL has indexed more than 230 million instances of taxonomic names throughout its collection, allowing researchers to locate publications about specific taxa. BHL also works to bring historical literature into the modern network of scholarly research by retroactively assigning DOIs (digital object identifiers) and making this historical content more discoverable and trackable. Biodiversity databases such as the Catalogue of Life, International Plant Names Index, Tropicos, World Register of Marine Species, and iNaturalist, rely on literature housed in BHL. Locked within its 60 million pages are valuable species occurrence data and observations from expeditions. To make this data FAIR (findable, accessible, interoperable, and reusable), BHL and its partners are working on a data pipeline to transform textual content into actionable data that can be deposited into data aggregators such as the Global Biodiversity Information Facility (GBIF).BHL’s shared vision began in 2006 among a small community of passionate librarians, technologists, and biodiversity researchers. Uniting as a consortium, BHL received grant funding to build and launch its digital library. BHL partners received additional grant funding for further technical development and targeted digitization projects. When initial grant funding ended in 2012, BHL established an annual dues model for its Members and Affiliates to help support central BHL operating expenses and technical development. This dues model continues today, along with in-kind contributions of staff time from Members and Affiliates. Significant funding is also provided by the Smithsonian in the form of an annual U.S. federal allocation, endowment funds, and SLA cost subvention, to host the technical infrastructure and Secretariat staff. BHL also relies on user donations to support its program.Though BHL has diversified funding streams over the years, it relies heavily on a few key institutions to cover operating costs. Though these institutions have overarching open access, research, and sustainability goals, priorities and resources to achieve these goals shift over time. Without long-term commitments, institutions may choose to prioritize new projects over established programs. Many BHL contributors have experienced funding loss for digitization projects, reducing the rate at which new content is added to BHL. Further loss of funding for central staff and technical infrastructure would reduce BHL from a data-rich technology project to an unsupported and deprecated platform. Without a long-term commitment to maintain and improve the technical infrastructure, BHL’s termination would result in countless broken links from biodiversity databases, library catalogs, Wikidata, and other aggregators across the web; detrimental impact on existing third-party projects relying on BHL citation and species data; and the elimination of more equitable and free access to biodiversity knowledge.To continue its mission, BHL must increase and improve its data integration with the wider biodiversity infrastructure and secure a sustainable future. Securing that future will require external expertise to diversify funding sources, re-engage support from existing partners, and identify new stakeholders for support. During the founding discussions of BHL, stakeholders agreed that the only way to do biodiversity science globally is through collaboration. One institution could not lead alone. Going forward, this imperative must also include collaborative funding models. Partnering with initiatives such as the Global Biodata Coalition (GBC) can lead to a stronger and more resilient biodiversity infrastructure. With ongoing collaboration, innovation, and an unwavering commitment to open access, BHL will continue to transform research on a global scale and provide researchers with the tools they need to study, explore, and conserve life on Earth

Effect of a Euglena gracilis Fermentate on Immune Function in Healthy, Active Adults: A Randomized, Double-Blind, Placebo-Controlled Trial

Euglena gracilis produce high amounts of algal β-1,3-glucan, which evoke an immune response when consumed. This study investigated the effect of supplementation with a proprietary Euglena gracilis fermentate (BG), containing greater than 50% β-1,3-glucan, on immune function as measured by self-reported changes in upper respiratory tract infection (URTI) symptoms. Thirty-four healthy, endurance-trained participants were randomized and received either 367 mg of BG or placebo (PLA) for 90 days. Symptoms were assessed by the 24-item Wisconsin Upper Respiratory Symptom Survey and safety via clinical chemistry, hematology, vitals, and adverse event reporting. Participants supplemented with BG over 90 days reported fewer sick days (BG: 1.46 ± 1.01; PLA: 4.79 ± 1.47 days; p = 0.041), fewer URTI symptoms (BG: 12.62 ± 5.92; PLA: 42.29 ± 13.17; p = 0.029), fewer symptom days (BG: 5.46 ± 1.89; PLA: 15.43 ± 4.59 days; p = 0.019), fewer episodes (BG: 2.62 ± 0.67; PLA: 4.79 ± 0.67; p = 0.032), and lower global severity measured as area under curve for URTI symptoms (BG: 17.50 ± 8.41; PLA: 89.79 ± 38.92; p = 0.0499) per person compared to placebo. Sick days, symptoms, and global severity were significantly (p < 0.05) fewer over 30 days in the BG group compared to PLA. All safety outcomes were within clinically normal ranges. The study provides evidence that supplementation with a proprietary Euglena gracilis fermentate containing greater than 50% β-1,3-glucan may reduce and prevent URTI symptoms, providing immune support and protecting overall health