Computer Emergency Response Team

When the marginal cost of generating scientific prose, code, and artifact-shaped analyses approaches zero, the scarce input that anchors scientific credibility becomes verification: time, compute, experimental runs, audits, replications, and methodological discipline deployed to discriminate truth from error. This paper introduces the \emph{verification budget} as a first-class institutional variable and proposes a resource law for modern science: holding fixed a community's verification capacity, increases in claim generation mechanically dilute verification per claim, reducing expected reliability unless institutions explicitly reprice credibility by making verification budgets legible, comparable, and rewarded. We define claims, evidence, and verification budgets; model credibility as a function of verification allocation using Bayesian information acquisition and microeconomic models with information asymmetry and costly signaling; and analyze three institutional equilibria---generation-driven, verification-driven, and regulatory-driven-that emerge as verification becomes the binding constraint. We derive two paradoxes of the near-zero generation regime: paper inflation, where publication volume can grow faster than the stock of verified knowledge, and evidence dilution, where average evidential strength per claim declines as claim supply explodes. To operationalize the framework, we propose a mandatory, machine-readable Verification Statement that inventories key claims, maps each to verification modalities, and declares budgets in standardized units, supported by stake-based calibration and random audits. The proposal aims to reduce credibility-asymmetry between authors and evaluators, mitigate adverse selection in scientific claims, and create scalable governance compatible with AI-accelerated research production.

BACKGROUNDIn the Netherlands, locally acquired animal and human cases of West Nile virus (WNV) were first identified in 2020 via multidisciplinary WNV monitoring and research activities focusing on mosquitoes, birds, horses, and humans.AIMWe investigated how different activities contributed to WNV detection and response in the Netherlands between 2020 and 2023, to determine best practices, challenges, and opportunities for improvement.METHODSWe identified WNV monitoring and research activities in the Netherlands from 2020 to 2023 and analysed their timeliness to detect and react to WNV circulation. An after-action review (AAR) was conducted with national WNV experts to assess best practices and challenges in the multidisciplinary approach.RESULTSIn 2020, WNV circulation was discovered in an infected bird through a wild live bird research survey and subsequently through mosquito research and monitoring. Thirty-five days after finding the WNV-PCR-positive bird, the first autochthonous human case was uncovered. Between 2021 and 2023, research projects in animals, including sentinel chickens, detected ongoing local enzootic WNV circulation. The AAR highlighted rapid information sharing and interpretation, enabled by multidisciplinary collaborations, as best practice. However, differing institute priorities could sometimes lead to diverging views on follow-up actions.CONCLUSIONResearch and monitoring activities in mosquitoes and animals, particularly wild birds and sentinel chickens, enabled early detection of WNV circulation. Real-time testing could provide early warning of human cases, enabling timely responses. Therefore, these research and monitoring activities should be maintained. Multidisciplinary collaboration enabled rapid detection and response, and addressing remaining challenges could further strengthen effectiveness.

<h3>Background and Importance</h3> Oral antibiotic therapy for bone and joint infections (BJIs) is often prolonged and frequently associated with adverse events (AEs), which can compromise adherence and clinical outcomes. Pharmacist involvement during the hospital to home transition may enhance patient safety and treatment continuity. <h3>Aim and Objectives</h3> To assess, through a prospective randomised controlled trial, the impact of pharmacist–patient consultations (PCs) on AE management and patient knowledge during oral antibiotic therapy for BJIs. <h3>Material and Methods</h3> This prospective, randomised controlled trial (EFIRAD) included adults hospitalised for BJI, undergoing surgery, and discharged with a 4–12 week oral antibiotic prescription. Patients were randomised 1:1 to receive either a structured pharmacist–patient consultation (PC group) or standard discharge counselling (control). Telephone follow-ups were conducted at day 7 (D7) and day 14 (D14) to collect AEs and evaluate AE management, classified as optimal or non-optimal using a predefined decision tree. Patient knowledge was assessed using a validated 12-item questionnaire. <h3>Results</h3> Eighty-four patients were included (PC: n=41; control: n=43), with comparable baseline characteristics. At D7, 74% of patients reported ≥1 AE, mostly gastrointestinal (72%) and mild (grade I, 84%). Adverse event evolution between D7 and D14 was monitored, showing a decrease in overall AEs (74% vs 59%) and in gastrointestinal events (72% vs57%), but an increase in infectious AEs such as oral candidiasis and fungal infections (11.1% vs 3.5%). Optimal AE management was significantly higher in the PC group (95% vs 79%, p=0.03). Knowledge scores were greater in the PC group (p=0.0019), particularly regarding AE recognition, drug interactions, dosing, and appropriate responses. Non-optimal management in the PC group involved minor misuse of symptomatic treatment (n=1) or lack of medical consultation for hypersensitivity (n=1), while in controls it mainly included misuse or non-use of symptomatic treatments (n=7) and absence of medical contact (n=2). No AE required hospital readmission. <h3>Conclusion and Relevance</h3> This prospective randomised controlled trial demonstrates that pharmacist–patient consultations significantly improve AE management and patient knowledge during oral antibiotic therapy for BJIs. These results highlight the clinical relevance of pharmacist involvement in antimicrobial stewardship and support the integration of structured pharmacist-led interventions into post-hospital care pathways. <h3>Conflict of Interest</h3> No conflict of interest

Background: The shift to remote and hybrid work models after the COVID-19 pandemic has introduced psychosocial hazards that may elevate burnout risk beyond levels observed in traditional high-contact professions. Although emotional exhaustion rates of 20–50% are well documented among healthcare and social service workers, prevalence in general remote and hybrid populations remains inconsistent, with limited data on modifiable predictors such as work–life boundaries, isolation, and supervisor support. Objective: To determine the prevalence of burnout and emotional exhaustion among remote and hybrid workers in technology, education, and finance sectors and to identify independent organisational and psychosocial predictors of high emotional exhaustion. Methods: We conducted a cross-sectional observational study from January to April 2025, recruiting 247 remote and hybrid employees via professional networks and workplace platforms. Burnout was assessed using the Maslach Burnout Inventory–Human Services Survey, with high emotional exhaustion defined as ≥27, high depersonalization as ≥10, and low personal accomplishment as ≤33. Psychosocial factors were measured with validated Likert-scale items. Multivariable logistic regression adjusted for gender, sector, work model, and confounders identified predictors of high emotional exhaustion. Results: High emotional exhaustion affected 63.1% (95% CI 56.9–68.9) of participants, and overall burnout (at least two elevated domains) 41.7% (95% CI 35.7–47.9). Fully remote workers had significantly higher emotional exhaustion than hybrid workers (mean difference 3.7, p=0.004). Independent predictors included poor work–life boundaries (adjusted OR 2.67, 95% CI 1.65–4.31), work hours &gt;45/week (OR 2.11, 1.31–3.39), and isolation (OR 1.24 per unit, 1.10–1.40). Conclusion: Emotional exhaustion is highly prevalent among remote and hybrid workers and is strongly driven by blurred boundaries, extended hours, and isolation. Organizational interventions targeting these factors may reduce burnout risk in flexible workforces.

Management of diabetes mellitus in hemodialysis is highly complex due to increased glycemic variability and hypoglycemic risk. The use of technologies applied to diabetes has been shown to improve glycemic control, however data in dialysis patients are limited. Purpose. To describe the efficacy and safety of the minimed 780G AHCL system in a stable hemodialysis patient and during hospitalization in the Intensive Care Unit (ICU). Case. A 47-year-old patient with chronic transplant rejection complicated by post-transplant diabetes mellitus (PTD) and chronic ischemic heart disease. He is undergoing MDI multi-injection insulin therapy with reduced compliance and the need for therapeutic adjustments in relation to hypoglycemia and daily and intradialytic glycemic variability. The use of an advanced integrated CGM+insulin pump system (AHCL) was indicated. Three-month data showed the achievement of therapeutic objectives for frail patients with comorbidities; they were also confirmed in a subsequent ICU admission for an episode of pneumonia and respiratory failure. The basal insulin requirement was adjusted automatically by the PID algorithm with daily adaptation of the insulin dose, even during hemodialysis sessions. Conclusions. The use of the AHCL system has proven to be safe, effective and flexible in achieving metabolic compensation both during dialysis and in interdialysis periods and also during a severe acute episode, with excellent control of glycemic values ​​during the same.

AimsDifferentiated or HPV‐independent vulvar intraepithelial neoplasia (dVIN) can progress rapidly to invasive cancer and accurate pathological diagnosis is essential to facilitate appropriate interventions. Histological similarities of dVIN with non‐neoplastic lesions, however, often make the diagnosis less reproducible. We investigated among a diverse group of pathologists whether the diagnostic agreement improves with the use of p53 immunohistochemistry (IHC) interpreted using the pattern‐based schema.Methods and resultsFifty haematoxylin–eosin (HE) stained archival slides (30 dVIN and 20 non‐dysplastic vulvar lesions) were selected and p53‐IHC was performed. Twenty‐four board‐certified pathologists from eight countries first assessed the HE slides alone, and after a washout period, re‐evaluated them alongside the p53‐IHC slides. During both rounds, slides were diagnosed as dVIN, favour dVIN, favour no‐VIN or no‐VIN. p53‐IHC was scored as wild‐type or mutant (diffuse, basal, cytoplasmic or null). Kappa (κ) statistics and McNemar's test were used for statistical analyses. Overall diagnostic agreement for dVIN saw a significant increase in the Kappa value (κ = 0.6 vs. κ = 0.4, P = 0.002) when HE and p53‐IHC slides were assessed together compared with histology assessment alone, although the level of agreement remained moderate. For p53‐IHC assessment, overall agreement was substantial (κ = 0.7). Diagnoses changing from no‐VIN/favour no‐VIN to dVIN correlated significantly with the identification of a p53‐mutant pattern (P < 0.001).ConclusionsOur findings indicate that p53‐IHC is a robust ancillary tool that can be reproducibly interpreted by pathologists with varying experience levels and supports the routine use of p53‐IHC in cases where dVIN is considered in the differential diagnosis.

The proliferation of cloud computing has rendered secure data sharing a paramount challenge, particularly in the post-quantum era where quantum computers threaten traditional public-key cryptosystems. While many schemes exist, achieving fine-grained, efficient, and quantum-resistant access control remains a key research area. To this end, this paper proposes a post-quantum secure data sharing scheme based on ideal lattices. We construct a new Ciphertext Policy Attribute-Based Encryption (CP-ABE) scheme for key distribution over ideal lattices, integrated into a hybrid encryption mechanism to protect data privacy efficiently. This approach allows data owners to enforce complex access policies on their encrypted data, ensuring that only authorized users can access it. Rigorous security proofs demonstrate that the proposed scheme is IND-CPA-secure under the Ring-LWE assumption. The efficiency of the scheme is due to its effective utilization of the algebraic structure of the ideal lattice, which accelerates polynomial operations through Number Theoretic Transformations (NTT). Comparative analysis and experimental results show that the scheme has significant advantages in computing efficiency and storage cost, thereby underscoring its practical feasibility for high-throughput cloud environments.

Local Climate Zones (LCZs) have become a widely used classification system to study urban environments and their impacts on air temperature (AT). LCZs have been proven to be an efficient tool for analysing urban structure and its effects on local overheating, thus providing input for AT modelling and diagnosis aimed at implementing adaptation measures. However, most LCZ classifications comparisons are made from a mapping accuracy perspective rather than meteorological data to assess their capacities to capture thermal spatial variations in urban environment. The goal of this study is to show how effectively different LCZ classifications approaches capture spatial variations in urban temperature patterns and to test to what extent these LCZ classifications may be helpful to characterise air quality at an urban micro-scale.To address this gap, we developed a generic framework to compare LCZ classifications using either sensor measurements or modelling data. LCZ classifications capabilities to capture spatial variations are evaluated using Kruskal-Wallis and Dunn tests.This framework is illustrated through an example using AT data from the MUSTARDijon UHI monitoring network and Black Carbon (BC) sensor measurements in Dijon (France). Three LCZ classifications based on different approaches are analysed: WUDAPT (Remote-sensing based), Geoclimate (GIS based), and Sat'LCZ (Hybride based). This example illustrates the ability of the methodology to compare the performance of different LCZ classifications in capturing spatial variations in urban AT and BC patterns.Preliminary results indicate that each tested LCZ classification identifies AT pattern differences between rural and urban environment. However, these LCZ classifications differ in their ability to capture AT and BC patterns at an urban micro-scale, emphasizing the need for careful LCZ classification selection in urban climate and air quality studies.

The growing complexity of global food security, exacerbated by climate change and socio-economic disparities, calls for a multi-hazard approach to risk evaluation and management. Recognizing the lack of a universally accepted measure for food insecurity covering all dimensions, we first review target variables and input features in existing ML modeling efforts, providing an assessment of current data availability, accessibility, and fragmentation, and improving the understanding of possibilities and limitations of ML for the food security community. &amp;#160;We further consolidate a comprehensive dataset, with an operational design for continuous enrichment, that includes various indicators and precursors, updated monthly on a subnational level across over one hundred countries. We apply innovative explainable artificial intelligence (XAI) methods to unravel the intricate relationships between food insecurity, drought, and conflict-related fatalities. Our models forecast food crises with different lead times, revealing the nuanced patterns recognized by machine learning algorithms over various time frames. Our analysis also shows that the relative importance of drivers can shift depending on the food security metric used, indicating that distinct processes are at play in its many dimensions. This study not only exposes the complex drivers of food security but also provides policymakers with an operational multi-risk forecasting tool, improving the ability to foresee and strategically manage food crises.&amp;#160; &amp;#160;