The classification of the legume family proposed here addresses the long‐known non‐monophyly of the traditionally recognised subfamily Caesalpinioideae, by recognising six robustly supported monophyletic subfamilies. This new classification uses as its framework the most comprehensive phylogenetic analyses of legumes to date, based on plastid matK gene sequences, and including near‐complete sampling of genera (698 of the currently recognised 765 genera) and ca. 20% (3696) of known species. The matK gene region has been the most widely sequenced across the legumes, and in most legume lineages, this gene region is sufficiently variable to yield well‐supported clades. This analysis resolves the same major clades as in other phylogenies of whole plastid and nuclear gene sets (with much sparser taxon sampling). Our analysis improves upon previous studies that have used large phylogenies of the Leguminosae for addressing evolutionary questions, because it maximises generic sampling and provides a phylogenetic tree that is based on a fully curated set of sequences that are vouchered and taxonomically validated. The phylogenetic trees obtained and the underlying data are available to browse and download, facilitating subsequent analyses that require evolutionary trees. Here we propose a new community‐endorsed classification of the family that reflects the phylogenetic structure that is consistently resolved and recognises six subfamilies in Leguminosae: a recircumscribed Caesalpinioideae DC., Cercidoideae Legume Phylogeny Working Group (stat. nov.), Detarioideae Burmeist., Dialioideae Legume Phylogeny Working Group (stat. nov.), Duparquetioideae Legume Phylogeny Working Group (stat. nov.), and Papilionoideae DC. The traditionally recognised subfamily Mimosoideae is a distinct clade nested within the recircumscribed Caesalpinioideae and is referred to informally as the mimosoid clade pending a forthcoming formal tribal and/or clade‐based classification of the new Caesalpinioideae. We provide a key for subfamily identification, descriptions with diagnostic charactertistics for the subfamilies, figures illustrating their floral and fruit diversity, and lists of genera by subfamily. This new classification of Leguminosae represents a consensus view of the international legume systematics community; it invokes both compromise and practicality of use.

Background The novel coronavirus disease 2019 (COVID-19) has infected 1.9% of the world population by May 2, 2021. Since most previous studies that examined risk factors for mortality and severity were based on hospitalized individuals, population-based cohort studies are called for to provide evidence that can be extrapolated to the general population. Therefore, we aimed to examine the associations of comorbidities with mortality and disease severity in individuals with COVID-19 diagnosed in 2020 in Ontario, Canada. Methods and findings We conducted a retrospective cohort study of all individuals with COVID-19 in Ontario, Canada diagnosed between January 15 and December 31, 2020. Cases were linked to health administrative databases maintained in the ICES which covers all residents in Ontario. The primary outcome is all-cause 30-day mortality after the first COVID-19 diagnosis, and the secondary outcome is a composite severity index containing death and hospitalization. To examine the risk factors for the outcomes, we employed Cox proportional hazards regression models and logistic regression models to adjust for demographic, socio-economic variables and comorbidities. Results were also stratified by age groups. A total of 167,500 individuals were diagnosed of COVID-19 in 2020 and included in the study. About half (43.8%, n = 73,378) had at least one comorbidity. The median follow-up period were 30 days. The most common comorbidities were hypertension (24%, n = 40,154), asthma (16%, n = 26,814), and diabetes (14.7%, n = 24,662). Individuals with comorbidity had higher risk of mortality compared to those without (HR = 2.80, 95%CI 2.35–3.34; p<0.001), and the risk substantially was elevated from 2.14 (95%CI 1.76–2.60) to 4.81 (95%CI 3.95–5.85) times as the number of comorbidities increased from one to five or more. Significant predictors for mortality included comorbidities such as solid organ transplant (HR = 3.06, 95%CI 2.03–4.63; p<0.001), dementia (HR = 1.46, 95%CI 1.35–1.58; p<0.001), chronic kidney disease (HR = 1.45, 95%CI 1.34–1.57; p<0.001), severe mental illness (HR = 1.42, 95%CI%, 1.12–1.80; p<0.001), cardiovascular disease (CVD) (HR = 1.22, 95%CI, 1.15–1.30), diabetes (HR = 1.19, 95%, 1.12–1.26; p<0.001), chronic obstructive pulmonary disease (COPD) (HR = 1.19, 95%CI 1.12–1.26; p<0.001), cancer (HR = 1.17, 95%CI, 1.09–1.27; p<0.001), hypertension (HR = 1.16, 95%CI, 1.07–1.26; p<0.001). Compared to their effect in older age groups, comorbidities were associated with higher risk of mortality and severity in individuals under 50 years old. Individuals with five or more comorbidities in the below 50 years age group had 395.44 (95%CI, 57.93–2699.44, p<0.001) times higher risk of mortality compared to those without. Limitations include that data were collected during 2020 when the new variants of concern were not predominant, and that the ICES databases do not contain detailed individual-level socioeconomic and racial variables. Conclusion We found that solid organ transplant, dementia, chronic kidney disease, severe mental illness, CVD, hypertension, COPD, cancer, diabetes, rheumatoid arthritis, HIV, and asthma were associated with mortality or severity. Our study highlights that the number of comorbidities was a strong risk factor for deaths and severe outcomes among younger individuals with COVID-19. Our findings suggest that in addition of prioritizing by age, vaccination priority groups should also include younger population with multiple comorbidities.

ising rates of antimicrobial resistance are an emerging public health crisis. 1,2 Antibiotic use is associated with antimicrobial resistance at both the patient and population level. 3-5 The largest modifiable driver of resistance is antibiotic use. In addition, antibiotics have important adverse effects, including up to a 30% risk of allergic reactions and gastrointestinal symptoms, including diarrhea associated with Clostridium difficile. 6-9 Existing evidence suggests there is a considerable amount of inappropriate antibiotic use in ambulatory settings, where 92% of antibiotics are prescribed in Canada. 10 In the United States, it is estimated that 30%-50% of antibiotics prescribed outside of hospitals are unnecessary. 11,12 In the United Kingdom, overprescribing of antibiotics for respiratory infections is common, particularly for acute bronchitis, sinusitis and acute otitis media in children. 13,14 Furthermore, an Ontario study identified that 46% of older adults with a presumed viral respiratory infection filled an antibiotic prescription. 15 However, the degree of unnecessary antibiotic use in Canadian primary care settings is not well defined. The US National Action Plan for Combatting Antibioticresistant Bacteria has set a goal to reduce inappropriate antibiotic prescribing by 50% by 2020. 16 The UK's 5-year plan is to reduce overall human antibiotic use by 15% by 2024. 17 Canada has yet to articulate a similar plan to reduce overall antibiotic use in humans, partly because, to date, reasonable targets