PanStop: a decade of rapid containment exercises for pandemic preparedness in the WHO Western Pacific Region.

Member States in the Western Pacific Region (WPR) of the World Health Organization (WHO), are highly vulnerable to emerging influenza viruses that have the potential to cause global pandemics. A well-coordinated strategy for preparedness is required at national and international levels for a robust response and to mitigate the potentially dire consequences of the next influenza pandemic. Of 37 countries and areas in the region, 23 have publically available national pandemic influenza preparedness and response plans; of these, only 17% have been updated in the last five years. However, many plans are pending update and may benefit from integrating some components of the 2017 WHO pandemic influenza risk management guide. Additionally, many plans need to be operationalized to test their functionality. Since 2007, WPRO has conducted annual PanStop exercises to test pandemic containment plans and RC mechanisms in a simulated environment that imitates pandemic events as they unfold. PanStop exercises provide an opportunity for countries to validate policies, protocols and procedures involved in implementing rapid containment (RC) operations, and to identify strengths and opportunities for improvement in planning activities for pandemic influenza. By participating in exercises such as PanStop and the annual regional International Health Regulation (IHR) Crystal Exercise, and subsequently adapting national preparedness plans based on exercise outcomes, WPR continues to improve readiness for the next influenza pandemic.</jats:p

Discovery, TESS Characterization, and Modeling of Pulsations in the Extremely Low-mass White Dwarf GD 278

We report the discovery of pulsations in the extremely low-mass (ELM), likely helium-core white dwarf GD 278 via ground- and space-based photometry. GD 278 was observed by the Transiting Exoplanet Survey Satellite (TESS) in Sector 18 at a 2 minute cadence for roughly 24 days. The TESS data reveal at least 19 significant periodicities between 2447 and 6729 s, one of which is the longest pulsation period ever detected in a white dwarf. Previous spectroscopy found that this white dwarf is in a 4.61 hr orbit with an unseen >0.4 M ⊙ companion and has T eff = 9230 ± 100 K and logg=6.627±0.056" role="presentation">logg=6.627±0.056 , which corresponds to a mass of 0.191 ± 0.013 M ⊙. Patterns in the TESS pulsation frequencies from rotational splittings appear to reveal a stellar rotation period of roughly 10 hr, making GD 278 the first ELM white dwarf with a measured rotation rate. The patterns inform our mode identification for asteroseismic fits, which, unfortunately, do not reveal a global best-fit solution. Asteroseismology reveals two main solutions roughly consistent with the spectroscopic parameters of this ELM white dwarf, but with vastly different hydrogen-layer masses; future seismic fits could be further improved by using the stellar parallax. GD 278 is now the tenth known pulsating ELM white dwarf; it is only the fifth known to be in a short-period binary, but is the first with extended, space-based photometry.Fil: Lopez, Isaac D.. North Carolina State University; Estados UnidosFil: Hermes, J. J.. University Of Boston. Departament Astronomy; Estados UnidosFil: Calcaferro, Leila Magdalena. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Astrofísica La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas. Instituto de Astrofísica La Plata; ArgentinaFil: Bell, Keaton. University of Washington; Estados UnidosFil: Samuels, Adam. University Of Boston. Departament Astronomy. Center For Space Physics; Estados UnidosFil: Vanderbosch, Zachary P.. University of Texas at Austin; Estados UnidosFil: Corsico, Alejandro Hugo. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Astrofísica La Plata. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas. Instituto de Astrofísica La Plata; ArgentinaFil: Istrate, Alina G.. University of Utrecht; Países Bajo

Simple Mathematical Model Of Pathologic Microsatellite Expansions: When Self-Reparation Does Not Work

We propose a simple model of pathologic microsatellite expansion, and describe an inherent self-repairing mechanism working against expansion. We prove that if the probabilities of elementary expansions and contractions are equal, microsatellite expansions are always self-repairing. If these probabilities are different, self-reparation does not work. Mosaicism, anticipation and reverse mutation cases are discussed in the framework of the model. We explain these phenomena and provide some theoretical evidence for their properties, for example the rarity of reverse mutations

National burden of influenza-associated hospitalizations in Cambodia, 2015 and 2016

The burden of influenza in Cambodia is not well known, but it would be useful for understanding the impact of seasonal epidemics and pandemics and to design appropriate policies for influenza prevention and control. The severe acute respiratory infection (SARI) surveillance system in Cambodia was used to estimate the national burden of SARI hospitalizations in Cambodia.This work was financially supported by the World Health Organization Pandemic and Epidemic Diseases grant for Burden of Disease studies HQPED1611421. The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health. The corresponding author was supported by an Australian Government Research Training Program Scholarship

The Sundowner Winds Experiment (SWEX) pilot study: Understanding downslope windstorms in the Santa Ynez Mountains, Santa Barbara, California

Sundowner winds are downslope gusty winds often observed on the southern slopes of the Santa Ynez Mountains (SYM) in coastal Santa Barbara (SB), California. They typically peak near sunset and exhibit characteristics of downslope windstorms through the evening. They are SB\u27s most critical fire weather in all seasons and represent a major hazard for aviation. The Sundowner Winds Experiment Pilot Study was designed to evaluate vertical profiles of winds, temperature, humidity, and stability leeward of the SYM during a Sundowner event. This was accomplished by launching 3-hourly radiosondes during a significant Sundowner event on 28-29 April 2018. This study showed that winds in the lee of the SYM exhibit complex spatial and temporal patterns. Vertical profiles showed a transition from humid onshore winds from morning to mid-afternoon to very pronounced offshore winds during the evening after sunset. These winds accompanied mountain waves and a northerly nocturnal lee jet with variable temporal behavior. Around sunset, the jet was characterized by strong wind speeds enhanced by mountain-wave breaking. Winds weakened considerably at 2300 PDT 29 April but enhanced dramatically at 0200 PDT 29 April at much lower elevations. These transitions were accompanied by changes in stability profiles and in the Richardson number. A simulation with the Weather Research and Forecasting (WRF) Model at 1-km grid spacing was examined to evaluate the skill of the model in capturing the observed winds and stability profiles and to assess mesoscale processes associated with this event. These results advanced understanding on Sundowner\u27s spatiotemporal characteristics and driving mechanisms

Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?

Background Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. Methods We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. Results Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. Conclusions The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours