Integrated Serologic Surveillance of Population Immunity and Disease Transmission.

Antibodies are unique among biomarkers in their ability to identify persons with protective immunity to vaccine-preventable diseases and to measure past exposure to diverse pathogens. Most infectious disease surveillance maintains a single-disease focus, but broader testing of existing serologic surveys with multiplex antibody assays would create new opportunities for integrated surveillance. In this perspective, we highlight multiple areas for potential synergy where integrated surveillance could add more value to public health efforts than the current trend of independent disease monitoring through vertical programs. We describe innovations in laboratory and data science that should accelerate integration and identify remaining challenges with respect to specimen collection, testing, and analysis. Throughout, we illustrate how information generated through integrated surveillance platforms can create new opportunities to more quickly and precisely identify global health program gaps that range from undervaccination to emerging pathogens to multilayered health disparities that span diverse communicable diseases

A framework to assess integration in flood risk management: implications for governance, policy, and practice

Over decades the concept of integration has been promoted to enhance alignment between policy domains, and to manage trade-offs and maximize synergies across management practices. Integrated approaches have the potential to enable better outcomes for flood risk management (FRM) and society as a whole. However, achieving integration in practice is a recurring challenge, especially for FRM where multiple actors need to work together across fragmented policy domains. To disentangle this complexity of integration, a framework is proposed for assessing integration and identifying different degrees of integration. This framework is based on evidence from a literature review, 50 interviews with FRM-related professionals in England, and participant observation at 24 meetings relevant for FRM. The framework sets out the context of integration, assesses the governance capacity for integration through the strength of relationships between different types of actors (bridging, bonding, and linking) and the mechanisms (actor-, rule- and resource-based) that influence them, and the realization of integration in practice through knowledge, policies, and interventions. The framework is applied for FRM in England and used to identify degrees of integration: high, intermediate, low, and minimal. An important characteristic of the framework is the interconnectivity between the governance capacity and realization of integration. The framework provides further theoretical insights into the concept of integration, while offering an approach for researchers, policy makers, and practitioners to recognize current degrees of integration in FRM and identify the critical elements for improvement. It is recommended that further research and practice-based applications of the framework are completed in different geographical and institutional contexts. Specifically, such applications can create further understanding of the interactions and dependencies between elements of the governance capacity and realization of integration

A multiwavelength radial velocity search for planets around the brown dwarf LP 944-20

The nearby brown dwarf LP 944-20 has been monitored for radial velocity variability at optical and near-infrared wavelengths using the VLT/UVES and the Keck/NIRSPEC spectrographs, respectively. The UVES radial velocity data obtained over 14 nights spanning a baseline of 841 days shows significant variability with an amplitude of 3.5 km s$^{-1}$. The periodogram analysis of the UVES data indicates a possible period between 2.5 hours and 3.7 hours, which is likely due to the rotation of the brown dwarf. However, the NIRSPEC data obtained over 6 nights shows an rms dispersion of only 0.36 km s$^{-1}$ and do not follow the periodic trend. These results indicate that the variability seen with UVES is likely to be due to rotationally modulated inhomogeneous surface features. We suggest that future planet searches around very low-mass stars and brown dwarfs using radial velocities will be better conducted in the near-infrared than in the optical.Comment: accepted by ApJ Letter

The Endoscopic Approach to the Diagnosis of Upper Gastrointestinal Bleeding

Fifty-nine consecutive patients who were bleeding from the upper gastrointestinal tract were examined endoscopically with fiberoptic instruments. The site and nature of the bleeding were identified in 84% of the patients without significant morbidity or mortality. Endoscopic examination of the esophagus, stomach and duodenum in the bleeding patient should be done within 12 to 24 hours after hospital admission and before barium study of the upper gastrointestinal tract

Enteropathogen antibody dynamics and force of infection among children in low-resource settings.

Little is known about enteropathogen seroepidemiology among children in low-resource settings. We measured serological IgG responses to eight enteropathogens (Giardia intestinalis, Cryptosporidium parvum, Entamoeba histolytica, Salmonella enterica, enterotoxigenic Escherichia coli, Vibrio cholerae, Campylobacter jejuni, norovirus) in cohorts from Haiti, Kenya, and Tanzania. We studied antibody dynamics and force of infection across pathogens and cohorts. Enteropathogens shared common seroepidemiologic features that enabled between-pathogen comparisons of transmission. Overall, exposure was intense: for most pathogens the window of primary infection was <3 years old; for highest transmission pathogens primary infection occurred within the first year. Longitudinal profiles demonstrated significant IgG boosting and waning above seropositivity cutoffs, underscoring the value of longitudinal designs to estimate force of infection. Seroprevalence and force of infection were rank-preserving across pathogens, illustrating the measures provide similar information about transmission heterogeneity. Our findings suggest antibody response can be used to measure population-level transmission of diverse enteropathogens in serologic surveillance

Needed: a systems approach to improve flood risk mitigation through private precautionary measures

Private precautionary measures play an increasingly important role in flood risk management. The degree to which private precautionary measures mitigate flood risk depends mainly on the type of measure (and how effective it is) and how frequently and successfully it is implemented. These aspects are influenced by a complex interaction of physical and socio-economic processes, which makes the assessment and the prediction of the mitigation of flood risk via private precautionary measures a challenge. This paper provides an overview of factors and processes that influence the implementation and effectiveness of private precaution in mitigating flood risk, underpinning it with highlights from international examples. We recommend private precautionary measures for further use to improve flood risk mitigation, but stress that they need to be considered and implemented through a holistic systems approach to maximize their effectiveness

Solar Physics - Plasma Physics Workshop

A summary of the proceedings of a conference whose purpose was to explore plasma physics problems which arise in the study of solar physics is provided. Sessions were concerned with specific questions including the following: (1) whether the solar plasma is thermal or non-themal; (2) what spectroscopic data is required; (3) what types of magnetic field structures exist; (4) whether magnetohydrodynamic instabilities occur; (5) whether resistive or non-magnetohydrodynamic instabilities occur; (6) what mechanisms of particle acceleration have been proposed; and (7) what information is available concerning shock waves. Very few questions were answered categorically but, for each question, there was discussion concerning the observational evidence, theoretical analyses, and existing or potential laboratory and numerical experiments

Ambipolar diffusion : self-similar solutions and MHD code testing. Cylindrical symmetry

Funding: This research has been supported by the Spanish Ministry of Science, Innovation and Universities through projects AYA2014-55078-P and PGC2018-095832-B-I00. The authors are also grateful to the European Research Council for support through the Synergy Grant number 810218 (ERC-2018-SyG). DNS acknowledges support by the Research Council of Norway through its Centres of Excellence scheme, project number 262622, and through grants of computing time from the Programme for Supercomputing. AWH gratefully acknowledges the financial support of STFC through the Consolidated grant, ST/S000402/1, to the University of St Andrews.Ambipolar diffusion is a process occurring in partially ionised astrophysical systems that imparts a complicated mathematical and physical nature to Ohm's law. The numerical codes that solve the magnetohydrodynamic (MHD) equations have to be able to deal with the singularities that are naturally created in the system by the ambipolar diffusion term. The global aim is to calculate a set of theoretical self-similar solutions to the nonlinear diffusion equation with cylindrical symmetry that can be used as tests for MHD codes which include the ambipolar diffusion term. First, following the general methods developed in the applied mathematics literature, we obtained the theoretical solutions as eigenfunctions of a nonlinear ordinary differential equation. Phase-plane techniques were used to integrate through the singularities at the locations of the nulls, which correspond to infinitely sharp current sheets. In the second half of the paper, we consider the use of these solutions as tests for MHD codes. To that end, we used the Bifrost code, thereby testing the capabilities of these solutions as tests as well as (inversely) the accuracy of Bifrost's recently developed ambipolar diffusion module. The obtained solutions are shown to constitute a demanding, but nonetheless viable, test for MHD codes that incorporate ambipolar diffusion. The Bifrost code is able to reproduce the theoretical solutions with sufficient accuracy up to very advanced diffusive times. Using the code, we also explored the asymptotic properties of our theoretical solutions in time when initially perturbed with either small or finite perturbations. The functions obtained in this paper are relevant as physical solutions and also as tests for general MHD codes. They provide a more stringent and general test than the simple Zeldovich-Kompaneets-Barenblatt-Pattle solution.PostprintPeer reviewe