Geomagnetic Semiannual Variation Is Not Overestimated and Is Not an Artifact of Systematic Solar Hemispheric Asymmetry

Mursula et al. [2011] (MTL11) suggest that there is a 22-year variation in solar wind activity that coupled with the variation in heliographic latitude of the Earth during the year, gives rise to an apparent semiannual variation of geomagnetic activity in averages obtained over several solar cycles. They conclude that the observed semiannual variation is seriously overestimated and is largely an artifact of this inferred 22-year variation. We show: (1) that there is no systematically alternating annual variation of geomagnetic activity or of the solar driver, changing with the polarity of the solar polar fields, (2) that the universal time variation of geomagnetic activity at all times have the characteristic imprint of the equinoctial hypothesis rather than that of the axial hypothesis required by the suggestion of MTL11, and (3) that the semiannual variation is not an artifact, is not overestimated, and does not need revision.Comment: Submitted to GR

Optimising the management of vaginal discharge syndrome in Bulgaria: cost effectiveness of four clinical algorithms with risk assessment

OBJECTIVES: To evaluate the performance and cost effectiveness of the WHO recommendations of incorporating risk-assessment scores and population prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) into vaginal discharge syndrome (VDS) algorithms. METHODS: Non-pregnant women presenting with VDS were recruited at a non-governmental sexual health clinic in Sofia, Bulgaria. NG and CT were diagnosed by PCR and vaginal infections by microscopy. Risk factors for NG/CT were identified in multivariable analysis. Four algorithms based on different combinations of behavioural factors, clinical findings and vaginal microscopy were developed. Performance of each algorithm was evaluated for detecting vaginal and cervical infections separately. Cost effectiveness was based on cost per patient treated and cost per case correctly treated. Sensitivity analysis explored the influence of NG/CT prevalence on cost effectiveness. RESULTS: 60% (252/420) of women had genital infections, with 9.5% (40/423) having NG/CT. Factors associated with NG/CT included new and multiple sexual partners in the past 3 months, symptomatic partner, childlessness and >or=10 polymorphonuclear cells per field on vaginal microscopy. For NG/CT detection, the algorithm that relied solely on behavioural risk factors was less sensitive but more specific than those that included speculum examination or microscopy but had higher correct-treatment rate and lower over-treatment rates. The cost per true case treated using a combination of risk factors, speculum examination and microscopy was euro 24.08. A halving and tripling of NG/CT prevalence would have approximately the inverse impact on the cost-effectiveness estimates. CONCLUSIONS: Management of NG/CT in Bulgaria was improved by the use of a syndromic approach that included risk scores. Approaches that did not rely on microscopy lost sensitivity but were more cost effective

Statistical Asynchronous Regression: Determining the Relationship Between two Quantities that are not Measured Simultaneously

We introduce the Statistical Asynchronous Regression (SAR) method: a technique for determining a relationship between two time varying quantities without simultaneous measurements of both quantities. We require that there is a time invariant, monotonic function Y = u(X) relating the two quantities, Y and X. In order to determine u(X), we only need to know the statistical distributions of X and Y. We show that u(X) is the change of variables that converts the distribution of X into the distribution of Y, while conserving probability. We describe an algorithm for implementing this method and apply it to several example distributions. We also demonstrate how the method can separate spatial and temporal variations from a time series of energetic electron flux measurements made by a spacecraft in geosynchronous orbit. We expect this method will be useful to the general problem of spacecraft instrument calibration. We also suggest some applications of the SAR method outside of space physics.Comment: 27 pages, 10 figures, stronger motivations and rewriting to make the paper more accessible to a general audience. in press in J. Geophys. Res. (Space Physics

Effects of solar wind magnetosphere coupling recorded at different geomagnetic latitudes: Separation of directly-driven and storage/release systems

The effect on geomagnetic activity of solar wind speed, compared with that of the strength of the interplanetary magnetic field, differs with geomagnetic latitude. In this study we construct a new index based on monthly standard deviations in the H-component of the geomagnetic field for all geomagnetic latitudes. We demonstrate that for this index the response at auroral regions correlates best with interplanetary coupling functions which include the solar wind speed while mid- and low-latitude regions respond to variations in the interplanetary magnetic field strength. These results are used to isolate the responsible geomagnetic current systems

Online vaccine-related information-seeking in mothers and HPV vaccine uptake in their daughters

Background: There is widespread concern about online vaccine misinformation. The aim of this study was to investigate the association between seeking vaccine-related information on the Internet and HPV vaccination uptake. Methods: Data were obtained from the 2015, 2016, 2017 and 2018 Vaccinoscopie® studies, a pluriannual web-based survey conducted on a nationally representative quota sample of mothers to monitor the dynamics of vaccine coverage, perception and attitudes towards vaccination in France. Mothers of girls aged 14-15 years were asked to state all vaccinations reported on the vaccinal pages of their child's healthcare records. We computed univariate and multivariate logistic regression models, with the outcome variable “HPV vaccination” defined as equal to 1 if the daughter received at least one dose of HPV vaccine, and equal to 0 otherwise; and the dependant variable “Internet use” defined as equal to 1 if the mother responded “Internet” (alone or combined with other sources) to the question “When in doubt about a vaccine, what source(s) of information do you turn to to decide whether or not to have your child vaccinated?”, and equal to 0 otherwise. Results: Over the 4 years, a total of 2038 mothers answered the self-administered online questionnaire. Overall, 96.1% declared their need to search for information, 23.9% of whom used the Internet as a source. Maternal Internet use was associated with lower HPV vaccination uptake in their daughters (Odds Ratio (OR)=0.49, 95%CI: 0.38-0.64). The association remained after adjusting for several potential confounders, including area of residence, household socio-professional category and income, maternal level of education, physician recommendation and use of other sources of information (adjusted OR = 0.68, 95%CI: 0.48-0.96). Conclusions: Specific information campaigns are required to empower parents to better use online information and guide them to reputable sources when they seek information on vaccination. Key messages: The findings of this study suggest that the use of online sources on information is negatively associated with HPV vaccination. Action is warranted to direct parents to use more correct online sources of information on vaccination

Immunogenicity, safety, and efficacy of the HPV vaccines among people living with HIV: A systematic review and meta-analysis

Background: Vaccines have been demonstrated to protect against high-risk human papillomavirus infection (HPV), including HPV-16/18, and cervical lesions among HIV negative women. However, their efficacy remains uncertain for people living with HIV (PLHIV).We systematically reviewed available evidence on HPV vaccine on immunological, virological, or other biological outcomes in PLHIV. Methods: We searched five electronic databases (PubMed, Medline and Embase, clinicaltrials.gov and the WHO clinical trial database) for longitudinal prospective studies reporting immunogenicity, virological, cytological, histological, clinical or safety endpoints following prophylactic HPV vaccination among PLHIV. We included studies published by February 11th, 2021. We summarized results, assessed study quality, and conducted meta-analysis and subgroup analyses, where possible. Findings: We identified 43 publications stemming from 18 independent studies (Ns =18), evaluating the quadrivalent (Ns =15), bivalent (Ns =4) and nonavalent (Ns =1) vaccines. A high proportion seroconverted for the HPV vaccine types. Pooled proportion seropositive by 28 weeks following 3 doses with the bivalent, quadrivalent, and nonavalent vaccines were 0.99 (95% confidence interval: 0.95-1.00, Ns =1), 0.99 (0.98-1.00, Ns =9), and 1.00 (0.99-1.00, Ns =1) for HPV-16 and 0.99 (0.96-1.00, Ns =1), 0.94 (0.91-0.96, Ns =9), and 1.00 (0.99-1.00, Ns =1) for HPV-18, respectively. Seropositivity remained high among people who received 3 doses despite some declines in antibody titers and lower seropositivity over time, especially for HPV-18, for the quadrivalent than the bivalent vaccine, and for HIV positive than negative individuals. Seropositivity for HPV-18 at 29-99 weeks among PLHIV was 0.72 (0.66-0.79, Ns =8) and 0.96 (0.92-0.99, Ns =2) after 3 doses of the quadrivalent and bivalent vaccine, respectively and 0.94 (0.90-0.98, Ns =3) among HIV-negative historical controls. Evidence suggests that the seropositivity after vaccination declines over time but it can lasts at least 2-4 years. The vaccines were deemed safe among PLHIV with few serious adverse events. Evidence of HPV vaccine efficacy against acquisition of HPV infection and/or associated disease from the eight trials available was inconclusive due to the low quality. Interpretation: PLHIV have a robust and safe immune response to HPV vaccination. Antibody titers and seropositivity rates decline over time but remain high. The lack of a formal correlate of protection and efficacy results preclude definitive conclusions on the clinical benefits. Nevertheless, given the burden of HPV disease in PLHIV, although the protection may be shorter or less robust against HPV-18, the robust immune response suggests that PLHIV may benefit from receiving HPV vaccination after acquiring HIV. Better quality studies are needed to demonstrate the clinical efficacy among PLHIV. Funding: World Health Organization. MRC Centre for Global Infectious Disease Analysis, Canadian Institutes of Health Research, UK Medical Research Council (MRC)

Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model: results for Zimbabwe and Morocco from 1995 to 2016.

OBJECTIVE: To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. METHODS: The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. RESULTS: Estimated syphilis prevalence (in men and women) declined from 1.9% (95% CI 1.1% to 3.4%) in 2000 to 1.5% (1.3% to 1.8%) in 2016 in Zimbabwe, and from 1.5% (0.76% to 1.9%) to 0.55% (0.30% to 0.93%) in Morocco. At these time points, gonorrhoea estimates for women aged 15-49 years were 2.5% (95% CI 1.1% to 4.6%) and 3.8% (1.8% to 6.7%) in Zimbabwe; and 0.6% (0.3% to 1.1%) and 0.36% (0.1% to 1.0%) in Morocco, with male gonorrhoea prevalences 14% lower than female prevalence. CONCLUSIONS: This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys