Angiostrongylus cantonensis has been found in Florida, USA, from the panhandle in the north to Miami and surrounding areas in the southern parts of the state, in both definitive and intermediate hosts in a limited studies completed in 2015. Additional studies have identified this parasite in a variety of intermediate hosts, both native and non-native gastropod species, with new host species recorded. Many areas in Florida with higher A. cantonensis prevalence were those with a high human population density, which suggests it is a matter of time before human infections occur in Florida. Case reports in the state currently involve non-human primates and include a gibbon and orangutan in Miami. Here, we report the current status of A. cantonensis in the state, as well as the infection in a capuchin monkey and presumptive infection in a red ruffed lemur in Gainesville, Florida.

Introduction: Emergency department (ED) patients with cellulitis that are treated with intravenous (IV) antibiotics may be eligible for outpatient parenteral antibiotic therapy (OPAT). The primary objective of this study was to determine whether the implementation of an OPAT clinic results in decreased hospitalization and return ED visits for patients treated with IV antibiotics. Methods: We conducted a before-after implementation study involving adults (age >=18 years) that presented to two tertiary care EDs with cellulitis and were treated with IV antibiotics. The intervention was referral to an infectious disease physician within one week of the index ED visit at the newly created OPAT clinic. The primary outcomes were hospital admission and return ED visits within 14 days. Secondary outcomes were treatment failure (admission after 48 hours of OPAT) and adverse events (e.g. vomiting, diarrhea). We conducted an interrupted time series analysis from January to December both pre-intervention (2013) and post-intervention (2015), with 24 monthly data points. The year of clinic implementation (2014) was considered a transition period. A segmented non-linear regression autoregressive error model was used to aggregate the monthly data to evaluate the effectiveness of the intervention. Results: A total of 1,666 patients met inclusion criteria: 858 pre-intervention (mean age 59 years, 53.1% male) and 808 post-intervention (mean age 62 years, 54.5% male). Hospitalization rates were not significantly higher one year after clinic implementation (p = 0.53) although there was a non-statistically significant gradual increase of 0.8% per month (95%CI -0.3% to 1.9%). One year after introduction of the OPAT clinic, return ED visits were significantly lower (change in intercept -24.4%, 95%CI -34.2% to -14.6%; p < 0.001), followed by an additional drop of 1.4% per month (95%CI -2.1% to -0.6%; p = 0.002). By the end of the study, return visits were 40.7% lower (95%CI 25.6% to 55.9%) than if the intervention had not been introduced. Treatment failure rates were <2% and adverse events were <5% in both groups. Conclusion: Implementation of an OPAT clinic significantly reduced return ED visits for cellulitis, which is critically important given the current ED overcrowding crisis. There was no significant change in hospital admission rates. There were low rates of treatment failures and adverse events. An OPAT clinic should be considered to reduce ED crowding while maintaining safe patient care.

We present a model for the scaling of mixing in weakly rotating stratified flows characterized by their Rossby, Froude and Reynolds numbers $Ro,Fr$ , $Re$ . This model is based on quasi-equipartition between kinetic and potential modes, sub-dominant vertical velocity, $w$ , and lessening of the energy transfer to small scales as measured by a dissipation efficiency $\unicode[STIX]{x1D6FD}=\unicode[STIX]{x1D716}_{V}/\unicode[STIX]{x1D716}_{D}$ , with $\unicode[STIX]{x1D716}_{V}$ the kinetic energy dissipation and $\unicode[STIX]{x1D716}_{D}=u_{rms}^{3}/L_{int}$ its dimensional expression, with $w,u_{rms}$ the vertical and root mean square velocities, and $L_{int}$ the integral scale. We determine the domains of validity of such laws for a large numerical study of the unforced Boussinesq equations mostly on grids of $1024^{3}$ points, with $Ro/Fr\geqslant 2.5$ , and with $1600\leqslant Re\approx 5.4\times 10^{4}$ ; the Prandtl number is one, initial conditions are either isotropic and at large scale for the velocity and zero for the temperature $\unicode[STIX]{x1D703}$ , or in geostrophic balance. Three regimes in Froude number, as for stratified flows, are observed: dominant waves, eddy–wave interactions and strong turbulence. A wave–turbulence balance for the transfer time $\unicode[STIX]{x1D70F}_{tr}=N\unicode[STIX]{x1D70F}_{NL}^{2}$ , with $\unicode[STIX]{x1D70F}_{NL}=L_{int}/u_{rms}$ the turnover time and $N$ the Brunt–Väisälä frequency, leads to $\unicode[STIX]{x1D6FD}$ growing linearly with $Fr$ in the intermediate regime, with a saturation at $\unicode[STIX]{x1D6FD}\approx 0.3$ or more, depending on initial conditions for larger Froude numbers. The Ellison scale is also found to scale linearly with $Fr$ . The flux Richardson number $R_{f}=B_{f}/[B_{f}+\unicode[STIX]{x1D716}_{V}]$ , with $B_{f}=N\langle w\unicode[STIX]{x1D703}\rangle$ the buoyancy flux, transitions for approximately the same parameter values as for $\unicode[STIX]{x1D6FD}$ . These regimes for the present study are delimited by ${\mathcal{R}}_{B}=ReFr^{2}\approx 2$ and $R_{B}\approx 200$ . With $\unicode[STIX]{x1D6E4}_{f}=R_{f}/[1-R_{f}]$ the mixing efficiency, putting together the three relationships of the model allows for the prediction of the scaling $\unicode[STIX]{x1D6E4}_{f}\sim Fr^{-2}\sim {\mathcal{R}}_{B}^{-1}$ in the low and intermediate regimes for high $Re$ , whereas for higher Froude numbers, $\unicode[STIX]{x1D6E4}_{f}\sim {\mathcal{R}}_{B}^{-1/2}$ , a scaling already found in observations: as turbulence strengthens, $\unicode[STIX]{x1D6FD}\sim 1$ , $w\approx u_{rms}$ , and smaller buoyancy fluxes together correspond to a decoupling of velocity and temperature fluctuations, the latter becoming passive.

The magnetized dusty plasma experiment (MDPX) is a newly commissioned plasma device that started operations in late spring, 2014. The research activities of this device are focused on the study of the physics, highly magnetized plasmas, and magnetized dusty plasmas. The design of the MDPX device is centered on two main components: an open bore, superconducting magnet that is designed to produce, in a steady state, both uniform magnetic fields up to 4 Tesla and non-uniform magnetic fields with gradients of 1–2 T m−1 and a flexible, removable, octagonal vacuum chamber that provides substantial probe and optical access to the plasma. This paper will provide a review of the design criteria for the MDPX device, a description of the research objectives, and brief discussion of the research opportunities offered by this multi-institution, multi-user project.

The Magnetized Dusty Plasma Experiment (MDPX) device is a newly constructed research instrument for the study of dusty (complex) plasmas. The MDPX device is envisioned as an experimental platform in which the dynamical behavior of all three charged plasma components, the electrons, ions, and charged microparticles (i.e., the ‘dust’) will be significantly influenced by the magnetic force. This brief paper will provide a short overview of the design, magnetic performance, and initial plasma measurements in the MDPX device.

We present numerical evidence of how three-dimensionalization occurs at small scale in rotating turbulence with Beltrami () forcing, creating helical flow. The Zeman scale at which the inertial and eddy turn-over times are equal is more than one order of magnitude larger than the dissipation scale, with the relevant domains (large-scale inverse cascade of energy, dual regime in the direct cascade of energy and helicity , and dissipation) each moderately resolved. These results stem from the analysis of a large direct numerical simulation on a grid of points, with Rossby and Reynolds numbers, respectively, equal to and . At scales smaller than the forcing, a helical wave-modulated inertial law for the energy and helicity spectra is followed beyond by Kolmogorov spectra for and . Looking at the two-dimensional slow manifold, we also show that the helicity spectrum breaks down at , a clear sign of recovery of three-dimensionality in the small scales.

Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as “dual purpose” substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in public health preparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve public health preparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk.

(Disaster Med Public Health Preparedness. 2010;4:318-325)

Background: Agents of opportunity (AO) are potentially harmful biological, chemical, radiological, and pharmaceutical substances commonly used for health care delivery and research. AOs are present in all academic medical centers (AMC), creating vulnerability in the health care sector; AO attributes and dissemination methods likely predict risk; and AMCs are inadequately secured against a purposeful AO dissemination, with limited budgets and competing priorities. We explored health care workers' perceptions of AMC security and the impact of those perceptions on AO risk.

Methods: Qualitative methods (survey, interviews, and workshops) were used to collect opinions from staff working in a medical school and 4 AMC-affiliated hospitals concerning AOs and the risk to hospital infrastructure associated with their uncontrolled presence. Secondary to this goal, staff perception concerning security, or opinions about security behaviors of others, were extracted, analyzed, and grouped into themes.

Results: We provide a framework for depicting the interaction of staff behavior and access control engineering, including the tendency of staff to “defeat” inconvenient access controls. In addition, 8 security themes emerged: staff security behavior is a significant source of AO risk; the wide range of opinions about “open” front-door policies among AMC staff illustrates a disparity of perceptions about the need for security; interviewees expressed profound skepticism concerning the effectiveness of front-door access controls; an AO risk assessment requires reconsideration of the security levels historically assigned to areas such as the loading dock and central distribution sites, where many AOs are delivered and may remain unattended for substantial periods of time; researchers' view of AMC security is influenced by the ongoing debate within the scientific community about the wisdom of engaging in bioterrorism research; there was no agreement about which areas of the AMC should be subject to stronger access controls; security personnel play dual roles of security and customer service, creating the negative perception that neither role is done well; and budget was described as an important factor in explaining the state of security controls.

Conclusions: We determined that AMCs seeking to reduce AO risk should assess their institutionally unique AO risks, understand staff security perceptions, and install access controls that are responsive to the staff's tendency to defeat them. The development of AO attribute fact sheets is desirable for AO risk assessment; new funding and administrative or legislative tools to improve AMC security are required; and security practices and methods that are convenient and effective should be engineered.

(Disaster Med Public Health Preparedness. 2010;4:291-299)