How parasites alter host feeding ecology remains elusive in natural populations. A powerful approach to investigate the link between infection and feeding ecology is quantifying unique and shared responses to parasite infection in related host species within a common environment. Here, 9 pairs of sympatric populations of the three-spined and nine-spined stickleback fishes were sampled across a range of freshwater and brackish habitats to investigate how parasites alter host feeding ecology: (i) biotic and abiotic determinants of parasite community composition, and (ii) to what extent parasite infection correlates with trophic niche specialization of the 2 species, using stable isotope analyses (δ15N and δ13C). It was determined that parasite community composition and host parasite load varied among sites and species and were correlated with dissolved oxygen. It was also observed that the digenean Cyathocotyle sp.'s abundance, a common directly infecting parasite with a complex life cycle, correlated with host δ13C in a fish species-specific manner. In 6 sites, correlations were found between parasite abundance and their hosts' feeding ecology. These effects were location-specific and occasionally host species or host size-specific. Overall, the results suggest a relationship between parasite infection and host trophic niche which may be an important and largely overlooked ecological factor. The population specificity and variation in parasite communities also suggest this effect is multifarious and context-dependent.

Monoclonal antibody therapeutics to treat coronavirus disease (COVID-19) have been authorized by the US Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from 3 sites at medical centers in the United States supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.

The Wilkes Subglacial Basin in East Antarctica contains ice equivalent to 3–4 m of global mean sea level rise and is primarily drained by Cook Glacier. Of concern is that recent observations (since the 1970s) show an acceleration in ice speed over the grounding line of both the Eastern and Western portions of Cook Glacier. Here, we use a numerical ice-flow model (Úa) to simulate the instantaneous effects of observed changes at the terminus of Cook Glacier in order to understand the link between these changes and recently observed ice acceleration. Simulations suggest that the acceleration of Cook West was caused by a retreat in calving-front position in the 1970s, potentially enhanced by grounding-line retreat, while acceleration of Cook East was likely caused by ice-shelf thinning and grounding-line retreat in the mid-1990s. Moreover, we show that the instantaneous ice discharge at Cook East would increase by up to 85% if the whole ice shelf is removed and it ungrounds from a pinning point; and that the discharge at Cook West could increase by ~300% if its grounding line retreated by 10 km.

The ablation zones of debris-covered glaciers in Himalaya exhibit heterogeneous processes and melt patterns. Although sub-debris melt is measured at ablation stakes, the high variability of debris thickness necessitates distributed melt measurements at the glacier scale. Focusing on Annapurna III Glacier, we used uncrewed aerial system (UAS) photogrammetry to estimate total volume loss and slope-perpendicular glacier melt between May and November 2019 using flow-corrected point clouds. Results indicated the average elevation change was −1.10 ± 0.19 m, while the mean melt was −0.87 m w.e., equating to a mean melt rate of −0.47 cm w.e. d−1. However, the spatial pattern was highly variable due to complex local processes necessitating future study over short intervals. The evaluation of specific areas showed the interplay of debris thickness variability, subseasonal debris redistribution, supraglacial channel reconfiguration and the imprint of relict ice cliffs in leading to contemporary melt rates. Ice cliffs had higher melt distances (mean −3.9 ± 0.19 m) compared to non-cliff areas (mean −0.75 ± 0.19 m) and were the predominant control on the spatial patterns of seasonal melt rates. Crucially, the definition of ice cliff areas from thinning data has a profound impact on derived melt rates and melt enhancement. Our study demonstrates the possibility and utility of deriving fully-distributed slope-perpendicular melt measurements.

A large class of new exact solutions to the steady, incompressible Euler equation on the plane is presented. These hybrid solutions consist of a set of stationary point vortices embedded in a background sea of Liouville-type vorticity that is exponentially related to the stream function. The input to the construction is a ‘pure’ point vortex equilibrium in a background irrotational flow. Pure point vortex equilibria also appear as a parameter $A$ in the hybrid solutions approaches the limits $A\to 0,\infty$. While $A\to 0$ reproduces the input equilibrium, $A\to \infty$ produces a new pure point vortex equilibrium. We refer to the family of hybrid equilibria continuously parametrised by $A$ as a ‘Liouville link’. In some cases, the emergent point vortex equilibrium as $A\to \infty$ can itself be the input for a second family of hybrid equilibria linking, in a limit, to yet another pure point vortex equilibrium. In this way, Liouville links together form a ‘Liouville chain’. We discuss several examples of Liouville chains and demonstrate that they can have a finite or an infinite number of links. We show here that the class of hybrid solutions found by Crowdy (Phys. Fluids, vol. 15, 2003, pp. 3710–3717) and by Krishnamurthy et al. (J. Fluid Mech., vol. 874, 2019, R1) form the first two links in one such infinite chain. We also show that the stationary point vortex equilibria recently studied by Krishnamurthy et al. (Proc. R. Soc. A, vol. 476, 2020, 20200310) can be interpreted as the limits of a Liouville link. Our results point to a rich theoretical structure underlying this class of equilibria of the two-dimensional Euler equation.

The weakening and/or removal of floating ice shelves in Antarctica can induce inland ice flow acceleration. Numerical modelling suggests these processes will play an important role in Antarctica's future sea-level contribution, but our understanding of the mechanisms that lead to ice tongue/shelf collapse is incomplete and largely based on observations from the Antarctic Peninsula and West Antarctica. Here, we use remote sensing of structural glaciology and ice velocity from 2001 to 2020 and analyse potential ocean-climate forcings to identify mechanisms that triggered the rapid disintegration of ~2445 km2 of ice mélange and part of the Voyeykov Ice Shelf in Wilkes Land, East Antarctica between 27 March and 28 May 2007. Results show disaggregation was pre-conditioned by weakening of the ice tongue's structural integrity and was triggered by mélange removal driven by a regional atmospheric circulation anomaly and a less extensive latent-heat polynya. Disaggregation did not induce inland ice flow acceleration, but our observations highlight an important mechanism through which floating termini can be removed, whereby the break-out of mélange and multiyear landfast sea ice triggers disaggregation of a structurally-weak ice shelf. These observations highlight the need for numerical ice-sheet models to account for interactions between sea-ice, mélange and ice shelves.

Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.

A 56-year-old woman with Down syndrome presented with right-sided weakness and dysarthria, and was found on CT/CTA to have a left middle cerebral artery infarct secondary to moyamoya disease. Her left posterior inferior cerebellar artery (PICA) was fed both by the left vertebral artery, and the left ascending pharyngeal artery (APA), with a variant origin from the internal carotid artery (ICA), then passing through the jugular foramen (Figure 1). Her right PICA originated exclusively from her right occipital artery, also via the jugular foramen (Figure 2). The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated from the brachiocephalic trunk. In addition, she had a trifurcated anterior cerebral artery (ACA), and just prior to this trifurcation, her left ACA was partially supplied by the left ICA, via a superior hypophyseal artery. This case is noteworthy for several reasons. First, though it is exceedingly rare to have the PICA supplied by the jugular branch of the APA, this is the first reported case with an ICA origin of that APA.1,2 The fact that both PICAs in this patient originate from the anterior circulation should remind clinicians that in unexplained posterior circulation infarctions, vascular anatomy should be explored, as carotid-vertebrobasilar anastomoses such as these are rare, but possible. Lastly, the conjunction of moyamoya disease and anomalies of the vertebrobasilar system in a patient with Down syndrome raises interesting questions about the influence of trisomy 21 on the developing vasculature. Connections from the APA to the vertebrobasilar system are hypothesized to result from a lack of regression of an embryological anastomosis, in line with the more common persistent trigeminal and persistent hypoglossal arteries.1 Patients with moyamoya disease have a significantly higher rate of persistent carotid-vertebrobasilar anastomoses than the general population,3 and are also 26 times more likely to have Down syndrome.4 Correspondingly, patients with Down syndrome have significantly higher levels of moyamoya disease, and are more than 10 times as likely as the general population to have abnormalities of the Circle of Willis5 and vertebral arteries.6 Several genes on chromosome 21 are known to affect angiogenesis, namely collagen XIII/endostatin (COL18A1), DYRK1A, and Down syndrome candidate region 1 (DSCR1), possibly through inhibition of VEGF activity.7 Whether additional copies of these genes are responsible for the anomalous vascular development seen in Down syndrome, in turn predisposing to the development of moyamoya disease, could benefit from further exploration.

Evolving conditions at the terminus of Thwaites Glacier will be important in determining the rate of its future sea-level contribution over the coming decades. Here, we use remote-sensing observations to investigate recent changes (2000–2018) in the structure and velocity of Thwaites Glacier and its floating tongue. We show that the main trunk of Thwaites Glacier has accelerated by 38% over this period, while its previously intact floating tongue has transitioned to a weaker mélange of fractured icebergs bounded by sea ice. However, the rate of structural weakening and acceleration was not uniform across the observational period and we identify two periods of rapid acceleration and structural weakening (2006–2012; 2016–2018), separated by a period of deceleration and re-advance of the structurally-intact shear margin boundary (2012–2015). The timing of these accelerations/decelerations strongly suggests a link to variable ocean forcing. The weakened tongue now has some dependency on landfast sea ice for structural integrity and is vulnerable to changes in landfast ice persistency. Future reductions in landfast sea ice could manifest from changes in climate and/or the imminent removal of the B-22A iceberg from the Thwaites embayment. Such changes could have important implications for the integrity of the ice tongue and future glacier discharge.

While hot-water drilling is a well-established technique used to access the subsurface of ice masses, drilling into high-elevation (≳ 4000 m a.s.l.) debris-covered glaciers faces specific challenges. First, restricted transport capacity limits individual equipment items to a volume and mass that can be slung by small helicopters. Second, low atmospheric oxygen and pressure reduces the effectiveness of combustion, limiting a system's ability to pump and heat water. Third, thick supraglacial debris, which is both highly uneven and unstable, inhibits direct access to the ice surface, hinders the manoeuvring of equipment and limits secure sites for equipment placement. Fourth, englacial debris can slow the drilling rate such that continued drilling becomes impracticable and/or boreholes deviate substantially from vertical. Because of these challenges, field-based englacial and subglacial data required to calibrate numerical models of high-elevation debris-covered glaciers are scarce or absent. Here, we summarise our experiences of hot-water drilling over two field seasons (2017–2018) at the debris-covered Khumbu Glacier, Nepal, where we melted 27 boreholes up to 192 m length, at elevations between 4900 and 5200 m a.s.l. We describe the drilling equipment and operation, evaluate the effectiveness of our approach and suggest equipment and methodological adaptations for future use.

A new family of exact solutions to the two-dimensional steady incompressible Euler equation is presented. The solutions provide a class of hybrid equilibria comprising two point vortices of unit circulation – a point vortex pair – embedded in a smooth sea of non-zero vorticity of ‘Stuart-type’ so that the vorticity $\unicode[STIX]{x1D714}$ and the stream function $\unicode[STIX]{x1D713}$ are related by $\unicode[STIX]{x1D714}=a\text{e}^{b\unicode[STIX]{x1D713}}-\unicode[STIX]{x1D6FF}(\boldsymbol{x}-\boldsymbol{x}_{0})-\unicode[STIX]{x1D6FF}(\boldsymbol{x}+\boldsymbol{x}_{0})$, where $a$ and $b$ are constants. We also examine limits of these new Stuart-embedded point vortex equilibria where the Stuart-type vorticity becomes localized into additional point vortices. One such limit results in a two-real-parameter family of smoothly deformable point vortex equilibria in an otherwise irrotational flow. The new class of hybrid equilibria can be viewed as continuously interpolating between the limiting pure point vortex equilibria. At the same time the new solutions continuously extrapolate a similar class of hybrid equilibria identified by Crowdy (Phys. Fluids, vol. 15, 2003, pp. 3710–3717).

Ice cliffs and ponds on debris-covered glaciers have received increased attention due to their role in amplifying local melt. However, very few studies have looked at these features on the catchment scale to determine their patterns and changes in space and time. We have compiled a detailed inventory of cliffs and ponds in the Langtang catchment, central Himalaya, from six high-resolution satellite orthoimages and DEMs between 2006 and 2015, and a historic orthophoto from 1974. Cliffs cover between 1.4% (± 0.4%) in the dry and 3.4% (± 0.9%) in the wet seasons and ponds between 0.6% (± 0.1%) and 1.6% (± 0.3%) of the total debris-covered tongues. We find large variations between seasons, as cliffs and ponds tend to grow in the wetter monsoon period, but there is no obvious trend in total area over the study period. The inventory further shows that cliffs are predominately north-facing irrespective of the glacier flow direction. Both cliffs and ponds appear in higher densities several hundred metres from the terminus in areas where tributaries reach the main glacier tongue. On the largest glacier in the catchment ~10% of all cliffs and ponds persisted over nearly a decade.

We describe the first case of angiostrongyliasis in a water rat, Hydromys chrysogaster, a large rodent adapted to aquatic life, which is endemic to Australia, New Guinea and adjacent islands.

We performed a spatial-temporal analysis to assess household risk factors for Ebola virus disease (Ebola) in a remote, severely-affected village. We defined a household as a family's shared living space and a case-household as a household with at least one resident who became a suspect, probable, or confirmed Ebola case from 1 August 2014 to 10 October 2014. We used Geographic Information System (GIS) software to calculate inter-household distances, performed space-time cluster analyses, and developed Generalized Estimating Equations (GEE). Village X consisted of 64 households; 42% of households became case-households over the observation period. Two significant space-time clusters occurred among households in the village; temporal effects outweighed spatial effects. GEE demonstrated that the odds of becoming a case-household increased by 4·0% for each additional person per household (P < 0·02) and 2·6% per day (P < 0·07). An increasing number of persons per household, and to a lesser extent, the passage of time after onset of the outbreak were risk factors for household Ebola acquisition, emphasizing the importance of prompt public health interventions that prioritize the most populated households. Using GIS with GEE can reveal complex spatial-temporal risk factors, which can inform prioritization of response activities in future outbreaks.

Introduction: Medical transport services are essential in the regionalization of trauma care. Given the limited number of designated trauma centers, transport times can be prolonged, with patient care managed by paramedics for the duration of their transfer. Pain management is a paramount component, but oligoanalgesia can occur. The primary objective of this study was to evaluate pain management practices during transport of trauma patients by air. Methods: We conducted a 12-month review of ORNGE electronic paramedic records. ORNGE is the exclusive provider of air and land transport in Ontario, Canada. Cases from 1 January 2015 to 31 December 2015 were screened. Patients were identified according to inclusion (≥18 years old requiring transportation to designated trauma center) and exclusion criteria (GCS<14; intubation; accompanied by a nurse or physician). Information was collected in a standardized, piloted data form used by a single trained data extractor. Demographics, injury description, and transportation parameters were recorded. Outcomes included pain assessment according to changes on a 10-point numeric rating scale (NRS), patterns of analgesia administration, and analgesia-related adverse events (AEs). Results were reported as mean, (standard deviation), [range], or percentage. Results: Of 600 potential records, 372 patients met our inclusion criteria with the following characteristics: age 47.0 [19-92] years; 70.4% male; 97.0% blunt injury. Duration of transport was 82.4 (46.3) minutes. Pain was initially assessed in 90.0% of patients. Overall, NRS at baseline was 4.9 (2.8). Of the 62.4% who received analgesia, NRS at baseline was 5.9 (2.5). Fentanyl was most commonly administered (78.5%) at 44.3 [25-60] mcg. NRS after the first dose of analgesia decreased by 1.1 (1.6) points. A total of 73.7% of patients received further analgesia, equal to 2.4 [1-19] additional doses. While 23.4% of patients had no change in NRS after the first dose of analgesia, subsequent doses resulted in no change in NRS in over 65% [65.4-71.3] of patients. A total of 43 AEs (6.7%) were recorded after 638 doses of analgesia, and the most common AE was nausea (39.5%). Conclusion: The majority of patients were assessed for pain. Although the first analgesia administration had minimal effect on NRS, subsequent doses appeared to have even less of an impact. AEs were infrequent.

Active Trypanosoma cruzi transmission persists in the Gran Chaco region, which is considered hyperendemic for Chagas disease. Understanding domestic and sylvatic transmission cycles and therefore the relationship between vectors and mammalian hosts is crucial to designing and implementing improved effective control strategies. Here we describe the species of triatomine vectors and the sylvatic mammal reservoirs of T. cruzi, in different localities of the Paraguayan and Bolivian Chaco. We identify the T. cruzi genotypes discrete typing units (DTUs) and provide a map of their geographical distribution. A total of 1044 triatomines and 138 sylvatic mammals were captured. Five per cent of the triatomines were microscopically positive for T. cruzi (55 Triatoma infestans from Paraguay and one sylvatic Triatoma guasayana from Bolivia) and 17 animals (12·3%) comprising eight of 28 (28·5%) Dasypus novemcinctus, four of 27 (14·8%) Euphractus sexcinctus, three of 64 (4·7%) Chaetophractus spp. and two of 14 (14·3%) Didelphis albiventris. The most common DTU infecting domestic triatomine bugs was TcV (64%), followed by TcVI (28%), TcII (6·5%) and TcIII (1·5%). TcIII was overwhelmingly associated with armadillo species. We confirm the primary role of T. infestans in domestic transmission, armadillo species as the principal sylvatic hosts of TcIII, and consider the potential risk of TcIII as an agent of Chagas disease in the Chaco.

Supraglacial ponds play a key role in absorbing atmospheric energy and directing it to the ice of debris-covered glaciers, but the spatial and temporal distribution of these features is not well documented. We analyse 172 Landsat TM/ETM+ scenes for the period 1999–2013 to identify thawed supraglacial ponds for the debris-covered tongues of five glaciers in the Langtang Valley of Nepal. We apply an advanced atmospheric correction routine (Landcor/6S) and use band ratio and image morphological techniques to identify ponds and validate our results with 2.5 m Cartosat-1 observations. We then characterize the spatial, seasonal and interannual patterns of ponds. We find high variability in pond incidence between glaciers (May–October means of 0.08–1.69% of debris area), with ponds most frequent in zones of low surface gradient and velocity. The ponds show pronounced seasonality, appearing in the pre-monsoon as snow melts, peaking at the monsoon onset at 2% of debris-covered area, then declining in the post-monsoon as ponds drain or freeze. Ponds are highly recurrent and persistent, with 40.5% of pond locations occurring for multiple years. Rather than a trend in pond cover over the study period, we find high interannual variability for each glacier after controlling for seasonality.