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Using temperature gradients measured in 10 holes at 6 sites, we generate the first high fidelity heat flow measurements from Integrated Ocean Drilling Program drill holes across the northern and central Lesser Antilles arc and back arc Grenada basin. The implied heat flow, after correcting for bathymetry and sedimentation effects, ranges from about 0.1 W/m2 on the crest of the arc, midway between the volcanic islands of Montserrat and Guadeloupe, to <0.07 W/m2 at distances >15 km from the crest in the back arc direction. Combined with previous measurements, we find that the magnitude and spatial pattern of heat flow are similar to those at continental arcs. The heat flow in the Grenada basin to the west of the active arc is 0.06 W/m2, a factor of 2 lower than that found in the previous and most recent study. There is no thermal evidence for significant shallow fluid advection at any of these sites. Present‐day volcanism is confined to the region with the highest heat flow. Key Points Heat flow in the Lesser Antilles is similar to other volcanic arcs No evidence for subsurface fluid flow Volcanism is confined to the region with high heat flow

Volcanic activity in the Lesser Antilles island arc (West Indies) produces large quantities of ash, pumice, and rock that are delivered to the shallow and deep marine environments of the western Caribbean Sea and eastern Atlantic Ocean. On the island of Montserrat, in the northern part of the Lesser Antilles, Soufriere Hills volcano has erupted frequently since 1995 (Figure 1). About 1.1 km super(3) of andesitic magma (Wadge et al., 2010) has erupted, and much of this material has been transported into the ocean as pyroclastic fows[mdash]hot avalanches of rocks, ash, and gas that travel at speeds in excess of 160 km per hour (Wadge et al., in press). In addition, mud flows (lahars) carrying volcanic debris wash into the ocean during periods of intense rain.

Geophysical mass-flows such as pyroclastic flows, lahars and avalanches, are commonly associated with explosive volcanism. These flows are primarily gravity-driven and are strongly influenced by the nature of the surface over which they move. Any spatial or temporal changes in the surface can affect the behavior of these flows. A series of investigations were conducted to determine the effects of changes in channel morphology on pyroclastic flows and lahars, the effects of long-term (century scale) changes in valley morphology on the behaviour of pyroclastic flows, and the effects of changes in the geology of a surface encountered by a debris avalanche during emplacement. A combination of numerical modeling (using the TITAN2D geophysical flow model) and fieldwork were used to gather data on the behavior of the mass-flows in question. Spatial changes in the morphology of a channel can cause pyroclastic flows to slow and thicken when encountering a break in slope, when entering a channel and when passing through a channel constriction. A change in channel width affects the flow thickness by a factor equal to that of the width change. Confined pyroclastic flows reach longer runout distances than unconfined flows with the same volume and bed friction. Long-term changes in the geomorphology of a valley can result in the rapid formation of thick pyroclastic flow deposits that choke existing channels leaving little or no space for deposition from subsequent flows to occur in. Temporal changes in the morphology of a channel caused by deposition from lahars resulted in an increase in the deceleration of flows in the deposition area, shorter runout distances, and increases in both the inundation and deposition areas. Assigning different values for basal friction to the various geological or geomorphological features encountered by a debris avalanche during emplacement significantly improved the accuracy of simulations when compared to documented examples of debris avalanches.

Adults undergoing treatment for breast cancer (BC) are advised to participate in regular exercise. However, many struggle to exercise consistently due to the side effects of systemic treatments including nausea, fatigue, and pain. In adults with newly diagnosed BC, this trial will evaluate the effectiveness of a new exercise intervention, compared with usual care, on outcomes including health-related quality of life (HRQoL). This randomised controlled trial is underway at an Australian tertiary hospital. The protocol was prospectively registered (Australian New Zealand Clinical Trials RegistryACTRN12623001168640p). Consenting adults with BC diagnosed within the prior six months, with planned chemotherapy and/or endocrine treatment will be randomised to an intervention or control group. Both groups receive usual physiotherapy and medical care. Those allocated to the intervention group are offered participation in the 'SMART' intervention (Self-determined, Monitored, Adaptable, Rehabilitation with Telehealth support). This involves 16-weeks of tailored, one-on-one physiotherapy-led exercise sessions including behaviour change techniques and the weekly goal of completing 150 minutes of aerobic exercise and two resistance training sessions. The primary outcome is HRQoL and secondary outcomes include physical assessments (muscle strength, exercise tolerance, body composition), healthcare utilisation, workplace absenteeism, mood, psychological determinants of behaviour change, chemotherapy completion rates and endocrine therapy completion. All outcomes are measured prior to randomisation and 16 weeks following randomisation. Additional assessments of all outcomes (excluding the physical assessment) occur at 8 weeks and 52 weeks following randomisation. Ongoing recruitment for two years from June 2024 is expected to achieve a sample size of 260. No results have been analysed. If the SMART intervention produces favourable change, this will support its adoption in clinical practice. A greater understanding of factors including BC stage, treatment type or variables relating to the exercise program, that influence the magnitude of exercise-induced change on HRQoL will inform future exercise programs.

Since 1999, dengue outbreaks in the continental United States involving local transmission have occurred only episodically and only in Florida and Texas. In Florida, these episodes appear to be coincident with increased introductions of dengue virus into the region through human travel and migration from countries where the disease is endemic. To date, the U.S. public health response to dengue outbreaks has been largely reactive, and implementation of comprehensive arbovirus surveillance in advance of predictable transmission seasons, which would enable proactive preventative efforts, remains unsupported. The significance of our finding is that it is the first documented report of DENV4 transmission to and maintenance within a local mosquito vector population in the continental United States in the absence of a human case during two consecutive years. Our data suggest that molecular surveillance of mosquito populations in high-risk, high-tourism areas of the United States may enable proactive, targeted vector control before potential arbovirus outbreaks. The incidence of locally acquired dengue infections increased during the last decade in the United States, compelling a sustained research effort concerning the dengue mosquito vector, Aedes aegypti , and its microbiome, which has been shown to influence virus transmission success. We examined the “metavirome” of four populations of Aedes aegypti mosquitoes collected in 2016 to 2017 in Manatee County, FL. Unexpectedly, we discovered that dengue virus serotype 4 (DENV4) was circulating in these mosquito populations, representing the first documented case of such a phenomenon in the absence of a local DENV4 human case in this county over a 2-year period. We confirmed that all of the mosquito populations carried the same DENV4 strain, assembled its full genome, validated infection orthogonally by reverse transcriptase PCR, traced the virus origin, estimated the time period of its introduction to the Caribbean region, and explored the viral genetic signatures and mosquito-specific virome associations that potentially mediated DENV4 persistence in mosquitoes. We discuss the significance of prolonged maintenance of the DENV4 infections in A. aegypti that occurred in the absence of a DENV4 human index case in Manatee County with respect to the inability of current surveillance paradigms to detect mosquito vector infections prior to a potential local outbreak. IMPORTANCE Since 1999, dengue outbreaks in the continental United States involving local transmission have occurred only episodically and only in Florida and Texas. In Florida, these episodes appear to be coincident with increased introductions of dengue virus into the region through human travel and migration from countries where the disease is endemic. To date, the U.S. public health response to dengue outbreaks has been largely reactive, and implementation of comprehensive arbovirus surveillance in advance of predictable transmission seasons, which would enable proactive preventative efforts, remains unsupported. The significance of our finding is that it is the first documented report of DENV4 transmission to and maintenance within a local mosquito vector population in the continental United States in the absence of a human case during two consecutive years. Our data suggest that molecular surveillance of mosquito populations in high-risk, high-tourism areas of the United States may enable proactive, targeted vector control before potential arbovirus outbreaks.

The incidence of locally acquired dengue infections increased during the last decade in the United States, compelling a sustained research effort on the dengue mosquito vector, Aedes aegypti, and its microbiome, which has been shown to influence virus transmission success. We examined the 'metavirome' of four populations of Ae. aegypti mosquitoes collected in 2016-2017 from Manatee County, Florida. Unexpectedly, we discovered that dengue virus serotype 4 (DENV4) was circulating in these mosquito populations, representing the first documented case of such a phenomenon in the absence of a local DENV4 human case in this county over a two-year period. We confirmed that all of the mosquito populations carried the same DENV4 strain, assembled its full genome, validated infection orthogonally by reverse transcriptase PCR, traced the virus origin, estimated the time period of its introduction to the Caribbean region, as well as explored the viral genetic signatures and mosquito-specific virome associations that potentially mediated DENV4 persistence in mosquitoes. We discuss the significance of prolonged maintenance of these DENV4 infections in Ae. aegypti that occurred in the absence of a DENV4 human index case in Manatee County with respect to the inability of current surveillance paradigms to detect mosquito vector infections prior to a potential local outbreak.