Explore the vast range of titles available.

Abstract Introduction International travellers contribute to the rapid spread of Zika virus (ZIKV) and its sentinel identification globally. We describe ZIKV infections among international travellers seen at GeoSentinel sites with a focus on ZIKV acquired in the Americas and the Caribbean, describe countries of exposure and traveller characteristics, and assess ZIKV diagnostic testing by site. Methods Records with an international travel-related diagnosis of confirmed or probable ZIKV from January 2012 through December 2019 reported to GeoSentinel with a recorded illness onset date were included to show reported cases over time. Records from March 2016 through December 2019 with an exposure region of the Americas or the Caribbean were included in the descriptive analysis. A survey was conducted to assess the availability, accessibility and utilization of ZIKV diagnostic tests at GeoSentinel sites. Results GeoSentinel sites reported 525 ZIKV cases from 2012 through 2019. Between 2012 and 2014, eight cases were reported, and all were acquired in Asia or Oceania. After 2014, most cases were acquired in the Americas or the Caribbean, a large decline in ZIKV cases occurred in 2018–19. Between March 2016 and December 2019, 423 patients acquired ZIKV in the Americas or the Caribbean, peak reporting to these regions occurred in 2016 [330 cases (78%)]. The median age was 36 years (range: 3–92); 63% were female. The most frequent region of exposure was the Caribbean (60%). Thirteen travellers were pregnant during or after travel; one had a sexually acquired ZIKV infection. There was one case of fetal anomaly and two travellers with Guillain-Barré syndrome. GeoSentinel sites reported various challenges to diagnose ZIKV effectively. Conclusion ZIKV should remain a consideration for travellers returning from areas with risk of ZIKV transmission. Travellers should discuss their travel plans with their healthcare providers to ensure ZIKV prevention measures are taken.

A monkeypox outbreak in Nigeria during 2017-2020 provides an illustrative case study for emerging zoonoses. We built a statistical model to simulate declining immunity from monkeypox at 2 levels: At the individual level, we used a constant rate of decline in immunity of 1.29% per year as smallpox vaccination rates fell. At the population level, the cohort of vaccinated residents decreased over time because of deaths and births. By 2016, only 10.1% of the total population in Nigeria was vaccinated against smallpox; the serologic immunity level was 25.7% among vaccinated persons and 2.6% in the overall population. The substantial resurgence of monkeypox in Nigeria in 2017 appears to have been driven by a combination of population growth, accumulation of unvaccinated cohorts, and decline in smallpox vaccine immunity. The expanding unvaccinated population means that entire households, not just children, are now more susceptible to monkeypox, increasing risk of human-to-human transmission.

The novel coronavirus 2019 (COVID-19) pandemic has changed the way we live, work, and study. As faculty members, staff members, and students attempt to create and maintain a new normal because of this pandemic, the preservation of wellbeing becomes the responsibility of each and every one of us. The pandemic has taught us not to presume the importance of wellbeing and has allowed us time to reflect on establishing new assumptions and beliefs about how and when we work and study; how to be more efficient in our work and home responsibilities; and above all, what is most important. We must support ourselves and our students by maintaining a routine, modifying work and coursework expectations, and seeking psychosocial support if needed. Focusing on promoting wellbeing through leadership will move our institutions forward to a brighter future beyond COVID-19.

The COVID-19 pandemic has caused boundless disruptions to every element of life. It has also brought with it lessons from the past that will likely extend into the future as humans continue to interface with the ever-increasing threats of zoonotic diseases. The pandemic has challenged the profession and the Academy to adjust, modify, and adapt. It has also stretched the bounds of what had previously been thought possible within the realms of medicine. As the Academy begins to reach and crest the apex of the epidemic it should be reminded of the many lessons associated with the pandemic and of the constant need to challenge the paradigm of what is possible.

Wildlife population declines in Africa are widespread. However, species‐specific population trends and dynamics in mammal community composition have rarely been described over long time periods. To describe population trends of 13 large herbivore species in Lake Manyara National Park (Tanzania) from 1959 to 2016 and to discover whether the herbivore community structure changed, we used general additive models and additional statistical methods to detect structural changes in the time series. Population dynamics were non‐linear and population growth rates were not correlated with precipitation anomalies. Relatively steep population declines of three megaherbivores occurred during the 1980s and early 1990s, resulting in severe reductions in African elephant and buffalo populations and the local extinction of black rhinoceros. These declines coincided with reported peaks of illegal hunting of these species and expansion of agriculture at the periphery of the park. Population densities of elephant and buffalo seem to have stabilized in recent times, yet have not recovered to previous densities. In contrast, eight species (giraffe, zebra, waterbuck, wildebeest, warthog, impala, bushbuck, and baboon) have apparently fared well (similar or higher densities in most recent compared to first decade), despite having undergone substantial fluctuations over the past 58 yr. Population fluctuations in these species were likely caused by disease outbreaks, heavy bush encroachment, and reduced competition with buffalo. Possibly, declines in megaherbivore densities (mainly elephants) facilitated bush encroachment. Albeit grazers are still dominating in the herbivore community, the proportion of browsers is currently increasing, likely encouraged by dense vegetation in the shrub layer in large parts of the park. Overall, herbivore biomass density has declined by ~40% compared to the baseline estimate in the first decade of the time series. Our analyses and ancillary information provide evidence that this overall decline in the herbivore assemblage was triggered by human‐induced reductions in megaherbivore population densities during the 1980s, either through excessive poaching, insularization of the park, or both. Likely, this had cascading and interacting effects on the vegetation structure and the herbivore assemblage. Thus, legacy effects of ineffective megaherbivore conservation efforts 30 yr ago are likely still affecting the ecology of this national park.

The COVID-19 pandemic disrupted global student mobility, leading to sharp declines in international student enrollment at U.S. higher education institutions (HEIs). Research on the pandemic’s effects highlights key challenges faced by international students, including financial instability, mental health concerns, and experiences of racism and xenophobia. Institutional responses varied, with some universities leveraging distance technology and policy adaptations, while others failed to provide adequate support. As mobility restrictions ease, international enrollment is rebounding, presenting HEIs with new opportunities to engage and attract students. Using Push-Pull Theory as a framework, this study examines how HEIs can strengthen pull factors—such as reaffirming the value of international students, expanding recruitment into new markets, and enhancing institutional infrastructure to support students during global crises. By understanding the lessons learned from COVID-19 and preparing for future disruptions, U.S. HEIs can position themselves competitively in an evolving global education landscape.

Background The rate of decline of antibody titers to influenza following infection can affect results of serological surveys, and may explain re-infection and recurrent epidemics by the same strain. Methods We followed up a cohort who seroconverted on hemagglutination inhibition (HI) antibody titers (≥4-fold increase) to pandemic influenza A(H1N1)pdm09 during a seroincidence study in 2009. Along with the pre-epidemic sample, and the sample from 2009 with the highest HI titer between August and October 2009 (A), two additional blood samples obtained in April 2010 and September 2010 (B and C) were assayed for antibodies to A(H1N1)pdm09 by both HI and virus microneutralization (MN) assays. We analyzed pair-wise mean-fold change in titers and the proportion with HI titers ≥ 40 and MN ≥ 160 (which correlated with a HI titer of 40 in our assays) at the 3 time-points following seroconversion. Results A total of 67 participants contributed 3 samples each. From the highest HI titer in 2009 to the last sample in 2010, 2 participants showed increase in titers (by HI and MN), while 63 (94%) and 49 (73%) had reduction in HI and MN titers, respectively. Titers by both assays decreased significantly; while 70.8% and 72.3% of subjects had titers of ≥ 40 and ≥ 160 by HI and MN in 2009, these percentages decreased to 13.9% and 36.9% by September 2010. In 6 participants aged 55 years and older, the decrease was significantly greater than in those aged below 55, so that none of the elderly had HI titers ≥ 40 nor MN titers ≥ 160 by the final sample. Due to this decline in titers, only 23 (35%) of the 65 participants who seroconverted on HI in sample A were found to seroconvert between the pre-epidemic sample and sample C, compared to 53 (90%) of the 59 who seroconverted on MN on Sample A. Conclusions We observed marked reduction in titers 1 year after seroconversion by HI, and to a lesser extent by MN. Our findings have implications for re-infections, recurrent epidemics, vaccination strategies, and for cohort studies measuring infection rates by seroconversion.

The management of multiple dilemmas became a norm overnight for Catholic school superintendents navigating the COVID-19 pandemic as they quickly moved to making decisions that would have long-term effects on the system of schools they led. This paper attempts to make sense of the new educational dilemmas that have confronted Catholic school superintendents during these past several months. Utilizing the 2019 framework for navigating and managing professional dilemmas in educational leadership (Spillane & Lowenhaupt), we explore educational dilemmas Catholic school superintendents face during this pandemic. We show in this paper that Catholic school superintendents have drawn on their professional expertise and tailored their responses to these COVID-19 dilemmas in illustrative and instructive ways for considering how the U.S. Catholic school system may better respond as the pandemic continues.

A third of schools' recent enrollment drop can't be explained by an aging population or switches to nonpublic schooling, a new paper finds.

Relationships are key to rebuilding attendance habits that eroded in the pandemic.