Background: On 31 March 2013, the first human infections with the novel influenza A/H7N9 virus were reported in Eastern China. The outbreak expanded rapidly in geographic scope and size, with a total of 132 laboratory-confirmed cases reported by 3 June 2013, in 10 Chinese provinces and Taiwan. The incidence of A/H7N9 cases has stalled in recent weeks, presumably as a consequence of live bird market closures in the most heavily affected areas. Here we compare the transmission potential of influenza A/H7N9 with that of other emerging pathogens and evaluate the impact of intervention measures in an effort to guide pandemic preparedness.

Methods: We used a Bayesian approach combined with a SEIR (Susceptible-Exposed-Infectious-Removed) transmission model fitted to daily case data to assess the reproduction number (R) of A/H7N9 by province and to evaluate the impact of live bird market closures in April and May 2013. Simulation studies helped quantify the performance of our approach in the context of an emerging pathogen, where human-to-human transmission is limited and most cases arise from spillover events. We also used alternative approaches to estimate R based on individual-level information on prior exposure and compared the transmission potential of influenza A/H7N9 with that of other recent zoonoses.

Results: Estimates of R for the A/H7N9 outbreak were below the epidemic threshold required for sustained human-to-human transmission and remained near 0.1 throughout the study period, with broad 95% credible intervals by the Bayesian method (0.01 to 0.49). The Bayesian estimation approach was dominated by the prior distribution, however, due to relatively little information contained in the case data. We observe a statistically significant deceleration in growth rate after 6 April 2013, which is consistent with a reduction in A/H7N9 transmission associated with the preemptive closure of live bird markets. Although confidence intervals are broad, the estimated transmission potential of A/H7N9 appears lower than that of recent zoonotic threats, including avian influenza A/H5N1, swine influenza H3N2sw and Nipah virus.

Conclusion: Although uncertainty remains high in R estimates for H7N9 due to limited epidemiological information, all available evidence points to a low transmission potential. Continued monitoring of the transmission potential of A/H7N9 is critical in the coming months as intervention measures may be relaxed and seasonal factors could promote disease transmission in colder months.

Background: The impact of socio-demographic factors and baseline health on the mortality burden of seasonal and pandemic influenza remains debated. Here we analyzed the spatial-temporal mortality patterns of the 1918 influenza pandemic in Spain, one of the countries of Europe that experienced the highest mortality burden.

Methods: We analyzed monthly death rates from respiratory diseases and all-causes across 49 provinces of Spain, including the Canary and Balearic Islands, during the period January-1915 to June-1919. We estimated the influenza-related excess death rates and risk of death relative to baseline mortality by pandemic wave and province. We then explored the association between pandemic excess mortality rates and health and socio-demographic factors, which included population size and age structure, population density, infant mortality rates, baseline death rates, and urbanization.

Results: Our analysis revealed high geographic heterogeneity in pandemic mortality impact. We identified 3 pandemic waves of varying timing and intensity covering the period from Jan-1918 to Jun-1919, with the highest pandemic-related excess mortality rates occurring during the months of October-November 1918 across all Spanish provinces. Cumulative excess mortality rates followed a south–north gradient after controlling for demographic factors, with the North experiencing highest excess mortality rates. A model that included latitude, population density, and the proportion of children living in provinces explained about 40% of the geographic variability in cumulative excess death rates during 1918–19, but different factors explained mortality variation in each wave.

Conclusions: A substantial fraction of the variability in excess mortality rates across Spanish provinces remained unexplained, which suggests that other unidentified factors such as comorbidities, climate and background immunity may have affected the 1918-19 pandemic mortality rates. Further archeo-epidemiological research should concentrate on identifying settings with combined availability of local historical mortality records and information on the prevalence of underlying risk factors, or patient-level clinical data, to further clarify the drivers of 1918 pandemic influenza mortality.

Cities around the world are facing an ever-increasing variety of challenges that seem to make more sustainable urban futures elusive. Many of these challenges are being driven by, and exacerbated by, increases in urban populations and climate change. Novel solutions are needed today if our cities are to have any hope of more sustainable and resilient futures. Because most of the environmental impacts of any project are manifest at the point of design, we posit that this is where a real difference in urban development can be made. To this end, we present a transformative model that merges urban design and ecology into an inclusive, creative, knowledge-to-action process. This design-ecology nexus—an ecology for cities—will redefine both the process and its products. In this paper we: (1) summarize the relationships among design, infrastructure, and urban development, emphasizing the importance of joining the three to achieve urban climate resilience and enhance sustainability; (2) discuss how urban ecology can move from an ecology of cities to an ecology for cities based on a knowledge-to-action agenda; (3) detail our model for a transformational urban design-ecology nexus, and; (4) demonstrate the efficacy of our model with several case studies.

Background: Ebola is one of the most virulent human viral diseases, with a case fatality ratio between 25% to 90%. The 2014 West African outbreaks are the largest and worst in history. There is no specific treatment or effective/safe vaccine against the disease. Hence, control efforts are restricted to basic public health preventive (non-pharmaceutical) measures. Such efforts are undermined by traditional/cultural belief systems and customs, characterized by general mistrust and skepticism against government efforts to combat the disease. This study assesses the roles of traditional customs and public healthcare systems on the disease spread.

Methods: A mathematical model is designed and used to assess population-level impact of basic non-pharmaceutical control measures on the 2014 Ebola outbreaks. The model incorporates the effects of traditional belief systems and customs, along with disease transmission within health-care settings and by Ebola-deceased individuals. A sensitivity analysis is performed to determine model parameters that most affect disease transmission. The model is parameterized using data from Guinea, one of the three Ebola-stricken countries. Numerical simulations are performed and the parameters that drive disease transmission, with or without basic public health control measures, determined. Three effectiveness levels of such basic measures are considered.

Results: The distribution of the basic reproduction number (R_0) for Guinea (in the absence of basic control measures) is such that R_ 0 ∈ [0.77,1.35], for the case when the belief systems do not result in more unreported Ebola cases. When such systems inhibit control efforts, the distribution increases to R_ 0 ∈ [1.15,2.05]. The total Ebola cases are contributed by Ebola-deceased individuals (22%), symptomatic individuals in the early (33%) and latter (45%) infection stages. A significant reduction of new Ebola cases can be achieved by increasing health-care workers’ daily shifts from 8 to 24 hours, limiting hospital visitation to 1 hour and educating the populace to abandon detrimental traditional/cultural belief systems.

Conclusions: The 2014 outbreaks are controllable using a moderately-effective basic public health intervention strategy alone. A much higher (>50%) disease burden would have been recorded in the absence of such intervention.

The purpose of applying social-ecological resilience thinking to food systems is twofold: First, to define those factors that help achieve a state in which food security for all and at all scales is possible. Second, to provide insights into how to maintain the system in this desirable regime. However, the resilience of food systems is distinct from the broader conceptualizations of resilience in social-ecological systems because of the fundamentally normative nature of food systems: humans need food to survive, and thus system stability is typically a primary policy objective for food system management. With that being said, society also needs food systems that can intensify sustainably i.e., feed everybody equitably, provide livelihoods and avoid environmental degradation while responding flexibly to shocks and uncertainty. Today’s failure in meeting food security objectives can be interpreted as the lack of current governance arrangements to consider the full and differential dimensions of food system functions – economic, ecological and social – at appropriate scales: in other words, the multifunctionality of food.

We focus on functional and response diversity as two key attributes of resilient, multifunctional food systems; respectively, the number of different functional groups and the diversity of types of responses to disturbances within a functional group. Achieving food security will require functional redundancy and enhanced response diversity, creating multiple avenues to fulfill all food system objectives. We use the 2013-15 drought in California to unpack the potential differences between managing for a single function – economic profit – and multiple functions. Our analysis emphasizes how the evolution of the Californian food system has reduced functional and response diversity and created vulnerabilities. Managing for the resilience of food systems will require a shift in priorities from profit maximization to the management for all functions that create full food security at multiple scales.

This article identifies equity outcomes associated with three biofuel systems in Brazil, Ethiopia and Guatemala. Acknowledging that winners and losers are socially and politically generated, the article identifies some of the factors behind the distribution of winners and losers along different stages of three sugarcane-ethanol supply chains. Analysing the outcomes for equity within each case study reveals an uneven distribution that we argue is related to the procedure and structure of the given sugarcane-ethanol system, and the recognition of the impacts on different actors within those structures. Increasing equity in sugarcane-ethanol systems will require greater openness in decision making processes, in order that multiple voices are taken into account in the promotion, production and consumption of biofuels – particularly those of smaller and less powerful actors.

Studies in both terrestrial and aquatic ecosystems have documented the potential importance of consumers on ecosystem-level nutrient dynamics. This is especially true when aggregations of organisms create biogeochemical hotspots through nutrient consumption, assimilation, and remineralization via excretion and egestion. Here, we focused on aggregations of humans in cities to examine how diet and waste management interact to drive nitrogen- (N) and phosphorus- (P) fluxes into nutrient pollution, inert forms, and nutrient recycling. We constructed six diet patterns (five US-based and one developing nation) to examine N- and P-consumption and excretion, and explored their implications for human health. Next, we constructed six waste-management patterns (three US and three for developing nations) to model how decisions at household and city scales determine the eventual fates of N and P. When compared to the US Recommended Daily Intake, all US diet patterns exceeded N and P requirements. Other than the “enriched CO₂ environment scenario” diet, the typical US omnivore had the greatest excess (37% N and 62% P). Notably, P from food additives could account for all of the excess P found in US omnivore and vegetarian diets. Across all waste-management approaches, a greater proportion of P was stored or recycled (0 to > 100% more P than N) and a greater proportion of N was released as effluent (20 to > 100% more N than P) resulting in pollution enriched with N and a recycling stream enriched with P. In developing nations, 60% of N and 50% of P from excreta entered the environment as pollution because of a lack of sanitation infrastructure. Our study demonstrates a novel addition to modeling sustainable scenarios for urban N- and P-budgets by linking human diets and waste management through socio-ecological systems.

Background: Elucidating the role of the underlying risk factors for severe outcomes of the 2009 A/H1N1 influenza pandemic could be crucial to define priority risk groups in resource-limited settings in future pandemics.

Methods: We use individual-level clinical data on a large series of ARI (acute respiratory infection) hospitalizations from a prospective surveillance system of the Mexican Social Security medical system to analyze clinical features at presentation, admission delays, selected comorbidities and receipt of seasonal vaccine on the risk of A/H1N1-related death. We considered ARI hospitalizations and inpatient-deaths, and recorded demographic, geographic, and medical information on individual patients during August-December, 2009.

Results: Seasonal influenza vaccination was associated with a reduced risk of death among A/H1N1 inpatients (OR = 0.43 (95% CI: 0.25, 0.74)) after adjustment for age, gender, geography, antiviral treatment, admission delays, comorbidities and medical conditions. However, this result should be interpreted with caution as it could have been affected by factors not directly measured in our study. Moreover, the effect of antiviral treatment against A/H1N1 inpatient death did not reach statistical significance (OR = 0.56 (95% CI: 0.29, 1.10)) probably because only 8.9% of A/H1N1 inpatients received antiviral treatment. Moreover, diabetes (OR = 1.6) and immune suppression (OR = 2.3) were statistically significant risk factors for death whereas asthmatic persons (OR = 0.3) or pregnant women (OR = 0.4) experienced a reduced fatality rate among A/H1N1 inpatients. We also observed an increased risk of death among A/H1N1 inpatients with admission delays >2 days after symptom onset (OR = 2.7). Similar associations were also observed for A/H1N1-negative inpatients.

Conclusions: Geographical variation in identified medical risk factors including prevalence of diabetes and immune suppression may in part explain between-country differences in pandemic mortality burden. Furthermore, access to care including hospitalization without delay and antiviral treatment and are also important factors, as well as vaccination coverage with the 2008–09 trivalent inactivated influenza vaccine.

The unicellular green microalga Desmodesmus sp. S1 can produce more than 50% total lipid of cell dry weight under high light and nitrogen-limitation conditions. After irradiation by heavy ¹²C⁶⁺ ion beam of 10, 30, 60, 90 or 120 Gy, followed by screening of resulting mutants on 24-well microplates, more than 500 mutants were obtained. One of those, named D90G-19, exhibited lipid productivity of 0.298 g L^-1⋅d^-1, 20.6% higher than wild type, likely owing to an improved maximum quantum efficiency (Fv/Fm) of photosynthesis under stress. This work demonstrated that heavy-ion irradiation combined with high-throughput screening is an effective means for trait improvement. The resulting mutant D90G-19 may be used for enhanced lipid production.

Urban areas consume more than 66% of the world’s energy and generate more than 70% of global greenhouse gas emissions. With the world’s population expected to reach 10 billion by 2100, nearly 90% of whom will live in urban areas, a critical question for planetary sustainability is how the size of cities affects energy use and carbon dioxide (CO₂) emissions. Are larger cities more energy and emissions efficient than smaller ones? Do larger cities exhibit gains from economies of scale with regard to emissions? Here we examine the relationship between city size and CO₂ emissions for U.S. metropolitan areas using a production accounting allocation of emissions. We find that for the time period of 1999–2008, CO₂ emissions scale proportionally with urban population size. Contrary to theoretical expectations, larger cities are not more emissions efficient than smaller ones.