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Article
| Open AccessPredicting mortality from AI cardiac volumes mass and coronary calcium on chest computed tomography
Chest computed tomography (CT) is one of the most common diagnostic tests. Here, the authors combine two AI models to measure from CT coronary artery calcium, left ventricular mass index, and left and right atrial and ventricular volumes, and show their association with cardiovascular mortality.
- Robert J. H. Miller
- , Aditya Killekar
- & Piotr J. Slomka
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Perspective
| Open AccessEcological countermeasures to prevent pathogen spillover and subsequent pandemics
In this Perspective, the authors discuss the importance of preventing zoonotic spillover to prevent pandemics. They highlight mechanisms by which environmental changes can enable spillover, identify ecological interventions for spillover prevention and suggest policy frameworks through which interventions can be implemented.
- Raina K. Plowright
- , Aliyu N. Ahmed
- & Annika T. H. Keeley
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Article
| Open AccessPredictive evolutionary modelling for influenza virus by site-based dynamics of mutations
Seasonal influenza vaccine effectiveness depends on including virus strains in the vaccine that closely match those circulating in the upcoming season. In this study, the authors develop a computational model of influenza virus evolution to predict future circulating strains and therefore support vaccine strain selection.
- Jingzhi Lou
- , Weiwen Liang
- & Maggie Haitian Wang
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Review Article
| Open AccessArtificial cells for in vivo biomedical applications through red blood cell biomimicry
Despite the enormous progress in the field of giant lipid vesicles, their use for in vivo biomedical applications is limited. Here, the authors discuss red blood cells as inspiration for enhancing those vesicles, investigating the required cellular features and the corresponding technical hurdles.
- Jorik Waeterschoot
- , Willemien Gosselé
- & Xavier Casadevall i Solvas
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Comment
| Open AccessPopulation imaging cerebellar growth for personalized neuroscience
Growth chart studies of the human cerebellum, which is increasingly recognized as pivotal for cognitive development, are rare. Gaiser and colleagues utilized population-level neuroimaging to unveil cerebellar growth charts from childhood to adolescence, offering insights into brain development.
- Zi-Xuan Zhou
- & Xi-Nian Zuo
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Article
| Open AccessGenomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique
Routine sampling of pregnant women at first antenatal care (ANC) visits could be used for malaria surveillance. Here, the authors compare the genetic structure of Plasmodium falciparum parasite populations between samples from first ANC users and children from the community in Mozambique, and show that it can inform about changes in transmission beyond epidemiological data.
- Nanna Brokhattingen
- , Glória Matambisso
- & Alfredo Mayor
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Article
| Open AccessUptake of COVID-19 vaccinations amongst 3,433,483 children and young people: meta-analysis of UK prospective cohorts
COVID-19 vaccination has been recommended for children and young people (aged 5–17) in the UK since 2021/2022. In this study, the authors use linked health and administrative data to estimate vaccine uptake in this age group and show that age and adult household vaccination status are associated with uptake.
- Sarah J. Aldridge
- , Utkarsh Agrawal
- & Rhiannon K. Owen
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Article
| Open AccessThe decline of the 2022 Italian mpox epidemic: Role of behavior changes and control strategies
Mpox cases in Italy rapidly declined following a peak in summer 2022. Here, the authors investigate potential reasons for the decline in cases using an individual-based model of a sexual contact network of men who have sex with men.
- Giorgio Guzzetta
- , Valentina Marziano
- & Stefano Merler
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Article
| Open AccessCost-effectiveness uncertainty may bias the decision of coal power transitions in China
China’s use of coal is complex to establish a clean and low-carbon transition for the country. With an uncertainty assessment framework, this study displays the risks of missing opportunities in obtaining cumulative positive net benefits and identifying an optimal transition strategy.
- Xizhe Yan
- , Dan Tong
- & Yu Lei
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Article
| Open AccessSpeaking without vocal folds using a machine-learning-assisted wearable sensing-actuation system
Addressing challenges in voice disorders, the authors present a self-powered, wearable sensor-actuator system based on magnetoelasticity. This innovation enables assisted speaking by capturing laryngeal movements and translating them into voice signals, bypassing the vocal folds.
- Ziyuan Che
- , Xiao Wan
- & Jun Chen
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Article
| Open AccessSystematic review and meta-analysis for a Global Patient co-Owned Cloud (GPOC)
Use of cloud-based personal health records are increasing globally. Here, authors introduce the Global Patient co-Owned Cloud (GPOC) concept. The systematic review and meta-analysis examine factors like data security, efficiency, privacy, and cost. It aims to establish a scientific basis for a GPOC, which may disseminate global artificial intelligence for healthcare.
- Niklas Lidströmer
- , Joe Davids
- & Eric Herlenius
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Article
| Open AccessUnderstanding the infection severity and epidemiological characteristics of mpox in the UK
Mpox cases without known travel links to endemic countries began to be detected in the UK in mid-2022. In this study, the authors characterise the severity of mpox cases in the UK and estimate the overall infection hospitalisation risk at ~4%.
- Thomas Ward
- , Christopher E. Overton
- & Martyn Fyles
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Article
| Open AccessEnabling large-scale screening of Barrett’s esophagus using weakly supervised deep learning in histopathology
Diagnosis of Barrett’s esophagus depends on pathologist assessment of stained slides. Here, the authors utilise a deep learning approach to prioritize potential cases using diagnostic labels in two datasets, with the aim to improve Barrett’s screening capacity.
- Kenza Bouzid
- , Harshita Sharma
- & Javier Alvarez-Valle
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Article
| Open AccessDeep learning model for personalized prediction of positive MRSA culture using time-series electronic health records
Identification of patients at high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection could improve treatment outcomes by optimising antimicrobial therapy. Here the authors develop a deep learning model that uses electronic health record data from the United States to predict MRSA culture positivity.
- Masayuki Nigo
- , Laila Rasmy
- & Degui Zhi
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Article
| Open AccessSystematic analysis of ChatGPT, Google search and Llama 2 for clinical decision support tasks
People will likely use ChatGPT to seek health advice. Here, the authors show promising performance of ChatGPT and open source models, but a lack of high accuracy considering medical question answering. Improvements are expected over time via domain-specific finetuning and integration of regulations.
- Sarah Sandmann
- , Sarah Riepenhausen
- & Julian Varghese
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Article
| Open AccessComparing frequency of booster vaccination to prevent severe COVID-19 by risk group in the United States
The optimal frequency of COVID-19 booster vaccination is unclear. Here, the authors use a microsimulation model to assess the impact of different vaccine schedules on severe disease and show that regular boosters have large benefits for older and immunocompromised individuals but less so for younger age groups.
- Hailey J. Park
- , Gregg S. Gonsalves
- & Nathan C. Lo
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Article
| Open AccessEnhancing the fairness of AI prediction models by Quasi-Pareto improvement among heterogeneous thyroid nodule population
Artificial Intelligence (AI) models for medical diagnosis often face challenges of generalizability and fairness. Here, the authors show that the Quasi-Pareto Improvement approach is widely applicable to improving AI models among less-prevalent subgroups, promoting equitable healthcare outcomes.
- Siqiong Yao
- , Fang Dai
- & Hui Lu
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Article
| Open AccessA phase I/IIa safety and efficacy trial of intratympanic gamma-secretase inhibitor as a regenerative drug treatment for sensorineural hearing loss
Pharmacological inhibition of gamma-secretase induced partial recovery of hearing in animal models. Here, the authors present the safety and efficacy results and key learnings of the First in Human Phase I/IIa study of a gamma-secretase inhibitor in patients with acquired Hearing Loss.
- Anne G. M. Schilder
- , Stephan Wolpert
- & Athanasios G. Bibas
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Article
| Open AccessInequalities in healthcare use during the COVID-19 pandemic
An indirect impact of the COVID-19 pandemic was a decline in healthcare utilisation for other conditions. Here, the authors quantify this decline in the Netherlands and show that impacts were greater for individuals with lower household income, females, older people, and those with a migrant background.
- Arun Frey
- , Andrea M. Tilstra
- & Mark D. Verhagen
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Article
| Open AccessEmpirical data drift detection experiments on real-world medical imaging data
Data drift is the systematic change in the underlying distribution of input features in prediction models, and can cause deterioration in model performance. Here, the authors highlight the importance of detecting data drift in clinical settings and evaluate methods for detecting drift in medical image data.
- Ali Kore
- , Elyar Abbasi Bavil
- & Mohamed Abdalla
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Article
| Open AccessDispersion patterns of SARS-CoV-2 variants Gamma, Lambda and Mu in Latin America and the Caribbean
Genomic surveillance has been important for tracking the evolution and spread of SARS-CoV-2. Here, the authors analyse ~300,000 SARS-CoV-2 genomes from two years of sequencing in the Latin America and Caribbean regions and describe the emergence and spread of different lineages over time.
- Tiago Gräf
- , Alexander A. Martinez
- & Juliana Almeida Leite
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Article
| Open AccessAutomatic data-driven design and 3D printing of custom ocular prostheses
Manual processes to produce ocular prostheses are time-consuming and yield varying quality. Here, authors present an automatic digital end-to-end process for custom ocular prostheses. It creates shape and appearance from image data of an OCT device and produces them using a full-colour 3D printer.
- Johann Reinhard
- , Philipp Urban
- & Mandeep S. Sagoo
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Article
| Open AccessPersistence in risk and effect of COVID-19 vaccination on long-term health consequences after SARS-CoV-2 infection
The long-term health consequences of COVID-19 infection are not fully understood. In this retrospective cohort study from Hong Kong, the authors describe changes in the risk of various clinical outcomes including all-cause mortality for one year following COVID-19 infection and how they vary by vaccination status.
- Ivan Chun Hang Lam
- , Ran Zhang
- & Eric Yuk Fai Wan
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Article
| Open AccessRapid deep learning-assisted predictive diagnostics for point-of-care testing
A key aim in the development of diagnostic assays is improving diagnostic speed while maintaining sensitivity. Here the authors report an approach for the rapid and accurate analysis of lateral flow tests, which integrates time-series deep learning and AI verification, achieving a diagnostic time of 1-2 minutes.
- Seungmin Lee
- , Jeong Soo Park
- & Jeong Hoon Lee
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Article
| Open AccessConcordance of randomised controlled trials for artificial intelligence interventions with the CONSORT-AI reporting guidelines
The CONSORT-AI extension was developed to provide specific guidance for randomised controlled trials involving Artificial Intelligence (AI) interventions. Here, the authors show that since publication of CONSORT-AI, several AI-specific considerations remain systematically underreported.
- Alexander P. L. Martindale
- , Benjamin Ng
- & Xiaoxuan Liu
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Article
| Open AccessData encoding for healthcare data democratization and information leakage prevention
Healthcare data democratization is often hampered by privacy constraints governing the sensitive healthcare data. Here, the authors show that encoding healthcare data could be a potential solution for achieving healthcare democratization within the context of deep learning.
- Anshul Thakur
- , Tingting Zhu
- & David A. Clifton
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Article
| Open AccessLeisure engagement in older age is related to objective and subjective experiences of aging
The benefits of different leisure activities for different aspects of aging remain unclear. Here, authors show that performing physical or creative activities is associated with important aging metrics and could help to prevent age-related decline.
- Jessica K. Bone
- , Feifei Bu
- & Daisy Fancourt
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Article
| Open AccessFlexible and cost-effective genomic surveillance of P. falciparum malaria with targeted nanopore sequencing
Genomic surveillance of Plasmodium falciparum could improve monitoring of drug resistance, but implementation has been hampered due to the large and complex genome. Here, de Cesare et al. develop a flexible and cost-effective nanopore sequencing approach to detect drug resistance and diagnostic escape for P. falciparum malaria.
- Mariateresa de Cesare
- , Mulenga Mwenda
- & Jason A. Hendry
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Article
| Open AccessAssessing emergence risk of double-resistant and triple-resistant genotypes of Plasmodium falciparum
Emergence of malaria parasites resistant to artemisinin has prompted the need for new drug regimens to ensure effective treatment. In this simulation study, the authors evaluate the risk of multidrug resistance under regimens with either concurrent or cyclic use of different first-line therapies.
- Eric Zhewen Li
- , Tran Dang Nguyen
- & Maciej F. Boni
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Article
| Open AccessGenomic epidemiology reveals geographical clustering of multidrug-resistant Escherichia coli ST131 associated with bacteraemia in Wales
Escherichia coli ST131 is a globally dominant multidrug resistant clone associated with high rates of recurring urinary tract infections. In this genomic epidemiology study, the authors describe the evolution, population structure, and antimicrobial resistance in 142 E. coli ST131 samples from Wales, UK.
- Rhys T. White
- , Matthew J. Bull
- & Scott A. Beatson
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Article
| Open AccessA deep-learning-based framework for identifying and localizing multiple abnormalities and assessing cardiomegaly in chest X-ray
Accurate localization of abnormalities is crucial in the interpretation of chest X-rays. Here the authors present a deep learning framework for simultaneous localization of 14 thoracic abnormalities and calculation of cardiothoracic ratio, based on large X-ray dataset with bounding boxes created via a human-in-the-loop approach.
- Weijie Fan
- , Yi Yang
- & Dong Zhang
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Article
| Open AccessIncome determines the impact of cash transfers on HIV/AIDS: cohort study of 22.7 million Brazilians
Brazil has operated a conditional cash transfer program to support families living in precarious conditions since 2004. Here, the authors use linked administrative and health data to investigate the impacts of the program on HIV/AIDS-related outcomes, demonstrating strong positive associations.
- Andréa F. Silva
- , Inês Dourado
- & Davide Rasella
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Article
| Open AccessComparative effectiveness of alternative intervals between first and second doses of the mRNA COVID-19 vaccines
The optimal timing between first and second mRNA COVID-19 vaccine doses has not been established. Here, the authors use electronic health record data from Georgia, USA in a target trial emulation study to estimate vaccine effectiveness against infection for different dose intervals.
- Kayoko Shioda
- , Alexander Breskin
- & Elizabeth T. Rogawski McQuade
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Article
| Open AccessContribution of climate change to the spatial expansion of West Nile virus in Europe
West Nile Virus is emerging as an important pathogen in Europe, likely driven by recent climate and land-use changes. Here, the authors estimate the extent of the climate change-driven impact by modelling the change in West Nile Virus ecological suitability across the continent in the absence of climate change.
- Diana Erazo
- , Luke Grant
- & Simon Dellicour
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Article
| Open AccessA multicenter clinical AI system study for detection and diagnosis of focal liver lesions
Early detection and accurate diagnosis of focal liver lesions are crucial for effective treatment and prognosis. Here, the authors present a fully automated diagnostic system that leverages multi-phase CT scans and clinical features, for diagnosing liver lesions.
- Hanning Ying
- , Xiaoqing Liu
- & Xiujun Cai
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Article
| Open AccessPredicting the risk and speed of drug resistance emerging in soil-transmitted helminths during preventive chemotherapy
Resistance to chemotherapy for soil-transmitted helminth infection has been detected in veterinary settings but not yet in human infections. Here, the authors investigate the risk of resistance in humans and how it may change as a result of scaling-up preventative deworming programs.
- Luc E. Coffeng
- , Wilma A. Stolk
- & Sake J. de Vlas
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Article
| Open AccessEarly onset diagnosis in Alzheimer’s disease patients via amyloid-β oligomers-sensing probe in cerebrospinal fluid
In this work, the authors characterize a small molecule fluorescent probe pioneering early diagnosis of Alzheimer’s disease through identification of amyloid-β oligomers in patients’ cerebrospinal fluid, demonstrating potential for clinical application.
- Jusung An
- , Kyeonghwan Kim
- & Jong Seung Kim
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Editorial
| Open AccessHealth in Africa
Africa is undergoing a demographic transition
1 that has led to significant reductions in the number of individuals living in extreme poverty, and to positive shifts in related health outcomes, across its diverse populations2 . Building on these successes requires a consideration of intersecting factors that impact health metrics, which is the focus of the United Nations Sustainable Development Goals3 . To support researchers in their efforts towards reaching these goals, Nature Communications, Communications Medicine and Scientific Reports invite submissions of papers that advance our understanding of all aspects of health in Africa. -
Article
| Open AccessCongenital heart disease detection by pediatric electrocardiogram based deep learning integrated with human concepts
Congenital heart disease is life threatening, and its screening is complex and costly. Here, authors use AI to detect the disease based on pediatric electrocardiogram, suggesting superior performance over cardiologists.
- Jintai Chen
- , Shuai Huang
- & Huiying Liang
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Article
| Open AccessMaternal pertussis immunization and the blunting of routine vaccine effectiveness: a meta-analysis and modeling study
Pertussis immunisation for pregnant women has been introduced to protect newborns, but immunological evidence suggests that this lessens subsequent infant immune response to vaccination. Here, the authors assess the epidemiological impacts of both consequences of maternal immunisation on infant infection.
- Michael Briga
- , Elizabeth Goult
- & Matthieu Domenech de Cellès
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Article
| Open AccessDimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Dimethyl fumarate (DMF) is an anti-inflammatory drug proposed as a treatment for COVID19. Here the results are reported from a randomised trial testing DMF treatment in 713 patients hospitalised with COVID-19. DMF was not associated with any improvement in day 5 outcomes.
- Peter Sandercock
- , Janet Darbyshire
- & Martin J. Landray
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Article
| Open AccessLongitudinal quantification of Bifidobacterium longum subsp. infantis reveals late colonization in the infant gut independent of maternal milk HMO composition
Here, the authors develop a high-throughput method to quantify Bifidobacterium longum subsp. infantis (BL. infantis), a proficient HMO-utilizer, from metagenomic sequencing, and applied it to a longitudinal cohort consisting of 21 mother-infant dyads, suggesting BL. infantis colonization to start late in the breast-feeding period.
- Dena Ennis
- , Shimrit Shmorak
- & Moran Yassour
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Comment
| Open AccessAfrican leadership is critical in responding to public health threats
The African continent demonstrated decisive leadership throughout its response to the COVID-19 pandemic, leveraging lessons learned from previous outbreaks and acting quickly to limit the impact of the SARS-CoV-2 virus. We propose a framework to build on these successes that calls for greater collaboration between African leaders, and greater inclusion of African voices in the global health ecosystem.
- Nicaise Ndembi
- , Aggrey Aluso
- & Jean Kaseya
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Article
| Open AccessGlobal surveillance of antimicrobial resistance in food animals using priority drugs maps
Monitoring antimicrobial resistance in food animals is challenging due to limited surveillance systems. Here, the authors combine data from point prevalence surveys in lower- and middle-income settings to map resistance to seven antimicrobials and predict which are likely to exceed key resistance thresholds.
- Cheng Zhao
- , Yu Wang
- & Thomas P. Van Boeckel
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Article
| Open AccessRapid and visual identification of β-lactamase subtypes for precision antibiotic therapy
The rapid identification of drug-resistant bacteria is vital for effective treatment and to avoid antibiotic misuse. Here authors report a paper-based sensor which utilises chromogenic carbapenem and cephalosporin substrates for the identification and discrimination of β-lactamase subtypes.
- Wenshuai Li
- , Jingqi Li
- & Dingbin Liu
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Article
| Open AccessSegment anything in medical images
Segmentation is an important fundamental task in medical image analysis. Here the authors show a deep learning model for efficient and accurate segmentation across a wide range of medical image modalities and anatomies.
- Jun Ma
- , Yuting He
- & Bo Wang
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Article
| Open AccessUsing big sequencing data to identify chronic SARS-Coronavirus-2 infections
Chronic SARS-CoV-2 infections have been hypothesised to be sources of new variants. Here, the authors use large-scale genome sequencing data to identify mutations predictive of chronic infections, which may therefore be relevant in future variants.
- Sheri Harari
- , Danielle Miller
- & Adi Stern
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Article
| Open AccessMarkets as drivers of selection for highly virulent poultry pathogens
Live poultry markets in rural areas can be hotspots for transmission of pathogens, but the effects of markets on selection of viral virulence are not known. This study demonstrates through mathematical modelling that high turnover rate and persistence of viral particles can select for highly virulent pathogens in markets.
- Justin K. Sheen
- , Fidisoa Rasambainarivo
- & C. Jessica E. Metcalf
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Article
| Open AccessDeterminants of epidemic size and the impacts of lulls in seasonal influenza virus circulation
Seasonal influenza levels were unusually low when non-pharmaceutical interventions for COVID-19 were in place. Here, the authors analyse serological and epidemiological evidence for the hypothesis that such lulls in influenza transmission lead to reduced immunity and therefore larger epidemics in subsequent seasons.
- Simon P. J. de Jong
- , Zandra C. Felix Garza
- & Colin A. Russell