Mammalian Orthoreovirus Reassortment Proceeds with Little Constraint on Segment Mixing.

Segmentation of viral genomes provides the potential for genetic exchange within coinfected cells. However, for this potential to be realized, coinfecting genomes must mix during the viral life cycle. The efficiency of reassortment, in turn, dictates its potential to drive evolution. The opportunity for mixing within coinfected cells may vary greatly across virus families, such that the evolutionary implications of genome segmentation differ as a result of core features of the viral life cycle. To investigate the relationship between viral replication compartments and genetic exchange, we quantified reassortment in mammalian orthoreovirus (reovirus). Reoviruses carry a 10-segmented, double-stranded RNA genome, which is replicated within proteinaceous structures termed inclusion bodies. We hypothesized that inclusions impose a barrier to reassortment. We quantified reassortment between wild-type (wt) and variant (var) reoviruses that differ by one nucleotide per segment. Studies of wt/var systems in both T1L and T3D backgrounds revealed frequent reassortment without bias toward particular genotypes. However, reassortment was more efficient in the T3D serotype. Since T1L and T3D viruses exhibit different inclusion body morphologies, we tested the impact of this phenotype on reassortment. In both serotypes, reassortment levels did not differ by inclusion morphology. Reasoning that the merging of viral inclusions may be critical for genome mixing, we then tested the effect of blocking merging. Reassortment proceeded efficiently even under these conditions. Our findings indicate that reovirus reassortment is highly efficient despite the localization of many viral processes to inclusion bodies, and that the robustness of this genetic exchange is independent of inclusion body structure and fusion. IMPORTANCE Quantification of reassortment in diverse viral systems is critical to elucidate the implications of genome segmentation for viral evolution. In principle, genome segmentation offers a facile means of genetic exchange between coinfecting viruses. In practice, there may be physical barriers within the cell that limit the mixing of viral genomes. Here, we tested the hypothesis that localization of the various stages of the mammalian orthoreovirus life cycle within cytoplasmic inclusion bodies compartmentalizes viral replication and limits genetic exchange. Contrary to this hypothesis, our data indicate that reovirus reassortment occurs readily within coinfected cells and is not strongly affected by the structure or dynamics of viral inclusion bodies. We conclude that the potential for reassortment to contribute to reovirus evolution is high.

Development of CNN models for the enteral feeding tube positioning assessment on a small scale data set.

BACKGROUND: Enteral nutrition through feeding tubes serves as the primary method of nutritional supplementation for patients unable to feed themselves. Plain radiographs are routinely used to confirm the position of the Nasoenteric feeding tubes the following insertion and before the commencement of tube feeds. Convolutional neural networks (CNNs) have shown encouraging results in assisting the tube positioning assessment. However, robust CNNs are often trained using large amounts of manually annotated data, which challenges applying CNNs on enteral feeding tube positioning assessment. METHOD: We build a CNN model for feeding tube positioning assessment by pre-training the model under a weakly supervised fashion on large quantities of radiographs. Since most of the model was pre-trained, a small amount of labeled data is needed when fine-tuning the model for tube positioning assessment. We demonstrate the proposed method using a small dataset with 175 radiographs. RESULT: The experimental result shows that the proposed model improves the area under the receiver operating characteristic curve (AUC) by up to 35.71% , from 0.56 to 0.76, and 14.49% on the accuracy, from 0.69 to 0.79 when compared with the no pre-trained method. The proposed method also has up to 40% less error when estimating its prediction confidence. CONCLUSION: Our evaluation results show that the proposed model has a high prediction accuracy and a more accurate estimated prediction confidence when compared to the no pre-trained model and other baseline models. The proposed method can be potentially used for assessing the enteral tube positioning. It also provides a strong baseline for future studies.

Dysregulation of M segment gene expression contributes to influenza A virus host restriction.

The M segment of the 2009 pandemic influenza A virus (IAV) has been implicated in its emergence into human populations. To elucidate the genetic contributions of the M segment to host adaptation, and the underlying mechanisms, we examined a panel of isogenic viruses that carry avian- or human-derived M segments. Avian, but not human, M segments restricted viral growth and transmission in mammalian model systems, and the restricted growth correlated with increased expression of M2 relative to M1. M2 overexpression was associated with intracellular accumulation of autophagosomes, which was alleviated by interference of the viral proton channel activity by amantadine treatment. As M1 and M2 are expressed from the M mRNA through alternative splicing, we separated synonymous and non-synonymous changes that differentiate human and avian M segments and found that dysregulation of gene expression leading to M2 overexpression diminished replication, irrespective of amino acid composition of M1 or M2. Moreover, in spite of efficient replication, virus possessing a human M segment that expressed avian M2 protein at low level did not transmit efficiently. We conclude that (i) determinants of transmission reside in the IAV M2 protein, and that (ii) control of M segment gene expression is a critical aspect of IAV host adaptation needed to prevent M2-mediated dysregulation of vesicular homeostasis.

Dual Josephson Impedance Bridge: Towards a Universal Bridge for Impedance Metrology.

This paper presents a full characterization of a Dual Josephson Impedance Bridge (DJIB) at frequencies up to 80 kHz by using the DJIB to compare the best available impedance standards that are (a) directly traceable to the quantum Hall effect, (b) used as part of international impedance comparisons, or (c) believed to have calculable frequency dependence. The heart of the system is a dual Josephson Arbitrary Waveform Synthesizer (JAWS) source that offers unprecedented flexibility in high-precision impedance measurements. The JAWS sources allow a single bridge to compare impedances with arbitrary ratios and phase angles in the complex plane. The uncertainty budget shows that both the traditional METAS bridges and the DJIB have comparable uncertainties in the kilohertz range. This shows that the advantages of the DJIB, including the flexibility which allows the comparison of arbitrary impedances, the wide frequency range, and the automated balancing procedure, are obtained without compromising the measurement uncertainties. These results demonstrate that this type of instrument can considerably simplify the realization and maintenance of the various impedance scales. In addition, the DJIB is a very sensitive tool for investigating the frequency-dependent systematic-errors that can occur in impedance construction and in the voltage provided by the JAWS source at frequencies greater than 10 kHz.

Influenza A Virus Reassortment Is Limited by Anatomical Compartmentalization following Coinfection via Distinct Routes.

Exchange of gene segments through reassortment is a major feature of influenza A virus evolution and frequently contributes to the emergence of novel epidemic, pandemic, and zoonotic strains. It has long been evident that viral diversification through reassortment is constrained by genetic incompatibility between divergent parental viruses. In contrast, the role of virus-extrinsic factors in determining the likelihood of reassortment has remained unclear. To evaluate the impact of such factors in the absence of confounding effects of segment mismatch, we previously reported an approach in which reassortment between wild-type (wt) and genetically tagged variant (var) viruses of the same strain is measured. Here, using wt/var systems in the A/Netherlands/602/2009 (pH1N1) and A/Panama/2007/99 (H3N2) strain backgrounds, we tested whether inoculation of parental viruses into distinct sites within the respiratory tract limits their reassortment. Using a ferret (Mustella putorius furo) model, either matched parental viruses were coinoculated intranasally or one virus was instilled intranasally whereas the second was instilled intratracheally. Dual intranasal inoculation resulted in robust reassortment for wt/var viruses of both strain backgrounds. In contrast, when infections were initiated simultaneously at distinct sites, strong compartmentalization of viral replication was observed and minimal reassortment was detected. The observed lack of viral spread between upper and lower respiratory tract tissues may be attributable to localized exclusion of superinfection within the host, mediated by innate immune responses. Our findings indicate that dual infections in nature are more likely to result in reassortment if viruses are seeded into similar anatomical locations and have matched tissue tropisms.IMPORTANCE Genetic exchange between influenza A viruses (IAVs) through reassortment can facilitate the emergence of antigenically drifted seasonal strains and plays a prominent role in the development of pandemics. Typical human influenza infections are concentrated in the upper respiratory tract; however, lower respiratory tract (LRT) infection is an important feature of severe cases, which are more common in the very young, the elderly, and individuals with underlying conditions. In addition to host factors, viral characteristics and mode of transmission can also increase the likelihood of LRT infection: certain zoonotic IAVs are thought to favor the LRT, and transmission via small droplets allows direct seeding into lower respiratory tract tissues. To gauge the likelihood of reassortment in coinfected hosts, we assessed the extent to which initiation of infection at distinct respiratory tract sites impacts reassortment frequency. Our results reveal that spatially distinct inoculations result in anatomical compartmentalization of infection, which in turn strongly limits reassortment.

Quantized Pulse Propagation in Josephson Junction Arrays.

We present time-domain electrical measurements and simulations of the quantized voltage pulses that are generated from series-connected Josephson junction (JJ) arrays. The transmission delay of the JJ array can lead to a broadening of the net output pulse, depending on the direction of the output pulse propagation relative to the input bias pulse. To demonstrate this, we compare time-domain measurements of output pulses from radio-frequency Josephson Arbitrary Waveform Synthesizer (RF-JAWS) circuits fabricated with two different output measurement configurations, so that the backward-propagating and forward-propagating pulses can be measured. Measurements were made on arrays with 1200 and 3600 JJs and show that the net backward-propagating output pulse is broadened by timing delays in the JJ array while the net forward-propagating output pulse is insensitive to delay effects and can theoretically be further scaled to longer JJ array lengths without significant output pulse broadening. These measurements match well with simulations and confirm the expectation that the net output pulses arise from the time-delayed superposition of individual JJ output pulses from the series array of JJs. The measurements and analysis shown here have important implications for the realization of RF-JAWS circuits to be used as quantum-based reference sources for communications metrology.

Survey of Australian psychiatrists' and psychiatry trainees' knowledge about and attitudes towards medicinal cannabinoids.

OBJECTIVE:: To assess Australian psychiatrists' and psychiatry trainees' knowledge about and attitudes towards medicinal cannabinoids, given the recent relaxation of cannabinoid-prescribing laws in Australia. METHOD:: All Australian members of the Royal Australian and New Zealand College of Psychiatrists were invited to participate in an anonymous, 64-item online questionnaire, through Royal Australian and New Zealand College of Psychiatrists' newsletters. The questionnaire ran for a 10-week period from March to May 2017. Participants were asked about their knowledge of the evidence for and against prescribing pharmaceutical-grade cannabidiol and tetrahydrocannabinol, and their concerns about prescribing medicinal cannabinoids. RESULTS:: In total, 88 doctors responded to the survey, with 55 completing all items (23 psychiatrists, 32 trainees). Overall, 54% of respondents would prescribe medicinal cannabinoids if it was legal to do so. Participants believed there was evidence for the use of cannabidiol and tetrahydrocannabinol in treating childhood epilepsy, chronic pain, and nausea and vomiting. They were most concerned about medicinal cannabinoids leading to psychotic symptoms, addiction and dependence, apathy and recreational use. CONCLUSIONS:: Our sample of Australian psychiatrists and trainees were aware of the main clinical indications for medicinal cannabinoids, but were poor at differentiating between the indications for cannabidiol versus tetrahydrocannabinol. Further education about medicinal cannabinoids appears necessary.

Gammaherpesvirus Co-infection with Malaria Suppresses Anti-parasitic Humoral Immunity.

Immunity to non-cerebral severe malaria is estimated to occur within 1-2 infections in areas of endemic transmission for Plasmodium falciparum. Yet, nearly 20% of infected children die annually as a result of severe malaria. Multiple risk factors are postulated to exacerbate malarial disease, one being co-infections with other pathogens. Children living in Sub-Saharan Africa are seropositive for Epstein Barr Virus (EBV) by the age of 6 months. This timing overlaps with the waning of protective maternal antibodies and susceptibility to primary Plasmodium infection. However, the impact of acute EBV infection on the generation of anti-malarial immunity is unknown. Using well established mouse models of infection, we show here that acute, but not latent murine gammaherpesvirus 68 (MHV68) infection suppresses the anti-malarial humoral response to a secondary malaria infection. Importantly, this resulted in the transformation of a non-lethal P. yoelii XNL infection into a lethal one; an outcome that is correlated with a defect in the maintenance of germinal center B cells and T follicular helper (Tfh) cells in the spleen. Furthermore, we have identified the MHV68 M2 protein as an important virus encoded protein that can: (i) suppress anti-MHV68 humoral responses during acute MHV68 infection; and (ii) plays a critical role in the observed suppression of anti-malarial humoral responses in the setting of co-infection. Notably, co-infection with an M2-null mutant MHV68 eliminates lethality of P. yoelii XNL. Collectively, our data demonstrates that an acute gammaherpesvirus infection can negatively impact the development of an anti-malarial immune response. This suggests that acute infection with EBV should be investigated as a risk factor for non-cerebral severe malaria in young children living in areas endemic for Plasmodium transmission.

Competitive Dominance within Biofilm Consortia Regulates the Relative Distribution of Pneumococcal Nasopharyngeal Density.

Streptococcus pneumoniae is a main cause of child mortality worldwide, but strains also asymptomatically colonize the upper airways of most children and form biofilms. Recent studies have demonstrated that ∼50% of colonized children carry at least two different serotypes (i.e., strains) in the nasopharynx; however, studies of how strains coexist are limited. In this work, we investigated the physiological, genetic, and ecological requirements for the relative distribution of densities, and spatial localization, of pneumococcal strains within biofilm consortia. Biofilm consortia were prepared with vaccine type strains (i.e., serotype 6B [S6B], S19F, or S23F) and strain TIGR4 (S4). Experiments first revealed that the relative densities of S6B and S23F were similar in biofilm consortia. The density of S19F strains, however, was reduced to ∼10% in biofilm consortia, including either S6B, S23F, or TIGR4, in comparison to S19F monostrain biofilms. Reduction of S19F density within biofilm consortia was also observed in a simulated nasopharyngeal environment. Reduction of relative density was not related to growth rates, since the Malthusian parameter demonstrated similar rates of change of density for most strains. To investigate whether quorum sensing (QS) regulates relative densities in biofilm consortia, two different mutants were prepared: a TIGR4ΔluxS mutant and a TIGR4ΔcomC mutant. The density of S19F strains, however, was similarly reduced when consortia included TIGR4, TIGR4ΔluxS, or TIGR4ΔcomC Moreover, production of a different competence-stimulating peptide (CSP), CSP1 or CSP2, was not a factor that affected dominance. Finally, a mathematical model, confocal experiments, and experiments using Transwell devices demonstrated physical contact-mediated control of pneumococcal density within biofilm consortia.IMPORTANCEStreptococcus pneumoniae kills nearly half a million children every year, but it also produces nasopharyngeal biofilm consortia in a proportion of asymptomatic children, and these biofilms often contain two strains (i.e., serotypes). In our study, we investigated how strains coexist within pneumococcal consortia produced by vaccine serotypes S4, S6B, S19F, and S23F. Whereas S6B and S23F shared the biofilm consortium, our studies demonstrated reduction of the relative density of S19F strains, to ∼10% of what it would otherwise be if alone, in consortial biofilms formed with S4, S6B, or S23F. This dominance was not related to increased fitness when competing for nutrients, nor was it regulated by quorum-sensing LuxS/AI-2 or Com systems. It was demonstrated, however, to be enhanced by physical contact rather than by a product(s) secreted into the supernatant, as would naturally occur in the semidry nasopharyngeal environment. Competitive interactions within pneumococcal biofilm consortia regulate nasopharyngeal density, a risk factor for pneumococcal disease.

The NIST Johnson Noise Thermometry System for the Determination of the Boltzmann Constant.

In preparation for the redefinition of the International System of Units (SI), five different electronic measurements of the Boltzmann constant have been performed using different Johnson noise thermometry (JNT) systems over the past seven years. In this paper, we describe in detail the JNT system and uncertainty components associated with the most recent National Institute of Standards and Technology (NIST) determination of the Boltzmann constant: k = 1.380642 9(69) × 10-23 J/K, with a relative standard uncertainty of 5.0 × 10-6 and relative offset of -4.05 × 10-6 from the Committee on Data for Science and Technology (CODATA) 2014 recommended value. We discuss the input circuits and the approach we used to match the frequency response of two noise sources. We present new measurements of the correlated noise of the 4 K on-chip resistors in the quantum-accurate, pseudorandom, voltage-noise source, which we used to estimate the correlated, frequency-dependent, nonthermal noise in our system. Finally, we contrast our system with those used in other measurements and speculate on future improvements.

Josephson Arbitrary Waveform Synthesis With Multilevel Pulse Biasing.

We describe the implementation of new commercial pulse-bias electronics that have enabled an improvement in the generation of quantum-accurate waveforms both with and without low-frequency compensation biases. We have used these electronics to apply a multilevel pulse bias to the Josephson arbitrary waveform synthesizer and have generated, for the first time, a quantum-accurate bipolar sinusoidal waveform without the use of a low-frequency compensation bias current. This uncompensated 1 kHz waveform was synthesized with an rms amplitude of 325 mV and maintained its quantum accuracy over a1.5 mA operating current range. The same technique and equipment was also used to synthesize a quantum-accurate 1 MHz sinusoid with a 1.2 mA operating margin. In addition, we have synthesized a compensated 1 kHz sinusoid with an rms amplitude of 1 V and a 2.7 mA operating margin.

Two-Volt Josephson Arbitrary Waveform Synthesizer Using Wilkinson Dividers.

The root-mean-square (rms) output voltage of the NIST Josephson arbitrary waveform synthesizer (JAWS) has been doubled from 1 V to a record 2 V by combining two new 1 V chips on a cryocooler. This higher voltage will improve calibrations of ac thermal voltage converters and precision voltage measurements that require state-of-the-art quantum accuracy, stability, and signal-to-noise ratio. We achieved this increase in output voltage by using four on-chip Wilkinson dividers and eight inner-outer dc blocks, which enable biasing of eight Josephson junction (JJ) arrays with high-speed inputs from only four high-speed pulse generator channels. This approach halves the number of pulse generator channels required in future JAWS systems. We also implemented on-chip superconducting interconnects between JJ arrays, which reduces systematic errors and enables a new modular chip package. Finally, we demonstrate a new technique for measuring and visualizing the operating current range that reduces the measurement time by almost two orders of magnitude and reveals the relationship between distortion in the output spectrum and output pulse sequence errors.

Different effects of whole-cell and acellular vaccines on Bordetella transmission.

BACKGROUND: Vaccine development has largely focused on the ability of vaccines to reduce disease in individual hosts, with less attention to assessing the vaccine's effects on transmission between hosts. Current acellular vaccines against Bordetella pertussis are effective in preventing severe disease but have little effect on less severe coughing illness that can mediate transmission. METHODS: Using mice that are natural host's of Bordetella bronchiseptica, we determined the effects of vaccination on shedding and transmission of this pathogen. RESULTS: Vaccination with heat-killed whole-cell B. bronchiseptica or B. pertussis inhibited shedding of B. bronchiseptica. Differences in neutrophil and B-cell recruitment distinguished sham-vaccine from whole-cell-----vaccine responses and correlated with shedding output. Both B and T cells were essential for vaccine-induced control of shedding. Adoptive transfer of antibodies was able to limit shedding, while depletion of CD4(+) T cells led to increased shedding in vaccinated mice. Finally, whole-cell vaccination was able to prevent transmission, but an acellular vaccine that effectively controls disease failed to control shedding and transmission. CONCLUSIONS: Our results highlight discrepancies between whole-cell and acellular vaccination that could contribute to the increased incidence of B. pertussis infection since the transition to the use of acellular vaccination.

Critical role of the hippocampus in memory for elapsed time.

Episodic memory includes information about how long ago specific events occurred. Since most of our experiences have overlapping elements, remembering this temporal context is crucial for distinguishing individual episodes. The discovery of timing signals in hippocampal neurons, including evidence of "time cells" and of gradual changes in ensemble activity over long timescales, strongly suggests that the hippocampus is important for this capacity. However, behavioral evidence that the hippocampus is critical for the memory of elapsed time is lacking. This is possibly because previous studies have used time durations in the range of seconds when assessing hippocampal dependence, a timescale known to require corticostriatal circuits. Here we developed a nonspatial paradigm to test the hypothesis that the hippocampus is critical for keeping track of elapsed time over several minutes. We report that rats have a robust ability to remember durations at this timescale. We then determined the role of the hippocampus using infusions of fluorophore-conjugated muscimol, a GABAA agonist. We found that the hippocampus was essential for discriminating smaller, but not larger, temporal differences (measured in log units), consistent with a role in temporal pattern separation. Importantly, this effect was observed at long (minutes) but not short (seconds) timescales, suggesting an interplay of temporal resolution and timescale in determining hippocampal dependence. These results offer compelling evidence that the hippocampus plays a critical role in remembering how long ago events occurred.

Enhancing Global Estimation of Fine Particulate Matter Concentrations by Including Geophysical a Priori Information in Deep Learning.

Global fine particulate matter (PM2.5) assessment is impeded by a paucity of monitors. We improve estimation of the global distribution of PM2.5 concentrations by developing, optimizing, and applying a convolutional neural network with information from satellite-, simulation-, and monitor-based sources to predict the local bias in monthly geophysical a priori PM2.5 concentrations over 1998-2019. We develop a loss function that incorporates geophysical a priori estimates and apply it in model training to address the unrealistic results produced by mean-square-error loss functions in regions with few monitors. We introduce novel spatial cross-validation for air quality to examine the importance of considering spatial properties. We address the sharp decline in deep learning model performance in regions distant from monitors by incorporating the geophysical a priori PM2.5. The resultant monthly PM2.5 estimates are highly consistent with spatial cross-validation PM2.5 concentrations from monitors globally and regionally. We withheld 10% to 99% of monitors for testing to evaluate the sensitivity and robustness of model performance to the density of ground-based monitors. The model incorporating the geophysical a priori PM2.5 concentrations remains highly consistent with observations globally even under extreme conditions (e.g., 1% for training, R2 = 0.73), while the model without exhibits weaker performance (1% for training, R2 = 0.51).

Early stimulation treatment provides complete sensory-induced protection from ischemic stroke under isoflurane anesthesia.

Using a rodent model of ischemia [permanent middle cerebral artery occlusion (pMCAO)], previous studies demonstrated that whisker stimulation treatment completely protects the cortex from impending stroke when initiated within 2 h following pMCAO. When initiated 3 h post-pMCAO, the identical treatment exacerbates stroke damage. Rats in these studies, however, were anesthetised with sodium pentobarbital, whereas human stroke patients are typically awake. To overcome this drawback, our laboratory has begun to use the anesthetic isoflurane, which allows rats to rapidly recover from pMCAO within minutes, to test stimulation treatment in awake rats and to determine whether isoflurane has an effect upon the pMCAO stroke model. We found no difference in infarct volume between pMCAO in untreated controls under either sodium pentobarbital or isoflurane, and the primary finding was that rats that received treatment immediately post-pMCAO maintain cortical function and no stroke damage, whereas rats that received treatment 3 h post-pMCAO exhibited eliminated cortical activity and extensive stroke damage. The only difference between anesthetics was the broad extent of evoked cortical activity observed during both functional imaging and electrophysiological recording, suggesting that the extent of evoked activity evident under isoflurane anesthesia is supported by underlying neuronal activity. Given the high degree of similarity with previous data, we conclude that the pMCAO stroke model is upheld with the use of isoflurane. This study demonstrated that the isoflurane-anesthetised rat pMCAO model can be used for cerebrovascular studies, and allows for highly detailed investigation of potential novel treatments for ischemic stroke using awake, behaving animals.

Biaxial tension of fibrous tissue: using finite element methods to address experimental challenges arising from boundary conditions and anisotropy.

Planar biaxial tension remains a critical loading modality for fibrous soft tissue and is widely used to characterize tissue mechanical response, evaluate treatments, develop constitutive formulas, and obtain material properties for use in finite element studies. Although the application of tension on all edges of the test specimen represents the in situ environment, there remains a need to address the interpretation of experimental results. Unlike uniaxial tension, in biaxial tension the applied forces at the loading clamps do not transmit fully to the region of interest (ROI), which may lead to improper material characterization if not accounted for. In this study, we reviewed the tensile biaxial literature over the last ten years, noting experimental and analysis challenges. In response to these challenges, we used finite element simulations to quantify load transmission from the clamps to the ROI in biaxial tension and to formulate a correction factor that can be used to determine ROI stresses. Additionally, the impact of sample geometry, material anisotropy, and tissue orientation on the correction factor were determined. Large stress concentrations were evident in both square and cruciform geometries and for all levels of anisotropy. In general, stress concentrations were greater for the square geometry than the cruciform geometry. For both square and cruciform geometries, materials with fibers aligned parallel to the loading axes reduced stress concentrations compared to the isotropic tissue, resulting in more of the applied load being transferred to the ROI. In contrast, fiber-reinforced specimens oriented such that the fibers aligned at an angle to the loading axes produced very large stress concentrations across the clamps and shielding in the ROI. A correction factor technique was introduced that can be used to calculate the stresses in the ROI from the measured experimental loads at the clamps. Application of a correction factor to experimental biaxial results may lead to more accurate representation of the mechanical response of fibrous soft tissue.

Self-Supervised Learning Application on COVID-19 Chest X-ray Image Classification Using Masked AutoEncoder.

The COVID-19 pandemic has underscored the urgent need for rapid and accurate diagnosis facilitated by artificial intelligence (AI), particularly in computer-aided diagnosis using medical imaging. However, this context presents two notable challenges: high diagnostic accuracy demand and limited availability of medical data for training AI models. To address these issues, we proposed the implementation of a Masked AutoEncoder (MAE), an innovative self-supervised learning approach, for classifying 2D Chest X-ray images. Our approach involved performing imaging reconstruction using a Vision Transformer (ViT) model as the feature encoder, paired with a custom-defined decoder. Additionally, we fine-tuned the pretrained ViT encoder using a labeled medical dataset, serving as the backbone. To evaluate our approach, we conducted a comparative analysis of three distinct training methods: training from scratch, transfer learning, and MAE-based training, all employing COVID-19 chest X-ray images. The results demonstrate that MAE-based training produces superior performance, achieving an accuracy of 0.985 and an AUC of 0.9957. We explored the mask ratio influence on MAE and found ratio = 0.4 shows the best performance. Furthermore, we illustrate that MAE exhibits remarkable efficiency when applied to labeled data, delivering comparable performance to utilizing only 30% of the original training dataset. Overall, our findings highlight the significant performance enhancement achieved by using MAE, particularly when working with limited datasets. This approach holds profound implications for future disease diagnosis, especially in scenarios where imaging information is scarce.

Assessment and management of secondary bacterial infections complicating Mpox (Monkeypox) using a telemedicine service. A prospective cohort study.

INTRODUCTION: During spring 2022, an outbreak of Monkeypox (mpox) emerged as an infection of concern in Europe. Due to the overlapping clinical features of mpox and bacterial infections, diagnosis of concomitant bacterial infection is challenging. In this prospective cohort study, we report the incidence, severity, and progression of patients with secondary bacterial infection complicating mpox infection. METHOD: Data were collected via a bespoke mpox telemedicine service provided by Infection services at North Manchester General Hospital, UK. A diagnosis of secondary bacterial infection was based on the history (balanitis, surrounding erythema, purulent discharge and nasal ulceration) and review of patient-collected medical photography. Patient were reviewed face-to-face where necessary. RESULTS: Secondary bacterial infection was diagnosed in 15 of 129 (11.6%) patients with mpox. Three patients with secondary bacterial infection (3/129, 2.3%) required admission to hospital and one patient underwent surgical debridement. Median healing (thus, isolation) times were longer in those with bacterial infection. DISCUSSION: In this prospective cohort study of patients with mpox, secondary bacterial infection was infrequent and predominantly mild. The virtual ward and telemedicine follow up allowed for the prompt recognition of secondary bacterial infections and timely antibiotic administration. Due to concerns regarding nosocomial transmission, mild clinical course and limited inpatient bed capacity, we believe this model of outpatient management for mpox (Clade II B.1 lineage) could be replicated in other low risk populations where suitable home isolation facilities exist.

BlpC-mediated selfish program leads to rapid loss of Streptococcus pneumoniae clonal diversity during infection.

Successful colonization of a host requires bacterial adaptation through genetic and population changes that are incompletely defined. Using chromosomal barcoding and high-throughput sequencing, we investigate the population dynamics of Streptococcus pneumoniae during infant mouse colonization. Within 1 day post inoculation, diversity was reduced >35-fold with expansion of a single clonal lineage. This loss of diversity was not due to immune factors, microbiota, or exclusive genetic drift. Rather, bacteriocins induced by the BlpC-quorum sensing pheromone resulted in predation of kin cells. In this intra-strain competition, the subpopulation reaching a quorum likely eliminates others that have yet to activate the blp locus. Additionally, this reduced diversity restricts the number of unique clones that establish colonization during transmission between hosts. Genetic variation in the blp locus was also associated with altered transmissibility in a human population, further underscoring the importance of BlpC in clonal selection and its role as a selfish element.