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1.
Proc Natl Acad Sci U S A ; 118(51)2021 12 21.
Article in English | MEDLINE | ID: mdl-34903655

ABSTRACT

Short-term forecasts of traditional streams from public health reporting (such as cases, hospitalizations, and deaths) are a key input to public health decision-making during a pandemic. Since early 2020, our research group has worked with data partners to collect, curate, and make publicly available numerous real-time COVID-19 indicators, providing multiple views of pandemic activity in the United States. This paper studies the utility of five such indicators-derived from deidentified medical insurance claims, self-reported symptoms from online surveys, and COVID-related Google search activity-from a forecasting perspective. For each indicator, we ask whether its inclusion in an autoregressive (AR) model leads to improved predictive accuracy relative to the same model excluding it. Such an AR model, without external features, is already competitive with many top COVID-19 forecasting models in use today. Our analysis reveals that 1) inclusion of each of these five indicators improves on the overall predictive accuracy of the AR model; 2) predictive gains are in general most pronounced during times in which COVID cases are trending in "flat" or "down" directions; and 3) one indicator, based on Google searches, seems to be particularly helpful during "up" trends.


Subject(s)
COVID-19/epidemiology , Health Status Indicators , Models, Statistical , Epidemiologic Methods , Forecasting , Humans , Internet/statistics & numerical data , Surveys and Questionnaires , United States/epidemiology
2.
Proc Natl Acad Sci U S A ; 118(51)2021 12 21.
Article in English | MEDLINE | ID: mdl-34903654

ABSTRACT

The COVID-19 pandemic presented enormous data challenges in the United States. Policy makers, epidemiological modelers, and health researchers all require up-to-date data on the pandemic and relevant public behavior, ideally at fine spatial and temporal resolution. The COVIDcast API is our attempt to fill this need: Operational since April 2020, it provides open access to both traditional public health surveillance signals (cases, deaths, and hospitalizations) and many auxiliary indicators of COVID-19 activity, such as signals extracted from deidentified medical claims data, massive online surveys, cell phone mobility data, and internet search trends. These are available at a fine geographic resolution (mostly at the county level) and are updated daily. The COVIDcast API also tracks all revisions to historical data, allowing modelers to account for the frequent revisions and backfill that are common for many public health data sources. All of the data are available in a common format through the API and accompanying R and Python software packages. This paper describes the data sources and signals, and provides examples demonstrating that the auxiliary signals in the COVIDcast API present information relevant to tracking COVID activity, augmenting traditional public health reporting and empowering research and decision-making.


Subject(s)
COVID-19/epidemiology , Databases, Factual , Health Status Indicators , Ambulatory Care/trends , Epidemiologic Methods , Humans , Internet/statistics & numerical data , Physical Distancing , Surveys and Questionnaires , Travel , United States/epidemiology
3.
Opt Express ; 31(6): 10500-10511, 2023 Mar 13.
Article in English | MEDLINE | ID: mdl-37157595

ABSTRACT

Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique. Here, we present a method to integrate optical coherence tomography (OCT) and SECM for complementary imaging by adding orthogonal scanning to the SECM configuration. The co-registration of SECM and OCT is automatic, as all system components are shared in the same order, eliminating the need for additional optical alignment. The proposed multimode imaging system is compact and cost-effective while providing the benefits of imaging aiming and guidance. Furthermore, speckle noise can be suppressed by averaging the speckles generated by shifting the spectral-encoded field in the direction of dispersion. Using a near infrared (NIR) card and a biological sample, we demonstrated the capability of the proposed system by showing SECM imaging at depths of interest guided by the OCT in real time and speckle noise reduction. Interfaced multimodal imaging of SECM and OCT was implemented at a speed of approximately 7 frames/s using fast-switching technology and GPU processing.

4.
Opt Express ; 31(21): 34391-34403, 2023 Oct 09.
Article in English | MEDLINE | ID: mdl-37859196

ABSTRACT

Spiral-phase-contrast imaging, which utilizes a spiral phase optical element, has proven to be effective in enhancing various aspects of imaging, such as edge contrast and shadow imaging. Typically, the implementation of spiral-phase-contrast imaging requires the formation of a Fourier plane through a 4f optical configuration in addition to an existing optical microscope. In this study, we present what we believe to be a novel single spiral-phase-objective, integrating a spiral phase plate, which can be easily and simply applied to a standard microscope, such as a conventional objective. Using a new hybrid design approach that combines ray-tracing and field-tracing simulations, we theoretically realized a well-defined and high-quality vortex beam through the spiral-phase-objective. The spiral-phase-objective was designed to have conditions that are practically manufacturable while providing predictable performance. To evaluate its capabilities, we utilized the designed spiral-phase-objective to investigate isotropic spiral phase contrast and anisotropic shadow imaging through field-tracing simulations, and explored the variation of edge contrast caused by changes in the thickness of the imaging object.

5.
PLoS Comput Biol ; 18(1): e1009733, 2022 01.
Article in English | MEDLINE | ID: mdl-35030163

ABSTRACT

The rates of cell growth, division, and carbon loss of microbial populations are key parameters for understanding how organisms interact with their environment and how they contribute to the carbon cycle. However, the invasive nature of current analytical methods has hindered efforts to reliably quantify these parameters. In recent years, size-structured matrix population models (MPMs) have gained popularity for estimating division rates of microbial populations by mechanistically describing changes in microbial cell size distributions over time. Motivated by the mechanistic structure of these models, we employ a Bayesian approach to extend size-structured MPMs to capture additional biological processes describing the dynamics of a marine phytoplankton population over the day-night cycle. Our Bayesian framework is able to take prior scientific knowledge into account and generate biologically interpretable results. Using data from an exponentially growing laboratory culture of the cyanobacterium Prochlorococcus, we isolate respiratory and exudative carbon losses as critical parameters for the modeling of their population dynamics. The results suggest that this modeling framework can provide deeper insights into microbial population dynamics provided by size distribution time-series data.


Subject(s)
Bayes Theorem , Computational Biology/methods , Models, Biological , Phytoplankton/physiology , Population Dynamics , Time Factors
6.
Opt Express ; 30(15): 27273-27284, 2022 Jul 18.
Article in English | MEDLINE | ID: mdl-36236901

ABSTRACT

Wavelength-tunable spiral-phase-contrast (SPC) imaging was experimentally accomplished in the visible wavelengths spanning a broad bandwidth of ∼200 nm based on a single off-axis spiral phase mirror (OSPM). By the rotation of an OSPM, which was designed with an integer orbital angular momentum (OAM) of l = 1 at a wavelength of 561 nm and incidence angle of 45°, high-quality SPC imaging was obtained at different wavelengths. For the comparison with wavelength-tunable SPC imaging using an OSPM, SPC imaging using a spiral phase plate (manufactured to generate an OAM of l = 1 at 561 nm) was performed at three wavelengths (473, 561, and 660 nm), resulting in clear differences. Theoretically, based on field tracing simulations, high-quality wavelength-tunable SPC imaging could be demonstrated in a very broad bandwidth of ∼400 nm, which is beyond the bandwidth of ∼200 nm obtained experimentally. This technique contribute to developing high-performance wavelength-tunable SPC imaging by simply integrating an OSPM into the current optical imaging technologies.

7.
Proc Natl Acad Sci U S A ; 116(48): 24268-24274, 2019 11 26.
Article in English | MEDLINE | ID: mdl-31712420

ABSTRACT

A wide range of research has promised new tools for forecasting infectious disease dynamics, but little of that research is currently being applied in practice, because tools do not address key public health needs, do not produce probabilistic forecasts, have not been evaluated on external data, or do not provide sufficient forecast skill to be useful. We developed an open collaborative forecasting challenge to assess probabilistic forecasts for seasonal epidemics of dengue, a major global public health problem. Sixteen teams used a variety of methods and data to generate forecasts for 3 epidemiological targets (peak incidence, the week of the peak, and total incidence) over 8 dengue seasons in Iquitos, Peru and San Juan, Puerto Rico. Forecast skill was highly variable across teams and targets. While numerous forecasts showed high skill for midseason situational awareness, early season skill was low, and skill was generally lowest for high incidence seasons, those for which forecasts would be most valuable. A comparison of modeling approaches revealed that average forecast skill was lower for models including biologically meaningful data and mechanisms and that both multimodel and multiteam ensemble forecasts consistently outperformed individual model forecasts. Leveraging these insights, data, and the forecasting framework will be critical to improve forecast skill and the application of forecasts in real time for epidemic preparedness and response. Moreover, key components of this project-integration with public health needs, a common forecasting framework, shared and standardized data, and open participation-can help advance infectious disease forecasting beyond dengue.


Subject(s)
Dengue/epidemiology , Epidemiologic Methods , Disease Outbreaks , Epidemics/prevention & control , Humans , Incidence , Models, Statistical , Peru/epidemiology , Puerto Rico/epidemiology
8.
Biometrics ; 77(3): 1037-1049, 2021 09.
Article in English | MEDLINE | ID: mdl-33434289

ABSTRACT

Changepoint detection methods are used in many areas of science and engineering, for example, in the analysis of copy number variation data to detect abnormalities in copy numbers along the genome. Despite the broad array of available tools, methodology for quantifying our uncertainty in the strength (or the presence) of given changepoints post-selection are lacking. Post-selection inference offers a framework to fill this gap, but the most straightforward application of these methods results in low-powered hypothesis tests and leaves open several important questions about practical usability. In this work, we carefully tailor post-selection inference methods toward changepoint detection, focusing on copy number variation data. To accomplish this, we study commonly used changepoint algorithms: binary segmentation, as well as two of its most popular variants, wild and circular, and the fused lasso. We implement some of the latest developments in post-selection inference theory, mainly auxiliary randomization. This improves the power, which requires implementations of Markov chain Monte Carlo algorithms (importance sampling and hit-and-run sampling) to carry out our tests. We also provide recommendations for improving practical useability, detailed simulations, and example analyses on array comparative genomic hybridization as well as sequencing data.


Subject(s)
Algorithms , DNA Copy Number Variations , Comparative Genomic Hybridization , DNA Copy Number Variations/genetics , Markov Chains , Monte Carlo Method
9.
Sensors (Basel) ; 21(13)2021 Jun 23.
Article in English | MEDLINE | ID: mdl-34201798

ABSTRACT

As network attacks are constantly and dramatically evolving, demonstrating new patterns, intelligent Network Intrusion Detection Systems (NIDS), using deep-learning techniques, have been actively studied to tackle these problems. Recently, various autoencoders have been used for NIDS in order to accurately and promptly detect unknown types of attacks (i.e., zero-day attacks) and also alleviate the burden of the laborious labeling task. Although the autoencoders are effective in detecting unknown types of attacks, it takes tremendous time and effort to find the optimal model architecture and hyperparameter settings of the autoencoders that result in the best detection performance. This can be an obstacle that hinders practical applications of autoencoder-based NIDS. To address this challenge, we rigorously study autoencoders using the benchmark datasets, NSL-KDD, IoTID20, and N-BaIoT. We evaluate multiple combinations of different model structures and latent sizes, using a simple autoencoder model. The results indicate that the latent size of an autoencoder model can have a significant impact on the IDS performance.

10.
PLoS Comput Biol ; 14(6): e1006134, 2018 06.
Article in English | MEDLINE | ID: mdl-29906286

ABSTRACT

Accurate and reliable forecasts of seasonal epidemics of infectious disease can assist in the design of countermeasures and increase public awareness and preparedness. This article describes two main contributions we made recently toward this goal: a novel approach to probabilistic modeling of surveillance time series based on "delta densities", and an optimization scheme for combining output from multiple forecasting methods into an adaptively weighted ensemble. Delta densities describe the probability distribution of the change between one observation and the next, conditioned on available data; chaining together nonparametric estimates of these distributions yields a model for an entire trajectory. Corresponding distributional forecasts cover more observed events than alternatives that treat the whole season as a unit, and improve upon multiple evaluation metrics when extracting key targets of interest to public health officials. Adaptively weighted ensembles integrate the results of multiple forecasting methods, such as delta density, using weights that can change from situation to situation. We treat selection of optimal weightings across forecasting methods as a separate estimation task, and describe an estimation procedure based on optimizing cross-validation performance. We consider some details of the data generation process, including data revisions and holiday effects, both in the construction of these forecasting methods and when performing retrospective evaluation. The delta density method and an adaptively weighted ensemble of other forecasting methods each improve significantly on the next best ensemble component when applied separately, and achieve even better cross-validated performance when used in conjunction. We submitted real-time forecasts based on these contributions as part of CDC's 2015/2016 FluSight Collaborative Comparison. Among the fourteen submissions that season, this system was ranked by CDC as the most accurate.


Subject(s)
Forecasting/methods , Influenza, Human/prevention & control , Centers for Disease Control and Prevention, U.S. , Communicable Diseases , Epidemics/prevention & control , Humans , Models, Biological , Models, Statistical , Public Health , Retrospective Studies , Seasons , United States
11.
PLoS Comput Biol ; 13(3): e1005248, 2017 03.
Article in English | MEDLINE | ID: mdl-28282375

ABSTRACT

Infectious diseases impose considerable burden on society, despite significant advances in technology and medicine over the past century. Advanced warning can be helpful in mitigating and preparing for an impending or ongoing epidemic. Historically, such a capability has lagged for many reasons, including in particular the uncertainty in the current state of the system and in the understanding of the processes that drive epidemic trajectories. Presently we have access to data, models, and computational resources that enable the development of epidemiological forecasting systems. Indeed, several recent challenges hosted by the U.S. government have fostered an open and collaborative environment for the development of these technologies. The primary focus of these challenges has been to develop statistical and computational methods for epidemiological forecasting, but here we consider a serious alternative based on collective human judgment. We created the web-based "Epicast" forecasting system which collects and aggregates epidemic predictions made in real-time by human participants, and with these forecasts we ask two questions: how accurate is human judgment, and how do these forecasts compare to their more computational, data-driven alternatives? To address the former, we assess by a variety of metrics how accurately humans are able to predict influenza and chikungunya trajectories. As for the latter, we show that real-time, combined human predictions of the 2014-2015 and 2015-2016 U.S. flu seasons are often more accurate than the same predictions made by several statistical systems, especially for short-term targets. We conclude that there is valuable predictive power in collective human judgment, and we discuss the benefits and drawbacks of this approach.


Subject(s)
Communicable Diseases/mortality , Disease Outbreaks/statistics & numerical data , Epidemiologic Methods , Forecasting/methods , Models, Statistical , Risk Assessment/methods , Humans , Prevalence , Reproducibility of Results , Sensitivity and Specificity , United States/epidemiology
12.
PLoS Comput Biol ; 11(8): e1004382, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26317693

ABSTRACT

Seasonal influenza epidemics cause consistent, considerable, widespread loss annually in terms of economic burden, morbidity, and mortality. With access to accurate and reliable forecasts of a current or upcoming influenza epidemic's behavior, policy makers can design and implement more effective countermeasures. This past year, the Centers for Disease Control and Prevention hosted the "Predict the Influenza Season Challenge", with the task of predicting key epidemiological measures for the 2013-2014 U.S. influenza season with the help of digital surveillance data. We developed a framework for in-season forecasts of epidemics using a semiparametric Empirical Bayes framework, and applied it to predict the weekly percentage of outpatient doctors visits for influenza-like illness, and the season onset, duration, peak time, and peak height, with and without using Google Flu Trends data. Previous work on epidemic modeling has focused on developing mechanistic models of disease behavior and applying time series tools to explain historical data. However, tailoring these models to certain types of surveillance data can be challenging, and overly complex models with many parameters can compromise forecasting ability. Our approach instead produces possibilities for the epidemic curve of the season of interest using modified versions of data from previous seasons, allowing for reasonable variations in the timing, pace, and intensity of the seasonal epidemics, as well as noise in observations. Since the framework does not make strict domain-specific assumptions, it can easily be applied to some other diseases with seasonal epidemics. This method produces a complete posterior distribution over epidemic curves, rather than, for example, solely point predictions of forecasting targets. We report prospective influenza-like-illness forecasts made for the 2013-2014 U.S. influenza season, and compare the framework's cross-validated prediction error on historical data to that of a variety of simpler baseline predictors.


Subject(s)
Computational Biology/methods , Epidemics/statistics & numerical data , Influenza, Human/epidemiology , Models, Biological , Models, Statistical , Bayes Theorem , Centers for Disease Control and Prevention, U.S. , Humans , Reproducibility of Results , United States
13.
Opt Express ; 23(7): 9121-9, 2015 Apr 06.
Article in English | MEDLINE | ID: mdl-25968746

ABSTRACT

A multi-wavelength interferometer utilizing the frequency comb of a femtosecond laser as the wavelength ruler is tested for its capability of ultra-precision positioning for machine axis control. The interferometer uses four different wavelengths phase-locked to the frequency comb and then determines the absolute position through a multi-channel scheme of detecting interference phases in parallel so as to enable fast, precise and stable measurements continuously over a few meters of axis-travel. Test results show that the proposed interferometer proves itself as a potential candidate of absolute-type position transducer needed for next-generation ultra-precision machine axis control, demonstrating linear errors of less than 61.9 nm in peak-to-valley over a 1-meter travel with an update rate of 100 Hz when compared to an incremental-type He-Ne laser interferometer.

14.
Opt Express ; 21(8): 9780-91, 2013 Apr 22.
Article in English | MEDLINE | ID: mdl-23609685

ABSTRACT

3-D profiles of discontinuous surfaces patterned with high step structures are measured using four wavelengths generated by phase-locking to the frequency comb of an Er-doped fiber femtosecond laser stabilized to the Rb atomic clock. This frequency-comb-referenced method of multi-wavelength interferometry permits extending the phase non-ambiguity range by a factor of 64,500 while maintaining the sub-wavelength measurement precision of single-wavelength interferometry. Experimental results show a repeatability of 3.13 nm (one-sigma) in measuring step heights of 1800, 500, and 70 µm. The proposed method is accurate enough for the standard calibration of gauge blocks and also fast to be suited for the industrial inspection of microelectronics products.


Subject(s)
Interferometry/instrumentation , Materials Testing/instrumentation , Surface Properties , Equipment Design , Equipment Failure Analysis
15.
Opt Express ; 21(24): 29179-85, 2013 Dec 02.
Article in English | MEDLINE | ID: mdl-24514469

ABSTRACT

We propose an all-fiber-based multi-channel optical scheme that enables simultaneous generation of multiple continuous-wave laser wavelengths with stabilization to the frequency comb of a femtosecond laser. The intention is to produce highly stable, accurate wavelength channels with immunity to environmental disturbance so as to enhance the transmission capacity of dense wavelength division multiplexing (DWDM) communications. Generated wavelengths lie over a wide spectral range of 5 THz about 1550 nm, each yielding a narrow linewidth of less than 24 kHz with an absolute position uncertainty of ~2.24 × 10¹² (10 s averaging) traceable directly to the atomic Rb clock.

16.
Front Microbiol ; 14: 1197329, 2023.
Article in English | MEDLINE | ID: mdl-37455725

ABSTRACT

Heterotrophic microbes play an important role in the Earth System as key drivers of major biogeochemical cycles. Specifically, the consumption rate of organic matter is set by the interaction between diverse microbial communities and the chemical and physical environment in which they reside. Modeling these dynamics requires reducing the complexity of microbial communities and linking directly with biogeochemical functions. Microbial metabolic functional guilds provide one approach for reducing microbial complexity and incorporating microbial biogeochemical functions into models. However, we lack a way to identify these guilds. In this study, we present a method for defining metabolic functional guilds from annotated genomes, which are derived from both uncultured and cultured organisms. This method utilizes an Aspect Bernoulli (AB) model and was tested on three large genomic datasets with 1,733-3,840 genomes each. Ecologically relevant microbial metabolic functional guilds were identified including guilds related to DMSP degradation, dissimilatory nitrate reduction to ammonia, and motile copiotrophy. This method presents a way to generate hypotheses about functions co-occurring within individual microbes without relying on cultured representatives. Applying the concept of metabolic functional guilds to environmental samples will provide new insight into the role that heterotrophic microbial communities play in setting rates of carbon cycling.

17.
Sci Rep ; 13(1): 3625, 2023 03 03.
Article in English | MEDLINE | ID: mdl-36869084

ABSTRACT

Biochip-based research is currently evolving into a three-dimensional and large-scale basis similar to the in vivo microenvironment. For the long-term live and high-resolution imaging in these specimens, nonlinear microscopy capable of label-free and multiscale imaging is becoming increasingly important. Combination with non-destructive contrast imaging will be useful for effectively locating regions of interest (ROI) in large specimens and consequently minimizing photodamage. In this study, a label-free photothermal optical coherence microscopy (OCM) serves as a new approach to locate the desired ROI within biological samples which are under investigation by multiphoton microscopy (MPM). The weak photothermal perturbation in sample by the MPM laser with reduced power was detected at the endogenous photothermal particles within the ROI using the highly sensitive phase-differentiated photothermal (PD-PT) OCM. By monitoring the temporal change of the photothermal response signal of the PD-PT OCM, the hotspot generated within the sample focused by the MPM laser was located on the ROI. Combined with automated sample movement in the x-y axis, the focal plane of MPM could be effectively navigated to the desired portion of a volumetric sample for high-resolution targeted MPM imaging. We demonstrated the feasibility of the proposed method in second harmonic generation microscopy using two phantom samples and a biological sample, a fixed insect on microscope slide, with dimensions of 4 mm wide, 4 mm long, and 1 mm thick.


Subject(s)
Microscopy , Movement , Phantoms, Imaging
18.
Proc Math Phys Eng Sci ; 478(2262): 20210875, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35756877

ABSTRACT

Remote sensing observations from satellites and global biogeochemical models have combined to revolutionize the study of ocean biogeochemical cycling, but comparing the two data streams to each other and across time remains challenging due to the strong spatial-temporal structuring of the ocean. Here, we show that the Wasserstein distance provides a powerful metric for harnessing these structured datasets for better marine ecosystem and climate predictions. The Wasserstein distance complements commonly used point-wise difference methods such as the root-mean-squared error, by quantifying differences in terms of spatial displacement in addition to magnitude. As a test case, we consider chlorophyll (a key indicator of phytoplankton biomass) in the northeast Pacific Ocean, obtained from model simulations, in situ measurements, and satellite observations. We focus on two main applications: (i) comparing model predictions with satellite observations, and (ii) temporal evolution of chlorophyll both seasonally and over longer time frames. The Wasserstein distance successfully isolates temporal and depth variability and quantifies shifts in biogeochemical province boundaries. It also exposes relevant temporal trends in satellite chlorophyll consistent with climate change predictions. Our study shows that optimal transport vectors underlying the Wasserstein distance provide a novel visualization tool for testing models and better understanding temporal dynamics in the ocean.

19.
Opt Express ; 17(13): 10939-45, 2009 Jun 22.
Article in English | MEDLINE | ID: mdl-19550493

ABSTRACT

Generating precise optical frequencies with a functional power is necessary in many fields of science and technology. Here we demonstrate an all-fiber-based apparatus built to generate near-infrared frequencies directly from an Er-doped fiber femtosecond laser. In our apparatus, only a single resonance mode is extracted at a time on demand via a composite fiber filter comprised of a Fabry-Perot etalon with a Bragg grating. The extracted mode having weak 40 nW power is amplified to 20 mW by means of optical injection locking to a distributed-feedback laser diode under phase-stabilization control. The amplified final output signal yields a frequency stability of 2 parts in 10(15) at 10 s averaging with a narrow linewidth of less than 1 Hz. This apparatus is precise and immune to environmental disturbance, thereby being well suited to on-site near-infrared applications of frequency calibration, spectroscopy, and optical clocks.

20.
Sci Rep ; 9(1): 683, 2019 01 24.
Article in English | MEDLINE | ID: mdl-30679458

ABSTRACT

Since 2013, the Centers for Disease Control and Prevention (CDC) has hosted an annual influenza season forecasting challenge. The 2015-2016 challenge consisted of weekly probabilistic forecasts of multiple targets, including fourteen models submitted by eleven teams. Forecast skill was evaluated using a modified logarithmic score. We averaged submitted forecasts into a mean ensemble model and compared them against predictions based on historical trends. Forecast skill was highest for seasonal peak intensity and short-term forecasts, while forecast skill for timing of season onset and peak week was generally low. Higher forecast skill was associated with team participation in previous influenza forecasting challenges and utilization of ensemble forecasting techniques. The mean ensemble consistently performed well and outperformed historical trend predictions. CDC and contributing teams will continue to advance influenza forecasting and work to improve the accuracy and reliability of forecasts to facilitate increased incorporation into public health response efforts.


Subject(s)
Influenza, Human/epidemiology , Models, Statistical , Centers for Disease Control and Prevention, U.S. , Disease Outbreaks , Humans , Influenza, Human/mortality , Morbidity , Seasons , United States/epidemiology
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