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Perspectives on Preparedness for Chemical, Biological, Radiological, and Nuclear Threats in the Middle East and North Africa Region: Application of Artificial Intelligence Techniques. 中东和北非地区防备化学、生物、辐射和核威胁的视角:人工智能技术的应用。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-09 DOI: 10.1089/hs.2023.0093
Hassan Farhat, Guillaume Alinier, Mariana Helou, Ionnais Galatis, Nidaa Bajow, Denis Jose, Sarra Jouini, Sermet Sezigen, Samia Hafi, Sheena Mccabe, Naoufel Somrani, Kawther El Aifa, Henda Chebbi, Asma Ben Amor, Yosra Kerkeni, Ahmed M Al-Wathinani, Nassem Mohammed Abdulla, Ammar Abdulrahman Jairoun, Brendon Morris, Nicholas Castle, Loua Al-Sheikh, Walid Abougalala, Mohamed Ben Dhiab, James Laughton

Over the past 3 decades, the diversity of ethnic, religious, and political backgrounds worldwide, particularly in countries of the Middle East and North Africa (MENA), has led to an increase in the number of intercountry conflicts and terrorist attacks, sometimes involving chemical and biological agents. This warrants moving toward a collaborative approach to strengthening preparedness in the region. In disaster medicine, artificial intelligence techniques have been increasingly utilized to allow a thorough analysis by revealing unseen patterns. In this study, the authors used text mining and machine learning techniques to analyze open-ended feedback from multidisciplinary experts in disaster medicine regarding the MENA region's preparedness for chemical, biological, radiological, and nuclear (CBRN) risks. Open-ended feedback from 29 international experts in disaster medicine, selected based on their organizational roles and contributions to the academic field, was collected using a modified interview method between October and December 2022. Machine learning clustering algorithms, natural language processing, and sentiment analysis were used to analyze the data gathered using R language accessed through the RStudio environment. Findings revealed negative and fearful sentiments about a lack of accessibility to preparedness information, as well as positive sentiments toward CBRN preparedness concepts raised by the modified interview method. The artificial intelligence analysis techniques revealed a common consensus among experts about the importance of having accessible and effective plans and improved health sector preparedness in MENA, especially for potential chemical and biological incidents. Findings from this study can inform policymakers in the region to converge their efforts to build collaborative initiatives to strengthen CBRN preparedness capabilities in the healthcare sector.

在过去的 30 年里,世界各地,尤其是中东和北非(MENA)国家,种族、宗教和政治背景的多样性导致国家间冲突和恐怖袭击的数量增加,有时还涉及化学和生物制剂。因此,有必要采取合作方式加强该地区的备灾工作。在灾难医学领域,人工智能技术得到了越来越多的应用,通过揭示看不见的模式进行全面分析。在这项研究中,作者利用文本挖掘和机器学习技术分析了灾害医学领域多学科专家就中东和北非地区的化学、生物、辐射和核(CBRN)风险准备情况提出的开放式反馈意见。2022 年 10 月至 12 月期间,我们采用修改后的访谈方法收集了 29 位国际灾害医学专家的开放式反馈意见,这些专家是根据他们的组织角色和对学术领域的贡献挑选出来的。使用机器学习聚类算法、自然语言处理和情感分析,并通过 RStudio 环境访问 R 语言,对收集到的数据进行了分析。研究结果显示了对缺乏备灾信息的负面和恐惧情绪,以及对修改后的访谈方法所提出的化生放核备灾概念的积极情绪。人工智能分析技术显示,专家们一致认为,在中东和北非地区制定可获取的有效计划并改善卫生部门的准备工作非常重要,尤其是针对潜在的化学和生物事件。这项研究的结果可以为该地区的决策者提供信息,使他们能够齐心协力,制定合作计划,加强医疗保健部门的化学、生物、辐射和核防备能力。
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引用次数: 0
Underreporting or Failed Notification? Global Botulism Reporting, 2000-2022. 报告不足还是通报失败?2000-2022年全球肉毒杆菌报告情况。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-05-20 DOI: 10.1089/hs.2023.0081
Tristan P Learoyd

Botulism is a rare, potentially fatal illness caused by botulinum toxins produced by Clostridium bacteria. There are no coordinated worldwide reporting mechanisms for botulism cases and therefore few reliable case frequency estimates. This study aimed to establish an international benchmark for case frequency to determine estimated global rates of underreporting of botulism cases. To this end, a comprehensive, multilingual search of major global and national databases, including gray data and government sources, was performed. Data from case series were pooled, standardized against United Nations midyear population estimates, and analyzed using Kolmogorov-Smirnov tests to identify normally distributed data series. National incidence rates of normally distributed series were compared with that of the United States, which was considered the gold standard due to its extensive data reported for 2004-2018. A total of 6,932 botulism cases from 59 nations were identified in the literature, with a global case fatality rate of 1.37%. The national mean incidence rate ranged from 0.00 to 8.04 cases per million people, with an international mean incidence rate of 0.62 cases per million people. At the continent level, incidence rates tended toward normal distributions, although few countries outside of North America and Europe exhibited normal distributions. Based on comparisons with the US standard, an estimated 88.71% of botulism cases worldwide were unreported in 2016. Better awareness of botulism among healthcare professionals, coordinated global reporting mechanisms, and research on additional contributing factors to underreporting would enable better understanding of global case frequency, thereby potentially reducing the global incidence of botulism and improving outcomes.

肉毒中毒是一种罕见的、可能致命的疾病,由梭状芽孢杆菌产生的肉毒毒素引起。肉毒中毒病例没有协调的全球报告机制,因此很少有可靠的病例频率估计。这项研究旨在建立一个病例频率的国际基准,以确定肉毒中毒病例的全球漏报率。为此,研究人员对全球和各国的主要数据库(包括灰色数据和政府资料来源)进行了全面、多语种的搜索。对病例系列数据进行汇总,根据联合国年中人口估计值进行标准化处理,并使用 Kolmogorov-Smirnov 检验进行分析,以确定正态分布的数据系列。将正态分布序列的全国发病率与美国的发病率进行比较,美国因其 2004-2018 年的大量数据被视为黄金标准。文献共发现了59个国家的6932例肉毒中毒病例,全球病死率为1.37%。全国平均发病率为每百万人0.00例至8.04例,国际平均发病率为每百万人0.62例。从各大洲来看,发病率呈正态分布,但北美和欧洲以外的国家很少呈现正态分布。根据与美国标准的比较,2016年全球估计有88.71%的肉毒中毒病例未报告。提高医护专业人员对肉毒中毒的认识、协调全球报告机制以及研究导致报告不足的其他因素,将有助于更好地了解全球病例发生率,从而有可能降低肉毒中毒的全球发病率并改善治疗效果。
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引用次数: 0
Ongoing Cooperative Engagement Facilitates Agile Pandemic and Outbreak Response: Lessons Learned Through Cooperative Engagement Between Uganda and the United States. 持续的合作参与有助于敏捷地应对大流行病和疫情:乌干达与美国合作参与的经验教训。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-26 DOI: 10.1089/hs.2023.0069
Andrew W Bartlow, Earl A Middlebrook, Armand E K Dichosa, John Kayiwa, Charity A Nassuna, Gladys Kiggundu, Jeanne M Fair

Pathogens threaten human lives and disrupt economies around the world. This has been clearly illustrated by the current COVID-19 pandemic and outbreaks in livestock and food crops. To manage pathogen emergence and spread, cooperative engagement programs develop and strengthen biosafety, biosecurity, and biosurveillance capabilities among local researchers to detect pathogens. In this case study, we describe the efforts of a collaboration between the Los Alamos National Laboratory and the Uganda Virus Research Institute, the primary viral diagnostic laboratory in Uganda, to implement and ensure the sustainability of sequencing for biosurveillance. We describe the process of establishing this capability along with the lessons learned from both sides of the partnership to inform future cooperative engagement efforts in low- and middle-income countries. We found that by strengthening sequencing capabilities at the Uganda Virus Research Institute before the COVID-19 pandemic, the institute was able to successfully sequence SARS-CoV-2 samples and provide data to the scientific community. We highlight the need to strengthen and sustain capabilities through in-country training, collaborative research projects, and trust.

病原体威胁着人类的生命,破坏着世界各地的经济。当前的 COVID-19 大流行以及牲畜和粮食作物疫情就清楚地说明了这一点。为了控制病原体的出现和传播,合作参与计划发展并加强了当地研究人员的生物安全、生物安保和生物监测能力,以检测病原体。在本案例研究中,我们介绍了洛斯阿拉莫斯国家实验室与乌干达病毒研究所(乌干达的主要病毒诊断实验室)之间为实施生物监测测序并确保其可持续性而开展的合作。我们介绍了建立这种能力的过程,以及合作双方的经验教训,为今后在中低收入国家开展合作提供参考。我们发现,通过在 COVID-19 大流行之前加强乌干达病毒研究所的测序能力,该研究所能够成功地对 SARS-CoV-2 样本进行测序并向科学界提供数据。我们强调了通过国内培训、合作研究项目和信任来加强和维持能力的必要性。
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引用次数: 0
Tracing the Untraceables: A Joint Outbreak Investigation With Law Enforcement Using a Geographic Information System. 追踪无法追踪者:利用地理信息系统与执法部门联合开展疫情调查。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI: 10.1089/hs.2023.0082
Yoojin Park, Boyeong Ryu, Eonjoo Park, Hyunjung Kim, GwangJin Kim, Jonghee Cho, Young Dea Kim, Sangwoo Tak, Young June Choe

The application of geospatial data often allows the tracing of people who are involved in activities of an illegal nature. In June 2021, we estimated the true magnitude of the spread of COVID-19 within the networks of escort-karaoke bars in Seoul, Republic of Korea, using geographic information system (GIS)-based contact tracing that was applied to our epidemiological investigation. Our joint rapid response team, composed of epidemic investigation officers and police personnel, identified 19 paper-traced cases and 158 GIS-traced cases from 5,692 confirmed cases in Seoul during the study period (June to July 2021). Our findings suggest that collaboration with law enforcement agencies and the use of overlaid satellite imagery in outbreak investigations enhances high vigilance and reduces the risk of potential breaches of human rights in the process.

应用地理空间数据往往可以追踪到参与非法活动的人员。2021 年 6 月,我们在流行病学调查中采用了基于地理信息系统(GIS)的接触者追踪技术,估计了 COVID-19 在大韩民国首尔陪唱卡拉 OK 酒吧网络中的真实传播规模。我们的联合快速反应小组由流行病调查官员和警务人员组成,在研究期间(2021 年 6 月至 7 月)从首尔的 5,692 例确诊病例中发现了 19 例纸质追踪病例和 158 例地理信息系统追踪病例。我们的研究结果表明,在疫情调查中与执法机构合作并使用叠加卫星图像可提高高度警惕性,并在此过程中降低潜在的侵犯人权风险。
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引用次数: 0
Meeting Gaps in the Public Health Workforce During Emergencies: How a Nongovernmental Organization Supported Critical Staffing Needs in the COVID-19 Response. 弥补紧急情况下公共卫生人员的缺口:非政府组织如何满足 COVID-19 应对行动中的关键人员需求。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-05-07 DOI: 10.1089/hs.2023.0113
Carol A Pertowski, Kathy Cahill, Tomas J Aguilar, Judith A Monroe

The public health workforce continues to experience staff shortages, which hampered the ability of US state, tribal, local, and territorial health departments to respond to the COVID-19 pandemic. In April 2020, the US Centers for Disease Control and Prevention (CDC) awarded $45 million to the CDC Foundation to provide field assignees to support these health departments. To expand these efforts, the CDC provided an additional $20 million in May 2021 for vaccination efforts and $200 million in June 2021 to support COVID-19 response and general infrastructure support. The CDC Foundation worked with jurisdictions across the United States to develop job descriptions based on need and recruit nationally for positions. This expanded project, called the Workforce/Vaccine Initiative, hired 3,014 staff in 91 jurisdictions, with 2,310 (77%) hired by January 2022. Most assignments were fully remote (55%) or hybrid (28%). The largest number of staff (n=720) supported COVID-19 response work in schools. Other common functions included contact tracing/case investigation (n=456), program coordination (n=330), epidemiology (n=297), data and surveillance (n=283), and administrative support (n=220). To advance health equity and improve response efforts, 79 health equity staff were assigned to 30 jurisdictions. To support the needs of tribes, 76 field staff supported 22 tribal entities. This project demonstrated the important role of a flexible, centralized approach to rapid placement of staff in public health departments during an emergency response. While the goal of the Workforce/Vaccine Initiative was to meet short-term staffing needs, lessons learned could provide insights for building a sustainable and scalable public health workforce.

公共卫生队伍继续面临人员短缺问题,这阻碍了美国各州、部落、地方和地区卫生部门应对 COVID-19 大流行的能力。2020 年 4 月,美国疾病控制和预防中心(CDC)向 CDC 基金会拨款 4500 万美元,用于提供实地派驻人员,为这些卫生部门提供支持。为了扩大这些工作,疾病预防控制中心在 2021 年 5 月为疫苗接种工作追加了 2000 万美元,并在 2021 年 6 月追加了 2 亿美元,用于支持 COVID-19 的响应和一般基础设施支持。疾病预防控制中心基金会与美国各地的辖区合作,根据需求制定职位说明,并在全国范围内进行职位招聘。这个名为 "劳动力/疫苗倡议 "的扩展项目在 91 个辖区招聘了 3014 名工作人员,其中 2310 人(77%)在 2022 年 1 月前被录用。大多数任务是完全远程的(55%)或混合任务(28%)。支持 COVID-19 在学校开展响应工作的员工人数最多(720 人)。其他常见职能包括接触追踪/病例调查(456 人)、项目协调(330 人)、流行病学(297 人)、数据和监测(283 人)以及行政支持(220 人)。为了促进健康公平和改善应对工作,79 名健康公平工作人员被派往 30 个辖区。为了支持部落的需求,76 名外勤人员为 22 个部落实体提供支持。该项目表明,在应急响应期间,以灵活、集中的方式在公共卫生部门快速安排工作人员具有重要作用。虽然 "劳动力/疫苗倡议 "的目标是满足短期的人员需求,但吸取的经验教训可为建立一支可持续和可扩展的公共卫生队伍提供启示。
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引用次数: 0
US Academic and NGO Engagement in Pandemic Preparedness and Response. 美国学术界和非政府组织参与大流行病防备和应对工作。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-01 Epub Date: 2024-02-23 DOI: 10.1089/hs.2023.0103
Helene McOwen, Judith N Wasserheit, Peter Rabinowitz
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引用次数: 0
Advancing Health Security and Disease Eradication Through Peace and Health: A Mali Case Study. 通过和平与健康促进健康安全和疾病根除:马里案例研究。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-01 Epub Date: 2024-02-22 DOI: 10.1089/hs.2023.0091
Angelia M Sanders, Madeline Warman, Frederic Deycard, John Goodman, April Klein, Karmen Unterwegner, Boukary Sangare, Sadi Moussa, Stacia George, Irene Pujol Chica, Cheick Oumar Coulibaly, Moussa Saye, Kimberly A Jensen, Adam J Weiss, Kashef Ijaz

Conflict and violence constitute threats to public health. As levels of conflict increase within and between countries, it is important to explore how conflict resolution initiatives can be adapted to meet the health needs of communities, and how addressing the health needs of communities can assist in conflict resolution and contribute to health security. In conflict-affected central Mali, a Peace through Health Initiative, piloted between 2018 and 2022, used conflict resolution trainings, facilitated community meetings, and human and animal health interventions to negotiate "periods of tranquility" to achieve public health goals. Project activities resulted in improved health, improved livelihoods, reduced violence, improved trust among stakeholders, and greater inclusion of community members in peace and health decisionmaking. The Peace-Health Initiative generated several lessons learned related to 3 phases of peace-health programming: preintervention, program development, and implementation. These lessons can be applied to support expanded Peace through Health Initiatives within Mali, may be adaptable to other conflict-afflicted contexts, and should be considered in relation to the implementation of global health security.

冲突和暴力对公共卫生构成威胁。随着国家内部和国家之间冲突程度的加剧,探索如何调整冲突解决倡议以满足社区的卫生需求,以及满足社区的卫生需求如何有助于解决冲突和促进卫生安全非常重要。在受冲突影响的马里中部,2018 年至 2022 年期间试行的 "通过健康实现和平倡议 "利用冲突解决培训、促进社区会议以及人类和动物健康干预措施,通过协商 "平静期 "来实现公共卫生目标。项目活动改善了健康、改善了生计、减少了暴力、增进了利益攸关方之间的信任,并使社区成员更多地参与和平与健康决策。和平与健康倡议在和平与健康计划编制的三个阶段(干预前、计划制定和实施)总结出了一些经验教训。这些经验教训可用于支持在马里扩大 "通过健康实现和平 "倡议,也可用于其他受冲突影响的环境,并应在实施全球健康安全时加以考虑。
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引用次数: 0
Computational and Systems Biology Advances to Enable Bioagent Agnostic Signatures. 计算生物学和系统生物学的进步实现了生物代理不可知论特征。
IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-01 Epub Date: 2024-03-13 DOI: 10.1089/hs.2023.0076
Andy Lin, Cameron M Torres, Errett C Hobbs, Jaydeep Bardhan, Stephen B Aley, Charles T Spencer, Karen L Taylor, Tony Chiang
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引用次数: 0
Exploring List-Based Approaches and Potential Threat Agnostic Applications in US Biodefense and Public Health-Toward a Hybrid Approach. 在美国生物防御和公共卫生领域探索基于清单的方法和潜在的与威胁无关的应用--实现混合方法。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-01 Epub Date: 2024-03-28 DOI: 10.1089/hs.2023.0098
Yong-Bee Lim, Saskia Popescu
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引用次数: 0
Next Generation Public Health Emergency Readiness: Standardized Tools and a Threat Agnostic Biosurveillance System. 下一代公共卫生应急准备:标准化工具和与威胁无关的生物监测系统。
IF 3.3 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1089/hs.2023.0102
Elizabeth Rubin, Caitlin Harvey, Alma Villatoro, Brandon Dean
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引用次数: 0
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