Alert Network Research Articles

CHANGES IN BIOELECTRICAL ACTIVITY OF THE CEREBRAL CORTEX IN CHILDREN AGED 8–12 AFTER INTERVAL HYPOXIC TRAINING

The period of early puberty is accompanied by significant cognitive, physical and emotional stress, which requires methods to optimize the functional brain state. Interval hypoxic training (IHT) activates adaptation mechanisms caused by hypoxia-inducible factor-1 (HIF-1), which increases the oxygen capacity of the blood, improve energy production and cerebral blood supply. Objective. The aim of the paper is to study the changes in the bioelectrical activity of the cerebral cortex in children aged 8–12 while adaptating to hypoxia during normobaric IHT. Materials and Methods. The study involved 95 boys aged 8–12 (main group – 50 trial subjects after IHT, comparison group – 45 trial subjects). Before the IHT, a hypoxic test was performed (10-minute inhalation of oxygen mixture (O2 10–14 %) with monitoring of SaO2, HR, BP, and saturation recovery time. IHT included sequences of hypoxia and normoxia: 5 days – 13 % O2, 5 days – 12 % O2, 5 days – 11 % O2. Compact-Neuro EEG electroencephalograph (16 leads, 10–20 system) was used to record cerebral bioelectrical activity at rest and under functional loads. Results. The hypoxic test revealed that when inhaling a mixture with 12 % O₂, the SaO₂ level decreased up to 85 % with a recovery to 97 % during the first minute of the recovery period, indicating the development of subcompensated hypoxia, which contributes to the activation of the body’s adaptive mechanisms. After IHT, the index and amplitude of alpha and beta rhythms increased, the index of theta and delta rhythms decreased. Moreover, reactions to functional loads improved, indicating increased alertness and neural network activity. Subjective improvement in concentration, memory, sleep quality and decreased anxiety indicate improved neuroplasticity and functional brain state. Conclusion. The obtained data demonstrate the IHT potential, as it can increase brain stress-resistance, and improve the adaptive capabilities of the central nervous system.

The early warning and response systems in Syria: A functionality and alert threshold assessment.

The early warning and response systems in Syria: A functionality and alert threshold assessment.

Climate Change and Emerging Infectious Diseases: A Precarious Relationship.

Climate change is apparent. Temperatures are rising. Floods are more frequent and devastating. Climate changes can favor the development of emerging infectious diseases. The number of animal reservoirs and vector hosts can increase, further spreading pathogens. Many emerging infectious diseases were not historically considered major threats in US but have become a major concern in US territories and various states. In June 2024, the Centers for Disease Control and Prevention issued a Health Alert Network advisory about an increase in local transmission of dengue fever. Preventing the transmission of emerging infectious diseases has become a focus of regulatory agencies. Nurse education at all levels should include infectious diseases and be coordinated with local, state, and regional institutions. Emerging infectious diseases are now formidable challenges to health care.

Training for outbreak response through the Global Outbreak Alert and Response Network

Abstract The WHO designated the Information Centre for International Health Protection (INIG/ZIG 1) at the Robert Koch Institute as the first WHO Collaborating Centre for Global Outbreak Alert and Response (WHO CC GOARN). Its mandate is to aid WHO’s efforts in improving the detection of public health events and enhancing preparedness, readiness, and capabilities for alerts and rapid responses. The main focus of WHO CC GOARN at RKI include supporting WHO in the development and implementation of the GOARN training programme on international outbreak alert and response, as well as facilitating knowledge exchange and information dissemination. GOARN’s extensive engagement in international public health response underscores the need to complement technical expertise with human-centred competencies like effective communication and teamwork, while respecting diversity. On 18 -22 September 2023, WHO CC GOARN at RKI hosted the first “GOARN Outbreak Response Leadership Training Programme”, inviting 24 public health leaders plus highly experienced mentors from all WHO. The training was designed to enhance leadership mind-sets and practices, including advanced interpersonal and situational awareness, managing polarised tension, establishing trusted relationships with stakeholders, and influencing collective decision-making. Alongside expert facilitators and experienced mentors from various fields, participants engaged in open discussion, shared experiences and reflected on lessons from the COVID-19 pandemic and other recent outbreaks. This course provided an opportunity to engage with diverse, experienced and highly regarded leaders, sharing their views and personal experiences on what it means to practise leadership in health emergency response. This training also aimed to build a network of diverse, well-trained and interconnected public health leaders, upholding the principles of diversity, equity and inclusion to ensure that our response efforts resonate with the communities we serve.

A SONAR report on Nirmatrelvir/ritonavir-associated rebound COVID-19: Using new databases for evaluating new diseases.

In May 2022, the Centers for Disease Control and Prevention disseminated an alert advising that "a few" persons with Nirmatrelvir/ritonavir (NM/R)-associated rebound of COVID-19 infection had been identified. Three case reports appearing as pre-print postings described the first cases. Analyses in March 2023 by NM/R's manufacturer and the Food and Drug Administration (FDA) reported no association between NM/R and COVID-19 rebound in a large phase 3 randomized clinical trial. Our study evaluated if social media databases or electronically disseminated new articles might provide insights related to the putative new toxicity, NM/R-associated COVID-19 rebound. Information on NM/R-associated COVID-19 rebound cases was abstracted from preprint postings of non-peer-reviewed manuscripts, social media websites, electronically disseminated print and television media reports, a new FDA adverse event database for drugs that received Emergency Use Approval, and news articles in scientific journals. Thirty-five persons experienced presumed or documented NM/R-associated COVID-19 rebound, based on information described in preprint services (n = 27), Twitter postings and related news articles (n = 7), and news articles without related Twitter reports (n = 1). These reports included information on dates of initial COVID-19 illness and rebound onset, COVID-19 testing, vaccine status, presentation, and outcome. A new FDA safety database identified 12,500 possible cases of this toxicity, but the quality of these data was poor. Preprint postings preceded peer-reviewed publications describing the same cases by four months. Social media websites including Instagram, Reddit, YouTube, the Center for Disease Control and Prevention's (CDC) Health Alert Network, CDC Twitter, and Facebook did not provide clinically meaningful information on individual cases. Preprint services and Twitter facilitated identification of the largest case series of NM/R-associated COVID-19 rebound. The cases were reported in non-peer-reviewed media several weeks prior to the first peer-reviewed electronically disseminated publication of one person with this diagnosis.

Subanesthetic Ketamine Suppresses Locus Coeruleus-Mediated Alertness Effects: A 7T fMRI Study.

The NMDA antagonist S-ketamine is gaining increasing use as a rapid-acting antidepressant, although its exact mechanisms of action are still unknown. In this study, we investigated ketamine in respect to its properties toward central noradrenergic mechanisms and how they influence alertness behavior. We investigated the influence of S-ketamine on the locus coeruleus (LC) brain network in a placebo-controlled, cross-over, 7T functional, pharmacological MRI study in 35 healthy male participants (25.1 ± 4.2 years) in conjunction with the attention network task to measure LC-related alertness behavioral changes. We could show that acute disruption of the LC alertness network to the thalamus by ketamine is related to a behavioral alertness reduction. The results shed new light on the neural correlates of ketamine beyond the glutamatergic system and underpin a new concept of how it may unfold its antidepressant effects.

Effects of brief mindfulness meditation training on attention and dispositional mindfulness in young adult males

Effects of brief mindfulness meditation training on attention and dispositional mindfulness in young adult males

One response: Global Outbreak Alert and Response Network supporting the COVID-19 response, Kiribati.

In January 2022, Kiribati experienced widespread community transmission of COVID-19, leading to high rates of infection among health-care workers (HCWs), which reduced essential HCWs during a period of increased hospital admissions. Kiribati, a Pacific island country made up of a remote group of 33 low-lying atolls in the Pacific Ocean, experienced its first surge of COVID-19 cases beginning on 24 January 2022. Reports of increasing numbers of COVID-19 cases in South Tarawa prompted the Kiribati Ministry of Health and Medical Services to request assistance from the international community, including the World Health Organization's Global Outbreak Alert and Response Network (GOARN), to support national COVID-19 response operations. Specialists in infection prevention and control (IPC) were deployed to Kiribati in February 2022 to assist the Ministry's National COVID-19 Taskforce in collaboration with national partners. These specialists helped review and strengthen IPC capacities to accommodate a potential patient surge and consequent demands for medical consumables in health-care facilities in South Tarawa. Strengthened knowledge about and processes for IPC among HCWs prevented health care-associated infections and reduced community disease transmission during the first surge of COVID-19 cases in Kiribati. GOARN has the capacity and ability to rapidly deploy experts to support requests for assistance. Outbreak response activities can be enhanced and sustained by using GOARN's resources and collaborating with all partners, as necessary.

Outbreak response capacity of the Global Outbreak Alert and Response Network across WHO's South-East Asia and Western Pacific regions.

The COVID-19 pandemic challenged the Global Outbreak Alert and Response Network's (GOARN) mechanism used to rapidly deploy technical support for international responses and highlighted areas that require strengthened capacity within the Network. GOARN's partners in the World Health Organization's (WHO) South-East Asia and Western Pacific regions were engaged to explore their levels of preparedness, readiness and ability to respond to international public health emergencies. Consultative discussions were held and a survey was conducted with GOARN's partners from the two WHO regions. Discussion topics included partners' capacity to support and participate in a GOARN deployment, training, research and collaboration. Descriptive and content analyses were conducted. Barriers to engaging in GOARN's international outbreak response efforts included limited numbers of personnel trained to respond to outbreaks; institutional, financial and administrative hurdles; and limited collaboration opportunities. Partners identified innovative solutions that could strengthen their engagement with deployment, such as financial subsidies, mentorship for less experienced staff, and the ability to provide remote support. GOARN plays an important role in enabling WHO to fulfil its international alert and response duties during disease outbreaks and humanitarian crises that have the potential to spark disease outbreaks. Yet without systematic improvement to strengthen national outbreak capacity and regional connectedness, support for international outbreak responses may remain limited. Thus, it is necessary to integrate novel approaches to support international deployments, as identified in this study.

Global Outbreak Alert and Response Network deployments during the COVID-19 pandemic, WHO Western Pacific Region.

The Global Outbreak Alert and Response Network (GOARN) has responded to more than 100 outbreaks during the past 23 years. The coronavirus disease (COVID-19) pandemic presented unprecedented operational constraints that challenged GOARN's core mission to rapidly deploy technical experts from its partners to support national in-country responses to public health emergencies. This paper describes the type and duration of GOARN deployments to and within the World Health Organization's (WHO's) Western Pacific Region during the COVID-19 pandemic. Despite strict border closures and ever-changing vaccination and quarantine requirements, GOARN continued to deploy international technical assistance to strengthen COVID-19 response operations within the Region, as requested. Data were analysed from the GOARN Knowledge Platform about deployments to and within the Region for responses to the COVID-19 pandemic between 1 January 2020 and 5 May 2023. Data were available about deployment duration, technical role requested, country or area, partner organization and deployed expert's demographics. Feedback from postdeployment briefings with the experts was collected and thematically analysed to determine ongoing needs and gaps to help improve deployment operations. There were 72 experts deployed on 89 missions through GOARN to 12 countries and areas in the Region, for a total of 4558 field days, to support the response to the COVID-19 pandemic. The volume of requests for assistance from countries and areas in the Region to respond to the COVID-19 pandemic uncovered a deficit in human resources available for domestic response to outbreaks and the reliance on international assistance. Strengthening the in-country capacity of ready-to-respond public health emergency staff is critical to meet the needs for outbreak response. The ongoing demand for technical experts to support national responses means that these lessons may have immediate implications.

Beyond deployments: Australia's strategic contributions to the Global Outbreak Alert and Response Network.

Beyond deployments: Australia's strategic contributions to the Global Outbreak Alert and Response Network.

Inaugural meeting of Global Outbreak Alert and Response Network partners from Australia.

Inaugural meeting of Global Outbreak Alert and Response Network partners from Australia.

Global Outbreak Alert and Response Network (GOARN) focal point engagement meeting with partners in Japan.

Global Outbreak Alert and Response Network (GOARN) focal point engagement meeting with partners in Japan.

Long Range (LoRa) and Alert Network System for Forest Fire Prediction

Forest fires are a regular occurrence throughout the year with an increasing intensity in the summer and fall periods. Forest fires pose a significant threat to ecosystems, property and human lives. Early detection and rapid response are critical to mitigate the devastating effects of these fires. This article presents a Long Range (LoRa) Alert Network System designed for the early prediction and timely notification of forest fires. The system leverages LoRa technology to create a robust and cost-effective wireless communication network in remote forested areas. These fires primarily stem from various natural and environmental phenomena and natural disasters. The timely dissemination of forest fire alerts was hampered, resulting in delays in fire management. In order to address this issue, efforts were made to enhance the capability for prompt forest fire detection. The challenges predominantly revolve around forested regions where data communication infrastructure is deficient. In the event of a forest fire, there exists a network barrier that impedes information transmission. Consequently, forest fire detection systems leveraging Mesh LoRa networks and image processing networks have been devised. An integrated module within the LoRa/GPS HAT has been explored as a potential solution to the fire predicament. The Flame Sensor Module, functioning as a fire detection sensor component, and the LoRa/GPS HAT, serving as a hardware medium for radio frequency data transmission communication, have been employed. The interconnection of these devices within a network facilitates the development of a prototype fire detection system. Combining a Flame Sensor Module with a LoRa/GPS HAT is indeed a viable approach to creating a prototype fire detection and alert system. By combining the Flame Sensor Module with the LoRa/GPS HAT, a scalable and cost-effective fire detection and alert system appropriate for distant and wooded locations with limited traditional communication infrastructure is created. This system can play a crucial role in early fire detection, potentially reducing the severity of forest fires and protecting both natural resources and human lives.

The Impact of Social Media Use on Entrepreneurial Opportunity: Evidence from Manipur, India

Objective: The present study aims to investigate the transformative influence of social media usage on entrepreneurial opportunity, recognition and exploitation in the unique context of Manipur, a northeastern state of India. This research aims to offer valuable insights into the dynamics of social media and entrepreneurship in a region which is characterized by its unique opportunities and challenges, ultimately contributing to a deeper understanding of the role of digital technology in fostering entrepreneurial growth.
 
 Theoretical Framework: This study is guided by seven hypotheses that lay the theoretical foundation, investigating the relationships among specific variables. The independent variable under study is the Social Media Usage (SMU) which is assumed to influence several aspects of entrepreneurial activity. Simultaneously, the study considers Prior Knowledge (PK), Entrepreneurial Alertness (EA) and Enhancing Social Networks (ESN) as intermediary variables, shaping the pathway from social media usage to entrepreneurial opportunity recognition and exploitation.
 
 Method: The authors surveyed 185 entrepreneurs in Manipur, India. Our study applied quantitative approaches to process data through PLS SEM.
 
 Results: The results of our study reveal that social media significantly enhances both entrepreneurial opportunity recognition and exploitation, as well as prior knowledge. However, Contrary to expectations, prior knowledge negatively influences entrepreneurial opportunity recognition and exploitation. Further, social media positively affects entrepreneurial alertness and has a significant impact on expanding social networks. However, the unexpected negative relationship between social networks and entrepreneurial opportunity recognition and exploitation was observed.
 
 Conclusion: In the context of Manipur, India, our study highlights social media’s pivotal role in boosting entrepreneurial opportunity recognition and exploitation, alongside positively affecting prior knowledge and alertness. However, the unexpected negative influence of prior knowledge and the surprising negative relationship between social networks and opportunities necessities further investigation.

A neuroergonomics approach to driver’s cooperation with Lane Departure Warning Systems

A neuroergonomics approach to driver’s cooperation with Lane Departure Warning Systems

Go.Data as a digital tool for case investigation and contact tracing in the context of COVID-19: a mixed-methods study

BackgroundA manual approach to case investigation and contact tracing can introduce delays in response and challenges for field teams. Go.Data, an outbreak response tool developed by the World Health Organization (WHO) in collaboration with the Global Outbreak Alert and Response Network, streamlines data collection and analysis during outbreaks. This study aimed to characterize Go.Data use during COVID-19, elicit shared benefits and challenges, and highlight key opportunities for enhancement.MethodsThis study utilized mixed methods through qualitative interviews and a quantitative survey with Go.Data implementors on their experiences during COVID-19. Survey data was analyzed for basic univariate statistics. Interview data were coded using deductive and inductive reasoning and thematic analysis of categories. Overarching themes were triangulated with survey data to clarify key findings.ResultsFrom April to June 2022, the research team conducted 33 interviews and collected 41 survey responses. Participants were distributed across all six WHO regions and 28 countries. While most implementations represented government actors at national or subnational levels, additional inputs were collected from United Nations agencies and universities. Results highlighted WHO endorsement, accessibility, adaptability, and flexible support modalities as main enabling factors. Formalization and standardization of data systems and people processes to prepare for future outbreaks were a welcomed byproduct of implementation, as 76% used paper-based reporting prior and benefited from increased coordination around a shared platform. Several challenges surfaced, including shortage of the appropriate personnel and skill-mix within teams to ensure smooth implementation. Among opportunities for enhancements were improved product documentation and features to improve usability with large data volumes.ConclusionsThis study was the first to provide a comprehensive picture of Go.Data implementations during COVID-19 and what joint lessons could be learned. It ultimately demonstrated that Go.Data was a useful complement to responses across diverse contexts, and helped set a reproducible foundation for future outbreaks. Concerted preparedness efforts across the domains of workforce composition, data architecture and political sensitization should be prioritized as key ingredients for future Go.Data implementations. While major developments in Go.Data functionality have addressed some key gaps highlighted during the pandemic, continued dialogue between WHO and implementors, including cross-country experience sharing, is needed ensure the tool is reactive to evolving user needs.

Design and development of a detector system and software tool installed on a mobile laboratory to provide both radiological characterisation of large areas and a simple tool for localising radioactive sources.

In emergency situations where an immediate response is required to make appropriate decisions by the competent authorities, it is essential to have measurement tools that provide results as accurate as possible in real-time. This paper presents the description of the upgrade of the mobile laboratory of the Radiological Alert Network of Extremadura, focusing on the characterisation of radioactive-contaminated land during emergency situations and the detection of radioactive sources. The detector system is based on two scintillation detectors and a car-borne dose rate monitor. Additionally, a software tool has been developed to collect information from the different devices involved (detectors, GPS, etc) and display it in an intuitive manner. This system has been tested in an area of a former phosphate facility where soils remain contaminated to varying degrees with radionuclides of TE-NORM origin.

Expansion of wastewater-based disease surveillance to improve health equity in California's Central Valley: sequential shifts in case-to-wastewater and hospitalization-to-wastewater ratios.

Over a third of the communities (39%) in the Central Valley of California, a richly diverse and important agricultural region, are classified as disadvantaged-with inadequate access to healthcare, lower socio-economic status, and higher exposure to air and water pollution. The majority of racial and ethnic minorities are also at higher risk of COVID-19 infection, hospitalization, and death according to the Centers for Disease Control and Prevention. Healthy Central Valley Together established a wastewater-based disease surveillance (WDS) program that aims to achieve greater health equity in the region through partnership with Central Valley communities and the Sewer Coronavirus Alert Network. WDS offers a cost-effective strategy to monitor trends in SARS-CoV-2 community infection rates. In this study, we evaluated correlations between public health and wastewater data (represented as SARS-CoV-2 target gene copies normalized by pepper mild mottle virus target gene copies) collected for three Central Valley communities over two periods of COVID-19 infection waves between October 2021 and September 2022. Public health data included clinical case counts at county and sewershed scales as well as COVID-19 hospitalization and intensive care unit admissions. Lag-adjusted hospitalization:wastewater ratios were also evaluated as a retrospective metric of disease severity and corollary to hospitalization:case ratios. Consistent with other studies, strong correlations were found between wastewater and public health data. However, a significant reduction in case:wastewater ratios was observed for all three communities from the first to the second wave of infections, decreasing from an average of 4.7 ± 1.4 over the first infection wave to 0.8 ± 0.4 over the second. The decline in case:wastewater ratios was likely due to reduced clinical testing availability and test seeking behavior, highlighting how WDS can fill data gaps associated with under-reporting of cases. Overall, the hospitalization:wastewater ratios remained more stable through the two waves of infections, averaging 0.5 ± 0.3 and 0.3 ± 0.4 over the first and second waves, respectively.

Effects of motor imagery based brain-computer interface on upper limb function and attention in stroke patients with hemiplegia: a randomized controlled trial

BackgroundSeeking positive and comprehensive rehabilitation methods after stroke is an urgent problem to be solved, which is very important to improve the dysfunction of stroke. The aim of this study was to investigate the effects of motor imagery-based brain-computer interface training (MI-BCI) on upper limb function and attention in stroke patients with hemiplegia.MethodsSixty stroke patients with impairment of upper extremity function and decreased attention were randomly assigned to the control group (CR group) or the experimental group (BCI group) in a 1:1 ratio. Patients in the CR group received conventional rehabilitation. Patients in the BCI group received 20 min of MI-BCI training five times a week for 3 weeks (15 sessions) in addition to conventional rehabilitation. The primary outcome measures were the changes in Fugl-Meyer Motor Function Assessment of Upper Extremities (FMA-UE) and Attention Network Test (ANT) from baseline to 3 weeks.ResultsAbout 93% of the patients completed the allocated training. Compared with the CR group, among those in the BCI group, FMA-UE was increased by 8.0 points (95%CI, 5.0 to 10.0; P < 0.001). Alert network response time (32.4ms; 95%CI, 58.4 to 85.6; P < 0.001), orienting network response (5.6ms; 95%CI, 29.8 to 55.8; P = 0.010), and corrects number (8.0; 95%CI, 17.0 to 28.0; P < 0.001) also increased in the BCI group compared with the CR group. Additionally, the executive control network response time (− 105.9ms; 95%CI, − 68.3 to − 23.6; P = 0.002), the total average response time (− 244.8ms; 95%CI, − 155.8 to − 66.2; P = 0.002), and total time (− 122.0ms; 95%CI, − 80.0 to − 35.0; P = 0.001) were reduced in the BCI group compared with the CR group.ConclusionMI-BCI combined with conventional rehabilitation training could better enhance upper limb motor function and attention in stroke patients. This training method may be feasible and suitable for individuals with stroke.Trial registration: This study was registered in the Chinese Clinical Trial Registry with Portal Number ChiCTR2100050430(27/08/2021).