Biological Catastrophe Research Articles

Systems analysis of the effects of the 2014-16 Ebola crisis on WHO-reporting nations’ policy adaptations and 2020-21 COVID-19 response: a systematized review

BackgroundRecent case studies indicate that the 2014-2016 Ebola outbreak, one of the worst pre-2020 global biological catastrophes in modern history, helped some nations to better prepared their responses for the COVID-19 pandemic. While such national case studies explore how specific nations applied EVD-related policies in their domestic battle against the COVID-19 pandemic, there is no known study that assesses how many WHO nations learned from the West African crisis and to what scale.ObjectiveApplying the policy legacies analytical framework and a systematized literature review, this research examines how prior policy experiences with the 2014-16 EVD crisis as a large-scale emergent outbreak helped to inform and to condition WHO nations to proactively prepare their national policies and health systems for future threats, including ultimately COVID-19.MethodsA systematized literature review of 803 evaluated sources assesses to what extent Ebola-affected and non-affected nations directly modified governmental health systems in relation to this warning. The study further evaluates how nations with documented Ebola-related changes fared during COVID-19 compared to nations that did not. We present a categorical theoretical framework that allows for classifying different types of national response activities (termed conditioned learning).ResultsTen (90.9%) of 11 nations that were affected by 2014-16 Ebola crisis have documented evidence of repurposing their EVD-related policies to fight COVID-19. 164 (70.0%) of 234 non-EVD-affected nations had documented evidence of specifically adapting national systems to incorporate policy recommendations developed from the 2014-16 crisis, which informed their COVID-19 responses in 2020.ConclusionsThe shock of 2014-16 EVD outbreak affected most nations around the world, whether they experienced Ebola cases. We further develop a categorical framework that helps characterised nations previous experiences with this biological catastrophe, providing a means to analyse to what extent that individual nations learned and how these EVD-related changes helped inform their COVID-19 response. Nations that demonstrated EVD-related conditioned learning nations tended to have more stringent COVID-19 responses before April 2020 and utilized documented response mechanisms developed out of the West African crisis.

Guarding Against Catastrophic Biological Risks: Preventing State Biological Weapon Development and Use by Shaping Intentions.

Guarding Against Catastrophic Biological Risks: Preventing State Biological Weapon Development and Use by Shaping Intentions.

Disasters – Sociocultural Effects on the Quality of Life of Local Communities

This article presents an analysis of the impact of disasters on the quality of life of local communities. Its empirical basis is collected field material within the framework of a study conducted by the Institute for Еthnology and Folklore Studies with the Ethnographic Museum at the Bulgarian Academy of Sciences as part of the project "Local Disasters and Quality of Life: Cultural Strategies in Overcoming Natural, Technological and Biological Catastrophes", funded from National Science Fund of the Ministry of Education and Science. The empirical data, on the basis of which the theoretical analysis is carried out, concern two natural disasters that occurred in Bulgaria - the earthquake in Pernik in 2012 and the flood in the Asparuhovo district in 2014. Research results show that the disaster affects, albeit to different degrees and in different ways, all components of the "quality of life" category, changing them at the moment or creating conditions for their later change. It has a powerful impact on the material and economic side of people's lives as the basis of their social well-being, which is entirely in a negative direction. Also negative is the impact of the disaster event on the affected person's physical and mental health, sense of security, tranquility, and mental balance. Unexpectedly, it turns out that disaster can also positively impact people's quality of life. This is most often in terms of their social connectedness and cohesion when the disaster event catalyzes social connections and support. Striving to restore the pre-disaster quality of life leads to social change that reflects the experience of survival through changes in local traditions and everyday life and the creation of new cultural memory and places of memory, thus building a new post-disaster model of social relations, accumulating gained experience and refracting it through the unique situation.

Guaranteeing biological safety as a basis for limiting the patent-protected rights of intellectual property subjects

The relevance of the subject under study is conditioned upon the rapid and active development of the biotechnological area. This segment of the economy and science requires not only comprehensive preliminary work, but also further legal protection of the interests of inventors and society. The development of biotechnologies regulates not only the present, but also the prospects for the future. But it is important to harmonize the use of biological processes to avoid a biological catastrophe. The purpose of this study was to investigate the possible legal instruments for limiting the patent-protected powers of subjects of intellectual property law to guarantee biological safety. The following methods were used to collect, process, and present information in this paper: general scientific (formal-logical, analysis and synthesis, comparison, induction and deduction, systematization) and special-legal methods (formal-legal, comparative-legal). This study considered the possibility of limiting the rights granted to the subjects of patenting to guarantee biological safety. International and Ukrainian legislation was analysed in the aspect of patenting biotechnological achievements, compulsory patenting and restrictions on the rights of patenting subjects. The legal nature of biotechnologies as objects of intellectual property rights was identified. Legal measures to restrict the patent-protected powers of subjects of intellectual property rights were highlighted. Attention was drawn to the legal consolidation of the resolution of controversial issues in the field of patenting of biotechnological inventions according to the criteria of ethics and morality. The need to improve the national legislation governing issues of biotechnological research considering the principle of sustainable development, according to which social and ecological aspects should be recognized as a priority, was substantiated. The importance of this study is reinforced by the increased demand for biotechnologies, which leads to certain legal actions related to their protection. The present paper will be useful for scientists in the field of law, medicine, and bioengineering.

Sirt6 mediates antioxidative functions by increasing Nrf2 abundance

Oxidative stress caused by excess ROS often leads to cellular macromolecule damage and eventually causes various biological catastrophes. Sirt6, a member of the mammalian homolog family of yeast Sir2 NAD+-dependent histone deacetylases, regulates multiple biological processes. Sirt6 exerts antioxidative functions by enhancing DNA repair and DNA end resection. In our study, we found that Sirt6 expression was induced by H2O2 and paraquat (PQ) in cells. When exposed to PQ, the Sirt6+/− C57BL/6 mice showed more serious liver damage and lower survival rate than the Sirt6+/+ mice. The Nrf2 protein levels and the mRNA levels of its target genes in mouse tissues were decreased by Sirt6 deficiency, and Sirt6 overexpression increased the Nrf2 protein content. Moreover, the endogenous H2O2 levels were increased in the tissues of Sirt6-deficient mice and were decreased in Sirt6 overexpression cells. Then, we found that Nrf2 was degraded faster in the Sirt6-deficient mouse embryonic fibroblasts (MEFs) than in the wild type MEFs and that Sirt6 enhanced the protein accumulation of Nrf2 in the nucleus. Lastly, we found that Sirt6 interacted with Nrf2 in co-IP and GST pull-down assays and that Sirt6 overexpression decreased the binding of Nrf2 to Keap1. Taken together, the results of the present study suggest that Sirt6 exerts antioxidative functions by increasing the Nrf2 protein level via Keap1-mediated regulation.

The undead new world: Zombie epidemics’ apocalyptic surroundings and social relations

The narratives of zombie films articulate social relations in the context of an apocalyic social environment, indicating unstoppable processes of disease spreading through the omnipresence of zombies as the primary infection carriers, emphasizing discourses of biological catastrophe, that is, epidemics of infectious diseases as a potential means of the end of a modern civilization. As portrayed in movies about zombies, epidemics could be observed as a type of imagined future of the virus, that is, as an advanced stage in infectious disease evolution, which leads to the deconstruction and complete collapse of the existing social system, and then to apocalyptic consequences and the forming of a new social order. An epidemic creates conditions in which previously known institutional organization ceases to exist and shapes individual behaviors that transform social environments to meet the demands of new social and biological discourses. Due to such circumstances, social surroundings are significantly changed, and disease establishes itself as a signifier of social strategies, relationships towards the infected, and the area for the redistribution of social power and livelihood. The aim of this paper is to reveal the ways of social reorganization and social disruption caused by the zombie epidemic, emphasizing the role of the disease in reshaping social groups and relationships, with the purpose of analyzing the ways in which movie narratives metaphorize the efficiency of infectious diseases.

Rapid Proliferation of Pandemic Research: Implications for Dual-Use Risks.

ABSTRACTThe COVID-19 pandemic has demonstrated the world’s vulnerability to biological catastrophe and elicited unprecedented scientific efforts. Some of this work and its derivatives, however, present dual-use risks (i.e., potential harm from misapplication of beneficial research) that have largely gone unaddressed. For instance, gain-of-function studies and reverse genetics protocols may facilitate the engineering of concerning SARS-CoV-2 variants and other pathogens. The risk of accidental or deliberate release of dangerous pathogens may be increased by large-scale collection and characterization of zoonotic viruses undertaken in an effort to understand what enables animal-to-human transmission. These concerns are exacerbated by the rise of preprint publishing that circumvents a late-stage opportunity for dual-use oversight. To prevent the next global health emergency, we must avoid inadvertently increasing the threat of future biological events. This requires a nuanced and proactive approach to dual-use evaluation throughout the research life cycle, including the conception, funding, conduct, and dissemination of research.

Agriculture 4.0. as a new vector towards increasing the food security in Russia

This study is aimed at assessing the quality of the transformations taking place in the structure of the national economy in the light of the transition to the philosophy of Industry 4.0. The fourth industrial revolution, which has affected all countries and all spheres of human life, is aimed at increasing labor productivity in conditions of deteriorating environmental conditions. The goal of the study is to solve the following objectives: to review the ongoing changes in the environment, to assess the scale of an impending biological catastrophe, to analyze the forecast for the reduction in the production of food stuff, to assess the scale of digitalization in the agro-industrial complex, to develop recommendations for the transition to the philosophy of Agriculture 4.0 in modern conditions.

Contingency Public Funds for Emergencies: The Lessons from the International Experience

Should societies (governments) save during economic expansions in order to cover the costs of extraordinary situations, such as natural or biological catastrophes or, more generally, economic crises? This question has been raised once again by the economic and social crisis linked to the confinement measures implemented to control the spread of the COVID-19 pandemic and the enormous public spending required to mitigate its impact. There are two general approaches in the economic literature to this debate, which are not mutually exclusive. First, the more standard approach indicates that governments, in these situations, should resort to borrowing. This allows the impact of shocks to be smoothed over time, as long as governments are sufficiently disciplined to rebuild the necessary room for manoeuvre during upswings. However, the evidence available shows that debt tends to decline only very gradually in post-crisis periods. Under the second approach, governments build up contingency funds or rainy-day funds during economic booms. International experience has numerous examples of national and regional funds of this type. This paper reviews the experience of such funds, with a view to drawing lessons as to their potential usefulness as an instrument of support in crisis situations and fiscal emergencies. Although the international evidence on their use is highly heterogeneous, it shows that when these funds are appropriately structured and sufficiently large they contribute to mitigating the impact of shocks and improving fiscal discipline.

American Eldercide

American Eldercide Margaret Morganroth Gullette (bio) Click for larger view View full resolution Transporting a sick nursing-home patient to the hospital in Austin, Texas (John Moore/Getty Images) [End Page 112] Contrary to what many believe, the tens of thousands of deaths of those living in long-term care (LTC) were no inevitable biological catastrophe. Their grieving, angry family members know better: they know the conditions that prematurely deprived their loved ones of the remainder of their lives. By December, just as vaccine distribution started, nearly 110,000 residents and over 1,000 staffers had died. The extra deaths among our elders constitute an appalling number of the diverse 1.4 million Americans who were living in nursing homes before the pandemic. Many people have also died in assisted living facilities, middle-class residences not currently inspected by the Centers for Medicare and Medicaid Services. Until other deaths soared toward 500,000 over the winter, the deaths in nursing and veterans’ facilities alone accounted for almost 40 percent of all the U.S. dead. If we can’t explain why these care homes failed the people they were responsible for, we cannot prevent the next pandemic. We may need to be reminded that people who choose congregate living in nursing and veteran’s homes include men and women of all races and ethnicities. Some are quite healthy or staying in rehab only temporarily. Other residents are chronically ill, disabled, frail, or living with some level of cognitive impairment. They may have little in common except their powerlessness to avert their fate. All of them should be able to look forward to living nicely, perhaps with some assistance—receiving help with activities of daily life such as showering and taking medications—as well as good meals, exercise classes, access to the outdoors, pleasant and helpful aides, conversation at mealtimes, and visits from loved ones. Many would have lived long lives in their new homes. All this was denied to those who sickened and died. We don’t know enough stories of the nursing home survivors from their own mouths—their anguish at being neglected, anxiety as they listened to the news of mounting deaths among people like them, compassion for friends who were taken to hospitals and did not return, or stubborn determination to survive. While journalists have interviewed family members and [End Page 113] administrators, few have spoken to residents to find out how they felt and what they observed. Aides were overworked, unprepared, and lacked protective equipment. Nurses were overextended. In one harrowing case at the Soldier’s Home in Holyoke, Massachusetts, where union officials had long warned about conditions, staff were instructed by the home’s leadership to merge two dementia units, cramming residents with COVID-19 into wards with residents who were uninfected. At least seventy-six residents died. All across the country, if an aide held an old hand and spoke words of love from the family members whom residents could not see, that was the best death available. The fact of the matter is this: No resident, however poor, feeble, or impaired, needed to die of COVID-19. Nor did those who work taking care of them. We don’t need to look far for proof. In a small, nonprofit, Baptist-run nursing home in Baltimore, Maryland, whose low-income residents were people of color, many with chronic conditions, not one person had even become infected as late as June 18, 2020. Everyone was protected by best practices, instituted early and with the greatest good will. Derrick DeWitt Sr., a reverend and the CFO of the nursing home, brought in personal protective equipment, more TVs for entertainment and social distancing, hired an extra activities coordinator, and provided food for employees so that they wouldn’t have to leave to buy lunch. They already had a full-time infection-control nurse on staff before the pandemic. Similar procedures led to lower mortality rates in other residences. A study of New York State LTC facilities showed that 30 percent fewer residents died in unionized than in nonunionized facilities. There were fewer infections. There were better masks and eye shields. Unionization often means better pay and infection...

Disaster Resiliency of U.S. Local Governments: Insights toStrengthen Local Response and Recovery from the COVID-19 Pandemic.

This research presents implications of the global pandemic for local government resiliency in the United States. The authors explore insights from local government officials and managers on the front lines of response and recovery efforts to the biological natural disaster. Findings from the latest nationwide survey of U.S. local governments regarding their preparedness for weather‐related natural disasters also inform responses to the current crisis. Results indicate that local governments are innovating and taking strategic actions to fight the virus, even as COVID‐19 has exposed social inequities that are exacerbated as the virus spreads. Survey findings of disaster readiness of local governments to weather‐related disasters shows that small, resource‐poor governments will not be able to respond well and social inequities will grow. Policy strategies at all levels of government must recognize and account for these inequities as threat of this virus subsides, to support stronger, more effective readiness for the next biological catastrophe.

Letter to the editor regarding ‘The challenging battle of mankind against COVID-19 outbreak: Is this global international biological catastrophe the beginning of a new era?’ – Is telehealth the future of orthopaedic and rehabilitation in post-COVID-19 era?

Letter to the editor regarding ‘The challenging battle of mankind against COVID-19 outbreak: Is this global international biological catastrophe the beginning of a new era?’ – Is telehealth the future of orthopaedic and rehabilitation in post-COVID-19 era?

A macroscopic theory for predicting catastrophic phenomena in both biological and mechanical chemical reactions

A possibility for predicting the time-dependent pattern of sickness of human beings, i.e., biological catastrophe, has been shown by proposal of a nonlinear ordinary differential equation, describing temporal features of six macroscopic molecular groups chemically interacting in living beings, (Naitoh in Jpn J Ind Appl Math 28:15–26, 2011; Naitoh and Inoue in J Artif Life Robot 18:127–132, 2013). Logically, we also find that, six is minimum and essential as the number of macroscopic molecular groups for describing living systems. Then, along with the number theory applied for the differential equation, we derive critical mathematical conditions for predicting the premonition just before sickness (discrepancy from a healthy condition), which agree with an important knowledge revealed by the linear analysis proposed by Chen (Dynamical network biomarkers for identifying early-warning signals of complex diseases, Beppu, Oita Japan, 2015). In the present report, we first show that computational several time-histories of sickness obtained by solving the nonlinear differential equation with various parameters describing polymorphism agree well with actual time-dependent patterns of sickness for human beings, which is further evidence of usefulness of the nonlinear differential equation and its critical mathematical conditions. Thus, to examine the boundary between biological and abiological chemical reaction systems, which is related to the origin of living systems, we next check whether or not the nonlinear equation can also predict such abiological catastrophic phenomenon as misfire in artifacts including mechanical combustion engines.

Cybernetic Approach to Problem of Interaction Between Nature and Human Sosiety in Context of Unprecedented Climate Change

In this paper, from a cybernetic perspective, the human-nature interactions are considered in the context of modern climate change, unprecedented in its scale and rate caused by anthropogenic activity. The developed structure of the “climate-economy” cybernetic system is presented, the weaknesses of the global governance bodies are analysed, and the main causes of the uncertainties in assessing climate change and the economic damage caused by this change are discussed. It is noted that adaptation measures and strategies developed and implemented by governments of different countries and intergovernmental organizations do not eliminate the causes of global warming and, therefore, have limited capacities, since humans and nature can exist only under specified environmental conditions. Going beyond these conditions, due to climate change, can lead to a global biological catastrophe. Climate policy decisions are made under uncertainty due to the ambiguity of estimates of the future climate, which, in turn, is the result of an insufficiently adequate description of feedbacks in the climate system models. Using low-parametric models of the Earth's climate system, the influence of system’s feedbacks on tangible inter-model differences of climate change estimates obtained using modern climate models of a high degree of complexity is illustrated. Since the climate change adaptation measures proposed by experts are not the struggle with causes, but the fight with consequences, we see geoengineering as a radical adaptation strategy. In contrast to previous studies, we consider the problem of purposefully modifying climatic conditions, implemented by geoengineering methods, within the framework of optimal control theory with mathematical formalization of geoengineering objectives and methods for achieving them. In this paper, an example of the formulation and solution of the optimization problem for stabilizing the Earth’s climate through the injection of finely dispersed sulfate aerosol into the stratosphere is presented.

Risk and Response to Biological Catastrophe in Lower Income Countries.

Natural and intentional biological risks threaten human civilization, both through direct human fatality as well as follow-on effects from a collapse of the just-in-time delivery system that provides food, energy and critical supplies to communities globally. Human beings have multiple innate cognitive biases that systematically impair careful consideration of these risks. Residents of low-income countries, especially those who live in rural areas and are less dependent upon global trade, may be the most resilient communities to catastrophic risks, but low-income countries also present a heightened risk for biological catastrophe. Hotspots for the emergence of new zoonotic diseases are predominantly located in low-income countries. Crowded, poorly supplied healthcare facilities in low-income countries provide an optimal environment for new pathogens to transmit to a next host and adapt for more efficient person-to-person transmission. Strategies to address these risks include overcoming our natural biases and recognizing the importance of these risks, avoiding an over-reliance on developing specific biological countermeasures, developing generalized social and behavioral responses and investing in resilience.

Modelling the Ecological Effect of the Golden Mussel Invasion in Uruguay River

Abstract The invasion of exotic species in aquatic environments is one of the several factors responsible for altering the dynamics of fish communities. The golden mussel Limnoperna fortunei was first recorded in the upper Uruguay river, Brazil in 2012 and since then there is an open need to discuss and evaluate how this invasive species interferes with the life of the ten must abundant fishes of this region. In order to achieve this, this work uses two different nonlinear state-space models to describe the dynamics of the K condition factor and abundance of these communities, whose parameters are identified by extended Least Squares procedures, considering real, in locus collected data. One model is polynomially nonlinear on the states and the other is linear, while both are output-nonlinear. This work also evaluates quantitatively how the (sudden) presence of the golden mussel medelled with the aquatic life of the upper Uruguay river, with the aid of high-fidelity simulation results. The methodology points to significant changes in five distinct fish communities, which was also partially observed in nature. Moreover, preliminary results regarding control techniques are also presented to illustrate how environmental policies could act to prevent a biological catastrophe due to this invasor.

Overfishing and Climate Drives Changes in Biology and Recruitment of the Indian Oil Sardine Sardinella longiceps in Southeastern Arabian Sea

The recent fluctuations in abundance of the Indian oil sardine Sardinella longiceps, a tropical small pelagic clupeid fish, was investigated in the light of overfishing and variations in its habitat ecology in southeastern Arabian Sea. In 2012, its landings peaked to an all-time record making it the fifth largest sardine fishery in the world, and within 3 years the catches were reduced to nearly a tenth of that level. This study examined the fishery dependant factors such as effort, catch rates and expansion of fishing area; the biological variations in fish size, maturity and recruitment; and tried to relate this to the environmental variations in the sardine habitat and food availability. The 2012 mega harvest was a result of a 2-time increase in gear size and engine capacity of fishing crafts and a 3.7-time increase in fishing effort. The female maturation process was strongly influenced primarily by rainfall and then by upwelling and the resulting influx of cold nutrient-rich water in the habitat from April much before the start of the monsoon in June. After 2013, the weak monsoons and the 2015 El Nino Southern Oscillation resulted in a warmer (by an average of 1.1°C) period which negatively impacted the maturation process. The abundance of jellyfishes which are larval and young fish predators in the habitat negatively affected recruitment after 2013. The mismatch in timing of phytoplankton productivity and sardine larvae in the habitat also affected the recruitment success. These environmental divergences coupled with the excessive capture (beyond maximum sustainable yields) of spawning stock and juveniles from 2010 has resulted in this biological catastrophe which has affected the livelihood of thousands of small-scale fishers. A more responsive fisheries administration with timely restriction on fishing effort and protection of spawning stocks by way of fishery closure would have helped minimize the impacts.

Pathogenic Nation-Making: Media Ecologies and American Nationhood Under the Shadow of Viral Emergence

In 1989, a group of US government scientists invented the concept of Emerging Infectious Diseases (EIDs), a framing of contagion preoccupied with unknowable, but always possible, ever-present future biological catastrophes. Public health efforts around the world have since placed an emphasis on the project of managing uncertain microbial futures. Within the United States, an emergent mode of nationhood has surfaced through this project, what this article calls “pathogenic nation-making”—the forging of national solidarity through the affects of everyday anxiety and precarity. Whereas much humanistic scholarship has emphasized the role of representation in such endeavors, this article documents how media and media ecologies—in their capacity to implicate representations, media, objects discourses, and practices within one network—play a crucial role in mobilizing a collective affect of everyday uncertainty around that project.

Catastrophes Promote Cooperation: Experimental Approach with Catastrophe Game

As seen in the Great East Japan Earthquake, people constantly face “abrupt changes” of which occurrence they cannot surely foresee. In this study, such “sudden changes” was defined as “catastrophes.” Building on this idea, the aim of this study is to indicate the evolution of cooperation is also promoted by catastrophes, as well as punishments, inspired by the evolution by biological catastrophes. The present study investigated whether: (a) the prior “Notice of Catastrophes” promotes cooperation or not and (b) the “Occurrence of Catastrophes” did. Therefore, the Total Catastrophe Game is examined based on a repeated public goods game with stranger matching and anonymous conditions, where changes occur on the player’s endowments. The results showed that although the notice of catastrophes was not found to have a significant effect, cooperation was promoted due to the occurrence of catastrophes. Furthermore, a correlation between the magnitude of the occurring loss and the contribution level was found.The results suggested that not only punishments, but also catastrophes promote cooperation as an emergency urge. Furthermore, cooperation is promoted not as strategic but as altruistic behavior.

Accelerated Manufacturing of Large-Scale, Full-Length, Human-Like Glycosylated Antibodies for Bio-Defense

From the point of DNA sequence confirmation until production of meaningful clinical quantities of novel therapeutics, current manufacturing systems for many glycosylated proteins require several months of development. Consequently, in the event of mass-casualty epidemics, current systems will fail to provide sufficient and timely quantities of emergency medical counter measures. As the identity of many new biological threats are unlikely to be known in advance, pre-emptive manufacturing and stockpiling of countermeasures cannot always be performed. Preparedness for all biological catastrophes requires a radical solution to replace the current slow scale-up and manufacture of certain lifesaving medical countermeasures. Current clinical and commercial manufacturing methods for glycosylated proteins use stable cell lines for protein expression, wherein the gene coding for the protein of interest is stably integrated into the host cell genome. The generation, identification, banking, testing, and scale-up of suitable stable clones generally takes many months. Because this development time is not compatible with emergency manufacturing, an alternative method for rapid production of medical counter measure antibodies is needed. One such potential technique is transient gene expression. Transient gene expression is a common approach for production of research-grade antibodies. It is frequently used to generate milligram to gram quantities of material within two to three weeks of DNA sequence confirmation. In the past, transient systems have been considered for emergency production of large quantities of antibodies, but dismissed due to low titers, high cost of DNA, uncertain regulatory environment, and the lack of sufficient, available manufacturing capacity. Recent developments, however, have substantially enhanced the viability of such an approach. This article will explore these developments and investigate the use of transient gene expression for rapid production of antibody-based medical countermeasures.