Conceptual Model for Automatic Early Warning Information System of Infectious Diseases Based on Internet Reporting Surveillance System

Objective To establish a conceptual model of automatic early warning of infectious diseases based on internet reporting surveillance system, with a view to realizing an automated warning system on a dally basis and timely identifying potential outbreaks of infectious diseases. Methods The statistic conceptual model was established using historic surveillance data with movable percentile method. Results Based on the infectious disease surveillance information platform, the conceptual model for early warning was established. The parameter, threshold, and revised sensitivity and specificity of early warning value were changed to realize dynamic alert of infectious diseases on a dally basis. Conclusion The instructive conceptual model of dynamic alert can be used as a validating tool in institutions of infectious disease surveillance in different districts.

Simulation of the spread of infectious diseases in a geographical environment

The study of mathematical models for the spread of infectious diseases is an important issue in epidemiology. Given the fact that most existing models cannot comprehensively depict heterogeneities (e.g., the population heterogeneity and the distribution heterogeneity) and complex contagion patterns (which are mostly caused by the human interaction induced by modern transportation) in the real world, a theoretical model of the spread of infectious diseases is proposed. It employs geo-entity based cel-lular automata to simulate the spread of infectious diseases in a geographical environment. In the model, physical geographical regions are defined as cells. The population within each cell is divided into three classes: Susceptible, Infective, and Recovered, which are further divided into some sub-classes by states of individuals. The transition rules, which determine the changes of proportions of those subclasses and reciprocal transformation formulas among them, are provided. Through defining suitable spatial weighting functions, the model is applied to simulate the spread of the infectious dis-eases with not only local contagion but also global contagion. With some cases of simulation, it has been shown that the results are reasonably consistent with the spread of infectious diseases in the real world. The model is supposed to model dynamics of infectious diseases on complex networks, which is nearly impossible to be achieved with differential equations because of the complexity of the prob-lem. The cases of simulation also demonstrate that efforts of all kinds of interventions can be visual-ized and explored, and then the model is able to provide decision-making support for prevention and control of infectious diseases.

Online Vaccine Information in a Knowledge Exchange Social Website (KESW)

Background: The potential for misinformation on usercontrolled Knowledge Exchange Social Websites (KESWs) is concerning since it can actively influence Internet users’ knowledge, attitudes, and behaviors related to childhood vaccinations. Objective: The present study examines the accuracy and predictors of health information posted to a Knowledge Exchange Social Website (KESW). Methods: A sample of 480 answers to childhood vaccination questions were retrieved and rated for accuracy. Multiple logistic regression modeling was used to examine whether answer characteristics (best answer, professional background, statistical information, source disclosure, online link, word count, vaccine stance, and tone) predict accuracy. Results: Overall, only 56.2% of the posted answers were rated as “accurate.” Accuracy varied by topics with between 52.8% - 64.3% being rated as accurate. When Yahoo Answers’ “best answers” were examined, only 49.2% rated as accurate compared to 57.7% of all other answers, a finding attributed to widespread nominations of vaccine misinformation as “best answers” for questions addressing the side effects of vaccines. For all other types of questions, “best answers” were more likely to be accurate. Regression modeling revealed that discussions of personal choices regarding childhood vaccinations predicted the accuracy of posted answers, with those who mentioned vaccinating their own children proving more likely to communicate accurate vaccine information, and those expressing vaccine hesitancy proving more likely to share factually inaccurate statements about vaccines. Conclusion: The high prevalence of misinformation on KESWs suggests that these websites may serve as a vector for spreading vaccine misperceptions. Further research is needed to assess the impact of various KESWs and to develop effective, coordinated responses by public health agencies.

Accuracy of Ebola Information in a Knowledge Exchange Social Website (KESW)

Background: Misinformation on interactive Knowledge Exchange Social Websites (KESWs) is concerning since it can influence Internet users’ health behaviors, especially during an infectious disease outbreak. Objective: The present study seeks to examine the accuracy and characteristics of health information posted to a Knowledge Exchange Social Website (KESW). Methods: A sample of 204 answers to Ebola questions were extracted and rated for accuracy. Multiple logistic regression modeling was used to examine whether answer characteristics (best answer, professional background, statistical information, source disclosed, link, and word count) predicted accuracy. Results: Overall, only 27.0% of the posted answers were rated as “accurate”. Accuracy varied across question topics with between 11.8% - 45.5% of answers being rated as accurate. When Yahoo Answers’ “best answers” were examined, the overall accuracy was substantially higher, with 80.0% of “best answers” being rated as accurate compared to 16.0% of all other answers. Conclusion: There is need for tools to help Internet users navigate health information posted on these dynamic user-generated knowledge exchange social websites.

大规模通信网络涉密信息安全动态预警方法

涉密信息在通信网络中传输时,会受到网络中异常节点的攻击,出现涉密信息泄露的危险。为保障涉密信息的安全性,提出大规模通信网络涉密信息安全动态预警方法。采用小波阈值去噪算法对数据中的噪声实施剔除,并对数据实施归一化处理,获取完整的大规模通信网络运行数据;结合通信数据的样本属性聚类结果,识别大规模通信网络中的异常数据,确定涉密信息威胁来源,建立涉密信息安全动态预警等级;根据传染病动力学理论,对网络安全威胁传播过程展开具体分析,建立涉密信息安全动态预警模型,结合微分博弈理论对模型实施求解处理,获取涉密信息传输过程安全动态变量值,结合制定的安全动态预警等级,实现对通信网络涉密信息安全的动态预警。实验结果表明,上述方法能够有效检测出通信网络节点内所有异常节点的预警等级,预警性能较高。

北京市临床医生新发传染病报告知信行调查

目的了解北京市临床医生对新发传染病报告的知信行情况,为将来更好地报告新发传染病提供参考依据。方法采用多阶段抽样方法,对呼吸科、感染科临床医生进行线上问卷调查,收集其人口学信息、传染病报告相关知识素养、新型冠状病毒感染(以下简称新冠感染)诊疗及报告行为等相关信息,组间比较采用χ^(2)检验。结果抽取152家医疗机构,实际完成调查148家。共收回问卷495份,其中491份有效,问卷有效率为99.2%。调查对象以30~<50岁(74.1%)、本硕学历(89.2%)、中高级职称(83.7%)、女性(67.8%)为主,对传染病报告工作感到不厌烦的占60.1%,认为传染病报告工作非常重要、传染病报告相关培训非常有必要的占比均≥80.0%。临床医生认为传染病报告卡中难以收集的项目包括现住址、人群分类、病人属于、工作单位、发病日期、联系方式;其中前3项被认为不必要收集项目;患者不配合、传染病报告卡内容理解问题、工作忙没时间、单位系统问题是传染病报告卡填写不顺利的主要原因。有新冠感染报告的医疗机构调查对象中高学历(χ^(2)=5.526,P<0.001)、高职称(χ^(2)=6.136,P=0.047)、填写过传染病报告卡(χ^(2)=8.384,P=0.004)及接到过新冠感染相关通知文件(χ^(2)=4.696,P=0.030)的占比均高于无新冠感染报告组,前者的传染病报告知识储备考试优秀占比高于后者(χ^(2)=14.166,P<0.001)。结论临床医生具备依法依规及时报告法定传染病的意识,传染病报告卡中的项目亟待梳理,临床医生填卡不顺利涉及患者、自身、系统三方面原因,需采取不同的改进措施。新发传染病的报告,受政策影响容易集中在高级别或定点医疗机构,非定点医疗机构的传染病报告工作需政策支持并提升诊疗能力。

应急标本信息采集系统的构建与应用评价

目的:构建应急标本信息采集系统,评价其在无网络条件下实现重大传染病疫情防控中的标本采集工作的规范性和准确性。方法:采用Sybase Power Builder开发工具,将Microsoft Access作为后台数据库,选取客户端与服务器(C/S)架构模式,以医院实验室信息系统(LIS)或第三方系统为基础,构建能够应对重大传染病大规模标本采样工作的应急标本信息采集系统,对比不同标本信息采样方式的应用效果。结果:应急标本采集系统采集信息的信息录入完整率、正确率及时效性均优于手工方式,差异有统计学意义(x^(2)=89.97、109.83,P<0.05)、(t=146.74,P<0.05),提高了标本采集的效率,减少信息差错率,还可降低交叉感染风险,使重大传染病疫情防控中的标本采集工作更加规范和便捷。结论:应急标本信息采集系统在应对重大传染病大规模采样工作中起到重要作用,能够提升工作效率,保障信息的安全性和准确性。

基于信息平台的发热门诊就诊模式优化实践

通过医院信息化建设整合患者诊疗数据,并用于智能服务设备、信息自动采集、信息区域共享。实现基于医院信息平台的发热门诊就诊模式,优化资源配置,减少患者候诊时长,提高患者满意度,同时强化发热门诊在新型病毒监测方面的哨点作用。该模式为发热门诊的整体诊疗流程提供了有力的支持,在改善患者就医体验、节约医院成本、院感防控方面均具有一定意义。

呼吸道传染病时空传播风险精细化评估系统构建与应用

目的开发多源城市大数据支持下的城市内部呼吸道传染病时空传播风险精细化评估系统,为城市内部实施更加精准的疾病防控提供决策支持。方法本研究面向流感等典型的呼吸道传染病,融合传染病、人群活动、地理环境等多源大数据,以500米网格为基本空间单元,通过德尔菲法构建高精度传播风险评估模型;通过构建基于人口流动网络的传播动力学模型,实现高精度的呼吸道传染病时空传播模拟,推演未来30天城市内部疾病发展的时空趋势;选取传染病传播高风险区域作为关键的空间防控节点,利用时空传播模拟模型精细化评估不同关键节点防控的效果。结果以深圳市为例,构建了呼吸道传染病时空传播风险精细化评估系统。结论本研究提供了一套面向大型城市内部区域的呼吸道传染病时空传播风险精细化评估系统,能够支持传染病时空扩散趋势的研判,并且能够在疫情发展的不同阶段快速预判高危风险区域防控措施的效果,为呼吸道传染病精准防控提供应急响应的技术和系统储备。

基于SIRS模型的核电事故致因传播机制研究

文章用自然语言处理技术对152起核电厂执照运行事件报告(Licensed Operation Event Report,LOER)进行风险致因分析,得出风险致因复杂网络的相关数据,借助改进SIR传染病模型,结合核电运行事件风险传播的特征,构建了适用于核电领域的改进传播模型。文章对核电运行事件致因传播过程进行动态仿真,对比了不同因素对传播风险的影响差异,对当前的核电安全管理工作进行优化。

2019—2021年某中医医院传染病报告分析与管理

目的分析某中医医院法定和其他重点监测传染病报告情况,为规范开展医院传染病报告和制定医院传染病报告管理策略提供参考。方法对2019—2021年某中医医院传染病报告数据进行描述性分析。结果2019—2021年某中医医院共报告法定和其他重点监测传染病6865例次,无甲类传染病报告,其中乙类传染病668例次(9.73%),丙类传染病5356例次(78.02%),其他重点监测传染病841例次(12.25%)。排名前5位的传染病分别是流行性感冒、水痘、梅毒、其他感染性腹泻病和肺结核,其中报告病例最多的流行性感冒,在报告时间上每年传染病报告例次数居首位的是第一季度。2019—2021年某中医医院法定和其他重点监测传染病报告例次数呈下降趋势。结论2019—2021年某中医医院法定和其他重点监测传染病报告以呼吸道传染病为主,应根据不同季节、疾病流行趋势,采取有针对性的传染病监测、防控策略。

Bifurcation and optimal control for an infectious disease model with the impact of information

A nonlinear infectious disease model with information-influenced vaccination behavior and contact patterns is proposed in this paper,and the impact of information related to disease prevalence on increasing vaccination coverage and reducing disease incidence during the outbreak is considered.First,we perform the analysis for the existence of equilibria and the stability properties of the proposed model.In particular,the geometric approach is used to obtain the sufficient condition which guarantees the global asymptotic stability of the unique endemic equilibrium Ee when the basic reproduction number Ro>1.Second,mathematical derivation combined with numerical simulation shows the existence of the double Hopf bifurcation around Ee.Third,based on the numerical results,it is shown that the information coverage and the average information delay may lead to more complex dynamical behaviors.Finally,the optimal control problem is established with information-infuenced vaccination and treatment as control variables.The corresponding optimal paths are obtained analytically by using Pontryagin's maximum principle,and the applicability and validity of virous intervention strategies for the proposed controls are presented by numerical experiments.

基于患者报告结局的风湿病儿童健康相关生活质量现状及照顾者负担的影响研究

目的 了解基于患者报告结局的风湿病儿童健康相关生活质量及其照顾者负担现状,并探讨其影响因素。方法 采取便利抽样法,应用一般资料调查表、照顾者负担量表(caregiver burden inventory, CBI)及儿童患者报告结局测量信息系统特征集(PROMIS pediatric-25 profile V2.0)横断面调查2022年6月-2023年6月在上海某儿童医院收治的100例8~12岁风湿病儿童的患者报告结局及其照顾者负担现状。结果 PROMIS Pediatric-25 Profile的抑郁、疲劳、疼痛、焦虑、同伴关系及身体功能-移动性6个维度的得分分别为(46.32±9.23)分、(45.94±8.99)分、(42.90±7.44)分、(46.07±8.49)分、(40.95±12.29)分、(25.21±4.57)分,其中抑郁、焦虑和疲劳得分最高。风湿病儿童照顾者中等负担发生率为45.3%,照顾者负担的时间依赖性负担、发展受限性负担、身体性负担、社会性负担和情感性负担5个维度的得分平均分分别为(1.33±0.76)分、(0.71±0.59)分、(0.67±0.60)分、(2.20±1.20)分、(1.47±0.88)分,其中社会性负担得分最高。单因素分析结果显示:家庭年收入在抑郁维度(F=3.44,P<0.05)和疼痛维度(F=3.58,P<0.05)差异有统计学意义,是否首次使用激素在身体功能-移动性维度差异有统计学意义(t=2.00,P<0.05)。结论 风湿病儿童抑郁、焦虑和疲劳现状有待改善,且家庭年收入在5万~10万元的儿童抑郁和疼痛水平最高、在10万~15万元的儿童抑郁和疼痛水平最低,初次使用激素可能对风湿病儿童的身体功能-移动性存在影响。未来可参照影响因素制定风湿病儿童精准症状管理模式,关注风湿病儿童的真实感受。这些发现也提供了风湿病儿童照顾者所面临的压力和挑战,未来的研究应该进一步探索不同类型的照顾者支持和干预措施,以帮助减轻他们的负担,并提高其生活质量。

临床实验室传染病八项报告自动审核系统的建立和优化

目的建立和优化传染病八项报告的自动审核系统。方法依据美国临床和实验室标准协会(CLSI)发布的AUTO-15及国家卫健委发布的WS/T 616-2018,基于中间件(infinity)及实验室信息系统(LIS)建立传染病八项结果的自动审核规则体系。采用质量控制、标本状态、仪器报警、灰区范围、常规模式以及历史数据对比(Delta check)六大规则对传染病八项检测结果进行自动审核判断。通过人工审核与自动审核相互比对,验证自动审核系统的有效性,并对该系统进行再次优化和验证,以实现该项目的自动审核。结果建立包括质量控制、标本状态、仪器报警、灰区范围、常规模式以及历史数据对比共六部分的自动审核规则体系。自动审核的敏感性和特异性分别为87%和95%,阳性预测值和阴性预测值分别为88%和95%。调整审核规则后,2022年传染病八项报告审核通过率从39%上升至85%,周转时间(TAT)从原来的209(52,215)min缩短到141(83,149)min,审核人员由2名减至1名,将因仪器异常导致的两对半结果、HIV和TP阳性被误发等错误率降低至0.04%。结论传染病八项检测结果自动审核系统可减轻审核人员的工作强度,缩短TAT,降低报告差错风险。

FMEA模式在医疗机构传染病信息报告管理风险管控中的应用价值

目的分析FMEA模式在医疗机构传染病信息报告管理风险管控中的应用价值。方法佛山市三水区妇幼保健院选择2020年1月—2023年12月20名专家构成FMEA专家小组,借助专家访谈法以及头脑风暴法分别明确医疗机构传染病信息报告管理过程中具体的工作流程环节以及潜在的失效模式,并且对于分项的风险数展开计算,按照从高到低的顺序构建FMEA分析表。结果专家小组进行充分评估,管理环节共计涉及17个,分项计算风险系数排名前5位的流程环节为医疗机构领导小组重视程度、临床医师及疫情报告人员职业素质和报告意识、考核指标、医院报告系统信息化建设、辅助科室异常结果反馈机制。结论在实际应用FMEA模式过程之中,能达到对传染病疫情报告过程中的失效模式进行识别以及处理的目的,尤其是在评估医疗机构传染病报告与管理的风险的过程中,能提供相对扎实的依据。

某传染病医院BIM暖通设计高共享度信息传递应用

传染病医院因功能多样,具有对通风、空调、压力梯度等精细化要求高的特点。某传染病医院项目机电管综复杂,全设计专业从方案阶段深化至精装修深度。为保质保量完成该项目,需保证专业设计信息能全面、准确、高效传递。而传统的设计方式在设计阶段及后期采购、施工、运维阶段因时空的不一致、人员更迭频繁,常常会顾此失彼。基于BIM三维协同管理的高共享度信息传递体系中,设计信息被赋值和结构化,精准、高效地传递于设计各专业之间及建筑全寿命周期中。本文以该项目实例展示了BIM暖通设计高共享度信息传递的具体应用,并分析了该体系的价值与未来展望,以供同行参考。

时空隔断下双层网络中信息扩散研究

[目的/意义]厘清时空隔断对信息扩散的影响,对减少信息冗余、建立良好的社会关系具有一定意义。[方法/过程]考虑线下时空隔断对信息扩散的影响,基于传染病模型,分别使用线下均匀网络、随机游走网络与线上网络进行耦合构建双层信息扩散网络模型,并通过数值仿真对这两类双层网络上的信息扩散行为进行分析。[结果/结论]相较于单层网络,双层网络中信息扩散的范围更广、速度更快且持续时间更短;依次增加隔断时间,信息扩散的范围和速度会逐渐减小且持续时间会相应延长;在时空隔断为6时,双层网络信息扩散的效率与范围都会低于单层网络。

计算机信息技术在传染病管理工作中的应用

本文通过探讨计算机信息技术在传染病管理工作中的应用,梳理了当前的应用场景,评估了应用效果,找出了现实中存在的现实问题并提出改进意见。本研究对提高基层医疗机构信息化水平、加强疾病监测、预防和控制,促进医疗资源优化配置和协作,提高医疗服务质量,具有促进作用,有助于公共卫生事业提高工作质量和效率,提高防疫人员的整体素质,促进传染病防控工作更快、更好地发展。

2004年法定传染病报告信息质量分析

目的 评价2 0 0 4年传染病网络直报质量,为进一步提高传染病网络直报质量,完善报告系统提供科学依据。方法 分析传染病疫情报告质量影响因素,计算影响因素的平均指数,对疫情报告质量进行综合评价。结果 审核传染病报告卡,对病例重复报告、报告及时性、零缺报以及主要报告单位类型等情况进行综合分析,获得全国各省疫情报告质量状况。结论 应对传染病疫情报告质量进行定期评估,分析影响报告质量的关键因素,以提示各地区传染病管理存在的问题,指导今后疫情报告工作。

医院应建立健全传染病监测报告系统

目的提高法定传染病报告率和报告卡填写完好率。方法完善各项规章制度和工作流程,严格法定传染病三级报告责任人追究制度;应用“军队医院信息管理系统”提高传染病疫情报告的实效性和准确性;强化医务人员培训,专人负责传染病报告卡的收集、核查、上报工作,将传染病疫情报告纳入科室医疗质量管理范畴。结果医院法定传染病报告率97.3%,传染病登记及报告卡填写完整率100%。结论医院应建立健全传染病监测报告系统,依法实行传染病报告管理,提高法定传染病报告质量。