Regulatory, safety, and privacy concerns of home monitoring technologies during COVID-19

There has been increasing interest in the use of home monitoring technologies during the COVID-19 pandemic to decrease interpersonal contacts and the resultant risks of exposure for people to the coronavirus SARS-CoV-2. This Perspective explores how the accelerated development of these technologies also raises major concerns pertaining to safety and privacy. We make recommendations for needed interventions to ensure safety and review best practices and US regulatory requirements for privacy and security. We discuss, among other topics, Emergency Use Authorizations for medical devices and privacy laws of the USA and Europe.

The 2019 Global Health Security Index (GHSI) and its implications for New Zealand and Pacific regional health security

It is important for all countries to secure themselves against infectious disease threats, including potential global catastrophic biological risks. The Global Health Security Index (GHSI), first published in 2019, is a comprehensive, objective assessment of health security capabilities across 195 States Parties to the International Health Regulations. The GHSI is a broader assessment than the World Health Organization Joint External Evaluation and emphasises public documentation of preparedness as well as sustainable capabilities. New Zealand scored 54/100 on the GHSI (35th in the world). But also worryingly, the range of scores for New Zealand's Pacific neighbours was 19.2-27.8, highlighting potential regional vulnerabilities. Clearly, the New Zealand Government needs to do more to ensure its own optimal preparedness for global biological threats, and document these preparations to assure the international community. But it should also provide additional overseas development assistance (bringing this assistance up to 0.7% of GNI as per UN recommendations) and work with Pacific Nations to enhance health security in the region.

Developing Vaccines for SARS-CoV-2 and Future Epidemics and Pandemics: Applying Lessons from Past Outbreaks

The COVID-19 pandemic is a stark reminder of the heavy toll that emerging infectious diseases (EIDs) with epidemic and pandemic potential can inflict. Vaccine development, scale-up, and commercialization is a long, expensive, and risky enterprise that requires substantial upfront planning and offers no guarantee of success. EIDs are a particularly challenging target for global health preparedness, including for vaccine development. Insufficient attention has been given to challenges, lessons learned, and potential solutions to support and sustain vaccine industry engagement in vaccine development for EIDs. Drawing from lessons from the most recent Ebola epidemic in the Democratic Republic of the Congo, as well as the 2009 H1N1 influenza, 2014-2016 Ebola, and 2015-16 Zika outbreaks preceding it, we offer our perspective on challenges facing EID vaccine development and recommend additional solutions to prioritize in the near term. The 6 recommendations focus on reducing vaccine development timelines and increasing business certainty to reduce risks for companies. The global health security community has an opportunity to build on the current momentum to design a sustainable model for EID vaccines.

Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries

BACKGROUND

Public health measures to prevent, detect, and respond to events are essential to control public health risks, including infectious disease outbreaks, as highlighted in the International Health Regulations (IHR). In light of the outbreak of 2019 novel coronavirus disease (COVID-19), we aimed to review existing health security capacities against public health risks and events.

METHODS

We used 18 indicators from the IHR State Party Annual Reporting (SPAR) tool and associated data from national SPAR reports to develop five indices: (1) prevent, (2) detect, (3) respond, (4) enabling function, and (5) operational readiness. We used SPAR 2018 data for all of the indicators and categorised countries into five levels across the indices, in which level 1 indicated the lowest level of national capacity and level 5 the highest. We also analysed data at the regional level (using the six geographical WHO regions).

FINDINGS

Of 182 countries, 52 (28%) had prevent capacities at levels 1 or 2, and 60 (33%) had response capacities at levels 1 or 2. 81 (45%) countries had prevent capacities and 78 (43%) had response capacities at levels 4 or 5, indicating that these countries were operationally ready. 138 (76%) countries scored more highly in the detect index than in the other indices. 44 (24%) countries did not have an effective enabling function for public health risks and events, including infectious disease outbreaks (7 [4%] at level 1 and 37 [20%] at level 2). 102 (56%) countries had level 4 or level 5 enabling function capacities in place. 32 (18%) countries had low readiness (2 [1%] at level 1 and 30 [17%] at level 2), and 104 (57%) countries were operationally ready to prevent, detect, and control an outbreak of a novel infectious disease (66 [36%] at level 4 and 38 [21%] at level 5).

INTERPRETATION

Countries vary widely in terms of their capacity to prevent, detect, and respond to outbreaks. Half of all countries analysed have strong operational readiness capacities in place, which suggests that an effective response to potential health emergencies could be enabled, including to COVID-19. Findings from local risk assessments are needed to fully understand national readiness capacities in relation to COVID-19. Capacity building and collaboration between countries are needed to strengthen global readiness for outbreak control.

FUNDING

None.

Real-time Concealed Object Detection from Passive Millimeter Wave Images Based on the YOLOv3 Algorithm

The detection of objects concealed under people's clothing is a very challenging task, which has crucial applications for security. When testing the human body for metal contraband, the concealed targets are usually small in size and are required to be detected within a few seconds. Focusing on weapon detection, this paper proposes using a real-time detection method for detecting concealed metallic weapons on the human body applied to passive millimeter wave (PMMW) imagery based on the You Only Look Once (YOLO) algorithm, YOLOv3, and a small sample dataset. The experimental results from YOLOv3-13, YOLOv3-53, and Single Shot MultiBox Detector (SSD) algorithm, SSD-VGG16, are compared ultimately, using the same PMMW dataset. For the perspective of detection accuracy, detection speed, and computation resource, it shows that the YOLOv3-53 model had a detection speed of 36 frames per second (FPS) and a mean average precision (mAP) of 95% on a GPU-1080Ti computer, more effective and feasible for the real-time detection of weapon contraband on human body for PMMW images, even with small sample data.

Development of Invisible Sensors and a Machine-Learning-Based Recognition System Used for Early Prediction of Discontinuous Bed-Leaving Behavior Patterns

This paper presents a novel bed-leaving sensor system for real-time recognition of bed-leaving behavior patterns. The proposed system comprises five pad sensors installed on a bed, a rail sensor inserted in a safety rail, and a behavior pattern recognizer based on machine learning. The linear characteristic between loads and output was obtained from a load test to evaluate sensor output characteristics. Moreover, the output values change linearly concomitantly with speed to attain the sensor with the equivalent load. We obtained benchmark datasets of continuous and discontinuous behavior patterns from ten subjects. Recognition targets using our sensor prototype and their monitoring system comprise five behavior patterns: sleeping, longitudinal sitting, lateral sitting, terminal sitting, and leaving the bed. We compared machine learning algorithms of five types to recognize five behavior patterns. The experimentally obtained results revealed that the proposed sensor system improved recognition accuracy for both datasets. Moreover, we achieved improved recognition accuracy after integration of learning datasets as a general discriminator.

Justice and rule of law failure in Haiti: A view from the Shanties

Since 1995, significant investments have been made in justice reform initiatives in Haiti. The results, however, have been meager. Drawing upon data from a longitudinal study conducted in Cité Soleil between 2008 and 2011, this article illuminates the short-sightedness of top-down reforms that fail to meet the demands of the population, leaving them to fend for themselves. In the absence of a viable justice system Cité Soleil residents have resorted to alternative, and at times pathological, measures to exact some level of "justice". In this article, we contend that an empirically grounded base of knowledge of the demand side of justice and the promotion of trust-building strategies that engage the active participation of citizens in the country are necessary to enact and sustain justice and rule of law reform. Such an approach will create a venue to channel civil society's demands, build political will and facilitate coordination between stakeholders and Haitian society for self-sustained rule of law institutions and long-term peace building in Haiti.

A comparison of long-term medium secure patients within NHS and private and charitable sector units in England

BACKGROUND

In England, forensic psychiatric hospital services are provided at three security levels: high, medium and low. All are publicly funded and similarly regulated, but medium and low secure services are provided in the private and charitable (PCS) sector as well as the National Health Service (NHS). Originally, medium secure hospital services were conceived as for up to 2 years' inpatient stay, but numbers of longer stay patients have been rising. Little is known about their characteristics or whether they differ between NHS and PCS settings.

AIMS

To describe and compare characteristics of long-stay patients in NHS and in PCS medium security hospital units.

METHODS

Data were extracted from clinical records in 14 NHS and 9 PCS hospital units for all patients fulfilling criteria for long stay: having been in high security for more than 10 years or medium security for more than 5 years or in a mix of both for more than 15 years in total.

RESULTS

178 NHS and 107 PCS patients were eligible for inclusion, respectively, 16 and 22% of the total patient populations in these settings. The mean length of stay in a medium or high secure setting was similar: 163 and 164 months. Characteristics of the patients, however, differed between unit type. NHS services admitted more patients from prison and PCS services more from other hospitals. NHS services included a lower proportion of patients with personality disorder or intellectual disability. 'Challenging behaviour' was more prevalent in PCS; a history of absconding was found more often among NHS patients.

CONCLUSIONS

The two systems of service appear to be used differently. More research is needed to explain why patients apparently without behavioural disturbances remain in specialist secure facilities for such a long time and whether their needs are truly being met in the least restrictive environment possible.

Nurses' Perspectives of Factors That Influence Therapeutic Relationships in Secure Inpatient Forensic Hospitals

BACKGROUND

The therapeutic relationship is synonymous with mental health nursing and fundamental to the provision of nursing care, regardless of the setting in which care is provided. This literature review examines, from a nursing perspective, factors influencing the formation and maintenance of therapeutic relationships in forensic mental health settings.

METHODS

A systematic search of the literature, using a range of electronic databases, focusing on nurse-patient therapeutic relationships in forensic settings was conducted. Articles were Critical Appraisal Skills Programme quality appraised, followed by a meta-aggregative thematic approach to data analysis and synthesis to identify themes and, finally, a production of an "action" policy statement.

FINDINGS AND IMPLICATION FOR PRACTICE

Eight articles met the criteria for review inclusion. Nine themes were identified; seven were categorized as internal/interpersonal factors, and two were categorized as external/environmental factors (with some themes interconnected). Synthesis of findings resulted in the production of a policy statement encouraging forensic mental health nurses to be aware of intrapersonal influences on therapeutic relationships and the need to provide a safe and supportive clinical environment for these relationships to form.

Taking Privacy to a New Level: Texas Lowers Reporting Threshold for Security Breaches

Federal requirements have not changed, but starting Jan. 1, breach notification requirements will become even more stringent for Texas physicians or medical entities. The Texas Legislature dropped the threshold for breach reporting from 500 patients to 250. House Bill 4390 also requires medical entities to report breaches to the Texas attorney general's office within 60 days of the breach.

A review of airport dual energy X-ray baggage inspection techniques: Image enhancement and noise reduction

In this paper, we present a review of the research literature regarding applying X-ray imaging of baggage scrutiny at airport. It discusses multiple X-ray imaging inspection systems used in airports for detecting dangerous objects inside the baggage. Moreover, it also explains the dual energy X-ray image fusion and image enhancement factors. Different types of noises in digital images and noise models are explained in length. Diagrammatical representations for different noise models are presented and illustrated to clearly show the effect of Poisson and Impulse noise on intensity values. Overall, this review discusses in detail of Poisson and Impulse noise, as well as its causes and effect on the X-ray images, which create un-certainty for the X-ray inspection imaging system while discriminating objects and for the screeners as well. The review then focuses on image processing techniques used by different research studies for X-ray image enhancement, de-noising, and their limitations. Furthermore, the most related approaches for noise reduction and its drawbacks are presented. The methods that may be useful to overcome the drawbacks are also discussed in subsequent sections of this paper. In summary, this review paper highlights the key theories and technical methods used for X-ray image enhancement and de-noising effect on X-ray images generated by the airport baggage inspection system.

An approach for adaptive automatic threat recognition within 3D computed tomography images for baggage security screening

BACKGROUND

The screening of baggage using X-ray scanners is now routine in aviation security with automatic threat detection approaches, based on 3D X-ray computed tomography (CT) images, known as Automatic Threat Recognition (ATR) within the aviation security industry. These current strategies use pre-defined threat material signatures in contrast to adaptability towards new and emerging threat signatures. To address this issue, the concept of adaptive automatic threat recognition (AATR) was proposed in previous work.

OBJECTIVE

In this paper, we present a solution to AATR based on such X-ray CT baggage scan imagery. This aims to address the issues of rapidly evolving threat signatures within the screening requirements. Ideally, the detection algorithms deployed within the security scanners should be readily adaptable to different situations with varying requirements of threat characteristics (e.g., threat material, physical properties of objects).

METHODS

We tackle this issue using a novel adaptive machine learning methodology with our solution consisting of a multi-scale 3D CT image segmentation algorithm, a multi-class support vector machine (SVM) classifier for object material recognition and a strategy to enable the adaptability of our approach. Experiments are conducted on both open and sequestered 3D CT baggage image datasets specifically collected for the AATR study.

RESULTS

Our proposed approach performs well on both recognition and adaptation. Overall our approach can achieve the probability of detection around 90% with a probability of false alarm below 20%.

CONCLUSIONS

Our AATR shows the capabilities of adapting to varying types of materials, even the unknown materials which are not available in the training data, adapting to varying required probability of detection and adapting to varying scales of the threat object.

Some cues are more equal than others: Cue plausibility for false alarms in baggage screening

This study investigated the effects of cue plausibility in a baggage screening task. 120 participants had to indicate whether a prohibited item was present in a series of grey-scaled X-ray images of baggage. They were assisted by a support system, which pointed at the location of a suspicious object. A 2 × 2 × 2 between-subjects design was used. Cue plausibility for false alarms (i.e. how the cued object was similar to a prohibited item) and support system reliability were manipulated at two levels (high/low). Furthermore, half of participants were provided with a rationale about automation failures (RAF) to reduce their negative impact on trust and performance. The results showed lower performance and more compliance with automation suggestions when cues were implausible than plausible. The RAF increased the response time and did not improve detection performance. Overall, this suggests that effective (computer-based) training is needed to reduce the negative effect of plausible cues.

Human health as a philosophic phenomenon and an important component of national security and state sovereignty potential

OBJECTIVE

The aim: Examination of the human health problem as a philosophical phenomenon and an important component of national security and potential of the state sovereignty.

PATIENTS AND METHODS

Materials and methods: The authors have analyzed scientific data (7 references) using methods of systemic approach and systemic analysis.

CONCLUSION

Conclusions: The population health was always and is currently a state priority in civilized countries. Ukrainian researchers have no doubt the problem "Population health and state security and defense" needs the participation of not only medical specialists, but also of sociologists, economists, ecologists, politicians; this problem is a poly-disciplinary one. Reforms in the health care field of Ukraine are to solve an especially important and urgent task - strengthening of Ukrainian people health. The essence of concepts «national security» та «sovereignty of the state» being conditioned to a significant degree by the health state of our citizens leads to affirmation the steadfast state sovereignty to be a factor ensuring the stability and high level of national security. It is currently of the greatest importance to take into consideration all the possible configurations of future having determined strategic priorities and preparing favorable conditions for steadfast development. Currently, such development is dependent on the level of community health and quality of state government.

A reference architecture for plausible Threat Image Projection (TIP) within 3D X-ray computed tomography volumes

BACKGROUND

Threat Image Projection (TIP) is a technique used in X-ray security baggage screening systems that superimposes a threat object signature onto a benign X-ray baggage image in a plausible and realistic manner. It has been shown to be highly effective in evaluating the ongoing performance of human operators, improving their vigilance and performance on threat detection.

OBJECTIVE

With the increasing use of 3D Computed Tomography (CT) in aviation security for both hold and cabin baggage screening a significant challenge arises in extending TIP to 3D CT volumes due to the difficulty in 3D CT volume segmentation and the proper insertion location determination. In this paper, we present an approach for 3D TIP in CT volumes targeting realistic and plausible threat object insertion within 3D CT baggage images.

METHOD

The proposed approach consists of dual threat (source) and baggage (target) volume segmentation, particle swarm optimisation based insertion determination and metal artefact generation. In our experiments, real baggage data collected from airports are used to generate TIP volumes for evaluation. We also propose a TIP quality score metric to automatically estimate the quality of generated TIP volumes.

RESULT

In our experiments with real baggage CT volumes and varying threat items, 90.25% of the generated TIP volumes are graded as good by human evaluation, 7% of them are of medium quality with minor flaws and 2.75% of them are bad.

CONCLUSION

Qualitative evaluations on real 3D CT baggage imagery show that our approach is able to generate realistic and plausible TIP which are indiscernible from real CT volumes and the TIP quality scores are consistent with human evaluations.

Challenging Europe: Technology, Environment, and the Quest for Resource Security

Since the nineteenth century, access to and the development of natural resources became an important element of national and international politics. Resource security emerged as an issue vital to national security; and resource competition and crises gave rise to international tensions as well as to technological innovation and new modes of transnational cooperation.

Ecological Security Assessment Based on Ecological Footprint Approach in Hulunbeir Grassland, China

Hulunbeir grassland, as a crucial ecological barrier and energy supply base in northwest China, suffers from a fragile ecological environment. Therefore, it is crucially important for Hulunbeir grassland to achieve the sustainable development of its social economies and ecological environments through the evaluation of its ecological security. This paper introduces the indexes of the ecological pressure index (EPI), ecological footprint diversity index (EFDI), and ecological coordination coefficient (ECC) based on the ecological footprint model. Furthermore, the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model was applied to analyze the main driving factors of the change of the ecological footprint. The results showed that: The ecological footprint (EF) per capita of Hulunbeir grassland has nearly doubled in 11 years to 11.04 ha/cap in 2016, while the ecological capacity (EC) per capita was rather low and increased slowly, leading to a continuous increase of per capita ecological deficit (ED) (from 5.7113 ha/cap to 11.0937 ha/cap). Within this, the footprint of fossil energy land and grassland contributed the most to the total EF, and forestland and cropland played the major role in EC. The EPI increased from 0.82 in 2006 to 1.25 in 2016, leading the level of ecological security to increase from level 3 (moderately safe) to level 4 (moderately risky). The indexes of the EFDI and ECC both reached a minimum in 2014 and then began to rise, indicating that Hulunbeir steppe’s ecological environment, as well as its coordination with economy, was considered to be worse in 2014 but then gradually ameliorated. The STIRPAT model indicated that the main factors driving the EF increase were per capita GDP and the proportion of secondary industry, while the decrease of unit GDP energy consumption played an effective role in curbing the continuous growth of the EF. These findings not only have realistic significance in promoting the coordinated development between economy and natural resource utilization under the constraint of fragile environment, but also provide a scientific reference for similar energy-rich ecologically fragile regions.

Plutonium Desorption from Nuclear Melt Glass-Derived Colloids and Implications for Migration at the Nevada National Security Site, USA

The migration of low levels of plutonium has been observed at the Nevada National Security Site (NNSS) and attributed to colloids. To better understand the mechanism(s) of colloid-facilitated transport at this site, we performed flow cell desorption experiments with mineral colloid suspensions produced by hydrothermal alteration of NNSS nuclear melt glass, residual material left behind from nuclear testing. Three different colloid suspensions were used: (1) colloidal material from hydrothermal alteration of nuclear melt glass at 140 °C; (2) at 200 °C; and (3) plutonium sorbed to SWy-1 montmorillonite at room temperature. The 140 °C sample contained only montmorillonite, while zeolite and other phases were present in the 200 °C sample. Overall, more plutonium was desorbed from the 140 °C colloids (ca. 9-16%) than from the 200 °C colloids (ca. 4-8%). Furthermore, at the end of the 4.5 day flow cell experiments, the desorption rates for the 140 °C colloids and the Pu-montmorillonite colloids were similar while the desorption rates from the 200 °C colloids were up to an order of magnitude lower. We posit that the formation of zeolites and clays hydrothermally altered at 200 °C may lead to a more stable association of plutonium with colloids, resulting in lower desorption rates. This may give rise to more extensive colloid-facilitated transport and help explain why trace levels of plutonium are found downgradient from their original source decades after a nuclear detonation. Interestingly, in the case of cesium (a co-contaminant of plutonium), no difference was observed between the 140 and 200 °C colloids. This reflects intrinsic differences between cesium and plutonium sorption/desorption behavior (charge, cation size) and suggests that the Cs sorption mechanism (cation exchange) is not similarly affected by colloid formation temperature.

Migration of noble gas tracers at the site of an underground nuclear explosion at the Nevada National Security Site

As part of an underground gas migration study, two radioactive noble gases (³⁷Ar and ¹²⁷Xe) and two stable tracer gases (SF₆ and PFDMCH) were injected into a historic nuclear explosion test chimney and allowed to migrate naturally. The purpose of this experiment was to provide a bounding case (natural transport) for the flow of radioactive noble gases following an underground nuclear explosion. To accomplish this, soil gas samples were collected from a series of boreholes and a range of depths from the shallow subsurface (3 m) to deeper levels (~160 m) over a period of eleven months. These samples have provided insights into the development and evolution of the subsurface plume and constrained the relative migration rates of the radioactive and stable gas species in the case when the driving pressure from the cavity is low. Analysis of the samples concluded that the stable tracer SF₆ was consistently enriched in the subsurface samples relative to the radiotracer ¹²⁷Xe, but the ratios of SF₆ and ³⁷Ar remained similar throughout the samples.

Healthcare under siege: a qualitative study of health-worker responses to targeting and besiegement in Syria

OBJECTIVES

To explore health-worker perspectives on security, improving safety, managing constrained resources and handling mass casualties during besiegement in Syria.

DESIGN

A qualitative study using semi-structured key informant interviews, conducted remotely over WhatsApp and Skype, and analysed thematically using inductive coding.

SETTING

Secondary and tertiary health facilities affected by besiegement in Aleppo (from July to December 2016) and Rural Damascus (from August 2013 to February 2018).

PARTICIPANTS

Twenty-one male Syrian health-workers and service-users who had experienced besiegement and targeting of their health facilities.

RESULTS

Participants described four related challenges of: (i) conflict-related responses, particularly responding to mass casualties; (ii) targeted attack responses, particularly preventing/surviving facility bombings; (iii) besiegement responses, particularly mitigating severe resource constraints; and (iv) chronic risk responses, particularly maintaining emotional resilience. Mass casualty response involved triage and training to prioritise mortality reduction and available resources, for example those with greatest need and likelihood of survival. Targeting response was largely physical, including fortification, working underground, reducing visibility and services dispersal. Besiegement response required resource conservation, for example, controlling consumption, reusing consumables, low-technology equipment, finding alternative supply routes, stockpiling and strengthening available human resources through online trainings and establishing a medical school in Ghouta. Risk responses included managing safety worries, finding value in work and maintaining hope.

CONCLUSION

Besieged health-workers were most affected by severe resource constraints and safety concerns while responding to overwhelming mass casualty events. Lessons for targeting/besiegement planning include training staff and preparing for: (i) mass casualties, through local/online health-worker training in triage, emergency response and resource conservation; allowing task-shifting; and providing access to low-technology equipment; (ii) attacks, through strengthened facility security, for example, protection and deterrence through fortification, working underground and reducing visibility; and (iii) besiegement, through ensuring access to internet, electricity and low-technology/reusable equipment; securely stockpiling fuel, medicines and supplies; and establishing alternative supply routes.

Risk Factors Associated With Inpatient Violence During Medium Security Treatment

Violence is a common phenomenon both in regular and forensic psychiatric settings, and has a profound impact on staff and other patients. Insight into the individual risk factors associated with violence in forensic psychiatric settings is rare and is therefore the subject of this research. A retrospective file study in three medium security units in Flanders was conducted to compare non-violent inpatients with inpatients who engaged in (verbal and physical) violent behavior. Binary logistic regression analyses were used to examine which variables contributed independently to the risk of violence. The results showed that absconding during treatment was independently associated with physical violence. A personality disorder diagnosis and general non-compliance with treatment were associated with verbal violence. Both types of violence predicted early termination of treatment. Contrary to previous research, the results from the risk assessment tools were not associated with inpatient violence. Clinical implications are discussed and include, among others, that clinicians should remain vigilant for early warning signs of non-compliance during treatment.

Hydrothermal Alteration of Nuclear Melt Glass, Colloid Formation, and Plutonium Mobilization at the Nevada National Security Site, U.S.A

Approximately 2.8 t of plutonium (Pu) has been deposited in the Nevada National Security Site (NNSS) subsurface as a result of underground nuclear testing. Most of this Pu is sequestered in nuclear melt glass. However, Pu migration has been observed and attributed to colloid facilitated transport. To identify the mechanisms controlling Pu mobilization, long-term (∼3 year) laboratory nuclear melt glass alteration experiments were performed at 25 to 200 °C to mimic hydrothermal conditions in the vicinity of underground nuclear tests. The clay and zeolite colloids produced in these experiments are similar to those identified in NNSS groundwater. At 200 °C, maximum Pu and colloid concentrations of 30 Bq/L and 150 mg/L, respectively, were observed. However, much lower Pu and colloid concentrations were observed at 25 and 80 °C. These data suggest that Pu concentrations above the drinking water Maximum Contaminant Levels (0.56 Bq/L) may exist during early hydrothermal conditions in the vicinity of underground nuclear tests. However, formation of colloid-associated Pu will tend to decrease with time as nuclear test cavity temperatures decrease. Furthermore, median colloid concentrations in NNSS groundwater (1.8 mg/L) suggest that the high colloid and Pu concentrations observed in our 140 and 200 °C experiments are unlikely to persist in downgradient NNSS groundwater. While our experiments did not span all groundwater and nuclear melt glass conditions that may be present at the NNSS, our results are consistent with the documented low Pu concentrations in NNSS groundwater.

Diversion of Controlled Drugs in Hospitals: A Scoping Review of Contributors and Safeguards

Drug losses and theft from the healthcare system are accelerating; hospitals are pressured to implement safeguards to prevent drug diversion. Thus far, no reviews summarize all known risks and potential safeguards for hospital diversion. Past incidents of hospital drug diversion have impacted patient and staff safety, increased hospital costs, and resulted in infectious disease outbreaks. We searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and Web of Science databases and the gray literature for articles published between January 2005 and June 2018. Articles were included if they focused on hospital settings and discussed either: (1) drug security or accounting practices (any drug) or (2) medication errors, healthcare worker substance use disorder, or incident reports (only with reference to controlled drugs). We included 312 articles and extracted four categories of data: (1) article characteristics (eg, author location), (2) article focus (eg, clinical areas discussed), (3) contributors to diversion (eg, factors enabling drug theft), and (4) diversion safeguards. Literature reveals a large number of contributors to drug diversion in all stages of the medication-use process. All health professions and clinical units are at risk. This review provides insights into known methods of diversion and the safeguards hospitals must consider to prevent them. Careful configuration of healthcare technologies and processes in the hospital environment can reduce the opportunity for diversion. These system-based strategies broaden the response to diversion beyond that of individual accountability. Further evidence is urgently needed to address the vulnerabilities outlined in this review and prevent harm.

Australian Medical Professionals, National Security and Administrative Offshore Punishment of Asylum-Seekers: Regulatory Update Including the Medevac Legislation

This article updates how Australia's national security concerns have intersected with the regulation of Australian medical practitioners in the area of mandatory, indefinite, administrative offshore detention of asylum-seekers. It outlines relevant recent decisions of the High Court, including dissenting opinions that such detention represents unconstitutional extra-judicial punishment with a primary deterrence aim. It evaluates recent amendments to the Australian Border Force Act 2015 (Cth) as well as exploring recent relevant legislation and administrative, political and judicial decisions made in both Papua New Guinea and the Republic of Nauru. It considers the Medical Evacuation legislation and the Australian Government's attempts to challenge judicial authority to transfer people off Nauru for medical treatment. The article concludes with an analysis of prospects for further Australian asylum seeker and refugee policy and legislative reform more coherent with basic principles of medical ethics and international human rights.

Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions

BACKGROUND

Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Courts largely rely on the evaluations of the prison psychiatrists and psychologists to form their decision. None of the few available instruments - e.g., the DUNDRUM-1 - is currently used to provide structured clinical judgment when determining security level.

METHOD

DUNDRUM-1 scores were collected for 150 forensic patients. Security levels according to DUNDRUM-1 assessment were compared to security levels as decided by the court.

RESULTS

There was little agreement between DUNDRUM-1 scores and proposals for secure care made by the court. The DUNDRUM-1 predicted eventual admission to a high security setting, but not a medium security setting.

CONCLUSION

The DUNDRUM-1 is an instrument that can help clinicians and judges to make more reliable and transparent decisions regarding secure care. However, further research with regard to practical applicability is needed.

Information Hazards in Biotechnology

With the advance of biotechnology, biological information, rather than biological materials, is increasingly the object of principal security concern. We argue that both in theory and in practice, existing security approaches in biology are poorly suited to manage hazardous biological information, and use the cases of Mousepox, H5N1 gain of function, and Botulinum toxin H to highlight these ongoing challenges. We suggest that mitigation of these hazards can be improved if one can: (1) anticipate hazard potential before scientific work is performed; (2) consider how much the new information would likely help both good and bad actors; and (3) aim to disclose information in the manner that maximally disadvantages bad actors versus good ones.

Predicting security incidents in high secure male psychiatric care

PURPOSE

The contribution of environmental and organisational factors in predicting security incidents within a high secure male psychiatric setting is considered using a series of connected studies; a systematic literature review comprising 41 studies and five inquiries (Study 1) to identify core themes of likely importance; application of these themes to incident data through assessment of the ward culture, as perceived by 73 male psychiatric patients and 157 staff (Study 2); and detailed examination of noted relevant factors in the form of interpersonal style, meaningful activity and physical environmental characteristics in a study comprising 62 patients and 151 staff (Study 3). It was predicted that security incidents would be identified through inclusion of environmental and organisational factors.

RESULTS

The systematic review demonstrated the importance of accounting for staff characteristics, patient interactions, physical environment and meaningful activity. The subsequent study noted the importance of only specific aspects of the social environment, with the final study demonstrating that incidents were associated with controlling interpersonal styles of staff, lower perceived fairness, and less involvement in off-ward activities. Perception of fair treatment and off-ward activities mediated the staff interpersonal style and security incident relationship.

CONCLUSIONS

The research proposes a preliminary framework - the McKenna Framework for understanding Incidents in Secure Settings (M-FISS) - to explain the occurrence of security incidents in secure psychiatric care.

Decision-making in livestock biosecurity practices amidst environmental and social uncertainty: Evidence from an experimental game

Livestock industries are vulnerable to disease threats, which can cost billions of dollars and have substantial negative social ramifications. Losses are mitigated through increased use of disease-related biosecurity practices, making increased biosecurity an industry goal. Currently, there is no industry-wide standard for sharing information about disease incidence or on-site biosecurity strategies, resulting in uncertainty regarding disease prevalence and biosecurity strategies employed by industry stakeholders. Using an experimental simulation game, with primarily student participants, we examined willingness to invest in biosecurity when confronted with disease outbreak scenarios. We varied the scenarios by changing the information provided about 1) disease incidence and 2) biosecurity strategy or response by production facilities to the threat of disease. Here we show that willingness to invest in biosecurity increases with increased information about disease incidence, but decreases with increased information about biosecurity practices used by nearby facilities. Thus, the type or context of the uncertainty confronting the decision maker may be a major factor influencing behavior. Our findings suggest that policies and practices that encourage greater sharing of disease incidence information should have the greatest benefit for protecting herd health.

High capacity reversible data hiding in MP3 based on Huffman table transformation

In practice, most audio files such as MP3 and AAC are stored and transmitted in the form of compressed files, which can serve as the cover in audio steganography. Currently, the prevailing audio steganography methods are not ideal because of the drawbacks. Some are characterized by low capacity while others are irreversible. In this paper, we propose a method to embed secret messages in MP3 encoding. Our strategy is to hide the information by Huffman table transformation. We extract secret information by analyzing side information. Experimental results show that our method can greatly improve the steganographic capacity with low distortion and high security. Meanwhile, it featured with higher decoding rate and reversible over some state-of-the-art methods.

Effects of Ticket-Checking Failure on Dynamics of Pedestrians at Multi-Exit Inspection Points with Various Layouts

It is of great significance to understand the dynamics and risk level of pedestrians at the multi-exit inspection points, since they are the bottlenecks of pedestrian flow leaving public places, such as subway and railway stations. Microscopic simulations were carried out with a cellular automata model to investigate the effects of ticket-checking failure on pedestrian dynamics when passing through the multi-exit inspection points with parallel, convex and concave layouts. It was found that although ticket-checking failure could reduce the passing efficiency, it also lowers the competitive level between pedestrians and enhances passing safety in the range of medium and high pedestrian density. The competitive level decreases when increasing the probability of ticket-checking failure and the corresponding delay. The probability of ticket-checking failure and the corresponding delay have equivalent effects on passing efficiency and safety, and can be integrated as average delay. A fitted equation was proposed for the dependence of passing efficiency and safety on average delay. With the existence of ticket-checking failure in reality, the concave layout of the multi-exit inspection points gives rise to a much lower competitive level compared with the parallel and convex ones, which would enhance the safety of pedestrians at the exits.

A Hazard Assessment Method for Waterworks Systems Operating in Self-Government Units

Informing users of waterworks systems about the quality of tap water is an obligatory trend. It should be accompanied by studies on the influence of the risk of threats on public health. Waterworks systems, being included in a critical infrastructure of the city, should be subject to special protection in this respect. In the paper, the authors' method of assessing threats to people and property from waterworks systems functioning in self-government units (SGUs), is proposed. Four categories of factors affecting the risk of threat to tap water consumers were assumed: the frequency or the probability of exposure-P, financial losses-C, damages to peoples' health-HL, the degree of the security-S. Based on this, a four-parametric risk matrix was developed. It was assumed that risk is a function of the parameters mentioned above: r = f(P, C, HL, S). For every parameter the five-parametric weight scale was assumed. An example of applying the method is presented. The proposed method should be an important element of water safety plans. It can also be adopted for other municipal systems subject to SGU.

Detecting Bombs in X-Ray Images of Hold Baggage: 2D Versus 3D Imaging

OBJECTIVE

This study compared the visual inspection performance of airport security officers (screeners) when screening hold baggage with state-of-the-art 3D versus older 2D imaging.

BACKGROUND

3D imaging based on computer tomography features better automated detection of explosives and higher baggage throughput than older 2D X-ray imaging technology. Nonetheless, some countries and airports hesitate to implement 3D systems due to their lower image quality and the concern that screeners will need extensive and specific training before they can be allowed to work with 3D imaging.

METHOD

Screeners working with 2D imaging (2D screeners) and screeners working with 3D imaging (3D screeners) conducted a simulated hold baggage screening task with both types of imaging. Differences in image quality of the imaging systems were assessed with the standard procedure for 2D imaging.

RESULTS

Despite lower image quality, screeners' detection performance with 3D imaging was similar to that with 2D imaging. 3D screeners revealed higher detection performance with both types of imaging than 2D screeners.

CONCLUSION

Features of 3D imaging systems (3D image rotation and slicing) seem to compensate for lower image quality. Visual inspection competency acquired with one type of imaging seems to transfer to visual inspection with the other type of imaging.

APPLICATION

Replacing older 2D with newer 3D imaging systems can be recommended. 2D screeners do not need extensive and specific training to achieve comparable detection performance with 3D imaging. Current image quality standards for 2D imaging need revision before they can be applied to 3D imaging.

Localization of Vehicle Back-Up Alarms by Users of Level-Dependent Hearing Protectors under Industrial Noise Conditions Generated at a Forge

The use of hearing protectors in various noisy workplaces is often necessary. For safety reasons, auditory information may be required to correctly localize the direction of an auditory danger signal. The purpose of this study was to verify if the selection of a specific level-dependent hearing protector may be important for the ability to localize a vehicle back-up alarm signal. The laboratory conditions reflected industrial conditions, under which an impulse noise was emitted against a background of continuous noise. A passive mode and a level-dependent mode (maximum and incomplete amplification) were considered. Four different models of level-dependent earmuffs and one model of level-dependent earplugs were included in the tests. The tests enabled differentiation between the individual hearing protectors. The use of earplugs in level-dependent mode did not significantly affect the ability to correctly localize the back-up alarm signal. For the earmuffs, the global assessment of the impact of a mode change revealed that, depending on the model of the earmuffs, the impact may be insignificant, but may also result in considerable impairment of the ability to localize the back-up alarm signal.

Does the Police-Monitored CCTV Scheme Really Matter on Crime Reduction? A Quasi-Experimental Test in Taiwan's Taipei City

Although numerous public closed-circuit television (CCTV) initiatives have been implemented at varying levels in Taiwan's cities and counties, systematic evaluations of these crime reduction efforts have been largely overlooked. To address this void, a quasi-experimental evaluation research project was designed to assess the effect of police-monitored CCTV on crime reduction in Taipei City for a period of 54 months, including data for both before and after camera installation dates. A total of 40 viewsheds within a 100-m (328 feet) radius were selected as research sites to observe variations in four types of crime incidents that became known to police during the January 2008 to June 2012 period. While crime incidents occurring in both the target and control sites were reduced in frequency after CCTV installation, results derived from time-series analysis indicated that the monitoring had no significant effect on the reduction of property crime incidents with the sole exception of robbery. With respect to the effects of comparing target and control sites, the average Crime Reduction Quotient (CRQ) was 0.36, suggesting that CCTV has an overall marginal yet noteworthy influence. Viewed broadly, however, the police-installed CCTV system in Taipei City did not appear to be as efficient as one would expect. Conversely, cameras installed in some observation sites proved to be significantly more effective than cameras in other sites. As a recommendation, future researchers should identify how particular micro-level attributes may lead to CCTV cameras working more effectively, thereby optimizing location choices where monitoring will prove to be most productive.

Limits on transfer learning from photographic image data to X-ray threat detection

BACKGROUND

X-ray imaging is a crucial and ubiquitous tool for detecting threats to transport security, but interpretation of the images presents a logistical bottleneck. Recent advances in Deep Learning image classification offer hope of improving throughput through automation. However, Deep Learning methods require large quantities of labelled training data. While photographic data is cheap and plentiful, comparable training sets are seldom available for the X-ray domain.

OBJECTIVE

To determine whether and to what extent it is feasible to exploit the availability of photo data to supplement the training of X-ray threat detectors.

METHODS

A new dataset was collected, consisting of 1901 matched pairs of photo & X-ray images of 501 common objects. Of these, 258 pairs were of 69 objects considered threats in the context of aviation. This data was used to test a variety of transfer learning approaches. A simple model of threat cue availability was developed to understand the limits of this transferability.

RESULTS

Appearance features learned from photos provide a useful basis for training classifiers. Some transfer from the photo to the X-ray domain is possible as ∼40% of danger cues are shared between the modalities, but the effectiveness of this transfer is limited since ∼60% of cues are not.

CONCLUSIONS

Transfer learning is beneficial when X-ray data is very scarce-of the order of tens of training images in our experiments-but provides no significant benefit when hundreds or thousands of X-ray images are available.

Nuclear and Radiological Source Security Culture Assessment of Radioactive Material Users at a University

Securing radioactive sources has become increasingly important given the rising threat of radiological terrorism. While radiation safety has long been established in most applicable industries, the importance of nuclear and radiological source security has lagged behind in nonnuclear material specific industries, such as academic institutions and medical facilities. To evaluate the attitudes and behaviors regarding nuclear security culture, an assessment of nuclear and radiological material practices was developed and conducted on 73 radioactive material users at a university. The survey portion of the assessment was comprised of a series of questions segregated into four categories: policy, enforcement, leadership, and behavior. Nuclear security awareness questions formed a subset of the questionnaire. Users were classified by their radioactive material experience and work classification: student, faculty, or other staff. Of the users surveyed, 9% were also interviewed face-to-face to further expand on their views of nuclear security culture. Results of the assessment showed that students from the work classification group as well as the cohort of radioactive material users with 2-5 y of experience possessed a greater degree of awareness towards nuclear security compared to faculty and other more experienced radioactive material users. Relative to students and faculty, other staff from the work classification group faced some difficulty judging the enforcement of policies, adequacy of inspection, and job performance review related to nuclear security. The response from all three groups emphasized the need to enhance threat-response preparedness and greater communication among stakeholders.

Observations as a way to assess the compliance of veterinary students with biosecurity procedures

In veterinary medicine, biosecurity relies on the implementation and respect of procedures that reduce the risk of the introduction and spread of pathogens. The main objective of the study was to assess the usefulness of observations in estimating the compliance of veterinary students with biosecurity measures implemented in the necropsy room of a Faculty of Veterinary Medicine (n = 122 observations) and in a private slaughterhouse (n = 56 observations) in Belgium, during day sessions of practical work. Checklists compiling the biosecurity rules to apply in both contexts were established (31 rules were considered for the necropsy room and 35 for the slaughterhouse). Observations were performed by a single person to ensure standardisation. The level of compliance with biosecurity rules was intermediate and reached 42% vs. 37% for the necropsy room and the slaughterhouse, respectively. No significant difference was observed between these compliance rates. Increasing staff supervision of students and increasing awareness through education should be encouraged. The follow-up of observations through time could be used to assess the evolution of compliance with biosecurity measures.

Disasters, climate change, and securitisation: the United Nations Security Council and the United Kingdom's security policy

Since climate change was included on the United Nations Security Council's agenda in 2007, there has been much debate about whether or not it has been securitised. This paper starts from the premise that climate change has undergone a partial securitisation-that is, a gradual process wherein political choices are made to frame certain issues in particular ways. Climate change has been reframed from a purely developmental and environmental concern to one that impels foreign policy and security domains. This paper makes a novel contribution to disasters, climate change, and security studies by arguing that explicit and implicit links to natural hazard-related disasters have been employed as part of a gradual process of securitisation, or, more specifically, the partial securitisation of climate change. This is demonstrated by drawing on two cases: United Nations Security Council debates between 2007 and 2017; and the United Kingdom's security policy between 1997 and 2017.

Automation in visual inspection tasks: X-ray luggage screening supported by a system of direct, indirect or adaptable cueing with low and high system reliability

The present study evaluated three automation modes for improving performance in an X-ray luggage screening task. One hundred and forty participants were asked to detect the presence of prohibited items in X-ray images of cabin luggage. Twenty participants conducted this task without automatic support (control group), whereas the others worked with either indirect cues (system indicated the target presence without specifying its location), or direct cues (system pointed out the exact target location) or adaptable automation (participants could freely choose between no cue, direct and indirect cues). Furthermore, automatic support reliability was manipulated (low versus high). The results showed a clear advantage for direct cues regarding detection performance and response time. No benefits were observed for adaptable automation. Finally, high automation reliability led to better performance and higher operator trust. The findings overall confirmed that automatic support systems for luggage screening should be designed such that they provide direct, highly reliable cues.Practitioner summary: The present study confirmed previous findings showing better detection performance in X-ray images of luggage when supported by automation providing direct, highly reliable cues. Furthermore, participants used adaptable automation only to select their preferred level of automation. This behaviour did not provide the benefits expected under adaptable automation.

Automation in airport security X-ray screening of cabin baggage: Examining benefits and possible implementations of automated explosives detection

Bomb attacks on civil aviation make detecting improvised explosive devices and explosive material in passenger baggage a major concern. In the last few years, explosive detection systems for cabin baggage screening (EDSCB) have become available. Although used by a number of airports, most countries have not yet implemented these systems on a wide scale. We investigated the benefits of EDSCB with two different levels of automation currently being discussed by regulators and airport operators: automation as a diagnostic aid with an on-screen alarm resolution by the airport security officer (screener) or EDSCB with an automated decision by the machine. The two experiments reported here tested and compared both scenarios and a condition without automation as baseline. Participants were screeners at two international airports who differed in both years of work experience and familiarity with automation aids. Results showed that experienced screeners were good at detecting improvised explosive devices even without EDSCB. EDSCB increased only their detection of bare explosives. In contrast, screeners with less experience (tenure < 1 year) benefitted substantially from EDSCB in detecting both improvised explosive devices and bare explosives. A comparison of all three conditions showed that automated decision provided better human-machine detection performance than on-screen alarm resolution and no automation. This came at the cost of slightly higher false alarm rates on the human-machine system level, which would still be acceptable from an operational point of view. Results indicate that a wide-scale implementation of EDSCB would increase the detection of explosives in passenger bags and automated decision instead of automation as diagnostic aid with on screen alarm resolution should be considered.

Control or rescue at sea? Aims and limits of border surveillance technologies in the Mediterranean Sea

The matter of boat migrants crossing the Mediterranean Sea, seeking to reach Europe, is interchangeably defined as a 'security issue', requiring stricter border controls, and as a humanitarian issue with corresponding rescue and protection requirements. This paper seeks to understand what role various surveillance technologies, such as radar, satellites, and unmanned aerial vehicles, can play in this respect (legally and technically), in comparison to the role that they are assigned (that is, political expectations). To unravel what surveillance technologies can and cannot do vis-à-vis the aims of control and rescue, there is a need to comprehend what information can be collected and what information is needed to fulfil these objectives. The paper contends that there is a mismatch between the information sought to 'control' borders, but which cannot be gathered effectively by or processed using surveillance technologies, and the valuable information needed to perform rescue operations, which these surveillance technologies can supply.

Engaging scientists and veterinarians in strengthening biosecurity systems

The engagement of both scientists and veterinarians in strengthening biosecurity systems is of paramount importance to ensure resilience and sustainability. Such commitment from scientists and veterinarians begins during their university education, is nurtured by the examples set by their mentors, and continues into their careers through professional development and the wisdom gained from experience. Resilient and sustainable biosecurity systems also require an organisational culture that encourages, recognises and rewards scientists and veterinarians who are committed to biosecurity education, research, outreach and preparedness. At present, such involvement is complicated by the range of definitions of biosecurity used in the life sciences and veterinary medicine, and by the various international organisations with biosecurity responsibilities. Biosecurity represents both a public and a private good. However, the priority given to biosecurity education, research, outreach and implementation differs widely among the public, private and academic sectors. The public sector has the broadest engagement and the broadest mandate for biosecurity. The private sector's approach to biosecurity is governed by business decisions and whether or not they produce consumer goods. In the academic sector, although biosecurity education is gaining increased attention in universities, there are disincentives to research in this field. Strategies for encouraging greater involvement from scientists and veterinarians include agreeing on an inclusive definition of biosecurity, developing teaching materials and experiential learning approaches for use in undergraduate curricula and postgraduate professional development, train-the-trainer programmes, increased involvement of government scientists and veterinarians in university education and professional development, and the fostering of public-private-academic partnerships around shared interests in biosecurity education, research, outreach and implementation.

Genome editing as a national security threat

Testimony from the intelligence community in the United States connecting genome editing with national security threats was a noted departure from past assessments of the implications of modern enabling biotechnologies. Rarely are individual biotechnologies included on lists of potential security threats. When they are, a broad range of advances are usually considered collectively - in terms of both risks and benefits. Given the classified nature of the rationale as to why gene editing tools were singled out, we are unlikely to fully understand for several decades what prompted this statement. This paper considers three ways in which these tools might impact national security: i) enabling the development of advanced biological weapons; ii) facilitating the development of new bioweapons based on ecological applications of genome editing, and iii) enhancing future generations of people in ways which could have an indirect impact on security, for example by improving a nation's cognitive ability and/or the physical endurance of its soldiers. Their implications are different and so are the possible policy and regulatory responses.

[Metal implants and airport security checks]

Orthopaedic surgeons and trauma surgeons in the Netherlands are implanting 65,000 joint replacements and treating nearly 300,000 fractures per year. For many travellers with a metal implant - but also for the physicians who are treating them - it is unclear what the consequences will be when they have to go through airport security checks. These checks follow a fixed procedure in accordance with European rules which involves travellers passing through a number of visible and invisible barriers. The first barrier is usually a metal detector or a millimetre wave scanner; when the implant has been detected, this is followed by a body search. The electromagnetic field of a metal detector penetrates into the body; the metal detector has therefore a higher detection rate for metal implants than a millimetre wave scanner, of which radio waves reach up to or just below the skin. Medical documentation can help reassure the traveller or the security officer, but possible additional checks cannot be avoided.