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A genetikai adatok szerepe a járványok elleni küzdelemben

Genetic data in the fight against pandemics

Scientia et Securitas
Authors: Ágnes Becsei, Orsolya Anna Pipek, Péter Pollner, and István Csabai

Összefoglaló. A COVID–19-járvány alatt bizonyossá vált, hogy az adattudományok, az adatok gyors megosztása és a nemzetközi összefogás a hatékony járványkezelés kulcsfontosságú eszközei. A járvány előtt létrejött Újonnan Felbukkanó fertőző betegségek Obszervatóriuma (Versatile Emerging infectious disease Observatory, VEO) nevű nemzetközi konzorcium célja egy olyan monitorozó rendszer kiépítése, amely a potenciálisan veszélyes kórokozókat még az előtt azonosítja, mielőtt azok tömeges megbetegedéseket okoznának, lehetőséget adva ezzel a gyors reagálásra. A járványok megelőzésére és kezelésére létrejött nemzetközi együttműködésekben, így a VEO-ban is a kórokozók, vagy a fertőzésnek kitett személyek genetikai szekvencia adatai kiemelkedő fontosságúak. Az ilyen típusú adatok kezelésével kapcsolatban az Európai Unióban többek között a Nagojai Jegyzőkönyv és a GDPR fogalmaz meg elveket, szabályokat.

Summary. Data science is proved to be a key tool in the fight against the ongoing COVID-19 pandemic, but it requires a huge amount of data shared between international research groups. The Versatile Emerging infectious disease Observatory (VEO) EU collaboration was established to generate and distribute high quality data for an evidence-based early warning system for emerging infectious diseases. Through an iterative process between data scientists, disease experts, social scientists and citizen scientists, a collaborative platform will be created for storing, secure sharing and analyses of traditional and new data sources. Next generation sequencing (NGS) has revolutionized genomic research. This versatile technology is broadly applicable to pathogens and human hosts. Rapid sharing of pathogen genetic resources, including physical samples of cultured pathogens and additionally genetic sequencing data of pathogens, is crucial in support of research and outbreak response. Access to genetic resources is regulated by the Nagoya protocol which is an internationally binding treaty to ensure equal sharing of benefits arising from the use of genetic resources. So far the Nagoya protocol has been applied only to biological samples, but digital data from genetic sequencing doesn’t necessarily fall under the treaty. Effects of diseases can differ based on genetic backgrounds, as certain gene variants may provide protection against or susceptibility to viral diseases. Human genomic data is an important resource for medical research. The General Data Protection Regulation (GDPR) lists identifiable human genetic data as sensitive, which is a subset of personal data. Sharing and analysis of this kind of data are strictly regulated and they are also subject to ethical challenges. These concerns become less pronounced when analyzing environmental samples like sewage. Samples collected from wastewater treatment plants can be used as pooled samples, containing naturally anonymized genetic information of the human population, near the wastewater treatment plant.

Open access

Gondolatok a mesterséges intelligencia egyes polgári jogi kérdéseiről

Reflections on certain civil law aspects of artificial intelligence

Scientia et Securitas
Author: Ádám Auer

Összefoglaló. A tanulmány kezdő axiómája a mesterséges intelligencia biztonságos alkalmazása. A biztonságos alkalmazás egyik aspektusa a jogi biztonság, az a jogi környezet, amelyben a felmerülő jogi kérdések rendezésére alkalmazható keretrendszer áll rendelkezésre. A tanulmány a Semmelweis Egyetem projektjében fejlesztett mesterséges intelligencia alkalmazásának olyan polgári jogi problémáit vizsgálja, amelyek a mindennapi hasznosítás során merülhetnek fel. A tanulmány következtetése szerint a vizsgált mesterséges intelligencia szerzői műnek minősül és több védelmi forma is alkalmazható. A jogi szabályozás de lege ferenda kiegészítésre szorul a szerzői mű folyamatos változása okán. Szükséges rögzíteni egy referenciapontot, amely a felelősség kiindulópontjául szolgál.

Summary. The starting point of the study is the safe use of artificial intelligence. Legal certainty is one aspect of safe usage, the legal environment in which a framework is available that can be used to resolve legal issues. The paper examines the civil law issues that may arise in the everyday use of the artificial intelligence application developed within the Semmelweis University project. The study will first focus on the legal protection of the Semmelweis AI, including whether this protection is currently international, regional (European Union) or national and which of these is the optimal choice. The study also reflects on the legislative preparatory work of the European Union in this regard. Our hypothesis is that the majority of civil law areas concerning AI can be regulated within a contractual framework. The AI software developed by the project is a forward-looking medical and practical solution. If we want to use a legal analogy, we can imagine its operation as if we had a solution that could analyse all the national court decisions in each legal field and provide an answer to the legal problem at hand, while simultaneously learning and applying the latest court decisions every day. For this AI solution, the diagnostic process must be carefully examined in order to identify the legal problems. I believe that the optimal solution is to classify this AI application as ‘software’ because this allows property rights to be acquired in their entirety and it opens the door to clarifying individual associated usage and copyright by contract. An important civil law question arises in relation to parallel copyright protection, when the individual personal contributions (creative development work) to the software cannot be separated. Therefore, it is important to record the process and to separate the individual contributions protecting by copyright. The AI plays a questionable role in the diagnostic process. If the software itself cannot make a decision, but only provides a framework and platform, then it will not be entitled to co-ownership relating to the diagnostic images (e.g. just as a camera will not own the rights to the pictures taken with it). However, if the algorithm is part of the decision-making (e.g. the selecting of negative diagnoses), it would possibly be co-owner of the right, because it was involved in the development of the classification. All this should be clearly stated in the licence agreement, based on full knowledge of the decision-making process. However, de lege ferenda, the legal regime needs to be supplemented in view of the constant changes of the copyright work and the changing authors. There is a need to establish a specific point in the legislation that serves as a reference point for liability and legal protection. The issues under consideration are of a legal security nature, since without precise legal protection both the creator of artificial intelligence and the persons who may be held liable in the event of a malfunctioning of such systems may be uncertain.

Open access

A H-UNCOVER vizsgálat eredményei és hatása a magyarországi járványkezelésre

Results of the H-UNCOVER cross-sectional nationwide survey and it’s impact on the Hungarian COVID-19 epidemic

Scientia et Securitas
Authors: Béla Merkely, Gábor Áron Fülöp, Annamária Kosztin, Zoltán Vokó, and

Összefoglaló. A HUNgarian COronaVirus disease-19 Epidemiological Research (H-UNCOVER) vizsgálat egy országos szintű reprezentatív felmérés volt, melyet az Innovációs és Technológiai Minisztérium (ITM) támogatásával végzett el a négy orvostudományi képzést folytató magyar egyetem a Központi Statisztikai Hivatallal (KSH) együttműködve. A vizsgálat célja az volt, hogy egy reprezentatív mintán keresztül felmérje a magyar lakosság SARS-CoV-2 átfertőzöttségét, és támaszul szolgáljon a koronavírus első hulláma kapcsán meghozott restriktív intézkedések utáni lazításra. A világszinten is jelentős méretű vizsgálat alacsony átfertőzöttségi arányt mutatott, így nemcsak a restriktív intézkedések hatékonyságát mutatta meg, de egy biztos járványügyi támaszt jelentett a gazdaság újranyitásának tervezéséhez.

Summary. Close to the end of the first wave of the COVID-19 pandemic in Europe, many countries started to consider the possibility of reopening their economy, and lifting some of the containment measures introduced in the previous weeks. Such a decision is utterly complicated, as reopening might easily lead to an increase in active SARS-CoV-2 cases, but a delay puts an almost unbearable burden on the country’s economy. The objective of the HUNgarian COronaVirus disease-19 Epidemiological Research (H-UNCOVER) study was to conduct a cross-sectional survey among the Hungarian population to estimate the total number of infectious cases and the prevalence of prior SARS-CoV-2 exposure, and by using these data help to plan an exit strategy. The H-UNCOVER study was performed by the 4 medical universities in Hungary (Semmelweis University, University of Pécs, University of Debrecen and University of Szeged) with the help of the Central Statistical Office, Hungarian National Ambulance Service, Governmental offices and General Practitioners.

The study was initiated 50 days after the Hungarian restrictions and performed between 1-16 May. With the help of the Central Statistical Office, 17,787 people were selected to represent the Hungarian population of 14 years or older living in private households (n=8,283,810). SARS-CoV-2 PCR and blood tests were performed to assess the prevalence of active infection and seropositivity. These tests were accompanied by a questionnaire about symptoms, comorbidities, and COVID-19 contacts. More specifically, questions included topics about home office, going abroad after the 1st of March, or possible contacts with COVID-19 positive, or quarantined individuals, as well as symptoms which might be due to COVID-19 infection.

Altogether 67.7% of the selected individuals participated in some form in the study, which is an exceptionally high number compared to such studies. 10,502 individuals had SARS-CoV-2 PCR testing and 10,501 people had a blood test to assess SARS-CoV-2 IgG levels. Of the tested individuals, three had positive PCR and 69 had positive serological tests. Population estimates of the number of SARS-CoV-2 infections and seropositivity were 2,421 and 56,439, respectively, thus the active infection rate (2.9/10,000, 95% confidence interval: 0-6.7/10,000) and the prevalence of prior SARS-CoV-2 exposure (68/10,000, 95% confidence interval: 50-86/10,000) were low. A total of 10,474 individuals completed the questionnaire. Self-reported loss of smell or taste and body aches were significantly more frequent among those with SARS-CoV-2.

Our study suggested that the early containment measures initiated by the Government of Hungary were effective in preventing the escalation of the first wave of COVID-19 in Hungary. We also found that the highest prevalence of the disease was in Budapest, and those who attended their workplace on a regular basis, travelled abroad after the 1st of March, or contacted with a COVID-19 positive or quarantined individual had a higher tendency to become infected. In conclusion, the H-UNCOVER study supported the exit strategy after the first wave of COVID-19 in Hungary.

Open access

Járvány, vírus, Virológiai Nemzeti Laboratórium

Epidemic, virus, National Laboratory of Virology

Scientia et Securitas
Author: Ferenc Jakab

Összefoglaló. A fertőző betegségek világméretű fenyegetettsége és terjedése komoly társadalmi, egészségügyi kockázatot jelent minden nemzet számára. A lokális problémák megoldása mellett minden esetben közös nemzeti és nemzetközi összefogás szükséges. Az elmúlt években hazánkban is egyre nagyobb számban jelentek, illetve erősödtek meg új fertőző betegségek, amelyek szignifikáns társadalmi fenyegetést jelentenek. Éppen ezért a Virológiai Nemzeti Laboratórium (VNL) létrehozásának célja a Pécsi Tudományegyetem, Szentágothai János Kutatóközpont (PTE SzKK) kötelékén belül működő komplex virológiai laboratóriumi egység kutatási teljesítményének és kutatás-fejlesztési tevékenységének növelése, és ezzel párhuzamosan részvétel a hazai és nemzetközi szintű kutatási hálózatok munkájában. A VNL-hez tartozó komplex virológiai kutatási egység egyedüli hazánkban, hiszen minden biológiai biztonsági szintű laboratóriumi facilitással rendelkezik. Ennek megfelelően lehetőség van a 2-es (BSL-2), 3-as (BSL-3) és egyetlen egyetemi fenntartású laboratóriumként 4-es biológiai biztonsági szintű (BSL-4) laboratóriumi tevékenység elvégzésére. Ezzel egyedülálló lehetőséget nyit hazánkban is a fertőző betegségek leküzdésében vívott harcban. Hazánkban a PTE rendelkezik az egyetlen ilyen komplex virológiai kutatólaboratóriummal, amelyet tisztán kutatási és nem járványügyi feladatok elvégzésére hoztak létre. Ennek megfelelően az itt munkát végző fiatal kollégák az egyetemi prioritásoknak megfelelően a nemzetközileg elismert, kimagasló tudományos eredmények elérését tűzték ki célul. Mivel a laboratóriumi egység egyedülálló hazánkban, így a virológia területén nemcsak a kutatást, de az oktatást is kiválóan szolgálja.

A PTE SzKK Virológia Kutatócsoportjának elsődleges kutatási területe az állatokról emberekre terjedő, úgynevezett virális zoonózisok vizsgálata. Ezen kórokozók a legtöbb esetben súlyos, akár halálos kimenetelű fertőzéseket is képesek okozni, éppen ezért a vizsgálatok igen magas szakmai kompetenciát és megfelelő laboratóriumi infrastruktúrát igényelnek. Mindazonáltal az ilyen irányú vizsgálatok száma nemzetközi szinten is igen megnőtt, hiszen az új betegségek megjelenése is gyakoribbá vált, amit elsősorban a környezeti és emberi tényezők együttes hatása eredményezhet. A kutatócsoport az alapkutatásokon kívül számos alkalmazott kutatási projektben is részt vesz, amelyek célja a humán diagnosztikában, betegellátási gyakorlatban is alkalmazható tesztek, potenciálisan antivirális hatóanyagok fejlesztése, tesztelése. Mivel a laboratórium egyedülálló biológiai biztonsági szinttel rendelkezik az ilyen irányú alkalmazott kutatásokban, kutatás-fejlesztési és innovációs (K+F+I) tevékenységekben is részt tud venni, ezzel emelve a hazai kutatás-fejlesztési irányokat a mikrobiológia területén. A virológiai laboratórium nemcsak alap- és alkalmazott kutatásokat folytat, de szükség esetén részt tud venni a hazai védelmi, biztonsági szervek munkájában is.

A VNL fő célja egy hazai, magas színvonalú nemzeti virológiai kutatási centrum létrehozása, amely elősegíti a hazai virológiai kutatások tudományos fejlesztését, valamint a szakterület K+F+I tevékenységének növelését.

Summary. Today, the global threat and spread of infectious diseases pose serious social and health risks for every nation of the world. In addition to local challenges, there is a sustained need for national and international collaborations. In recent years, numerous new infectious diseases have emerged and grown into significant social threats also in Hungary. Therefore, in collaboration with national and international research networks, the ultimate goal of the National Laboratory of Virology (NLV) is to boost the performance and R&D activities of the Virology Laboratory complex of the Szentágothai János Research Centre (PTE-SzKK) at the University of Pécs. Due to its specific, high level facilities, our virology research unit has a unique asset in Hungary. Accordingly, it is capable of conducting experiments requiring Biosafety Level 2 (BSL-2), Biosafety Level 3 (BSL-3) and as the only academically supported unit in Hungary, it is also capable of covering Biosafety Level 4 (BSL-4) standards to uniquely combat infectious diseases in the area. Our laboratory is a distinctive research facility not only nationally, but internationally as well. Currently, the University of Pécs possesses the only virological research laboratory in Hungary that was established purely for research purposes and not for performing epidemiological tasks. Accordingly, aligned with their academic priorities, our young investigators set their horizons towards achieving internationally recognized, outstanding scientific results. Notably, because our renowned laboratory unit is unparalleled throughout the country, colleagues are wishing to pursue research and training in the field of virology.

The primary research field of the PTE-SzKK Virology Research Group is studying the so-called viral zoonoses; infectious transmissions from animals to humans. In most cases, these pathogens may cause serious, or even fatal infections requiring high level professional competence and corresponding laboratory infrastructure. Nevertheless, the number of international studies has recently surged as new diseases evolve and become more common due to the combined effects of environmental and human factors. In addition to basic science, our team is also conducting a number of applied research projects such as development of potential antiviral agents and tests for human diagnostics and medical care. Since our laboratory possesses a particularly high level of biosafety, it may be equally utilized in clinical practice and by providing novel directions for the national microbiology research and R&D field. Moreover, NLV not only implements basic and applied research, but also collaborates with various organizations of the Homeland Security of Hungary.

The primary goal to establish an NLV was to utilize a National research facility in the field of virology in Hungary in order to increase both research and R&D activity in the country.

Open access

Kiberbiztonság a koronavírus idején – a COVID–19 nemzetbiztonsági aspektusai

Cyber Security in the Time of the Coronavirus – National Security Aspects of COVID-19

Scientia et Securitas
Authors: Tamás Palicz, Balázs Bencsik, and Miklós Szócska

Összefoglaló. A COVID–19 pandémia az információbiztonság területén új kihívásokat jelentett. A távolról végzett munka különböző formái jelentős mértékben növelték az online tér biztonsági kockázatát. Nőtt a hálózatok nagysága, az adatforgalom, és azon felhasználók száma, akiknek nem volt érdemi tapasztalatuk az online térben. A járvány ideje alatt a kibertérből érkező támadások szektoronként és időszakonként eltérő intenzitásúak voltak, a támadások típusa a phishingtől a malwareken keresztül az információs zavarkeltésig széles spektrumban változott. Számos jelenségnek nemzetbiztonsági vonatkozásai is voltak. Összefoglaló cikkünkben a fenti jelenségek nemzetközi és hazai tapasztalatait összegezzük, különös figyelmet szentelve az egészségügyi rendszernek, illetve a vakcinafejlesztés kibertérből érkező fenyegetéseinek.

Summary. During the COVID-19 pandemic, new challenges emerged in the field of information security and cyber security. Home office, home schooling and distance learning, or even telemedicine hit some organizations unprepared. Security risks in online space have increased significantly: the number of network endpoints and the number of computers, laptops and mobile devices have increased with network data traffic as well as the number of users who had no significant experience in online space. They appeared as a significant risk factor. This has been exacerbated, especially in healthcare, by the extremely high workload, which has made systems highly vulnerable. During the epidemic, attacks from cyberspace varied in intensity from sector to sector and period to period. Statistics from international and national organizations have shown that from the end of the first quarter of 2020, the number of cyber security incidents jumped sharply and then remained high even after a small decline. The types of attacks had an extremely wide range: from phishing through malware to misinformation, almost all types of attacks occurred. Many phenomena also had national security implications. Ransomware virus attacks on health have affected almost all health systems and reached high levels by the end of 2020 in particular. It was during the first period that, in an emergency case, there is thought to be an association between a ransomware virus attack and the death of a patient who was not admitted because of the attack.

In addition to distance measures and the associated increase in cyber threats, the emerging threats related to vaccination, which is central to the fight against the epidemic, should also be highlighted. This period has shed light on how many vulnerabilities there are, from vaccine development through drug trials to delivery to vaccines and the organization of vaccines, that cybercriminals are able to attack. In order to prevent and combat these threats and attacks, and to respond appropriately, complex, multidisciplinary collaborations are needed in which security science has a privileged place. In our review article, we summarize the international and national experiences of the above phenomena, paying special attention to the health care system and the threats coming from cyberspace in vaccine development.

Open access

Kontaktkutatás, vezetői információs rendszer

Contact tracing, management support system

Scientia et Securitas
Authors: Eszter Bokányi, Péter Pollner, and Tamás Joó

Összefoglaló. Tanulmányunkban bemutatjuk a hazai COVID-járvány első hulláma során kidolgozott informatikai megoldást, amely a kontaktkutatást hálózattudományi megközelítés alapján segítette, és hozzájárult az első hullám sikeres megfékezéséhez.

A kifejlesztett vizuális reprezentációs technika látványos és részletekbe menő megértést, problémafeltárást képes biztosítani a járványügyi szakemberek számára. A grafikus elemek segítenek a gyors megértésben, a különböző hálózati elrendezések bizonyos jelenségekre, például gócpontokra, fertőzési klikkekre vagy a földrajzi terjedésre irányíthatják a figyelmet. A böngészőből történő futtatás alacsony technológiai belépési küszöböt biztosít a társterületeken kutatók számára, nekik így nem szükséges a problémafeltáráshoz külön szoftvereket telepíteni. Az adatbázis SQL-alapú szűrése a vizualizációs felületről lehetőséget biztosít összetettebb kérdések megfogalmazására is.

Summary. In our study, we present an IT solution developed during the first wave of the domestic COVID epidemic. This tool served as an aid for contact tracing. The development focused on the network scientific aspects and contributed to the successful handling of the first wave.

In case of absence of effective drugs or vaccines, controlling a contagious disease can only be achieved by preventing its spread. To this end

  • infectious individuals must be identified,

  • patients, exposed to the infection must be identified,

  • the epidemic branching points that cause the greatest infection must be uncovered,

  • information on the course of the disease must be collected,

  • temporal and efficacy parameters must be determined, and

  • potential cases of infection must be described.

One possible way to accomplish these tasks is achieved by contact tracing. Classical contact tracing is carried out by personal data collection, during which the commissioned epidemiologist has to fill in a questionnaire. The questionnaire basically includes data used to identify the infected person, as well as the data of the persons who were in contact with the infected person, i.e. in contact with them. The effectiveness of the research is also enhanced if the questionnaire records disease-related parameters (e.g., symptoms, timing-related times, etc.) as well. Once the disease is known, questionnaires can be designed according to a definite template format, the organization of data collection groups and the associated costs can be planned in advance. However, in the case of a new, unknown disease, flexibility and the ability to adapt quickly during data collection are of paramount importance.

The developed visual representation technique is able to provide spectacular and detailed understanding and a problem-solving user interface for epidemiologists. Graphical elements help in quick understanding, different network layouts can direct the attention to certain phenomena such as focal points, infectious cliques, or geographical spreading patterns. Running from a browser provides a low technology entry threshold for researchers in other scientific fields, so they don’t need to install separate software. The SQL-based filtering of the database on the visualization interface also provides an opportunity to study more complex questions.

Thus, with the help of the presented computer system, a relational database can be generated from the initially unstructured data of the contact research protocols through several steps. The relational database is made available to analysts and decision-makers.

As the final balance of the first wave of COVID-19 in Hungary showed, data from well-organized contact research and processed in appropriate analytical tools can provide important information for controlling the epidemic and saving lives.

Open access

Összefoglaló. A klinikai orvosbiológiai vizsgálatok elkezdéséhez a kutatásban részt vevők biztonságát ellenőrző Egészségügyi Tudományos Tanács (ETT) kutatásetikai bizottságainak hozzájárulása szükséges. A járványt csak tudományos eredményekkel lehet legyőzni, ezért kitörésekor gyorsították a COVID–19 kutatási protokollok bírálatát. A koronavírus világjárvány szükségessé tett egy megváltozott kutatási adatkezelést is. A járványok megoldása a megelőzés. Bár a vírusellenes vakcinák adása hamar megkezdődött, ami jelentős tudományos teljesítmény, mégis tudományellenes hullám söpör végig a világon, és a kötelező védőoltások körüli jogi, etikai viták fellángoltak. Áltudományos érvelésekkel félrevezetnek embereket. Az ETT nemzeti kutatásfejlesztési programot javasolt a járvány következményeinek leküzdésére.

Summary. Biomedical research activities are subjects to prior professional-ethical approval. ETT (the Medical Research Council in Hungary) through its research-ethics committees ensures the safety of people and protects their interests and health in various clinical investigations and trials. Thus, science, ethics, and safety cannot be separated in biomedical research. The ETT operates three national ethics committees. The opinions of ethical bodies are binding; clinical and biomedical research may not be initiated without the consent of the relevant ETT committees. This is in line with international regulations. The ETT has published the “Codex of Bioethics. On the concepts and practice of biomedical research” on its website.

When the epidemic broke out, the ETT Presidency initiated immediate legislative changes that allowed for online meetings as well as digital consent to investigations, in addition to the previously exclusive personal ones. In the epidemic, time became the determining dimension, but this and the aim of the research could not be combined with such “lightening” that would endanger the safety and interests of the participants in the COVID studies. Thus, under the still strict requirements, the time for reviewing the COVID-19 protocols had to be radically shortened. However, the ETT research ethics committees also rejected submissions during the epidemic. A total of 171 COVID-19-related research protocols were approved in Hungary in 2020. The ETT Presidency initiated a national Research and Development program on infectious diseases, a call for scientific clinical R&D proposals on COVID-19, and also elaborated its priorities.

Throughout human history, the solution to epidemics has always been to prevent the spread of disease through vaccinations. The average production time for traditional vaccines is about 15 years, whereas in the year of the SARS-CoV-2 virus pandemic outbreak, mass vaccinations began with completely new coronavirus vaccines partly made using brand new molecular biology technology that had never been used before. Despite the tremendous professional scientific achievements, a wave of hostilities is sweeping across the world, and the ethos and successes of science, and scientific communities in research are being questioned when their roles are dominant and outstanding. The concept of compulsory vaccination has been arguably classified as a human right. With this, the world of vaccinations was tied to concepts that it really had nothing to do with. Arbitrary pairing and joint treatment of remote concepts favours the spread of fatal diseases such as measles and poliomyelitis, for which there are already vaccines. Meanwhile, pseudosciences are misleading the public.

The coronavirus pandemic has also necessitated changes in data management. The ETT has previously initiated a number of legal and professional proposals on health data management and access to research data, and has developed its own data protection rules following the introduction of the GDPR.

Open access

A preventív és proaktív fogászati azonosítás bevezetése és jelentősége tömegkatasztrófa áldozat azonosításkor

The introduction and importance of preventive and proactive dental identification in disaster victim identification

Scientia et Securitas
Authors: Botond Simon, Ajang Armin Farid, and János Vág

Összefoglaló. A modern kriminalisztika interdiszciplináris területe a tömegkatasztrófa áldozat azonosítás. A katasztrófát általában egy előre nem látható esemény okozza, amelyben mind az emberi, mind pedig az anyagi kár jelentős. Napjainkban az áldozatazonosítás folyamata reaktív módon történik, tehát az azonosításhoz szükséges dokumentáció az esemény bekövetkezése után kerül összegyűjtésre. A fogászati ante-mortem (AM) adatokat előre, hatóságilag egy központi adatbázisban, preventív jelleggel, kötelező módon nem tárolják.

A preventív AM adatbázis létrehozása felgyorsíthatja és költséghatékonnyá teheti az áldozatazonosítást, mert a jelenlegi reaktív módszer helyett preventív módon, proaktív jelleggel kerülne sor az azonosításra.

Summary. Mass disaster identification is an interdisciplinary field of modern forensic science. A disaster is usually caused by an unforeseen event in which both human and material damage is significant. Nowadays, the victim identification process is reactive, i.e., the authorities react to the event that has occurred and collect the necessary documentation for identification after the event has taken place. Primary identifiers include fingerprints, DNA and dental records. In mass casualty incidents, teeth are usually the most common means of identifying victims. However, dental ante-mortem (AM) documentation is not stored in advance in a central database as a preventive measure.

The creation of a preventive AM database could speed up and make victim identification cost-effective, because it would be done in a preventive and proactive way instead of the current reactive method. The quality of the AM documentation would be guaranteed to be good and accurate, so that post-mortem (PM) data collected in the field can be easily and efficiently compared by a smart pattern recognition software, increasing the likelihood of successful identification. The introduction of digital health involves not only security and technology, but also cultural change. In Hungary, from 2020 onwards, the private sector will be obliged to provide data to the National eHealth Infrastructure (Elektronikus Egészségügyi Szolgáltatási Tér, EESZT), so digital health information will be stored in a centralized system, which can improve the quality of ante-mortem documentation. When identifying victims, it is important to have biometric identifiers that are resistant to environmental influences, have individual characteristics, are easy to collect and compare with reference information, and can be stored and used in a cost-effective way. The palatal ridge has been shown to meet the above properties. The development of digital dentistry and the involvement of the dental sector in data collection will facilitate the work of forensic dental experts, enabling the state to ensure effective identification and subsequent dignified farewells and burials for its citizens in the event of a mass disaster. According to the principle of operation of the preventive AM-PM database, the two- and three-dimensional X-ray and other imaging data, findings, anamnesis documentation and final reports collected during the lifetime of a citizen are stored in a central database. Changes during screening examinations can be traced. One of the most valuable is dental documentation. All information linked to the individual is stored with AM ID, which is also linked to passport and ID card information. In the event of an accident, post-mortem data is also stored in the AM-PM database, which is saved with a PM ID. With the help of a smart algorithm, the AM-PM ID match helps to identify the victim. In the case of missing persons, it is important that the missing person’s medical AM documentation, if not already stored, is immediately included, since when identifying an unknown body, it is probably best to start the search among the missing persons first.

Open access

A szennyvíz alapú epidemiológia jelentősége a COVID–19 járványban és azon túl

The importance of wastewater-based epidemiology in the COVID-19 pandemic and beyond

Scientia et Securitas
Authors: Tamás Pándics, Eszter Róka, Bernadett Khayer, Zoltán Kis, Luca Bella Kovács, Nóra Magyar, Tibor Málnási, Orsolya Oravecz, Bernadett Pályi, Eszter Schuler, and Márta Vargha

Összefoglaló. A szennyvízalapú epidemiológia módszere a jelenlegi világjárványban egyre inkább előtérbe kerül. Mivel a szennyvízhálózatot szinte mindenki használja, ezzel a módszerrel gyorsan és olcsón lehet reprezentatív egészségügyi információhoz jutni, az így keletkező adatok pedig támogatást és visszajelzést nyújthatnak a döntéshozatalban. A Nemzeti Népegészségügyi Központ 2020 júniusa óta működteti a COVID–19 előrejelző rendszert. A mintavételek hetente történnek Budapest három szennyvíztisztítójából, valamint a megyeszékhelyekről. A kapott adatok hazánkban is előrejelzik az esetszám alakulását, az eredmények gyors kommunikációja pedig lehetővé teszi a járványhelyzetre történő felkészülést. A szennyvízalapú epidemiológia alkalmazása a jövőben más területeken is megfontolandó hazánkban is.

Summary. Wastewater based epidemiology (WBE) is an emerging method in the current COVID-19 pandemic. Since almost everyone uses the sewerage system, wastewater is technically a composite sample representing the entire population of the area serviced by a wastewater plant. This community sample contains pathogens and compounds excreted by the human body through feces or urine, and can be used to obtain information on the health status of the community. It was successfully used previously for confirming the eradication of poliovirus and tracking legal and illegal drug consumption.

The etiological agent of COVID-19, the SARS-CoV-2 virus is an enveloped, single strand RNA coronavirus. Although it is a respiratory virus, it is also shed in feces both in symptomatic and asymptomatic infections. Wastewater therefore can be used to estimate outbreak trends and support outbreak management.

Wastewater monitoring efforts in Hungary started in June 2020, first in Budapest, then gradually extended to a national surveillance system. Weekly samples are collected in the three wastewater treatment plants servicing Budapest, and from every county seat. The analyzed 22 samples represent approximately 40 % of the population. Raw sewage samples are centrifuged to remove the debris and concentrated by membrane ultrafiltration. RNA is extracted from the concentrate and SARS-CoV-2 is quantified by RT-qPCR. Results are normalized to Enterococcus counts to correct for the bias of dilution from precipitation.

The first results in June reflected the decline of the first wave of the outbreak. During the summer, viral RNA concentrations were low, mainly below the limit of detection. The increase of RNA in the sewage preceded the resurge of cases by 2 weeks. Trends of viral concentration followed the same pattern as the number of infections in the second and third wave. SARS-CoV in sewage shows statistically significant association with the number of new cases in the following weeks, thus it can be used as an early warning system.

Results are communicated weekly to the governance board responsible for outbreak management, or more frequently in case of outstanding results or when it is necessary for decision support. Weekly information is also made available to the public. To inform the public, concentration categories (low, medium, elevated and high) were defined, representing orders of magnitude of the viral RNA concentration. Trends (increasing, stagnating or decreasing) are also indicated.

The establishment of a long-term wastewater surveillance system would provide an opportunity for early recognition of future emerging infections, tracking seasonal influenza, drug use or even the detection of certain bioterror attacks. It would be an important addition to maintaining the health and safety of the Hungarian population.

Open access

Abstract

Building on ecosystem models that examine individuals’ development within professional environments (Roxå, 2014; Hannah & Lester, 2009), we explore how campus centers for educational development and research can provide a range of experiences for faculty to learn about scholarship of teaching and learning (SoTL), conduct individual or collaborative – and sometimes multi-institutional – SoTL, and go public with their work. Using extended case studies of colleagues who have become increasingly more active in SoTL, we created a typology of the experiences that supported their development. The case studies illustrate that offering a variety of educational development options at different institutional levels and with different time commitments enables developers to meet faculty where they are – and to provide growth opportunities for deepening SoTL commitments. Our typology can help educational developers prioritize among potential programs by considering the cost-benefit analysis not only for individual faculty but also for micro-, meso-, and macro-level institutional cultures.

Open access