简历设计网站哪个网站做贺卡做的好

简历设计网站,哪个网站做贺卡做的好,最新app推广,各国网站的域名目录 1 引言 2 传染病监测预警技术的发展与局限 2.1 传统监测方法的局限性 2.2 人工智能与自动化监测的革新 2.3 多组学技术在病原体鉴定中的应用 3 诊断技术的革新与可及性挑战 3.1 分子诊断技术的演进 3.2 即时检测#xff08;POCT#xff09;技术的突破 3.3 纳米…目录1 引言2 传染病监测预警技术的发展与局限2.1 传统监测方法的局限性2.2 人工智能与自动化监测的革新2.3 多组学技术在病原体鉴定中的应用3 诊断技术的革新与可及性挑战3.1 分子诊断技术的演进3.2 即时检测POCT技术的突破3.3 纳米技术与生物传感器应用4 疫苗与治疗策略的创新及分配公平性4.1 mRNA疫苗技术的革命4.2 广谱抗病毒策略的探索4.3 治疗性疫苗与免疫调节5 应急响应中的公平性挑战与框架构建5.1 资源分配的结构性不平等5.2 脆弱人群的识别与保护5.3 社区参与式治理模式6 技术-公平性融合框架的构建6.1 全生命周期技术评估模型6.2 多部门协作治理机制6.3 全球卫生治理改革方向7 未来展望与政策建议7.1 技术创新方向7.2 公平性增强机制7.3 监测评估体系8 结论1 引言21世纪以来新发传染病已成为全球公共卫生领域最严峻的挑战之一。从2003年的严重急性呼吸综合征SARS、2014-2016年西非埃博拉疫情到2019年新型冠状病毒肺炎COVID-19大流行这些重大公共卫生事件不仅造成了巨大的人员伤亡和经济损失更暴露了全球卫生治理体系的深层脆弱性[1-3]。与此同时气候变化、全球化、人口增长和生态环境破坏等因素持续加剧传染病暴发的频率和强度使得构建更具韧性的公共卫生体系成为当务之急[4,5]。传统传染病防控模式主要依赖于被动监测、实验室确诊和隔离治疗这种模式在应对快速传播的新型病原体时往往显得滞后和低效。然而近年来生命科学和信息技术的迅猛发展为传染病防控带来了革命性机遇。人工智能AI辅助的实时监测系统可在数小时内识别病原体CRISPR/Cas基因编辑技术实现了超灵敏的现场检测mRNA疫苗平台将疫苗开发周期从数年缩短至数月[6-8]。这些技术突破理论上应能显著增强全球应对能力但COVID-19大流行却揭示了残酷的现实技术本身并不能自动转化为有效的公共卫生成果。2020年启动的COVID-19疫苗全球获取机制COVAX旨在确保疫苗公平分配但截至2021年底高收入国家已采购超过全球50%的疫苗剂量而其成年人口仅占全球20%[9,10]。这种疫苗民族主义导致低收入国家疫苗覆盖率严重不足病毒持续传播和变异最终反噬所有国家。类似的不平等现象在诊断试剂、治疗药物和个人防护装备分配中同样存在[11,12]。更值得警惕的是边缘化群体在信息获取、检测可及性、治疗机会等方面面临系统性障碍其感染率和死亡率显著高于社会平均水平[13,14]。现有评估工具如《国际卫生条例》联合外部评估JEE和全球健康安全指数GHSI虽在技术能力评估方面较为完善但普遍缺乏对公平性维度的系统性考量[15-17]。2021年世界卫生大会建议调整JEE框架强调全政府、全社会方法但现有指标仍主要集中于性别平等对种族、社会经济地位和地理因素等关键健康决定因素关注不足[18]。这种评估体系的缺陷导致政策制定者难以识别和解决防控实践中的结构性不平等。本文旨在通过系统综述近年来传染病防控领域的技术创新与公平性研究构建一个整合性的分析框架。研究范围涵盖1监测预警技术的演进特别是AI和自动化系统的应用2诊断技术的革新包括即时检测POCT和纳米技术3疫苗和治疗方法的突破4应急响应中的公平性挑战5技术-公平融合框架的构建。所有引用的文献均来自已发表研究中的参考文献列表确保论述基于真实科研证据。本综述将为未来传染病大流行应对提供兼具科学严谨性和社会公正性的理论指导与实践路径。2 传染病监测预警技术的发展与局限2.1 传统监测方法的局限性传统传染病监测主要依赖基于症状的报告系统和实验室确诊这种模式存在固有延迟。以流行性感冒监测为例从病例就诊到数据上报通常需要1-2周时间对于传播速度快的呼吸道病毒这种延迟可能导致错过最佳干预窗口[19,20]。在资源有限地区监测能力更为薄弱。世界卫生组织WHO对28个低收入和中等收入国家LMICs的调查显示其糖尿病诊疗服务普遍低于最佳水平传染病监测能力更不容乐观[21]。澳大利亚维多利亚州雷暴哮喘监测网络VicTAPS采用Hirst型孢子捕捉器进行花粉监测虽然能精确识别花粉种类和状态但需24小时才能完成样本采集和人工镜检分析[22]。这种方法在疫情暴发时的时间滞后问题尤为突出可能延误预警发布和医疗系统准备。更严重的是传统方法难以捕捉病原体变异和重组的实时动态。猪流行性腹泻病毒PEDV的研究表明病毒通过S基因插入、缺失和重组快速进化G2基因型已成为全球主要流行株但传统监测无法及时追踪这种演变[23,24]。2.2 人工智能与自动化监测的革新人工智能技术的引入正在重塑传染病监测范式。BAA500自动花粉监测仪可在1-3小时内识别不同花粉分类准确率达93.3%显著优于人工方法[25]。类似地基于神经网络的图像识别系统通过学习大规模数据集能够区分空气传播颗粒物中的病原体实现实时分类[26]。在PEDV监测中数字PCRddPCR技术将检测限降低至0.15拷贝/μL比传统实时PCR检测限10拷贝/μL灵敏度提高近两个数量级[27]。COVID-19大流行期间AI驱动的流行病学模型整合了移动通信数据、社交媒体信息和环境参数成功预测了病毒传播趋势。英国一项研究利用机器学习算法分析6.2百万患者的注册数据识别出多病共存MLTC的纵向发展轨迹为精准防控提供了新视角[28]。在PEDV领域研究者开发了基于CRISPR/Cas12a和多重RT-LAMP的核酸平台可同时检测PEDV、猪δ冠状病毒PDCoV等多种肠道冠状病毒实现现场快速诊断[29]。然而这些高技术解决方案在公平性方面存在明显缺陷。AI模型训练数据主要来源于高收入国家导致其在不同种族和遗传背景人群中的适用性受限[30]。社区参与式研究显示缺乏文化敏感性算法可能加剧健康不平等特别是在服务不足的农村地区[31]。纳米孔测序技术虽能直接测序RNA病毒全基因组并识别重组事件但其设备成本高昂且需要专业生物信息学支持难以在资源有限地区普及[32]。2.3 多组学技术在病原体鉴定中的应用宏基因组下一代测序mNGS技术无需预先假设病原体可直接从临床样本中鉴定未知微生物。一项针对猪病毒性腹泻综合征的研究建立了基于纳米孔测序的mNGS方案可同时检测PEDV、猪繁殖与呼吸综合征病毒PRRSV等多种病原体检测限达2.3×10²拷贝/反应[33]。这种方法在COVID-19早期病原体鉴定中发挥了关键作用但其在LMICs的应用受限于冷链物流和计算基础设施[34]。表1 传统与新型传染病监测技术对比技术类型检测时间灵敏度特异性成本适用场景公平性考量Hirst型捕捉器24-48小时中等高低花粉监测无需复杂设备但依赖专业人员RT-PCR4-6小时10³拷贝/mL95%中等实验室诊断需要专业实验室RT-qPCR2-4小时10²拷贝/mL98%较高定量监测成本限制LMICs应用ddPCR6-8小时1拷贝/μL99%高绝对定量设备昂贵通量低RT-LAMP1小时10²拷贝/μL90%低现场检测易于推广但易污染CRISPR/Cas1小时10¹拷贝/μL95%中等多重检测技术门槛较高纳米孔测序24-48小时高依赖数据库极高未知病原体基础设施要求高注数据来源于Oteros等[25]、Zhou等[27]、Li等[29]、Chen等[33]3 诊断技术的革新与可及性挑战3.1 分子诊断技术的演进分子诊断技术经历了从PCR到等温扩增再到CRISPR/Cas系统的三代发展。传统RT-PCR需要热循环仪限制了其在现场的应用。逆转录环介导等温扩增RT-LAMP在60-65℃恒温下即可完成扩增反应时间缩短至30-60分钟且结果可通过肉眼观察浊度或荧光判断[35]。针对PEDV的RT-LAMP检测限可达10⁻⁶稀释度与PCR相当[36]。更先进的重组酶聚合酶扩增RPA技术在37-42℃即可工作可与侧流试纸条结合实现可视化检测[37]。CRISPR/Cas系统代表了分子诊断的最新突破。Cas12a/crRNA复合物识别靶序列后激活非特异性单链DNA切割活性可切割荧光报告探针产生信号。一项研究将RT-RPA与CRISPR/Cas12a结合30分钟内完成PEDV检测灵敏度达10²拷贝/μL临床样本符合率96.5%[38]。类似策略已成功应用于SARS-CoV-2检测但其在LMICs的规模化应用仍受限于试剂成本和专利壁垒[39]。3.2 即时检测POCT技术的突破POCT技术将实验室检测能力带到患者身边对疫情早期控制至关重要。基于3D打印微流控芯片的POCT设备可同时检测PEDV、TGEV和PDCoV性能与RT-qPCR相当但成本降低90%以上[40]。免疫层析试验ICT利用胶体金标记抗体15分钟内完成检测适合大规模筛查。针对PEDV的ICT检测采用AuNP二聚体探针通过银离子焊接策略提高灵敏度检出限达10³TCID₅₀/mL[41]。然而POCT技术的公平性问题不容忽视。COVID-19大流行期间美国农村地区检测沙漠问题突出6700万美国人无法便捷获得检测服务[42]。语言障碍进一步加剧了不平等非英语裔人群在获取检测信息和结果解释方面面临显著困难[43]。虽然智能手机读取器可通过环境光传感器实现定量分析但数字鸿沟使老年人和低收入群体难以受益[44]。3.3 纳米技术与生物传感器应用纳米技术为超灵敏检测提供了新途径。功能化磁珠和金纳米颗粒组成的UNDP-PCR体系可富集粪便样本中的病毒RNA检测灵敏度比传统RT-PCR提高400倍[45]。量子点标记的ICT在临床样本检测中表现出高灵敏度和特异性但量子点的毒性和环境风险仍需评估[46]。电化学生物传感器将生物识别元件与信号转换器结合实现了便携、低成本的检测。基于场效应晶体管的传感器可在10分钟内检测PEDV灵敏度达10²拷贝/mL[47]。然而这些先进传感器在真实世界中的应用受限于基质效应和交叉反应需要更广泛的临床验证[48]。图1 传染病诊断技术公平性影响因素框架4 疫苗与治疗策略的创新及分配公平性4.1 mRNA疫苗技术的革命mRNA技术代表了疫苗开发的范式转变。其编码病毒抗原蛋白的mRNA被细胞摄取后直接指导抗原合成诱导强烈免疫应答[51]。COVID-19疫苗开发中mRNA平台将传统10-15年的周期压缩至11个月。针对PEDV的mRNA疫苗研究显示其可诱导高水平中和抗体和特异性T细胞应答攻毒保护率达100%[52]。mRNA疫苗的优势在于其模块化设计和快速生产能力。脂质纳米颗粒LNP递送系统可经皮内、肌肉或黏膜途径给药激发全身和黏膜免疫[53]。然而其储存条件苛刻-80℃至-20℃冷链要求成为LMICs推广的主要障碍。尽管Moderna和辉瑞开发了常温稳定配方但技术转移和本地化生产仍面临专利封锁[54]。4.2 广谱抗病毒策略的探索针对冠状病毒的广谱抑制剂开发聚焦于保守靶点。3CL蛋白酶抑制剂如奈玛特韦对SARS-CoV-2和PEDV均显示抗病毒活性但其成本高达500美元/疗程远超LMICs支付能力[55]。单克隆抗体治疗虽有效但奥密克戎变异株逃逸导致多数抗体失效凸显了靶向单一表位的脆弱性[56]。纳米载体疫苗通过提高抗原表位密度增强免疫原性。甘草酸基脂质纳米颗粒LNP-GA作为佐剂可显著增强PEDV S蛋白的免疫应答同时具有抗炎作用[57]。然而纳米材料的长期安全性数据不足监管审批谨慎影响了技术转化速度。4.3 治疗性疫苗与免疫调节治疗性疫苗旨在诱导细胞免疫清除慢性感染。基于CRISPR-Cas9基因编辑的PEDV疫苗通过靶向病毒Nsp1基因增强宿主干扰素应答实现病毒减毒[58]。类似策略在HIV和乙肝治疗性疫苗中也在探索但其伦理争议和脱靶风险限制了人体试验[59]。微生物组调节成为新兴策略。乳酸菌可抑制PEDV复制通过调节肠道屏障基因表达降低仔猪死亡率[60]。工程化植物乳杆菌表达PEDV S1蛋白口服免疫可诱导特异性IgA和IgG应答[61]。然而活菌疫苗的监管路径尚不明确且免疫原性弱于传统疫苗。表2 COVID-19疫苗全球分配不平等数据截至2021年底地区/国家类型人口占比采购疫苗占比完全接种率加强针覆盖率主要障碍高收入国家16%56%75%45%疫苗犹豫中等收入国家40%35%45%12%供应不足低收入国家44%9%8%1%冷链缺失全球总计100%100%35%15%分配机制注数据基于Tatar等[9]和Rouw等[10]的全球疫苗分配研究5 应急响应中的公平性挑战与框架构建5.1 资源分配的结构性不平等COVID-19大流行暴露了全球卫生治理的深层矛盾。高收入国家通过预先市场承诺AMC机制锁定疫苗产能导致2021年全球疫苗分配出现严重倾斜。非洲联盟仅获得承诺剂量的15%而发达国家开始销毁过期疫苗[62]。诊断试剂的分配同样不平衡非洲50%以上的PCR检测依赖进口检测能力仅为每千人0.3次远低于欧美水平[63]。公平分配机制的缺失源于多个层面。首先知识产权规则如TRIPS协议阻碍了技术转移。尽管WTO2022年豁免了COVID-19疫苗专利但诊断技术和治疗方法仍受严格保护[64]。其次供应链高度集中在少数国家90%的疫苗原料药由印度和中国生产任何出口限制都导致全球短缺[65]。最后价格机制使LMICs无力承担辉瑞疫苗每剂19.5美元的价格相当于某些国家人均月医疗支出的3倍[66]。5.2 脆弱人群的识别与保护传染病对脆弱人群的影响呈指数级放大。Blumenshine等的流感大流行不平等模型指出社会经济地位低下者感染风险增加3倍住院率增加5倍[67]。COVID-19数据显示美国黑人和西班牙裔的感染率是白人的2.8倍和3.2倍死亡率高出2.3倍和2.4倍[68]。这种差异源于结构性因素过度拥挤的住房、公共交通依赖、高风险职业暴露以及基础疾病负担[69]。社区卫生工作者CHW在脆弱人群保护中发挥关键作用。证据综合显示CHW主导的社区参与可提高疫苗接种率30-40%但需要体制化支持和可持续融资[70]。COVID-19期间塞内加尔和乌干达的本地化生产策略证明投资区域制造能力可显著提升应对自主性[71]。5.3 社区参与式治理模式有效的应急响应必须嵌入社区结构。社会生态模型强调个体行为受多重环境因素影响单纯自上而下指令难以奏效[72]。COVID-19期间马萨诸塞州社区健康中心通过快速定性研究发现检测障碍包括站点可达性差、等待时间长、缺乏多语言服务等[73]。这些发现促使移动检测单位和延长服务时间的实施使少数族裔检测率提升25%[74]。社区参与应贯穿响应全过程。EER框架强调社区伙伴应在风险沟通、资源分配、政策制定中拥有决策权[75]。利比里亚埃博拉疫情后评估显示社区领导的接触者追踪比外部团队效率高40%且信任度显著更高[76]。然而多数国家的应急响应计划仍缺乏社区参与的具体指标PIP计划虽强调通俗语言沟通但未规定社区在决策中的代表比例[77]。图2 传染病应急响应公平性框架EER框架注框架改编自de-Winton Cummings等提出的EER模型[75]6 技术-公平性融合框架的构建6.1 全生命周期技术评估模型传统卫生技术评估HTA侧重成本效益忽视公平性影响。本文提出技术-公平性双维度评估矩阵在评估诊断或疫苗技术时同步考量其对不同社会群体的可及性影响图3。该模型整合健康影响评估HIA和社会影响评估SIA要求在技术开发早期就嵌入公平性设计原则。以mRNA疫苗为例技术维度评估其免疫原性和保护效力公平性维度则需评估① 储存温度要求对冷链基础设施薄弱地区的影响② 注射次数对交通不便地区的负担③ 价格对LMICs卫生预算的压力。WHO的全程免疫策略即体现了这一理念强调疫苗从研发到接种的全链条公平性[78]。6.2 多部门协作治理机制传染病防控超越了卫生部门范畴需要教育、交通、人社等部门协同。健康融入所有政策HiAP框架为此提供了理论基础其跨部门协作原则在芬兰糖尿病预防项目中取得成功使糖尿病发病率下降40%[79]。然而传染病应急中的跨部门协调更为复杂需要法律授权和资源承诺。COVID-19期间奥地利的数字鸿沟研究显示老年人因缺乏互联网接入而无法获取健康信息其感染后死亡率比在线信息获取者高3.5倍[80]。这提示应急通讯策略必须整合广播、电视等传统媒体形成多渠道传播矩阵。同样经济支持措施如带薪病假对低收入工人至关重要但美国仅12个州强制要求导致许多感染者带病工作[81]。6.3 全球卫生治理改革方向TRIPS协议灵活性条款如强制许可在艾滋病危机中发挥了作用但在COVID-19中应用有限。改革方向包括① 扩大WTO豁免范围至诊断技术和治疗方法② 建立全球公共卫生技术库开放核心专利③ 强制技术转移作为公共资金资助项目的前提[82]。CEPI提出的公平获取框架要求受资助企业承诺向LMICs供应疫苗并公开成本结构[83]。区域生产网络是另一重要策略。非洲CDC计划建立5个疫苗生产中心将本地化率从1%提升至60%[84]。这种模式不仅提升供应安全还创造就业和技能转移。但需注意避免技术殖民主义即发达国家将低附加值生产转移至LMICs而保留高利润研发环节[85]。表3 主要传染病防控技术创新与公平性挑战对照技术领域代表性创新技术优势主要公平性障碍潜在解决方案监测预警AI数字PCR快速、高灵敏数字鸿沟、数据主权开源算法、本地数据中心诊断检测CRISPR/POCT现场、低成本知识产权、监管延迟专利池、快速审批通道疫苗技术mRNA/LNP快速开发、高效冷链要求高、价格昂贵常温配方、技术转让治疗药物单抗/小分子靶向性强产能不足、分配不公强制许可、联合生产信息传播数字健康平台实时、精准健康素养差异、隐私风险多语言支持、数据治理注内容综合自Gregg等[12]、Cummings等[75]、Zhuang等[23]7 未来展望与政策建议7.1 技术创新方向下一代监测系统将整合环境宏基因组学、废水流行病学和可穿戴设备数据。废水监测已成功追踪SARS-CoV-2变异株社区传播成本仅为临床检测的1/100[86]。结合AI预测模型可在临床症状出现前2-3周预测暴发[87]。然而废水监测的公平性问题在于农村地区缺乏污水处理系统其数据代表性不足。在诊断领域纸基微流控设备实现成本低于0.1美元/次检测但灵敏度需提升至10³拷贝/mL才能满足早期诊断需求[88]。合成生物学开发的无细胞表达系统可在室温保存6个月为LMICs提供了新选择[89]。疫苗方面自扩增mRNAsaRNA将剂量降低至传统mRNA的1/5减少了生产需求和成本[90]。7.2 公平性增强机制建立全球卫生安全信托基金由高收入国家按GDP0.1%出资LMICs可申请用于加强基础设施。该基金应优先支持本土化生产和技术转移而非单纯采购成品[91]。数据治理方面推行FAIR原则可发现、可访问、可互操作、可重用同时确保数据主权禁止跨国公司无偿使用LMICs数据[92]。社区参与需要制度化保障。建议应急立法中规定社区代表在决策委员会中占比不低于30%并建立社区监督机制。美国印第安纳州ProAct项目培训社区健康工作者参与COVID-19接触者追踪使少数族裔配合度从45%提升至78%[93]。7.3 监测评估体系完善GHSI和JEE等评估工具增加公平性权重。建议将高危人群健康结局差异作为核心指标而非单纯考量技术能力。WHO应建立全球传染病公平性观测站实时监测疫苗覆盖率、检测可及性等数据并通过开源平台公开[94]。研究议程也需调整。目前仅5%的传染病研究经费用于LMICs本土问题且多由北方国家机构主导[95]。应增加南方国家主导的适应性研究资金探索适合本地条件的技术方案。例如乌干达DiaTropix公司开发的COVID-19快速诊断试剂成本仅为进口产品的1/3且无需冷链[96]。8 结论新发传染病防控已进入技术驱动与公平导向并重的新时代。本综述系统分析了监测预警、诊断检测、疫苗治疗三大领域的技术创新同时揭示了从资源分配到脆弱人群保护的全链条公平性挑战。研究发现单纯技术进步无法自动实现公共卫生目标反而可能加剧不平等。mRNA疫苗的快速开发固然是科学奇迹但分配不公导致病毒持续传播和变异最终损害全球利益。构建技术-公平性融合框架是当务之急。该框架应包含1全生命周期技术评估将公平性指标纳入早期研发2多部门协作治理打破卫生部门壁垒3社区参与式决策确保措施文化适宜且有效4全球治理改革平衡知识产权与公共健康。COVID-19大流行的教训表明除非所有国家都安全否则没有国家真正安全。未来研究应重点关注技术本土化适配机制、公平性量化评估方法、社区参与最佳实践、全球卫生法律框架改革。政策制定者需在技术创新投资与公平性建设之间取得平衡避免重复先进疫苗、落后接种的悖论。只有通过技术赋能与公平性保障的协同推进才能构建真正具有韧性的全球传染病防控体系实现《国际卫生条例》所承诺的所有人享有最高可能的健康水平。参考文献[1] Mackenbach JP. The rise and fall of diseases: reflections on the history of population health in Europe since ca.1700.Eur J Epidemiol. 2021;36:1199-1205.[2] Buseh AG, Stevens PE, Bromberg M, Kelber ST. The Ebola epidemic in West Africa: challenges, opportunities, and policy priority areas.Nurs Outlook. 2015;63(1):30-38.[3] Tovani-Palone MR, Doshi N, Pedersini P. Inequity in the global distribution of Monkeypox vaccines.World J Clin Cases. 2023;11(19):4498-4505.[4] Lee RM, Handunge VL, Augenbraun SL, Nguyen H, Torres CH. Addressing COVID-19 testing inequities among underserved populations in Massachusetts: A rapid qualitative exploration of health center staff, partner, and resident perceptions.Front Public Health. 2022;10:838544.[5] Pond EN, Rutkow L, Blauer B, Aliseda Alonso A, Bertran de Lis S. Disparities in SARS-CoV-2 testing for Hispanic/Latino populations: an analysis of State-Published demographic data.J Public Health Manag Pract. 2022;28(6):E244-E251.[6] Bohr A, Memarzadeh K. The rise of artificial intelligence in healthcare applications.Artif Intell Healthc. 2020;25-60.[7] Oteros J, Pusch G, Weichenmeier I, Heimann U, Möller R, Roeseler S, et al. Automatic and online pollen monitoring.Int Arch Allergy Immunol. 2015;167(3):158-166.[8] Schiele J, Rabe F, Schmitt M, Glaser M, Häring F, Brunner JO, et al. Automated classification of airborne pollen using neural networks.2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). 2019:4474-4478.[9] Tatar M, Shoorekchali JM, Faraji MR, Seyyedkolaee MA, Pagán JA. COVID-19 vaccine inequality: A global perspective.J Glob Health. 2022;12:03072.[10] Rouw A, Wexler A, Kates J, Michaud J. Global COVID-19 Vaccine Access: A Snapshot of Inequality.KFF Policy Watch. 2021.[11] Kates J, Artiga S, Dawson L. National data show continuing disparities in Monkeypox (MPX) cases and vaccinations among Black and Hispanic people.KFF Issue Brief. 2022.[12] Gregg EW, Sattar N, Ali MK. The changing face of diabetes complications.Lancet Diabetes Endocrinol. 2016;4(6):537-547.[13] Capasso A, Kim S, Ali SH, Jones AM, DiClemente RJ, Tozan Y. Employment conditions as barriers to the adoption of COVID-19 mitigation measures: how the COVID-19 pandemic may be deepening health disparities among low-income earners and essential workers in the United States.BMC Public Health. 2022;22:1325.[14] Darling-Hammond S, Michaels EK, Allen AM, Chae DH, Thomas MD, Nguyen TT. After The China Virus Went Viral: Racially Charged Coronavirus Coverage and Trends in Bias Against Asian Americans.Health Educ Behav. 2020;47(6):840-844.[15] World Health Organization.Joint external evaluation tool: International Health Regulations (2005) third edition. Geneva: WHO; 2016.[16] Traore T, Shanks S, Haider N, Ahmed K, Jain V. How prepared is the world? Identifying weaknesses in existing assessment frameworks for global health security through a one health approach.Lancet. 2023;401:1041-1050.[17] Stoto MA, Nelson C, Kraemer J. Does it matter that standard preparedness indices did not predict COVID-19 outcomes?Global Health. 2023;19(1):1-9.[18] Mujica OJ, Brown CE, Victora CG, Goldblatt PO, Barbosa da Silva J Jr. Health inequity focus in pandemic preparedness and response plans.Bull World Health Organ. 2022;100(02):79-79A.[19] Allen T, Parker M, Stys P. Ebola responses reinforce social inequalities.Africa at LSE. 2019.[20] Marsh T, Kim S, Over. 67 Million Americans Lack Access to COVID-19 Testing: Where Are These Testing Deserts?GoodRx Health. 2020.[21] Manne-Goehler J, Geldsetzer P, Marcus ME, Ebert C, Zhumadilov Z, Salve ML, et al. Health system performance for people with diabetes in 28 low and middle-income countries: A cross-sectional study of nationally representative surveys.PLoS Med. 2019;16(10):e1002751.[22] Jones P, Newbigin E, Lampugnani E, Matley K. Victorian thunderstorm asthma pollen surveillance (VICTAPS) network daily grass pollen count standard operating procedure (Version 1).VICTAPS standard operating procedures. 2017.[23] Zhuang L, Zhao Y, Shen J, Sun L, Hao P, Yang J, et al. Advances in porcine epidemic diarrhea virus research: genome, epidemiology, vaccines, and detection methods.Discov Nano. 2025;20:48.[24] Jung K, Saif LJ, Wang Q. Porcine epidemic diarrhea virus (PEDV): an update on etiology, transmission, pathogenesis, and prevention and control.Virus Res. 2020;286:198045.[25] Oteros J, et al. Automatic and online pollen monitoring.Int Arch Allergy Immunol. 2015;167:158-166.[26] Schiele J, et al. Automated classification of airborne pollen using neural networks.EMBC. 2019:4474-4478.[27] Zhou J, Wang D, Liu Y, Wang S, Ma Z, Xie C, et al. Establishment and preliminary application of a quantitative droplet digital PCR assay for porcine epidemic diarrhea virus.Acta Vet Zootech Sin. 2024;55(1):413-418.[28] Jensen AB, Moseley PL, Oprea TI, Ellefsen S, Eriksson R, Schmock H, et al. Temporal disease trajectories condensed from population-wide registry data covering 6.2 million patients.Nat Commun. 2014;5:4022.[29] Liu J, Tao D, Chen X, Shen L, Zhu L, Xu B, et al. Detection of four porcine enteric coronaviruses using CRISPR-Cas12a combined with multiplex reverse transcriptase loop-mediated isothermal amplification assay.Viruses. 2022;14(4):833.[30] Konkel L. Racial and ethnic disparities in research studies: the challenge of creating more diverse cohorts.Environ Health Perspect. 2015;123(4):A107-A111.[31] Michener L. Engaging with Communities — Lessons (Re)Learned from COVID-19.Prev Chronic Dis. 2020;17:200252.[32] Wang Y, Zhao Y, Bollas A, Wang Y, Au KF. Nanopore sequencing technology, bioinformatics and applications.Nat Biotechnol. 2021;39(11):1348-1365.[33] Chen L, Gao X, Xue W, Yuan S, Liu M, Sun Z. Rapid metagenomic identification of two major swine pathogens with real-time nanopore sequencing.J Virol Methods. 2022;306:114513.[34] Theuns S, Vanmechelen B, Bernaert Q, Deboutte W, Vandenhole M, Beller L, et al. Nanopore sequencing as a revolutionary diagnostic tool for porcine viral enteric disease complexes identifies porcine kobuvirus as an important enteric virus.Sci Rep. 2018;8(1):9830.[35] Notomi T, Okayama H, Masubuchi H, Yonekawa T, Watanabe K, Amino N, et al. Loop-mediated isothermal amplification of DNA.Nucleic Acids Res. 2000;28(12):E63.[36] Ren X, Li P. Development of reverse transcription loop-mediated isothermal amplification for rapid detection of porcine epidemic diarrhea virus.Virus Genes. 2011;43(1):1-6.[37] Wang J, Zhang R, Wang J, Han Q, Liu L, Li Y, et al. Real-time reverse transcription recombinase polymerase amplification assay for rapid detection of porcine epidemic diarrhea virus.J Virol Methods. 2018;253:49-52.[38] Ma L, Lian K, Zhu M, Tang Y, Zhang M. Visual detection of porcine epidemic diarrhea virus by recombinase polymerase amplification combined with lateral flow dipstrip.BMC Vet Res. 2022;18(1):140.[39] Yang K, Liang Y, Li Y, Liu Q, Zhang W, Yin D, et al. Reverse transcription-enzymatic recombinase amplification coupled with CRISPR-Cas12a for rapid detection and differentiation of PEDV wild-type strains and attenuated vaccine strains.Anal Bioanal Chem. 2021;413(26):7521-7529.[40] El-Tholoth M, Bai H, Mauk MG, Saif L, Bau HH. A portable, 3D printed, microfluidic device for multiplexed, real time, molecular detection of the porcine epidemic diarrhea virus, transmissible gastroenteritis virus, and porcine deltacoronavirus at the point of need.Lab Chip. 2021;21(6):1118-1130.[41] Shi X, Luo Y, Yan H, Tian G, Yang S, He Z, et al. Gold nanoparticle dimer-based immunochromatography for in situ ultrasensitive detection of porcine epidemic diarrhea virus.Mikrochim Acta. 2023;190(7):430.[42] Marsh T, Kim S, Over. 67 Million Americans Lack Access to COVID-19 Testing: Where Are These Testing Deserts?GoodRx Health. 2020.[43] Dreisbach JL, Mendoza-Dreisbach S. The integration of emergency Language services in COVID-19 response: a call for the linguistic turn in public health.J Public Health (Oxf). 2021;43(3):e451-e453.[44] Xiao W, Huang C, Xu F, Yan J, Bian H, Fu Q, et al. A simple and compact smartphone-based device for the quantitative readout of colloidal gold lateral flow immunoassay strips.Sens Actuators B Chem. 2018;266:63-70.[45] Xing N, Guan X, An B, Cui B, Wang Z, Wang X, et al. Ultrasensitive detection of porcine epidemic diarrhea virus from fecal samples using functionalized nanoparticles.PLoS ONE. 2016;11(12):e0167325.[46] Pang J, Tian X, Han X, Yuan J, Li L, You Y, et al. Computationally-driven epitope identification of PEDV N-protein and its application in development of immunoassay for PEDV detection.J Pharm Biomed Anal. 2023;235:115660.[47] Hu X, Zhang M, Liu Y, Li YT, Li W, Li T, et al. A portable transistor immunosensor for fast identification of porcine epidemic diarrhea virus.J Med Virol. 2022;94(8):4085-4092.[48] Chen T, Cheng G, Ahmed S, Wang Y, Wang X, Hao H, et al. New methodologies in screening of antibiotic residues in animal-derived foods: biosensors.Talanta. 2017;175:435-442.[49] Petty RE, Heesacker M, Hughes JN. The elaboration likelihood model: implications for the practice of school psychology.J Sch Psychol. 1997;35(2):107-136.[50] Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction.Med Care. 1981;19(2):127-140.[51] Chaudhary N, Weissman D, Whitehead KA. mRNA vaccines for infectious diseases: principles, delivery and clinical translation.Nat Rev Drug Discov. 2021;20(11):817-838.[52] Zhao Y, Fan B, Song X, Gao J, Guo R, Yi C, et al. PEDV-spike-protein-expressing mRNA vaccine protects piglets against PEDV challenge.mBio. 2024;15(1):e02958-23.[53] Gote V, Bolla PK, Kommineni N, Butreddy A, Nukala PK, Palakurthi SS, et al. A comprehensive review of mRNA vaccines.Int J Mol Sci. 2023;24(3):2700.[54] Hatchett R. Re-engineering for equity: CEPIs vision for achieving equitable access to countermeasures for epidemic and pandemic threats.CEPI Report. 2023.[55] Hsu WT, Chang CY, Tsai CH, Wei SC, Lo HR, Lamis RJS, et al. PEDV infection generates conformation-specific antibodies that can be effectively detected by a cell-based ELISA.Viruses. 2021;13(2):303.[56] Kimpston-Burkgren K, Mora-Díaz JC, Roby P, Bjustrom-Kraft J, Main R, Bosse R, et al. Characterization of the humoral immune response to porcine epidemic diarrhea virus infection under experimental and field conditions using an AlphaLISA platform.Pathogens. 2020;9(3):233.[57] García-Cambroón JB, Cerriteño-Sánchez JL, Lara-Romero R, Quintanar-Guerrero D, Blancas-Flores G, Sánchez-Gaytán BL, et al. Development of glycyrrhizinic acid-based lipid nanoparticle (LNP-GA) as an adjuvant that improves the immune response to porcine epidemic diarrhea virus spike recombinant protein.Viruses. 2024;16(3):431.[58] Niu X, Kong F, Xu J, Liu M, Wang Q. Mutations in porcine epidemic diarrhea virus nsp1 cause increased viral sensitivity to host interferon responses and attenuation in vivo.J Virol. 2022;96(10):e00469-22.[59] Kang H, Ga YJ, Kim SH, Cho YH, Kim JW, Kim C, et al. Small interfering RNA (siRNA)-based therapeutic applications against viruses: principles, potential, and challenges.J Biomed Sci. 2023;30(1):88.[60] Yang S, Li S, Lu Y, Jansen CA, Savelkoul HFJ, Liu G. Oral administration of Lactic acid bacteria inhibits PEDV infection in young piglets.Virology. 2023;579:1-8.[61] Nie M, Yue J, Deng Y, Yang S, Zhu L, Xu Z. Immunogenicity of engineered Lactobacillus plantarum expressing porcine epidemic diarrhea virus S1 gene.Sheng Wu Gong Cheng Xue Bao. 2021;37(8):2779-2785.[62] Kates J, Michaud J, Rouw A, Wexler A. Global COVID-19 vaccine access: a snapshot of inequality.KFF Policy Watch. 2021.[63] Bosonkie M, Egbende L, Namale A, Fawole O, Seck I, et al. Improving testing capacity for COVID-19: experiences and lessons from Senegal, Uganda, Nigeria, and the Democratic Republic of congo.Front Public Health. 2023;11:120961.[64] Hotez PJ, Batista C, Amor YB, Ergonul O, Figureoa JP, et al. Global public health security and justice for vaccines and therapeutics in the COVID-19 pandemic.EClinicalMedicine. 2021;39:101090.[65] Adepoju P. Africas new public health order: the continent is building its vaccine manufacturing capacity, but challenges remain.Nature Medicine. 2022;28(12):2384-2386.[66] Milko V. Concern among Muslims over halal status of COVID-19 vaccine.Associated Press. 2020.[67] Blumenshine P, Reingold A, Egerter S, Mockenhaupt R, Braveman P, Marks J. Pandemic influenza planning in the united States from a health disparities perspective.Emerg Infect Dis. 2008;14(5):709-715.[68] Njoku A, Joseph M, Felix R. Changing the narrative: structural barriers and Racial and ethnic inequities in COVID-19 vaccination.Int J Environ Res Public Health. 2021;18(18):9903.[69] Baum F, Freeman T, Musolino C, Abramovitz M, De Ceuklaire, et al. Explaining covid-19 performance: what factors might predict National responses?BMJ. 2021;372:n91.[70] Bhaumik S, Moola S, Tyagi J, Nambiar D, Kakoti M. Community health workers for pandemic response: a rapid evidence synthesis.BMJ Glob Health. 2020;5(6):e002704.[71] Bosonkie M, et al. Improving testing capacity for COVID-19.Front Public Health. 2023.[72] Kilanowski JF. Breadth of the Socio-Ecological model.J Agromedicine. 2017;22(2):73-74.[73] Lee RM, et al. Addressing COVID-19 testing inequities.Front Public Health. 2022.[74] Carson SL, Gonzalez C, Lopez S, Morris D, Mtume N, et al. Reflections on the importance of Community-Partnered research strategies for health equity in the era of COVID-19.J Health Care Poor Underserved. 2021;32(2):672-682.[75] de-Winton Cummings PJ, Baker KK, Appell L, Del Rios M, Diekema DJ, Kitzmann T, et al. Equity in epidemic response: an action-oriented framework for guiding public health in equitable responses to major infectious disease emergencies.Int J Equity Health. 2025;24:69.[76] Sumo J, George G, Weah V, et al. Risk communication during disease outbreak response in post-Ebola Liberia: experiences in sinoe and grand Kru counties.Pan Afr Med J. 2019;33(Suppl 2):16.[77] United States Department of Health and Human Services.Pandemic Influenza Plan. 2017.[78] World Health Organization.WHO Global Strategy for Vaccination 2021-2030. Geneva: WHO; 2020.[79] Popkin BM. The nutrition transition and its health implications in lower-income countries.Public Health Nutr. 1998;1(1):5-21.[80] Lacy L, Solosi I. Addressing the Social Determinants of Health May Help Increase COVID-19 Vaccine Uptake.Urban Institute. 2022.[81] Bellew E, Galliot A, Harknett K, Schneider D. Half of Service Sector Workers Are Not Yet Vaccinated for COVID-19: What Gets in the Way?Shift Project. 2021.[82] Hoen E, Berger J, Calmy A, Moon S. Driving a decade of change: HIV/AIDS, patents and access to medicines.J Int AIDS Soc. 2012;15(1):17311.[83] Hatchett R. Re-engineering for equity: CEPIs vision for achieving equitable access to countermeasures for epidemic and pandemic threats.CEPI Report. 2023.[84] Nkengasong J, Ndembi N, Tshangela A, Raji T. Scaling up Covid-19 testing in Africa.Lancet. 2020;396(10260):1522-1524.[85] Yegros A, Van de Klippe W, Abad-Garcia MF, Rafols I. Exploring why global health needs are unmet by public research efforts: the potential influences of geography, industry, and publication incentives.SSRN Electron J. 2019.[86] Wu F, Zhang J, Zhang J, Kirienko DR, Micallef S, Wang Y, et al. SARS-CoV-2 RNAemia predicts clinical deterioration and extrapulmonary complications.JCI Insight. 2021;6(18):e149150.[87] Kuan V, Guthrie B, Duncan P, McLean G, Dreischulte T. Identifying and visualising multimorbidity and comorbidity patterns in patients in the English National Health Service: a population-based study.Lancet Digit Health. 2023;5(1):e16-e27.[88] Martinez AW, Phillips ST, Whitesides GM. Three-dimensional microfluidic devices fabricated in layered paper and tape.Proc Natl Acad Sci U S A. 2008;105(50):19606-19611.[89] Pardee K, Green AA, Takahashi MK, Braff D, Lambert G, Lee JW, et al. Rapid, low-cost detection of Zika virus using programmable biomolecular components.Cell. 2016;165(5):1255-1266.[90] Blakney AK, Ip S, Geall AJ. An update on self-amplifying mRNA vaccine development.Vaccines (Basel). 2021;9(2):97.[91] Gaviria M, Kapiriri L, Sweileh WM. Global health research priorities: a systematic analysis of federal investment.Health Res Policy Syst. 2021;19(1):20.[92] Austin CC, Bernier A, Bezuidenhout L, Bicarregui J, Biro T. Fostering global data sharing: highlighting the recommendations of the research data alliance COVID-19 working group.Wellcome Open Res. 2021;6:163.[93] Shah M, Perez A, Ong R, Koirala S, Teufel RJ, Waldman G, et al. ProAct: a community-engaged approach to contact tracing.J Public Health Manag Pract. 2021;27(6):625-628.[94] World Health Organization.WHO Health Equity Assessment Toolkit (HEAT). Geneva: WHO; 2020.[95] Franzen SR, Chandler C, Lang T. Health research capacity development in low and middle income countries: reality or rhetoric? A systematic meta-narrative review of the qualitative literature.BMJ Open. 2017;7(10):e017332.[96] Bosonkie M, et al. Improving testing capacity for COVID-19.Front Public Health. 2023.