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  1. Abstract Background

    The coronavirus disease 2019 (COVID-19) presents critical diagnostic challenges for managing the pandemic. We investigated the 30-month changes in COVID-19 testing modalities and functional testing sites from the early period of the pandemic to the most recent Omicron surge in 2022 in Kyoto City, Japan.

    Methods

    This is a retrospective-observational study using a local anonymized population database that included patients' demographic and clinical information, testing methods and facilities from January 2020 to June 2022, a total of 30 months. We computed the distribution of symptomatic presentation, testing methods, and testing facilities among cases. Differences over time were tested using chi-square tests of independence.

    Results

    During the study period, 133,115 confirmed COVID-19 cases were reported, of which 90.9% were symptomatic. Although nucleic acid amplification testing occupied 68.9% of all testing, the ratio of lateral flow devices (LFDs) rapidly increased in 2022. As the pandemic continued, the testing capability was shifted from COVID-19 designated facilities to general practitioners, who became the leading testing providers (57.3% of 99,945 tests in 2022).

    Conclusions

    There was a dynamic shift in testing modality during the first 30 months of the pandemic in Kyoto City. General practitioners increased their role substantially as the use of LFDs spread dramatically in 2022. By comprehending and documenting the evolution of testing methods and testing locations, it is anticipated that this will contribute to the establishment of an even more efficient testing infrastructure for the next pandemic.

     
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    Free, publicly-accessible full text available December 1, 2024
  2. Abstract

    The Covid‐19 pandemic greatly impacted global public policy implementation. There is a lack of research synthesizing the lessons learned during Covid‐19 from a policy perspective. A systematic review was conducted following PRISMA guidelines to examine the literature on public policy implementation during the Covid‐19 pandemic in order to gain comprehensive insights into current topics and future directions. Five clusters of topics were identified: lessons from science, crisis governance, behavior and mental health, beyond the crisis, and frontlines and trust. Extensive collaboration among public health departments emerged as a significant research theme. Thirty recommendations for future research were identified, including the examination of frontline worker behavior, the use of just tech in policy implementation, and the investigation of policies driving improvements in global public health. The findings indicate that current research on public policy implementation during the Covid‐19 pandemic extends beyond health and economic crisis‐related policies. However, further studies in a post‐pandemic context are needed to validate the identified topics and future directions.

     
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    Free, publicly-accessible full text available March 30, 2025
  3. Abstract

    Location-based alerts have gained increasing popularity in recent years, whether in the context of healthcare (e.g., COVID-19 contact tracing), marketing (e.g., location-based advertising), or public safety. However, serious privacy concerns arise when location data are used in clear in the process. Several solutions employ searchable encryption (SE) to achievesecurealerts directly on encrypted locations. While doing so preserves privacy, the performance overhead incurred is high. We focus on a prominent SE technique in the public-key setting–hidden vector encryption, and propose a graph embedding technique to encode location data in a way that significantly boosts the performance of processing on ciphertexts. We show that the optimal encoding is NP-hard, and we provide three heuristics that obtain significant performance gains: gray optimizer, multi-seed gray optimizer and scaled gray optimizer. Furthermore, we investigate the more challenging case of dynamic alert zones, where the area of interest changes over time. Our extensive experimental evaluation shows that our solutions can significantly improve computational overhead compared to existing baselines.

     
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  4. Free, publicly-accessible full text available July 15, 2025
  5. Free, publicly-accessible full text available July 1, 2025
  6. Differentially Private Federated Learning (DP-FL) has garnered attention as a collaborative machine learning approach that ensures formal privacy. Most DP-FL approaches ensure DP at the record-level within each silo for cross-silo FL. However, a single user's data may extend across multiple silos, and the desired user-level DP guarantee for such a setting remains unknown. In this study, we present Uldp-FL, a novel FL framework designed to guarantee user-level DP in cross-silo FL where a single user's data may belong to multiple silos. Our proposed algorithm directly ensures user-level DP through per-user weighted clipping, departing from group-privacy approaches. We provide a theoretical analysis of the algorithm's privacy and utility. Additionally, we improve the utility of the proposed algorithm with an enhanced weighting strategy based on user record distribution and design a novel private protocol that ensures no additional information is revealed to the silos and the server. Experiments on real-world datasets show substantial improvements in our methods in privacy-utility trade-offs under user-level DP compared to baseline methods. To the best of our knowledge, our work is the first FL framework that effectively provides user-level DP in the general cross-silo FL setting.

     
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    Free, publicly-accessible full text available July 1, 2025
  7. Human mobility data offers valuable insights for many applications such as urban planning and pandemic response, but its use also raises privacy concerns. In this paper, we introduce the Hierarchical and Multi-Resolution Network (HRNet), a novel deep generative model specifically designed to synthesize realistic human mobility data while guaranteeing differential privacy. We first identify the key difficulties inherent in learning human mobility data under differential privacy. In response to these challenges, HRNet integrates three components: a hierarchical location encoding mechanism, multi-task learning across multiple resolutions, and private pre-training. These elements collectively enhance the model's ability under the constraints of differential privacy. Through extensive comparative experiments utilizing a real-world dataset, HRNet demonstrates a marked improvement over existing methods in balancing the utility-privacy trade-off.

     
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    Free, publicly-accessible full text available July 1, 2025
  8. The spread of infectious diseases is a highly complex spatiotemporal process, difficult to understand, predict, and effectively respond to. Machine learning and artificial intelligence (AI) have achieved impressive results in other learning and prediction tasks; however, while many AI solutions are developed for disease prediction, only a few of them are adopted by decision-makers to support policy interventions. Among several issues preventing their uptake, AI methods are known to amplify the bias in the data they are trained on. This is especially problematic for infectious disease models that typically leverage large, open, and inherently biased spatiotemporal data. These biases may propagate through the modeling pipeline to decision-making, resulting in inequitable policy interventions. Therefore, there is a need to gain an understanding of how the AI disease modeling pipeline can mitigate biased input data, in-processing models, and biased outputs. Specifically, our vision is to develop a large-scale micro-simulation of individuals from which human mobility, population, and disease ground-truth data can be obtained. From this complete dataset—which may not reflect the real world—we can sample and inject different types of bias. By using the sampled data in which bias is known (as it is given as the simulation parameter), we can explore how existing solutions for fairness in AI can mitigate and correct these biases and investigate novel AI fairness solutions. Achieving this vision would result in improved trust in such models for informing fair and equitable policy interventions.

     
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    Free, publicly-accessible full text available June 30, 2025
  9. Free, publicly-accessible full text available June 24, 2025
  10. Free, publicly-accessible full text available May 13, 2025