Medical Stations Research Articles

Mental Health Support of Frontline Medical Personnel in the Javits New York Medical Station Federal COVID-19 Treatment Center.

The federal government responded to the early epicenter of the COVID-19 pandemic in the United States by mobilizing uniformed services and other federal medical personnel to treat patients at the Javits New York Medical Station. Deployment of large numbers of personnel required flexible psychiatric and psychological support. This report details the establishment of mental health support services for frontline personnel in a large convention center and explores lessons learned to encourage future mental health professionals to apply creative and assertive mental health interventions in disaster settings. Timely and effective interventions included securing safe therapeutic space in high-traffic areas, developing relationships with leadership and frontline workers in their own work environments, and disseminating services throughout the civilian medical system. We suggest mental health supplementation during the medical response mission strengthened morale in frontline workers in a disaster scenario.

Athlete Medical Services at the Marathon and Race Walking Events During Tokyo 2020 Olympics.

Epidemiological data from race walk and marathon events suggest that a high incidence rate of exertional heat illness is associated with high ambient temperature and relative humidity. The 2020 Summer Olympics in Tokyo was no exception, which led the organizing committee to relocate the race walk and marathon competitions to Sapporo, which was predicted to experience much milder heat. Nonetheless, during the Games, Sapporo recorded the highest daytime ambient temperature in the past 97 years, with consecutive days over 30°C from July 22nd to August 7th, 2021. Five events (men's and women's 20 km race walk, men's 50 km race walk, women's and men's marathon) were held in Sapporo from August 5th to August 8th, 2021. The percentage of athletes who did not finish (DNF) in each event was 8.8% in men's 20 km race walk, 20.3% in men's 50 km race walk, 8.6% in women's 20 km race walk, 17.1% in women's marathon and 28.3% in men's marathon. A total of fifty athletes were transferred to the athlete medical station: 28 athletes completed the race (i.e., collapsed after finish line), while 24 were DNF athletes transported from the course. Forty-eight (96%) of athletes who were admitted to the athlete medical station exhibited signs and symptoms of exertional heat illness. Two athletes diagnosed with exertional heat stroke and three athletes diagnosed with severe heat exhaustion (rectal body temperature >39.5°C with or without central nervous system disturbance) were cooled using whole-body cold water immersion at the heat deck located within the athlete medical station. All athletes who were cooled successfully recovered without any complications. These athletes required an average of 14 ± 9.4 min (range, 6–30 min) to cool their rectal temperature below 39°C. These results show the importance for event organizers to prepare strategies to keep athletes cool, such as an ample amount of ice and water to supply whole-body cold water immersion.

Healthcare worker safety program in a coronavirus disease 2019 (COVID-19) alternate care site: The Javits New York Medical Station experience.

In March 2020, New York City became the epicenter of the coronavirus disease 2019 (COVID-19) pandemic in the United States. Because healthcare facilities were overwhelmed with patients, the Jacob K. Javits Convention Center was transformed into the nation's largest alternate care site: Javits New York Medical Station (hereafter termed Javits). Protecting healthcare workers (HCWs) during a global shortage of personal protective equipment (PPE) in a nontraditional healthcare setting posed unique challenges. We describe components of the HCW safety program implemented at Javits. Javits, a large convention center transformed into a field hospital, with clinical staff from the US Public Health Service Commissioned Corps and the US Department of Defense. Key strategies to ensure HCW safety included ensuring 1-way flow of traffic on and off the patient floor, developing a matrix detailing PPE required for each work activity and location, PPE extended use and reuse protocols, personnel training, and monitoring adherence to PPE donning/doffing protocols when entering or exiting the patient floor. Javits staff who reported COVID-19 symptoms were immediately isolated, monitored, and offered a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) test. A well-designed and implemented HCW safety plan can minimize the risk of SARS-CoV-2 infection for HCWs. The lessons learned from operating the nation's largest COVID-19 alternate care site can be adapted to other environments during public health emergencies.

Modeling location–allocation of emergency medical service stations and ambulance routing problems considering the variability of events and recurrent traffic congestion: A real case study

One of the most important and common criteria for evaluating the emergency medical systems is the response time, which is a function of the availability of an ambulance at the time of the request and the time that it takes for the ambulance to arrive at the call location. In this study, an optimization model is proposed to deal with the problem of the emergency medical service stations’ location and ambulance allocation. In order to capture the impacts of uncertainty in the network and obtain more realistic results, it is assumed that medical aid demands from any location in the city at any time slot of the day have a probabilistic distribution. In addition, to consider the traffic fluctuations in the modeling process, it is assumed that the arrival time to the request location is a time dependent variable. To deal with the complexity of the proposed approach and find optimal solutions in a reasonable execution time, some heuristic algorithms are suggested to solve the ambulance routing problem and the proposed non-linear integer model. To show the applicability of proposed models and algorithms in large-scale networks, the models and algorithms have been applied to the emergency medical system of the city of Isfahan, Iran. Three different scenarios are defined to improve the performance of the emergency medical services in Isfahan. The results show that relocating emergency medical service stations and reallocating ambulances will lead to significant improvements in both response time and coverage area in Isfahan.

Chemical Weapons in the Iran-Iraq War (1980–1988) 6. Accumulated Experience in the Treatment of Lesions with Poisonous Nerve Agents

The Iran-Iraq war (1980–1988) was the first modern war in which chemical weapons were used. The purpose of this work is to summarize the experience of treating victims, affected by nerve agents. The publications of Iranian authors in different scientific journals were used for the preparation of the article. The first use of chemical weapons by the Iraqi army occurred in August 1983 in Kurdistan (sulfur mustard). Nerve agent (tabun) was first used on February 29, 1984 in the battles for the Majnun Islands. In total, 140 tons of tabun and about 600 tons of sarin / cyclosarin were used against Iranian troops during the war. Around 5.5 thousand servicemen died directly from the nerve agents. For one dead from tabun, there were at least 7 poisoned people who needed qualified toxicological assistance; lethal outcomes among servicemen affected by the herd amounted to at least 15%. Military personnel without protective equipment, who received large doses of nerve agents, lost consciousness within 30 seconds and died in positions within a few minutes. The most sensitive to such agents were women, children and the elderly, who accidentally fell under a chemical attack. The use of nerve agents by the enemy was accompanied by panic in the troops and the arrival of a huge number of military personnel in critical condition at medical stations. Sweating, fasciculations and miosis were the first clinical signs by which those affected by such toxic agents were recognized. The effectiveness of antidote therapy (atropine + oxime + diazepam) depended on the time of medical care. The most effective was the use of atropine by titration (fractional intravenous drip) to achieve ease of breathing, absence of bronchospasm, disappearance of secretions from the respiratory tract and heart rate >80 beats/min. The oximes turned out to be not effective in the treatment of those poisoned by tabun. The most effective was degassing by physical removal of toxic chemical. Degassing of the affected had to be carried out by washing with sea or river water, using solutions of chlorine-containing household chemicals, and sprinkling with dry earth

A Wasserstein distributionally robust chance constrained programming approach for emergency medical system planning problem

This paper proposes a distributionally robust chance constrained programming model for an emergency medical system location problem with uncertain demands. By minimising the total expected cost, the location of emergency medical stations, the allocation of the ambulances and demand assignments of system are optimised. The Wasserstein-metric is employed to construct the ambiguity set centred at an empirical distribution with a proper radius, which contains all the probability distributions of the uncertainties. We introduce a big-M technique to reformulate distributionally robust chance constrained programming into a corresponding mixed integer programm, which can be inner and outer approximated by Value-at-Risk (VaR) and Conditional-Value-at-Risk (CVaR). Numerical experiments are illustrated to demonstrate the effectiveness of the formulations.

Epidemiology and Cutaneous Manifestations of Psoriasis in Saudi Arabia: A Narrative Review.

BackgroundPsoriasis is an inflammatory immune-mediated illness with an unknown cause. It is a painful, disfiguring, and disabling condition without a complete cure and has enormous negative effects on patients’ quality of life. Ethnicity, genetics, and environmental variables all have a role in determining the disease’s prevalence. Currently, the large-scale epidemiological studies on cutaneous manifestations of psoriasis in Saudi Arabia are limited.AimTo evaluate the prevalence of different forms of psoriasis and cutaneous manifestations, pattern, and associated clinical presentation of psoriasis in the Kingdom of Saudi Arabia (KSA).MethodologyA thorough search of studies on cutaneous manifestations of psoriasis in KSA was conducted from July first 2021 to September 30 2021 using the key phrases “psoriasis,” “cutaneous manifestations of psoriasis in KSA,” “psoriasis clinical presentation in Saudi Arabia,” and “psoriasis skin lesions in Saudi Arabia” at four medical search stations PubMed, Scopus, Google, and Research Gate.ResultsPsoriasis was found to be present in up to 5.33% of the population. More men than women were affected and the age of onset was under 30 years. It was more prevalent in the northern region of KSA. A family history was confirmed in many cases. Plaque psoriasis was the most prevalent kind of psoriasis, followed by guttate psoriasis. Other types of psoriasis, such as pustular psoriasis, erythrodermic psoriasis, follicular psoriasis, inverse psoriasis, and congenital psoriasis, were also found in Saudi patients. There was no evidence of life-threatening psoriasis among Saudis.ConclusionThe major findings of this narrative review revealed plaque-type psoriasis was the most frequent among Saudis followed by guttate psoriasis. Further epidemiological research is needed to better understand the type of cutaneous psoriasis, its impact on the quality of life, and the current therapeutic options which would help advance the national health policy.

Quantity and Quality of Healthcare Professionals, Transfer Delay and In-hospital Mortality Among ST-Segment Elevation Myocardial Infarction: A Mixed-Method Cross-Sectional Study of 89 Emergency Medical Stations in China.

BackgroundTransfer delay provokes prolongation of prehospital time, which contributes to treatment delay that endangers patients with ST-segment elevation myocardial infarction (STEMI). A key constraint in reducing transfer delay is the shortage of emergency healthcare workers. This study was to explore the influence of the quality and quantity of healthcare professionals at emergency medical stations on transfer delay and in-hospital mortality among STEMI patients.MethodsA cross-sectional study using mixed methods was conducted at 89 emergency stations in 9 districts in China's Shenzhen province. Based on a sample of 31 hospitals, 1,255 healthcare professionals, and 3,131 patients with STEMI, a generalized linear model was used to explore the associations between the quality and quantity of healthcare professionals and transfer delay and in-hospital mortality among STEMI patients. Qualitative data were collected and analyzed to explore the reasons for the lack of qualified healthcare professionals at emergency medical stations.ResultsThe analysis of the quantity of healthcare professionals showed that an increase of one physician per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 5.087 min (95% CI −6.722, −3.452; P < 0.001). An increase of one nurse per 100,000 individuals was associated with decreased transfer delay by 1.471 min (95% CI −2.943, 0.002; P=0.050). Analysis of the quality of healthcare professionals showed that an increase of one physician with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 8.508 min (95% CI −10.457, −6.558; P < 0.001). An increase of one nurse with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay by 6.645 min (95% CI −8.218, −5.072; P < 0.001). Qualitative analysis illustrated that the main reasons for low satisfaction of healthcare professionals at emergency medical stations included low income, limited promotion opportunities, and poor working environment.ConclusionsThe quantity and quality of emergency healthcare professionals are key factors influencing transfer delay in STEMI patients. The government should increase the quantity of healthcare professionals at emergency medical stations, strengthen the training, and improve their performance by linking with clinical pathways to enhance job enthusiasm among emergency healthcare professionals.

Uniformed Services and the Field Hospital Experience During Coronovirus Disease 2019 (SARS-CoV-2) Pandemic: Open to Closure in 30 Days With 1,100 Patients: The Javits New York Medical Station.

ABSTRACTIntroductionThe surge of SARS-CoV-2-virus infected (COVID-19) patients presenting to New York City (NYC) hospitals quickly overwhelmed and outnumbered the available acute care and intensive care resources in NYC in early March 2020. Upon the arrival of military medical assets to the Javits Convention Center in NYC, the planned mission to care for non-SARS-CoV-2 patients was immediately changed to manage patients with (SARS-CoV-2)COVID-19 and their comorbid conditions.Healthcare professionals from every branch of the uniformed services, augmented by state and local resources, staffed the Javits New York Medical Station (JNYMS) from April 2020.Methods The data review reported aggregated summary statistics and participant observations collected by N.Y. State and U.S. military officials.ResultsDuring the 28 days of patient intake at the JNYMS, 1,095 SARS-CoV-2-positive patients were transferred from NYC hospitals to the JNYMS. At its peak, the JNYMS accepted 119 patients in a single day, had a maximum census of 453, and had a peak intensive care unit census of 35. The median length of stay was 4.6 days (interquartile range: 3.1-6.9 days). A total of 103 patients were transferred back to local hospitals, and there were 6 deaths, with an overall mortality rate of 0.6% (95% CI, 0.3-1.2).Discussion and ConclusionsThis is the first report of the care provided at the JNYMS. Within 2 weeks, this multi-agency effort was able to mobilize to care for over 1,000 SARS-CoV-2 patients with varying degrees of illness in a 1-month period. This was the largest field hospital mobilization in the U.S. medical history in response to a non-wartime pandemic. Its success with huge patient throughput including disposition and low mortality relieved critical overcrowding and supply deficiencies throughout NYC hospitals. The downstream impact likely saved additional hundreds of lives and reduced stress on the system during this healthcare crisis.

Kuala Lumpur train collision during the COVID-19 pandemic

BackgroundTwo city trains collided in an underground tunnel on 24 May 2021 at the height of COVID-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia, immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide.MethodsInformation regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported.ResultsThe train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. Two hundred and fourteen passengers were in the trains. Sixty-four of them were injured. They had a median (range) ISS of 2 (1–43), and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9%) patients were admitted to the hospital (3 to the ICU, 3 to the ward and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) were discharged home. Six (9.4%) needed surgery. The COVID-19 tests were conducted on seven patients (10.9%) and were negative. There were no deaths.ConclusionsThe mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a 'binary' system for 'COVID-risk' and 'non-COVID-risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

Об опыте организации работы трассовых медико-спасательных пунктов для оказания экстренной медицинской помощи при дорожно-транспортных происшествиях

The paper presents a comparative analysis of three similar forms of emergency medical care on remote routes (experience of Denmark, Russia and Kazakhstan). Expediency of creating and placing medical stations on routes, which include not only provision of emergency medical care, but also conducting of emergency rescue operations, is noted.Organization of emergency medical care to victims of road traffic accidents lies in timeliness and integrated approach. Staff structure and staff of teams of rescue service of the route medical station, assignment of the “area of responsibility” of reaction and procedure for notifying an accident are also important.

Time Management Attitudes of Health Care Workers Employed in the Ambulance Service in Turkey

Introduction Health care workers employed in the ambulance service should minimize their response time when responding to a medical emergency. Prehospital emergency medical services operate on a 24-h basis; hence, time management in both the work and social lives of the staff is more difficult than in other occupational groups. In the case of emergency health services, time management is no doubt the most important aspect in terms of human health. The purpose of this research was to examine the time management skills and influencing factors of health care workers employed in the ambulance service. Methods In this cross-sectional study, a questionnaire containing time management inventory (TMI) and demographics was applied. In the analysis of the data, the number, chi square, percentage, and t test were applied using SPSS statistical software. Results Of those who participated in the survey, 57.8% were male, 86.2% were working at the emergency medical service station, and 49.9% were paramedics. The average TMI was 70.49. In the time-consumption subdimension of the survey, when the genders of the health care workers who were employed in the ambulance service were compared, there was a statistically significant difference according to education status for the total time management. Conclusion A statistically significant difference was observed with regards to education status for the total time management according to gender for the time loss subdimension of the healthcare workers employed in the ambulance service. This research concluded that males working in the ambulance service managed their use of time better than the females, and that high school graduates used their time better than the undergraduates.

The scientific and life path of the outstanding comparative psychologist N.A.Tikh

The article explores the life and scientific work of Nina Aleksandrovna Tikh (1905–1983), an outstanding Russian zoopsychologist and comparative psychologist, and professor at Leningrad (St Petersburg) State University in 1951–1975. She followed V. A.Wagner, was a student of V. M.Borovsky, and was a colleague of N. Yu. Voitonis, N. N.Ladygina-Kots, G. Z.Roginsky, and M. F.Nesturkh. She made a significant contribution to the development of comparative psychology and zoopsychology. Tikh conducted observations and experiments on animals and birds; she published about fifty works, of which four are monographs. Tikh’s main areas of interest were the origin and development of human consciousness, thinking, speech, and social behavior. Most of all, she was engaged in the least developed problem of anthropogenesis: the history of the transformation of the herd life of human ancestors into the social life of people. For sixteen years Tikh studied the prehistory of social life, observing the herd life of apes in the Sukhumi Monkey Nursery, the medical and biological station of the USSR Academy of Medical Sciences. Tikh concluded that living together in a herd would not have advantages over individual life without mutual help. The materials of these observations, their analysis, and an attempt to reconstruct the development of the hominid community from the herd life of animal human ancestors were included in the final monograph Prehistory of Society, which is a fundamental scientific work.

Computer simulation of spatial placement of emergency medical stations in urban agglomeration

The provision of first aid and saving the lives of victims in an emergency situation are the main tasks of the ambulance service. Since the time of arrival of the ambulance team to the call is one of the key factors affecting the outcome of treatment in emergency cases, the question of the location and number of ambulance stations is relevant. The article proposes a solution to one of the tasks of the strategic level of planning the logistics of emergency medical care in a large urban agglomeration - determining the best location of the required number of emergency medical care points to cover the service region, provided that the time to reach the ambulance brigade to any point will be minimal. To build a model of the optimal spatial location of emergency departments, the capabilities of the K-Medoid clustering algorithm are used. The implementation of the proposed model was carried out using the Statistic Toolbox tool of the MATLAB application software package based on geographical data of Yekaterinburg. A comparative analysis of the current and model time indicators show a noticeable reduction in the arrival time of the ambulance team to the call.

CHARITABLE ACTIVITY OF LYUBOVE IVANOVNA KURIS (1852-1935)

The article examines the life and charitable activities of the famous Kuris family representative in the South of Ukraine – Lyubov Ivanovna Kuris. Based on the primary sources study, archival documentation and publications of the Lyubov I. Kuris' life period, Lybov Ivanivna's activity in Odesa region charitable societies, in her own noble estate in her homeland and in Kurisovo-Pokrovsky is covered.Particular attention is paid to Kuris family charity tracing and continuing charitable work from generation to generation. Research of the charitable activity basis and types in the south of Ukraine.It is established that Lyubov I. Kuris continued to carry out charitable activities after her husband's mother, Lyubov Stanislavivna Kuris, who worked fruitfully for the benefit of the Odessa Women's Charitable Society until her death.Among the Lyubov Ivanovna main merits is the construction and maintenance of educational institutions, churches, patronage, assistance to sick children and the needy. Lyubov Ivanivna Kuris was fascinated by the idea of public education spreading. As a trustee of Kurisovo-Pokrovsky, she did a lot for the village school and school garden. In 1862, her father Ivan Alexandrovich Gizhitsky founded the first local school in Ryasnopil, which he maintained at his own expense until 1869. Later, Lyubov I. Kuris tried to continue his work.However, the greatest cause in the field of charity Lyubov I. Kuris was her participation in the work of the Odessa Society for the Sick Children Care. She devoted almost 30 years of her life to this activity, having done many good deeds and invested in it her Christian love, charity and unquenchable energy.Lyubov I. Kuris' activity as the chairman of the society allowed to establish contacts and involve many famous and influential people of the city. The main achievement of the Society was the medical station for children and a children's kitchen "Drop of Milk" construction. By 1901, more than 1,500 children had undergone a treatment full course at the sanitary station. Lyubov I. Kuris was also a member of the Odessa Society of History and Antiquities, was a philanthropist, passing part of her husband's collection, antique exhibits, the museum for the benefit of society.

Medical care provision at the venue of the weightlifting event of the Tokyo 2020 Olympic Games

PurposeThis study aimed to investigate the medical care provided at the venue of the weightlifting event of the Tokyo 2020 Olympic Games.MethodsWe retrospectively evaluated athletes who availed of medical services at the venue during the weightlifting event of the Tokyo 2020 Olympic Games. In total, 194 athletes participated in the weightlifting competition.Injuries and illnesses were classified into cases handled without physician or cases requiring medical examination by a physician. These were tabulated for each examination location (athlete medical station, field of play [FOP], first-aid station of training floor or warm-up area).ResultsThroughout the event, a cumulative total of 132 people used the venue medical services. Nine athletes required medical attention at the athlete medical stations. Of these nine cases, six occurred on the training floor. In the FOP, nine athletes were examined. Two experienced light-headedness, two had knee pain, and the rest had other symptoms. No athletes wanted to undergo medical examination at the athlete medical station. 89 medical procedures were performed in the first-aid station on the training floor, including 52 tapings and 37 ice compressions, and the most frequent body part which needed treatment was the knee, followed by the fingers. At the first-aid station on the match floor, 25 medical procedures were performed, including 17 ice compressions, 5 haemostasis, and 4 tapings. The body parts that most frequently needed treatment were the fingers, knees, and lower legs.ConclusionSeveral athletes needed treatment; however, only a few required medical care from a physician.

Dynamic on-site treatment strategy for large-scale mass casualty incidents with rescue operation

The spatial dispersion of casualties and temporal variations of emergency resources are the two critical factors that complicate the casualty management operation in large-scale mass casualty incidents. These factors are studied in this paper to develop an optimal casualty treatment strategy for a medical station that provides first aid assistance for severely injured casualties on the site. This study shows that the optimal treatment strategy to save the highest number of casualties at a medical station with nonstationary arrival and treatment rates is dynamic with time-dependent resource allocation and casualty prioritization strategies. The dynamic treatment strategy is compared with static treatment strategies used in practice. Findings show that the expected performance of the dynamic strategy is always better than the static approaches regardless of the disaster severity level. Also, the overperformance of the dynamic strategy is not affected by the tentative errors that may happen in estimating the parameters of the problem. We show that the shortage of search and rescue resources mitigates the overperformance of the dynamic strategy. In contrast, the medical resource shortage amplifies the importance of implementing the dynamic treatment strategy.

Outbreaks of COVID-19 in Medical organizations

Relevance. Prevention of the outbreak of a new coronavirus infection in medical organizations (MO) is one of the tasks facing the Rospotrebnadzor service and practical health care. Analysis of the causes and conditions of the spread of SARS-CoV-2 in the MO allows us to determine the most effective measures to contain the infection and prevent the occurrence of subsequent diseases in the focus.The aim is to characterize the epidemiological features of a new coronavirus infection during its nosocomial spread in medical organizations based on the analysis of outbreak incidence.Materials and methods. The data of the reporting forms «General information on patients with positive COVID-19», «General information on patients with community-acquired pneumonia with positive COVID-19» (138 pieces of information), copies of «Acts of epidemiological investigation of foci of infectious (parasitic) diseases with the establishment of a causal relationship» (57 pieces of information), copies of extraordinary reports on an emergency of a sanitary and epidemiological nature (57 pieces of information) were analyzed. The work uses epidemiological and statistical methods of research.Results. When analyzing 57 COVID-19 outbreaks in 30 medical organizations, it was found that the outbreak incidence was more often registered in multidisciplinary hospitals – 70.2% compared to 12.3% in specialized organizations of noninfectious profile, 10.5% of outbreaks were in polyclinics, 1.8% at emergency medical stations. The total number of people affected by the spread of the infection was 961, with a small proportion of children (15 people or 1.7%). Among those who fell ill with the spread of infection in the foci, the share of employees of medical organizations was 62.6%, including doctors – 16.6%, middle and junior medical workers-50.6% and 11.3%, respectively, and other categories – 21.5%. In nosocomial outbreaks of COVID-19, the focality index corresponded to 16.9, and the average duration of the focus was 32.4 days. The construction of the so-called «combined» outbreak diagram in the course of the epidanalysis allowed us to establish its total duration, which was 71 days, with the peaks of morbidity within the outbreak at intervals of 3–7 days, the greatest number of cases in the 1st and 8th days, and the gradual «extinction» of its activity in dynamics.Conclusions. The outbreak of COVID-19 in medical organizations usually occurred when there was an epidemic problem with COVID-19 in the territory. The peculiarity of nosocomial outbreaks was a significant proportion of adults (98.3%), mainly employees of medical organizations, who were often active sources of infection, as well as the involvement of structural units and hospitals for adults in the epidemic process, a high frequency of etiological interpretation of outbreaks (95.9%), a significant proportion of asymptomatic forms of infection and carrier, and the complexity of differential diagnosis of cases of out – of-hospital and nosocomial infection. The patterns of occurrence and spread of morbidity in medical organizations can be used in practical anti-epidemic work.

Forecasting Mobility Trends in Southeast Asia during the Coronavirus (Covid-19) Pandemic by Machine Learning Approaches

The novel coronavirus (COVID-19) was declared as the 2019-20 coronavirus pandemic by the World Health Organization (WHO) in March 2020. The COVID-19 virus has rapidly spread nationwide and internationally and caused 188 countries to report more than ten million cases of individuals contracting COVID-19. Typically, the virus is conveyed from person to person via respiratory droplets produced by coughing and sneezing. The time period between exposure and onset of symptoms is typically between two and fourteen days, and on average five days. The COVID-19 pandemic has affected many businesses relating to transportation including tourism, import-export commerce, the aviation business, and so forth. Governmental intervention in each country has had an impact on mobility trends depending on the degree of restriction such as social distancing, sharing mobility, and public transport. A COVID-19 surveillance system is one of the principal methods used for detecting COVID-19 epidemics, using short-period monitoring. However, while these networks present information on the activities of COVID-19, acquiring completed surveillance data from every medical station is profusely difficult due to many factors. This research aims to propose a performance model of machine learning approaches for COVID-19 pandemic forecasting of mobility trends in each country in Southeast Asia. Spatial data and non-spatial data are used to build the machine learning models. The experiments conducted showed that the model gave a forecasting accuracy in walking and driving mobility of 94.40% and 92.00%, respectively. The proposed forecasting model was developed to be of benefits to health authorities in the planning and administration of a suitable strategy to make decisions concerning transportation planning in each country.

Prevalence and trends in obesity among Austrian conscripts from 1983 to 2017.

This article describes the recent prevalence and trend in weight status in young men over three and half decades among Austrian conscripts overall and by subgroups defined by education and smoking behavior. We extracted medical record data from six medical examination stations across the country of all Austrian military conscripts (aged 17-19years) recruited between 1983 and 2017 (n = 1.5million). Weight and height were measured to calculate body mass index (BMI). Mean BMI increased from 22.7to 24.3 kg/m2 between 1983 and 2017. Over time, the prevalence of obesity (BMI ≥ 30 kg/m2) increased from 1.6% (95% CI 1.6-1.7%) to 8.2% (95% CI 8.1-8.3%). The prevalence of obesity among Austrian young men increased remarkably in the past 35years. Higher levels of education appeared to be associated with lower prevalence of obesity, particularly among the non-smokers.