Alternate Care Sites for COVID-19 Patients: Experience from the H144 Hospital of the Health Service of the Principality of Asturias, Spain

Coronavirus disease 2019 (COVID-19) temporary hospitals, also called “alternate care sites” (ACS), as support to the health network have had uneven use. The World Health Organization (WHO) has published different recommendations in this regard. World-wide, many health services have improved their surge capacity with the implementation of new temporal hospital structures, but there have been few experiences of use over time despite representing an important element as support to the hospital network in the management of COVID-19 patients. In this article, the experiences are explained in the design, execution, and use of the temporal COVID-19 Hospital H144 of the Health Service of the Principality of Asturias (Sespa), with 144 beds, which was in operation from April 1 through July 1, 2020 (without admitting patients) and from November 12, 2020 through March 5, 2121, admitting a total of 334 COVID-19 patients (66% women; 34% men) and generating 3,149 hospital stays. Maximum occupancy was 74 patients. Mean stay was 9.42 days (MD = 3.99; [1-34]). At discharge, 126 patients (38%) went to a nursing home, 112 (33%) to their home, 40 (12%) were transferred to another hospital, and 56 (17%) died. The mean age of the admitted patients was 82.79 years (MD = 8.68; [29-104]) and was higher in women (85.09; MD = 7.57; P = .000) than in men (78.28; MD = 9.22). Some aspects to consider for future experiences of use have been: teamwork from different fields of knowledge (ie, architecture, engineering, medicine, and nursing) is essential for success; integration in the health system must be fully developed from different perspectives (ie, information system, logistics, medical records, or clinical procedures, among others); clear procedures for patient admission from different structures (ie, home, hospitals, nursing homes, or primary health care network) must combine with flexibility of use to adapt to new and unknown circumstances; and they must not compromise specialized staff availability in other health facilities.

Designing Multiple Short-Turn Routes to Mitigate the Crowding on a Bus Network

On a transit route, initiating a trip beyond a transit route’s departure terminus and terminating the trip before its arrival is called “short-turn.” This study develops a method to design short-turn services to alleviate crowding on a transit network consisting of multiple overlapping routes. The proposed method consists of two processes: (i) optimizing routes, turn-back points, and fleet sizes of short-turn services by a genetic algorithm to minimize the sum of waiting, in-vehicle, operation, and social costs; (ii) assigning passenger trip demands to short-turn and existing services. These processes are performed iteratively to design multiple short-turn routes. The proposed method is applied to a real-world transit network in Seoul, Republic of Korea, to design 10 short-turn routes. The results are compared with two naïve methods that introduce short-turn services to sections with the maximum occupancy and the maximum demand divided by the section length, respectively. The comparison results show the proposed method is much superior to both of the naïve methods in reducing total costs. The result of the sensitivity analysis suggests that the value of in-vehicle time needs to be estimated accurately and site-specifically. The proposed model contributes to enhancing the convenience of transit users by effectively mitigating the crowding under budget constraints.

Reopening universities during the COVID-19 pandemic: A testing strategy to minimize active cases and delay outbreaks

BackgroundUniversity campuses present an ideal environment for viral spread and are therefore at extreme risk of serving as a hotbed for a COVID-19 outbreak. While active surveillance throughout the semester such as widespread testing, contact tracing, and case isolation, may assist in detecting and preventing early outbreaks, these strategies will not be sufficient should a larger outbreak occur. It is therefore necessary to limit the initial number of active cases at the start of the semester. We examine the impact of pre-semester NAT testing on disease spread in a university setting.MethodsWe implement simple dynamic transmission models of SARS-CoV-2 infection to explore the effects of pre-semester testing strategies on the number of active infections and occupied isolation beds throughout the semester. We assume an infectious period of 3 days and vary R0 to represent the effectiveness of disease mitigation strategies throughout the semester. We assume the prevalence of active cases at the beginning of the semester is 5%. The sensitivity of the NAT test is set at 90%.ResultsIf no pre-semester screening is mandated, the peak number of active infections occurs in under 10 days and the size of the peak is substantial, ranging from 5,000 active infections when effective mitigation strategies (R0 = 1.25) are implemented to over 15,000 active infections for less effective strategies (R0 = 3). When one NAT test is mandated within one week of campus arrival, effective (R0 = 1.25) and less effective (R0 = 3) mitigation strategies delay the onset of the peak to 40 days and 17 days, respectively, and result in peak size ranging from 1,000 to over 15,000 active infections. When two NAT tests are mandated, effective (R0 = 1.25) and less effective (R0 = 3) mitigation strategies delay the onset of the peak through the end of fall semester and 20 days, respectively, and result in peak size ranging from less than 1,000 to over 15,000 active infections. If maximum occupancy of isolation beds is set to 2% of the student population, then isolation beds would only be available for a range of 1 in 2 confirmed cases (R0 = 1.25) to 1 in 40 confirmed cases (R0 = 3) before maximum occupancy is reached.ConclusionEven with highly effective mitigation strategies throughout the semester, inadequate pre-semester testing will lead to early and large surges of the disease and result in universities quickly reaching their isolation bed capacity. We therefore recommend NAT testing within one week of campus return. While this strategy is sufficient for delaying the timing of the outbreak, pre-semester testing would need to be implemented in conjunction with effective mitigation strategies to reduce the outbreak size.

INFLUENCE OF PUMP PRESSURE AND ENGINE SPEED ON ERGONOMIC PARAMETERS OF FORWARDER OPERATORS

ABSTRACT Reducing engine speed and pressure of forest machine hydraulic pumps may be a strategy to achieve a reduction in fuel costs. However, this approach can positively or negatively affect the ergonomic parameters of the operators, in particular, the whole-body vibration and repetitive movements of the operators. The objective of this research was to evaluate the acceleration force resulting from normalized exposure (Aren) and the Real Occupancy Rate and Maximum Occupancy Rate considering Repetitive Activities (ROR-MORCRA) of forwarder operating at different pump pressures, engine speed, and volume of trees. The research was carried out in forest stands with an individual average volume of 0.10, 0.14, and 0.29 m³ tree-1. For each volume, the machine was configured to operate at hydraulic pump pressures of 240, 235, and 230 bar and engine speed of 1550, 1475, and 1400 rpm, totaling 9 combinations. The values were measured in the 9 combinations and also in each phase of the machine operational cycle, using a triaxial accelerometer of the 01dB brand, model Vib 008. To determine ROR, percentage of rest due to regular breaks, percentage of time with low demand activities, percentage of usual irregular breaks, and percentage of very short breaks were calculated. To estimate MORCRA, the repetition, strength, and static effort factors were calculated. In volumes of 0.10, 0.14, and 0.29 m³ tree-1, the highest Aren values were 0.82, 0.88, and 0.99 m s-2, respectively, being obtained at the 1550 rpm engine speed. The forwarder logging operation is characterized as an ergonomic risk, which can cause discomfort, fatigue, and injuries to operators.

Antihistamines in pediatric allergology

Allergic diseases without a doubt have become one of the biggest problems of pediatrics in recent decades. One of the evidence of this is the maximum occupancy of halls at the IV All-Russian Congress of the Association of Pediatric Allergists and Immunologists of Russia. The symposium «Antihistamines in children’s allergology» was among the most popular.

The maximum occupancy condition for the localized property-optimized orbitals

It is shown analytically that the Chemist's Localized Property-optimized Orbitals (CLPOs), which are the localized orbitals obtainable from the results of ab initio calculations by using the open-source program JANPA (http://janpa.sourceforge.net/) according to the recently proposed optimal property partitioning condition, form the Lewis structure with nearly maximum possible total electron occupancy.

A Robust Routing Strategy for Efficient Reallocation in Multi-Grid Environment

Grid Computing is becoming the rising procedure in this ongoing condition. System figuring is the social affair of PC resources from various territories to accomplish a run of the mill objective. The framework can be considered as a spread structure with non-instinctive workloads that incorporate innumerable, the multi-grid environment which provides the multi-tenancy startup for the multiple inputs that is transmitted in the form of the data. The routing strategy which provides the robust reallocation in the grid environment. This paper proposes a Strategic Multi-Reallocation procedure which makes the reallocation in the multi-grid environment. We Propose the Grid-Hadlock Algorithm for the efficient reallocation in the multi-grid environment. The implementation proves the maximum occupancy and its reallocation strategies more efficient. The experimental results proves the phenomenon is more efficient.

Mapping similarities in temporal parking occupancy behavior based on city-wide parking meter data

The search for a parking space is a severe and stressful problem for drivers in many cities. The provision of maps with parking space occupancy information assists drivers in avoiding the most crowded roads at certain times. Since parking occupancy reveals a repetitive pattern per day and per week, typical parking occupancy patterns can be extracted from historical data.<br> In this paper, we analyze city-wide parking meter data from Hannover, Germany, for a full year. We describe an approach of clustering these parking meters to reduce the complexity of this parking occupancy information and to reveal areas with similar parking behavior. The parking occupancy at every parking meter is derived from a timestamp of ticket payment and the validity period of the parking tickets. The similarity of the parking meters is computed as the mean-squared deviation of the average daily patterns in parking occupancy at the parking meters. Based on this similarity measure, a hierarchical clustering is applied. The number of clusters is determined with the Davies-Bouldin Index and the Silhouette Index.<br> Results show that, after extensive data cleansing, the clustering leads to three clusters representing typical parking occupancy day patterns. Those clusters differ mainly in the hour of the maximum occupancy. In addition, the lo-cations of parking meter clusters, computed only based on temporal similarity, also show clear spatial distinctions from other clusters.

Integration of Simulation Modeling and Comparison of Scheduling Methods to Minimize the Makespan in a Printing Industry

This paper considers the problem of scheduling production activities in a real-life printing industry. The problem is modeled as a two-stage flexible flow shop problem with minimization of the makespan and the number of tardy jobs as the objective. Discrete event simulation has been performed using Extend simulation software to depict the real time model of the print industry. The setup time, processing time and completion time of the prioritized customers were obtained and validated with the real time industry inputs. After validation, the output of simulation data has been used to perform preliminary scheduling experiments. This paper deals with the comparison of three scheduling algorithms such as earliest completion time first (ECT), Earliest start time first (EST) and PCmax algorithm for the calculation of maximum occupancy time of various printing jobs. The results obtained using PC max shows the reduced make span of the printing jobs compared to other two algorithms with approximately 12% improvement in minimizing the makespan. Hence the P||Cmax scheduling method can be implemented in the industry to minimize the maximum occupancy time of a particular printing machine. This motivates the actual implementation of the proposed ILP (PCmax scheduling) procedure for the printing industry.