Enhancing BIM security in emergency construction projects using lightweight blockchain-as-a-service.

Rapid design and construction of mobile cabin hospitals (MCHs) have become imperative in the COVID-19 response. However, due to unique design specifications (e.g., parallel design and model pre-revision), collaboration in emergency construction projects (ECPs) like MCHs presents data security vulnerabilities, including a lack of traceability and transparency. These hazards invariably reduce design effectiveness, leading to undesirable rework and project delay. Blockchain technology is a potential solution to address the aforementioned security issues in ECPs because it offers immutable and traceable data storage. Nevertheless, directly implementing blockchain in ECPs is impractical, for the blockchain has a complex deployment process and provides limited functions supporting BIM-based design. Therefore, this paper develops a lightweight blockchain-as-a-service (LBaaS) prototype to enhance the ECPs design efficiency by securing and automating information exchange while eliminating the difficulties of deploying and using blockchain. This paper contributes three elements: (1) Security vulnerabilities of design in ECP are identified. Taking an MCH in Hong Kong as an example, this paper investigates its design process and determines two design characteristics and associated security flaws. (2) Key technologies to support easy deployment and usage of blockchain in ECPs are developed. New technical elements, including a Multi-to-One mapping (MtOM) kit for easy blockchain registration, an integrated workflow retaining existing design practices, and smart contracts for secure interaction with blockchain, are developed to support LBaaS functionality. (3) An LBaaS prototype is validated and evaluated. The prototype is illustrated and evaluated using design examples based on actual MCH project data. Results show that the LBaaS is a feasible and secure approach for ECPs collaboration. This paper deepens the understanding of data security issues in ECPs and offers technical guidance in establishing blockchain solutions.

Physician scheduling problem in Mobile Cabin Hospitals of China during Covid-19 outbreak.

In this paper, we investigate a novel physician scheduling problem in the Mobile Cabin Hospitals (MCH) which are constructed in Wuhan, China during the outbreak of the Covid-19 pandemic. The shortage of physicians and the surge of patients brought great challenges for physicians scheduling in MCH. The purpose of the studied problem is to get an approximately optimal schedule that reaches the minimum workload for physicians on the premise of satisfying the service requirements of patients as much as possible. We propose a novel hybrid algorithm integrating particle swarm optimization (PSO) and variable neighborhood descent (VND) (named as PSO-VND) to find the approximate global optimal solution. A self-adaptive mechanism is developed to choose the updating operators dynamically during the procedures. Based on the special features of the problem, three neighborhood structures are designed and searched in VND to improve the solution. The experimental comparisons show that the proposed PSO-VND has a significant performance increase than the other competitors.

Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital.

Aim: COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods: A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results: Three latent profiles were identified-low security (Class 1), moderate security (Class 2), and high security (Class 3)-accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3; Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions: Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.

Can the nucleic acid Ct value of discharged patients infected with SARS-CoV-2 Omicron variant be 35?--A retrospective study on fluctuation of nucleic acid Ct values in SNIEC mobile cabin hospital.

Objective: To explore the meaning of cycle threshold (Ct) value fluctuation and the appropriateness of setting the discharge Ct value to 35, which is the current standard in Chinese guidelines. Method: A retrospective study was conducted on 95 patients with Ct value fluctuation (Ct value below 35 on day 3; group A) and 97 patients with a normal discharge process (control; group B). Their clinical characteristics and follow-up data were collected. Results: (1) There was no significant difference between the groups in age, gender distribution, number of vaccinations, initial ORF-Ct value, and initial N-Ct value. The proportion of patients complicated with chronic internal disorders, respiratory symptoms, and abnormal chest radiology in group A was significantly higher than that in group B. (2) Between the two groups, there was no significant difference in the ORF-Ct or N-Ct value on day 1, but the ORF-Ct and N-Ct values of group B on days 2 to 4 were significantly higher than those of group A. (3) There was no significant difference between the groups in the ORF-Ct value at discharge, but there was a significant difference in the N-Ct value at discharge. Seven days after discharge, almost 100% of the patients had been cured. The mean negative conversion interval of nucleic acid of the patients in group A was 14.5 ± 4.6 days, which was longer than that of the patients in group B (11.8 ± 4 days). (4) Logistic regression analysis showed that the ORF-Ct value on day 2 was the key factor influencing the Ct value fluctuation. Conclusion: The fluctuation of Ct value is only a normal phenomenon in the recovery period of the disease, and there is no need for excessive intervention. It is reasonable to set the Ct value of the discharge standard to 35 and retest the nucleic acid on the 10th day after discharge for patients with underlying diseases or symptoms.

Awareness and Skills of Correctly Donning and Doffing Personal Protective Equipment in SARS-CoV-2 Omicron Containment Workers from a Mobile Cabin Hospital

Background The transmission speed and concealment of the Omicron variant of SARS-CoV-2 have been enhanced. The awareness level and skills of correctly donning and doffing personal protective equipment （PPE） in SARS-CoV-2 containment workers from the mobile cabin hospital are associated with their own health status, and the overall quality of COVID-19 pandemic control. Objective To understand the awareness and skills of correctly donning and doffing PPE in SARS-CoV-2 containment workers from a mobile cabin hospital. Methods By use of cluster sampling, 460 SARS-CoV-2 containment workers were selected from the Fourth Branch of Shanghai Mobile Cabin Hospital located in the National Exhibition and Convention Center （Shanghai）, from April 10 to May 10, 2022. Their awareness and skills of correctly donning and doffing PPE were assessed using an online survey with a self-developed questionnaire named Awareness of Correctly Donning and Doffing Personal Protective Equipment, and using an onsite performance assessment with a self-developed questionnaire named Skills of Correctly Donning and Doffing Personal Protective Equipment, respectively. Results The survey obtained a response rate of 83.5% （384/460）. According to the survey, both doctors and nurses had significantly higher average scores with regards to the operations at the first donning area, second donning area, front doffing area and first doffing area, second doffing area, and hand hygiene disinfection than public security officers and fire fighters（P<0.05）. All of the 460 cases completed the onsite performance assessment. Both doctors and nurses obtained lower average scores in terms of completing the operations at the first donning area, and donning steps in clean area into contaminated area than public security officers and fire fighters （P<0.05）. Doctors had much lower average score for completing the operations at the first donning area than nurses （P<0.05）. Conclusion There were significant differences in the levels of awareness and skills of correctly donning and doffing PPE in SARS-CoV-2 containment workers by occupation. Targeted and focused trainings and supervisions should be carried out to improve the mismatching between the levels of awareness and skills. © 2022 Chinese General Practice. All rights reserved.

Emergency Preparedness and Management of Mobile Cabin Hospitals in China During the COVID-19 Pandemic.

The healthcare systems in China and globally have faced serious challenges during the coronavirus disease (COVID-19) pandemic. The shortage of beds in traditional hospitals has exacerbated the threat of COVID-19. To increase the number of available beds, China implemented a special public health measure of opening mobile cabin hospitals. Mobile cabin hospitals, also called Fangcang shelter hospitals, refer to large-scale public venues such as indoor stadiums and exhibition centers converted to temporary hospitals. This study is a mini review of the practice of mobile cabin hospitals in China. The first part is regarding emergency preparedness, including site selection, conversion, layout, and zoning before opening the hospital, and the second is on hospital management, including organization management, management of nosocomial infections, information technology support, and material supply. This review provides some practical recommendations for countries that need mobile cabin hospitals to relieve the pressure of the pandemic on the healthcare systems.

Medical Staff Scheduling Problem in Chinese Mobile Cabin Hospitals During Covid-19 Outbreak

In this paper, we discuss the medical staff scheduling problem in the Mobile Cabin Hospital (MCH) during the pandemic outbreaks. We investigate the working contents and patterns of the medical staff in the MCH of Wuhan during the outbreak of Covid-19. Two types of medical staff are considered in the paper, i.e., physicians and nurses. Besides, two different types of physicians are considered, i.e., the expert physician and general physician, and the duties vary among different types of physicians. The objective of the studied problem is to get the minimized number of medical staff required to accomplish all the duties in the MCH during the planning horizon. To solve the studied problem, a general Variable Neighborhood Search (general VNS) is proposed, involving the initialization, the correction strategy, the neighborhood structure, the shaking procedure, the local search procedure, and the move or not procedure. The mutation operation is adopted in the shaking procedure to make sure the diversity of the solution and three neighborhood structure operations are applied in the local search procedure to improve the quality of the solution. © 2021, Springer Nature Switzerland AG.

How to Reduce the Transmission Risk of COVID-19 More Effectively in New York City: An Age-Structured Model Study.

Background: In face of the continuing worldwide COVID-19 epidemic, how to reduce the transmission risk of COVID-19 more effectively is still a major public health challenge that needs to be addressed urgently. Objective: This study aimed to develop an age-structured compartment model to evaluate the impact of all diagnosed and all hospitalized on the epidemic trend of COVID-19, and explore innovative and effective releasing strategies for different age groups to prevent the second wave of COVID-19. Methods: Based on three types of COVID-19 data in New York City (NYC), we calibrated the model and estimated the unknown parameters using the Markov Chain Monte Carlo (MCMC) method. Results: Compared with the current practice in NYC, we estimated that if all infected people were diagnosed from March 26, April 5 to April 15, 2020, respectively, then the number of new infections on April 22 was reduced by 98.02, 93.88, and 74.08%. If all confirmed cases were hospitalized from March 26, April 5, and April 15, 2020, respectively, then as of June 7, 2020, the total number of deaths in NYC was reduced by 67.24, 63.43, and 51.79%. When only the 0-17 age group in NYC was released from June 8, if the contact rate in this age group remained below 61% of the pre-pandemic level, then a second wave of COVID-19 could be prevented in NYC. When both the 0-17 and 18-44 age groups in NYC were released from June 8, if the contact rates in these two age groups maintained below 36% of the pre-pandemic level, then a second wave of COVID-19 could be prevented in NYC. Conclusions: If all infected people were diagnosed in time, the daily number of new infections could be significantly reduced in NYC. If all confirmed cases were hospitalized in time, the total number of deaths could be significantly reduced in NYC. Keeping a social distance and relaxing lockdown restrictions for people between the ages of 0 and 44 could not lead to a second wave of COVID-19 in NYC.

Association Between Clinical Characteristics and Short-Term Outcomes in Adult Male COVID-19 Patients With Mild Clinical Symptoms: A Single-Center Observational Study.

Majority of patients with 2019 novel coronavirus infection (COVID-19) exhibit mild symptoms. Identification of COVID-19 patients with mild symptoms who might develop into severe or critical illness is essential to save lives. We conducted an observational study in a dedicated make-shift hospital for adult male COVID-19 patients with mild symptoms between February and March 2020. Baseline characteristics, medical history, and clinical presentation were recorded. Laboratory tests and chest computed tomography were performed. Patients were observed until they were either transferred to a hospital for advanced care owing to disease exacerbation or were discharged after improvement. Patients were grouped based on their chest imaging findings or short-term outcomes. A total of 125 COVID-19 patients with mild symptoms were enrolled. Of these, 7 patients were transferred for advanced care while 118 patients were discharged after improvement and showed no disease recurrence during an additional 28-day follow-up period. Eighty-five patients (68.0%) had abnormal chest imaging findings. Patients with abnormal chest imaging findings were more likely to have disease deterioration and require advanced care as compared to those with normal chest imaging findings. Patients with deteriorated outcomes were more likely to have low peripheral blood oxygen saturation and moderately-elevated body temperature. There were no significant differences between patients with deteriorated or improved outcomes with respect to age, comorbidities, or other clinical symptoms (including nasal congestion, sore throat, cough, hemoptysis, sputum production, shortness of breath, fatigue, headache, nausea or vomiting, diarrhea). Abnormal chest imaging findings, low peripheral blood oxygen saturation, and elevated temperature were associated with disease deterioration in adult male COVID-19 patients with mild clinical symptoms. Clinical Trial Registration: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009RA3&selectaction=Edit&uid=U0003F4L&ts=2&cx=-ajpsbw, identifier NCT04346602.

A psychological investigation of coronavirus disease 2019 (COVID-19) patients in mobile cabin hospitals in Wuhan.

BACKGROUND: This study investigated the depression, anxiety, and insomnia levels of coronavirus disease 2019 (COVID-19) patients admitted to two mobile cabin hospitals in Jianghan District (Wuhan, China). METHODS: Thirty COVID-19 (eight mild type and twenty-two common type) patients were evaluated using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7 Questionnaire, the Insomnia Severity Index, and a semi-structured interview. RESULTS: All 30 patients reported varying degrees of anxiety, depression, and insomnia. The levels of depression and anxiety in mild type COVID-19 patients were significantly lower than those in common type COVID-19 patients. Significant improvements in depression (P<0.001) and anxiety (P<0.001) levels were found in the COVID-19 patients at the second evaluation compared with the baseline (admittance to hospital). More than 80% patients agreed that medical security, support from other patients, and a better living environment were the main reasons for improvements to their adverse psychological states. CONCLUSIONS: Varying degrees of anxiety, depression, and insomnia frequently occur in patients with COVID-19. Standard treatment protocols and patient-centered care in the mobile cabin hospitals in this study provided the chance for COVID-19 patients to successfully improve their mental health during the outbreak of the pandemic.

Epidemiological and clinical course of 483 patients with COVID-19 in Wuhan, China: a single-center, retrospective study from the mobile cabin hospital.

During the COVID-19 outbreak, the mobile cabin hospital has effectively isolated and treated patients diagnosed as mild-moderate disease. However, a detailed clinical course has not been well described. We included 483 patients who were isolated and treated from Feb 6, 2020, to Feb 15, 2020, including definite outcome (discharge or deterioration). Sixty-two patients were transferred to severe cases, of whom were trasfered to designated hospital for intensive care. By March 9, 2020, all patients were discharged without dead. The mobile cabin hospital provides feasible strategy of isolation of mild-moderate cases and timely intervention during the virus outbreak.

The role played by traditional Chinese medicine in preventing and treating COVID-19 in China.

Traditional Chinese medicine (TCM), an ancient system of alternative medicine, played an active role in the prevention and control of COVID-19 in China. It improved the clinical symptoms of patients, reduced the mortality rate, improved the recovery rate, and effectively relieved the operating pressure on the national medical system during critical conditions. In light of the current global pandemic, TCM-related measures might open up a new channel in the control of COVID-19 in other countries and regions. Here, we summarize the TCM-related measures that were widely used in China, including TCM guidelines, the Wuchang pattern, mobile cabin hospitals, integrated treatment of TCM and modern medicine for critical patients, and non-medicine therapy for convalescent patients, and describe how TCM effectively treated patients afflicted with the COVID-19. Effective TCM therapies could, therefore, be recommended and practiced based on the existing medical evidence from increased scientific studies.

[Health protection guideline of mobile cabin hospitals during COVID-19 outbreak].

This guideline is applicable to the health protection requirements of large indoor stadiums which are reconstructed as treatment sites for COVID-19 patients with mild symptoms during the outbreak. Focusing on the health emergency scenario of severe virus infectious diseases and atypical places where COVID-19 patients with mild symptom gather, from perspectives of functional zones, hygiene facilities, personal protection, and management system, health risk protection recommendations and countermeasures are comprehensively proposed to mainly protect staffs and surrounding environment. The implementation of this guideline will provide technique support for emergency requirements of indoor stadiums reconstructed as mobile cabin hospitals.