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Election campaigns and polling stations might be areas of potential infections; however, it is unknown whether elections can impact the spread of coronavirus disease (COVID-19). This study aimed to evaluate the association between election process and COVID-19 infection in Japan. Quasi-experimental design using time-series COVID-19 cases data with an election intervention. We chose the cities where elections for major and/or city/ward assembly members were held in 2021 January in Japan. The study period for each city spans one weeks before the start date of the election campaign and three weeks after the voting day (36 days). The daily number of patients testing positive for COVID-19. We used Poisson regression analysis with sandwich estimator to evaluate the association between election and the spread of COVID-19 infections. For Miyakojima City, we assessed the relationship between election and COVID-19 infections by using the Box-Jenkins autoregressive integrated moving average (ARIMA) model. We also estimated the instantaneous reproduction number (Rt) in the city. There were 17 cities that met the inclusion criteria. In all models with three types of different lag effects (i.e., 4, 9, and 14 days), election was not a significant predictor of COVID-19 infections in the 17 cities. For Miyakojima City, the autoregressive integrated moving average (0, 0, 0) with a lag of 14 (=14) was the best model. The partial coefficient ({omega}) of the election was 11.91 (95% confidence interval: 3.10-20.72, P<0.001), indicating that the election was associated with an increase in the number of COVID-19 cases 14 days after the election campaign (mean: 12 cases/day). Rt hovered far above 1 during and after the election campaign in Miyakojima. Although elections were associated with an increased number of COVID-19 cases in Miyakojima, this association was not verified in the analysis including all 17 cities. Therefore, if preventive measures prescribed by election guidelines are followed, elections do not necessarily relate to a spread of COVID-19 as long as the election process does not involve activities necessitating close contact.
RESUMO
Sources of research funding: We gratefully acknowledge the support of the 17th Congress of the Japanese Society for Emergency Medicine support of this program.<br>Ethical considerations: The program was conducted after receiving approval from the Institutional Animal Experiment Committee of the Jichi Medical University, and in accordance with the Institutional Regulation for Animal Experiments and Fundamental Guideline for Proper Conduction of Animal Experiment and Related Activities in Academic Research Institutions under the jurisdiction of the Ministry of Education, Culture, Sports, Science and Technology of Japan. It was approved on April 9th, 2014. The approval number is 14-225.<br>Disclosure of conflicts of interests: We gratefully acknowledge the contributions of personnel from Panasonic Corp. who enabled the interactive communication system.<br>Abstract<br>Introduction: Live surgery demonstrations have been widely used in surgical education. However, they cannot be used to demonstrate trauma surgery due to the emergency situation and lack of informed consent. The aim of this study was to conduct a live demonstration of trauma surgery with a porcine model to increase educational opportunities in trauma surgery.<br>Methods: Live demonstration was conducted at the Center for Development of Advanced Medical Technology (CDAMtec) , Jichi Medical University, Japan. An experienced trauma surgeon instructed three trainees during a live demonstration using pre-planned injuries in a porcine model. A six-point Likert Scale was used on a written survey to determine the value of the program to the viewers. Free-form written comments were also obtained from the participants. Live images of the surgical field were transmitted to a lecture room by a closed wireless LAN with interactive bidirectional audio capability.<br>Results: Eighty-three participants viewed this live demonstration and completed the questionnaire. Participants were highly satisfied with the live demonstration (mean survey scores: 4.6-5.1/6) , and gave very positive feedback concerning the educational value of this program. Nine free-form comments were submitted, which revealed that the participants felt they could acquire concrete skills for trauma surgery.<br>Discussion: Live demonstrations for trauma surgery using a porcine model are a feasible and effective educational tool to demonstrate technical procedures and non-technical skills, with possible added advantages regarding the ethical considerations of performing a live surgery demonstration.
