Emergency medical services preparedness in dual disasters: war in the era of COVID-19 in Armenia

Introduction: Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties. Armenia is also a country prone to disasters, and recently, the ArmenianEMSsystem was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic. Study Objective: This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers. Methods: This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients. Results: Survey response rate was 70.6%.Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score −3.26; P value <.01) or as anEMS physician (z-score −2.76; P value <.01) as well as being at least 30 years old (z-score −2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%). Conclusion: Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers

Physics with Positron Beams at Jefferson Lab 12 GeV

Positron beams, both polarized and unpolarized, are identified as essential ingredients for the experimental program at the next generation of lepton accelerators. In the context of the Hadronic Physics program at the Jefferson Laboratory (JLab), positron beams are complementary, even essential, tools for a precise understanding of the electromagnetic structure of the nucleon, in both the elastic and the deep-inelastic regimes. For instance, elastic scattering of (un)polarized electrons and positrons off the nucleon allows for a model independent determination of the electromagnetic form factors of the nucleon. Also, the deeply virtual Compton scattering of (un)polarized electrons and positrons allows us to separate unambiguously the different contributions to the cross section of the lepto-production of photons, enabling an accurate determination of the nucleon Generalized Parton Distributions (GPDs), and providing an access to its Gravitational Form Factors. Furthermore, positron beams offer the possibility of alternative tests of the Standard Model through the search of a dark photon or the precise measurement of electroweak couplings. This letter proposes to develop an experimental positron program at JLab to perform unique high impact measurements with respect to the two-photon exchange problem, the determination of the proton and the neutron GPDs, and the search for the $A^{\prime}$ dark photon