Search Results (38)

Landslides present a significant global hazard, resulting in substantial socioeconomic losses and casualties each year. Traditional monitoring approaches, such as geodetic, geotechnical, and geophysical methods, have limitations in providing early warning capabilities due to their inability to detect precursory subsurface deformations. In contrast, the acoustic emission (AE) technique emerges as a promising alternative, capable of capturing the elastic wave signals generated by stress-induced deformation and micro-damage within soil and rock masses during the early stages of slope instability. This paper provides a comprehensive review of the fundamental principles, instrumentation, and field applications of the AE method for landslide monitoring and early warning. Comparative analyses demonstrate that AE outperforms conventional techniques, with laboratory studies establishing clear linear relationships between cumulative AE event rates and slope displacement velocities. These relationships have enabled the classification of stability conditions into “essentially stable”, “marginally stable”, “unstable”, and “rapidly deforming” categories with high accuracy. Field implementations using embedded waveguides have successfully monitored active landslides, with AE event rates linearly correlating with real-time displacement measurements. Furthermore, the integration of AE with other techniques, such as synthetic aperture radar (SAR) and pore pressure monitoring, has enhanced the comprehensive characterization of subsurface failure mechanisms. Despite the challenges posed by high attenuation in geological materials, ongoing advancements in sensor technologies, data acquisition systems, and signal processing techniques are addressing these limitations, paving the way for the widespread adoption of AE-based early warning systems. This review highlights the significant potential of the AE technique in revolutionizing landslide monitoring and forecasting capabilities to mitigate the devastating impacts of these natural disasters. Full article

Background/Objectives: Emergency Medical Response Systems (EMRSs) play a vital role in delivering medical aid during natural and man-made disasters. This quantitative research delves into the analysis of risk and effectiveness within Serbia’s Emergency Medical Services (EMS), with a special emphasis on how work organization, resource distribution, and preparedness for mass casualty events contribute to overall disaster preparedness. Methods: The study was conducted using a questionnaire consisting of 7 sections and a total of 88 variables, distributed to and collected from 172 healthcare institutions (Public Health Centers and Hospitals). Statistical methods, including Pearson’s correlation, multivariate regression analysis, and chi-square tests, were rigorously applied to analyze and interpret the data. Results: The results from the multivariate regression analysis revealed that the organization of working hours (β = 0.035) and shift work (β = 0.042) were significant predictors of EMS organization, explaining 1.9% of the variance (R² = 0.019). Furthermore, shift work (β = −0.045) and working hours (β = −0.037) accounted for 2.0% of the variance in the number of EMS points performed (R² = 0.020). Also, the availability of ambulance vehicles (β = 0.075) and financial resources (β = 0.033) explained 4.1% of the variance in mass casualty preparedness (R² = 0.041). When it comes to service area coverage, the regression results suggest that none of the predictors were statistically significant. Based on Pearson’s correlation results, there is a statistically significant correlation between the EMS organization and several key variables such as the number of EMS doctors (p = 0.000), emergency medicine specialists (p = 0.000), etc. Moreover, the Chi-square test results reveal statistically significant correlations between EMS organization and how EMS activities are conducted (p = 0.001), the number of activity locations (p = 0.005), and the structure of working hours (p = 0.001). Conclusions: Additionally, the results underscore the necessity for increased financial support, standardized protocols, and enhanced intersectoral collaboration to strengthen Serbia’s EMRS and improve overall disaster response effectiveness. Based on these findings, a clear roadmap is provided for policymakers, healthcare administrators, and EMS personnel to prioritize strategic interventions and build a robust emergency medical response system. Full article

Strain rockburst is a severe failure phenomenon caused by the release of elastic strain energy in intact rocks under high-stress conditions. They frequently occur in deep tunnels, causing significant economic losses, casualties, and construction delays. Understanding the factors influencing this disaster is of significance for tunnel construction. This paper first proposes a novel three-dimensional (3D) discrete element numerical analysis method for rockburst numerical analysis considering the full stress state energy based on the bonded block model and the mechanics, brittleness, integrity, and energy storage of the surrounding rock. This numerical method is first validated via laboratory tests and engineering-scale applications and then is applied to study the effects of compressive and tensile strengths of rock mass, tunnel depth, and lateral pressure coefficient on strain rockburst. Meanwhile, sensitivity analyses of these influencing factors are conducted using numerical results and systematic analysis methods, and the influence degree of each factor on the rockburst tendency is explored and ranked. The results reveal that laboratory tests and actual engineering conditions are consistent with numerical simulation results, which validates the rationality and applicability of the novel rockburst analysis method proposed in this paper. With the increase in compressive strength, the stress concentration degree, energy accumulation level, maximum stress difference, and maximum elastic strain energy within the rock mass all increase, leading to a stronger rockburst tendency. Tunnel depth and the lateral stress coefficient are positively correlated with rockburst tendency. As the lateral pressure coefficient and tunnel depth increase, rockburst tendency exponentially increases, while the maximum stress difference and maximum elastic strain energy within the rock mass also increase. The influence degree of each factor is ranked from highest to lowest as follows: tensile strength, lateral pressure coefficient, compressive strength, and tunnel depth. The research results provide theoretical support and technical guidance for the effective prediction, prevention, and control of rock burst disasters in deep tunnels. Full article

Civilian mass-casualty disasters and armed conflict share many features, including the fact that both maximally challenge multidisciplinary burn teams. Rigorous training is required to build teams and systems that can respond effectively. One of the critical but potentially overlooked components of readiness for crisis care is a robust clinical research program. Rather than stalling progress, disasters and conflict over the last 100 years consistently energized advances in care. This was made possible by the hard work of our predecessors to learn from the crisis in the midst of the crisis, and resulted in significant reductions in postburn mortality. Now, further work is needed not only to maintain these improvements in mortality, but also to understand the long-term functional outcomes and to improve the quality of life of burn survivors. Clinical research programs to address these issues must be established now, so that we are optimally prepared for the next conflict or disaster. Full article

Burn mass casualty event occurrences are rare but will place significant burdens on any burn unit or healthcare system. Effective disaster preparedness plays a significant role in mitigating the aftermath of a burn mass casualty. The aim of this study was to assess the resource requirements during the initial two weeks of a burn mass casualty event. Eight patients in a burn mass casualty event were simulated using the Emergo Train System^®. These simulated patients were matched with real historical patients treated in our burn centre, and their resource requirements were analysed. An average of eight staff is required to care for a patient per day along with almost 75 h of operating time (excluding anaesthesia and turnover time). A substantial quantity of consumables was used in the first two weeks. This study has demonstrated the substantial material consumption and staff requirements in the first two weeks of management in a burn mass casualty event. Such findings will offer valuable insight for disaster preparedness planning and resource management strategies. Full article

Anticipating and planning for the urgent response to large-scale disasters is critical to increase the probability of survival at these events. These incidents present various challenges that complicate the response, such as unfavorable weather conditions, difficulties in accessing affected areas, and the geographical spread of the victims. Furthermore, local socioeconomic factors, such as inadequate prevention education, limited disaster resources, and insufficient coordination between public and private emergency services, can complicate these situations. In large-scale emergencies, multiple demand points (DPs) are generally observed, which requires efforts to coordinate the strategic allocation of human and material resources in different geographical areas. Therefore, the precise management of these resources based on the specific needs of each area becomes fundamental. To address these complexities, this paper proposes a methodology that models these scenarios as a multi-objective optimization problem, focusing on the location-allocation problem of resources in Mass Casualty Incidents (MCIs). The proposed case study is Mexico City in a earthquake post-disaster scenario, using voluntary geographic information, open government data, and historical data from the 19 September 2017 earthquake. It is assumed that the resources that require optimal location and allocation are ambulances, which focus on medical issues that affect the survival of victims. The designed solution involves the use of a metaheuristic optimization technique, along with a parameter tuning technique, to find configurations that perform at different instances of the problem, i.e., different hypothetical scenarios that can be used as a reference for future possible situations. Finally, the objective is to present the different solutions graphically, accompanied by relevant information to facilitate the decision-making process of the authorities responsible for the practical implementation of these solutions. Full article

Introduction: Triage is a dynamic and complex decision-making process to determine fair access to medical care in mass casualty situations. Triage takes place through healthcare settings including Intensive Care Units (ICUs). Triage governing principles have been subject to ethical debates for a long time specifically with the recent global pandemic of COVID-19. This study aims to revisit the ethical principles guiding patient prioritisation during recent COVID-19 disaster triage in the Indian subcontinent and attempts to look for principles with consideration of social justice. Methods: Key electronic databases such as WHO, EMBASE, and DOAJ were used to access published literature relating to ICU triage in the Indian subcontinent. Literature on and from 2015–2022 were included in this study. The SPICE framework was used to identify the literature. The Inclusion criteria were as follows: Literature with ethical connotations focusing on India and neighbouring countries, and in an ICU setting during pandemics. The Exclusion criteria were as follows: Literature focusing on other countries, without ethical foundations, hospital admissions, and non-COVID-19 ICU admissions. The PRISMA standard was applied to screen the appropriate literature. The BOOLEAN operator “OR” was used to enhance the literature search. Finally, six papers were found suitable for this study and thus were included in the literature review. Additionally, for the second time, the frequency of certain ethical phrases was reassessed in the plans and guidelines to check the changed awareness of ethical pandemic planning, if any. A thematic analysis was applied to analyse the data and generate findings and new knowledge. Results: The findings highlight gaps in knowledge around ICU triaging in the region which indicates the scope of better ethical pandemic preparation at the regional level. The findings show that there is a debate between researchers on prioritisation from available resources and ethical perspectives and principles associated with fair access to healthcare even during pandemic times. The literature also highlights enhancing the regional capacity and building equitable approaches to reduce existing health inequities and the need of the social justice framework for ICU triaging during a pandemic. Conclusions: ICU triaging in five South Asian neighbour nations was studied for the presence of a guided ethical framework. Additionally, for the second time, certain ethical phrases were reassessed in the plans and guidelines; however, usage of those terms was found to be significantly low. The discussion shows that the plans and guidelines have the scope to improve ethical ICU triaging in these countries and in the specific region. After analysing different ethical guidelines, this study emphasises that there is a need for a just and fair framework, specifically a social justice framework in ICU triage in the subcontinent to address the underlying health inequities. Full article

Throughout history, seafarers have been exposed to potential thermal injuries during naval warfare; however, injury prevention, including advances in personal protective equipment, has saved lives. Thankfully, burn injuries have decreased over time, which has resulted in a significant clinical skills gap. Ships with only Role 1 (no surgical capability) assets have worse outcomes after burn injury compared to those with Role 2 (surgical capability) assets. To prepare for future burn care challenges during a war at sea, Military Medicine must re-learn the lessons of World War I and World War II. Burn injuries do not occur in isolation during war and are associated with concomitant traumatic injuries. To care for burn casualties at sea, there is an urgent need to increase the availability of whole blood and dried plasma, resuscitation fluids that were ubiquitous throughout the naval force during World War II for both hemorrhagic and burn shock resuscitation. Furthermore, those providing trauma care at sea require formal burn care training and skills sustainment experiences in the clinical management of Burn, Trauma, and Critical Care patients. While burn education, training, and experience must be improved, modern high-energy weapons systems and anti-ship ballistic missiles necessitate concurrent investments in prevention, countermeasures, and personal protective equipment to decrease the likelihood of burn injury and damage resulting from these attacks. Full article

Mixed reality (MR) technology has the potential to enhance the disaster preparedness of medical first responders in mass-casualty incidents through new training methods. In this manuscript, we present an MR training solution based on requirements collected from experienced medical first responders and technical experts, regular end-user feedback received through the iterative design process used to develop a prototype and feedback from two initial field trials. We discuss key features essential for an effective MR training system, including flexible scenario design, added realism through patient simulator manikins and objective performance assessment. Current technological challenges such as the responsiveness of avatars and the complexity of smart scenario control are also addressed, along with the future potential for integrating artificial intelligence. Furthermore, an advanced analytics and statistics tool that incorporates complex data integration, machine learning for data analysis and visualization techniques for performance evaluation is presented. Full article

This pre–post interventional study explores the effectiveness of simulation-based training in enhancing disaster nursing skills among nursing students at Taif University, Saudi Arabia. The training, which uses a realistic train accident simulation and involves a response team of healthcare professionals, aims to improve knowledge and performance in crisis management and triage during mass casualty incidents. The study’s necessity stems from the critical role nurses play in disaster response, requiring a comprehensive understanding of challenges, collaboration among stakeholders, and improved capabilities. A random sample of 101 nursing students voluntarily participated in the study, with the necessary approvals obtained. We measured their emergency management skills and knowledge using a detailed questionnaire (27 items) and conducted pretest and posttest evaluations. Data analysis was performed using SPSS. The results indicate the training’s effectiveness, as a significant portion of participants achieved high performance levels in the posttest, contrasting with a higher percentage of fail-level grades in the pretest. These findings underscore the potential to improve disaster management protocols and nursing professionals’ preparedness in Saudi Arabia. The study emphasizes the importance of comprehensive education in disaster nursing in enhancing emergency response and patient outcomes. Full article

Landslide disasters are one of the most severe geological hazards in China. Soil slopes are prone to triggering landslides under the influence of main factors such as rainfall, resulting in economic losses, casualties, and ecological damage. Taking a residual soil landslide in Xingguo County as an example, this study investigated the influencing factors and mechanical properties of soil slope stability under rainfall infiltration through physical model experiments. The main conclusions were as follows: with the increase in rainfall intensity, the amount of rainwater infiltration and the weight of the soil mass increased, which led to greater changes in soil pressure. The maximum amplitude of the experimental process was 5.51 kPa. The response time of pore water pressure under a rainfall intensity of 45 mm/h was 20–30 min earlier than that under a rainfall intensity of 21 mm/h, with a larger fluctuation range. The maximum amplitude of the experimental process was 6.66 kPa. Under the condition of rainfall intensity of 21 mm/h, the slope undergone local shallow sliding failure, while under the condition of rainfall intensity of 45 mm/h, the slope undergone overall shallow sliding failure. The physical model experimental results were consistent with the historical deformation of the landslide and the actual situation on site. The conclusions of the experiment can provide a reference for the research on the failure mechanism of similar landslides. Full article

Using a discrete-event simulation (DES) model, the current disaster plan regarding the allocation of multiple injured patients from a mass casualty incident was evaluated for an acute specialty hospital in Vienna, Austria. With the current resources available, the results showed that the number of severely injured patients currently assigned might have to wait longer than the medically justifiable limit for lifesaving surgery. Furthermore, policy scenarios of increasing staff and/or equipment did not lead to a sufficient improvement of this outcome measure. However, the mean target waiting time for critical treatment of moderately injured patients could be met under all policy scenarios. Using simulation-optimization, an optimal staff-mix could be found for an illustrative policy scenario. In addition, a multiple regression model of simulated staff-mix policy scenarios identified staff categories (number of radiologists and rotation physicians) with the highest impact on waiting time and survival. In the short term, the current hospital disaster plan should consider reducing the number of severely injured patients to be treated. In the long term, we would recommend expanding hospital capacity—in terms of both structural and human resources as well as improving regional disaster planning. Policymakers should also consider the limitations of this study when applying these insights to different areas or circumstances. Full article

Mass-casualty incidents and disaster scenarios pose significant challenges for medical facilities, necessitating robust preparedness measures. This study aimed to evaluate the preparedness of a specific medical facility in Poland, using the hospital safety index (HSI). A comprehensive analysis of structural, functional, and organizational factors was conducted, assessing facility infrastructure, technical facilities, safety standards, work organization, cooperation with external facilities, human resource management, crisis planning, and communication strategies. The facility exhibited strengths in infrastructural requirements and inter-facility cooperation. Areas of improvement included adherence to safety procedures, crisis communication, and the frequency of evacuation drills. Furthermore, recommendations were provided for enhancing nurse reserves, adopting lean management, promoting a safety culture, and refining business continuity plans. The findings should be interpreted with caution, due to the single-facility focus, potential HSI protocol subjectivity, and the possible Hawthorne effect. This study underscores the importance of continuous research and improvement in crisis management strategies and disaster-victim care, emphasizing the pivotal role of the HSI as an evaluative tool. Full article

Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources. Full article

Mine landslides are geological disasters with the highest frequency and cause the greatest harm worldwide. This typically causes significant casualties and damage to property. The study of the formation mechanisms and kinematic processes of mine landslides is important for the prevention and control of mine geological disasters and mine production safety. This study examined the “7.26” landslide, which occurred in the West Open-pit Mine of Fushun, China, in 2016, based on detailed investigations, interferometric synthetic aperture radar (InSAR) monitoring, and numerical simulations. The mechanism of landslide formation was explored, its kinematic process was inverted, and its disaster evolution process was summarized. The results indicate that: (1) For the formation mechanism of the “7.26” landslide, in July 2015, the old sliding mass was reactivated and deformed along the dominant joints in the shale. The following year, owing to continuous rainfall during the rainy season, the sliding surface accelerated its connection. Finally, a rainstorm on 25–26 July 2016, triggered slope instability. (2) The process of continued movement after landslide instability was approximately 250 s. It can be divided into the landslide initiation (0–10 s), collision scraping (10–150 s), and accumulation stages (150–250 s). (3) The entire process of landslide disasters includes four stages. During the weak-deformation stage, the maximum deformation of the sliding mass monitored by InSAR was approximately 50 mm. During the strong deformation stage, the tensile cracks at the rear edge of the landslide continued to expand, and shear outlets at the front edge had already formed. During the instability and failure stages, rainstorms trigger slope instability, leading to landslides. During the sliding accumulation stage, the landslide mass transformed into debris flow along the slope surface and accumulated at the bottom of the pit. This study provides a theoretical basis for the subsequent evaluation, treatment, monitoring, and warning of landslides in the Fushun West Open-pit Mine and other deep excavation open-pit mines. Full article