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BACKGROUND: This study assesses the operational challenges and clinical outcomes encountered by a university-based Emergency Medical Team (EMT) during the medical search and rescue (mSAR) response to the February 2023 earthquakes in Kahramanmaras, Turkey. METHODS: In this observational study, data were retrospectively collected from 42 individuals who received mSAR services post-earthquake. The challenges were categorized as environmental, logistical, or medical, with detailed documentation of rescue times, patient demographics, injury types, and medical interventions. RESULTS: In this mSAR study, 42 patients from 30 operations were analyzed and divided into environmental (26.2%), logistical (52.4%), and medical (21.4%) challenge groups. Median rescue times were 29 (IQR 28-30), 36.5 (IQR 33.75-77.75), and 30.5 (IQR 29.5-35.5) hours for each group, respectively (P = .002). Age distribution did not significantly differ across groups (P = .067). Hypothermia affected 18.2%, 45.5%, and 66.7% in the respective groups. Extremity injuries were most common in the medical group (88.9%). Intravenous access was highest in the medical group (88.9%), while splinting was more frequent in the medical (55.6%) and logistical (18.2%) groups. Hypothermia was most prevalent in the medical group (66.7%), followed by the logistical group (45.5%). Ambulance transport post-rescue was utilized for a minority in all groups. CONCLUSION: The study concludes that logistical challenges, more than environmental or medical challenges, significantly prolong the duration of mSAR operations and exacerbate clinical outcomes like hypothermia, informing future enhancements in disaster response planning and execution.

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Laboratory acoustic emissions (AEs) serve as small-scale analogues to earthquakes, offering fundamental insights into seismic processes. To ensure accurate physical interpretations of AEs, rigorous calibration of the acoustic system is essential. In this paper, we present an empirical calibration technique that quantifies sensor response, instrumentation effects, and path characteristics into a single entity termed instrument apparatus response. Using a controlled seismic source with different steel balls, we retrieve the instrument apparatus response in the frequency domain under typical experimental conditions for various piezoelectric sensors (PZTs) arranged to simulate a three-component seismic station. Removing these responses from the raw AE spectra allows us to obtain calibrated AE source spectra, which are then effectively used to constrain the seismic AE source parameters. We apply this calibration method to acoustic emissions (AEs) generated during unstable stick-slip behavior of a quartz gouge in double direct shear experiments. The calibrated AEs range in magnitude from -7.1 to -6.4 and exhibit stress drops between 0.075 MPa and 4.29 MPa, consistent with earthquake scaling relation. This result highlights the strong similarities between AEs generated from frictional gouge experiments and natural earthquakes. Through this acoustic emission calibration, we gain physical insights into the seismic sources of laboratory AEs, enhancing our understanding of seismic rupture processes in fault gouge experiments.

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PURPOSE: This study aimed to explore the impact of psychological stress on erectile dysfunction (ED) in male patients following the Gaziantep-Kahramanmaras earthquake. The investigation aimed to establish correlations between earthquake-induced stress and changes in sexual function using International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scores. MATERIALS AND METHODS: A retrospective analysis was conducted on male ED patients from a Gaziantep urology clinic post-earthquake (March to August 2023). Patients with deteriorated erectile function post-earthquake (group 1) and those with pre-existing ED experiencing worsened symptoms post-earthquake (group 2) were included. Data collected encompassed sexual histories, IIEF scores, laboratory tests, and PHQ-9/GAD-7 evaluations. Patients were also evaluated mild and mild to moderate ED, moderate and severe ED according to IIEF erectile function. RESULTS: Seventy-six patients were evaluated (24 in group 1 and 52 in group 2). Significant reductions in total IIEF scores (58 to 40 in group 1 and 49 to 33 in group 2) were observed post-earthquake in both groups (p<0.001). PHQ-9/GAD-7 scores was 11.12±3.79/9.34±3.11 in mild and mild to moderate ED and 13.17±3.05/12.14±3.17 in moderate and severe ED (p=0.011, p<0.001, respectively). Negative correlations existed between PHQ-9/GAD-7 scores and IIEF erectile function (p<0.05) and total IIEF (p<0.05). CONCLUSIONS: This research suggests a plausible connection between the Gaziantep-Kahramanmaras earthquake and heightened ED cases. Psychological stress post-earthquake may contribute to worsened ED symptoms. Further investigations are warranted to comprehensively understand the interplay between natural disasters and sexual dysfunction, essential for optimizing patient care in challenging situations.

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OBJECTIVE: This cross-sectional study investigates the immediate psychological effects of disaster relief operations on team members following 2 consecutive major earthquakes in Turkey. METHODS: A total of 170 participants, including professional firefighters, search and rescue (SAR) workers, and volunteers, were surveyed approximately 1 month after the conclusion of active SAR operations. The study utilizes the DSM-V criteria and the Posttraumatic Stress Disorder Checklist (PCL-5) to assess symptoms of post-traumatic stress disorder (PTSD) among participants. RESULTS: The findings reveal a point prevalence of 35.3% for probable PTSD, highlighting the substantial psychological impact on disaster relief teams. Factors such as age, residency in affected areas, and active SAR involvement significantly influenced probable PTSD rates. Interestingly, actively engaged SAR members had lower probable PTSD rates, possibly due to their training. Those who directly witnessed the earthquakes had higher scores, highlighting the impact of firsthand exposure. Additionally, individuals aged 50 and above displayed a higher mean total severity score compared to younger participants. CONCLUSIONS: This research contributes to understanding the mental well-being of disaster relief professionals. The study's findings underscore the importance of timely mental health support and training for these responders, emphasizing the need for preparedness in disaster relief teams.

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Maladaptive behaviors during a disaster refer to actions that do not benefit the individual or society. Quarantelli highlights several maladaptive behaviors myths associated with disasters: widespread antisocial behavior, passivity, role conflict or abandonment, and sudden widespread mental health breakdowns (1). Despite early work reporting these myths, the common perception is that maladaptive behaviors such as rioting, looting, panic, and criminal conduct are prevalent in the wake of disasters. This is despite research by de Ville de Goyet and Arnold which has called on public officials and the media to stop propagating false disaster myths (2, 3). The classic academic response has been that this is a misconception and that, in fact, such behaviors are a very small part of the overall disaster and are mostly non-existent. Misconceptions about the prevalence of maladaptive behaviors can lead to inappropriate resource allocation, such as allocating extra police officers to prevent looting when the overall crime rate for the most part, decreases during disasters (4). Furthermore, while there are several persistent maladaptive behaviors myths, this is confounded by the presence of actual negative behaviors post disaster: false damage claims, insurance fraud, illegally obtaining relief supplies, failure to provide contracted repair services, hoarding of essential items, psychological trauma (which can lead to intergenerational transmission of the disaster memory) and medications and price gouging (5).When reading lay-press articles about recent disasters, it appears that these behaviors are on the rise. This raises the question: Has there been a change in the basic human reaction to disasters and are maladaptive behaviors on the rise? This review article focuses on case studies from three natural disasters: Hurricanes Hugo and Katrina, and the Haiti Earthquake. The goal of this review article is to evaluate these three natural disasters for evidence of maladaptive behaviors.

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PURPOSE: Amputations are a common surgical procedure resulting from trauma during earthquakes, leading to severe disability. This study aims to investigate surgical outcomes specific to amputations that occurred in Adiyaman after the Kahramanmaras earthquakes. METHODS: This descriptive study included amputees who presented to Adiyaman University Training and Research Hospital. Between March 6, 2024 and March 29, 2024, amputees were contacted by phone and asked the questions in the form. Data analyzed included demographic information, number and level of amputated extremities, phantom limb pain, stump infection, extrication time, time to initiation of rehabilitation, number of revision, and whether a prosthesis was fitted. RESULTS: The study reached 75 amputees. The mean age was 37.9 ± 19.2, and the most frequently amputated age group was adults. Stump infection was observed in 40 amputees (53.3%), phantom limb pain in 47 (62.6%), and revision in 29 (38.7%). The median extrication time was 36 h and initiation of rehabilitation time was 45 days. It was noted that 35 amputees (62.5%) used prostheses. A statistically significant relationship was found between fasciotomy and stump infection (p = .000). Infection was detected in 65% of those who underwent fasciotomy. CONCLUSION: Earthquake-related amputations most frequently affected the adult age group and primarily involved lower extremity amputations, such as transfemoral and transtibial amputations. Phantom limb pain, need for revision, and infection are common in earthquake-induced amputations. Delayed fasciotomy increases the risk of stump infection. The data obtained in this study will help plan local health services to coordinate amputation care in disasters.

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PURPOSE: This study aimed to determine the forms of ocular and adnexal injuries and to examine the treatment modalities applied after two major earthquakes in Turkey on February 6, 2023. METHODS: Following the earthquakes, the medical records of 34 patients admitted with emergency ophthalmic complaints to Hatay Training and Research Field Hospital and Etlik City Hospital were retrospectively reviewed. Of these patients, 35 eyes of 34 individuals diagnosed with earthquake-related ocular and adnexal injuries were included in the study. Demographic characteristics were recorded, including ocular and adnexal findings, treatment modalities, and postoperative complications. RESULTS: Of the patients, 16 (47.1%) were female, and 18 (52.9%) were male. The mean age was 37.38 ± 17.3 years. The mean time from the earthquake to the first admission to the hospital was 3.82 ± 1.78 days. Initial and final best-corrected visual acuities (BCVA) were 0.54 ± 0.66 logMAR and 0.22 ± 0.41 logMAR, respectively (p = 0.0003). The initial and final BCVA of 2 eyes was no light perception. The most common forms of ocular/periocular injury associated with earthquakes were eyelid laceration (n:25, 71.4%) and orbital fracture (n:17, 48.6%). The most common accompanied systemic trauma was extremity/rib fractures (38.2). The most frequently performed surgery was the primary repair of the eyelid/canalicular (n:17, 48.6%). CONCLUSION: While earthquake-related ocular and adnexal traumas are relatively uncommon, understanding the specific injury types, promptly identifying cases requiring urgent intervention, and mastering effective treatment modalities are essential for minimizing the risk of severe permanent visual impairment in these patients.

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This article delves into the profound impact of various types of disasters, examining some specific contexts. It provides insights into the unique challenges posed by different disasters, ultimately highlighting the invaluable role of maxillofacial surgery in addressing the critical healthcare needs of affected populations. A comprehensive review of the literature was conducted to analyze the role of maxillofacial surgery in disaster management. Relevant studies were examined to gather evidence supporting the criticality of maxillofacial surgeons in disaster response. Continuous training, coordination, and international collaboration among maxillofacial surgeons were reported as key factors in enhancing preparedness and improving post-disaster recovery. Sharing experiences, implementing best practices, and staying updated with advancements in the field seemed crucial for maximizing the impact of maxillofacial surgery in disaster medicine. By prioritizing the inclusion of maxillofacial surgeons in disaster response teams, lives can be saved, functional outcomes can be improved, and hope can be restored in affected communities. Understanding the intricacies and patterns associated with various types of disasters can be crucial details for successful rescue operations.

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Nature abounds in examples of evolutionary designs (bio and non-bio) that evolve freely into configurations that provide easier and greater access for movement. The present article considers three seemingly unrelated phenomena that appear to obstruct flow: stick-slip friction, animal jump, and earthquake. The analysis is based on simple models of rhythmic energy store & release motion. In each case, the rhythm is the sole degree of freedom. The analyses show that stick-slip friction facilitates movement because the coefficient of static friction is greater than the coefficient of sliding friction. Next, all forms of animal locomotion under gravity consist of cycles of energy storage (jump to a height) and energy release (forward fall). The rhythm of the cycle is natural such that the forward advance of the animal is economical. Finally, the onset of the earthquake is modeled the same way, as shear stresses at the rock-on-rock interface, which are matched by bending stresses in the bent 'blades' of rock contained between fissures perpendicular to the interface. In sum, naturally evolved store & release rhythm facilitates the movement, contrary to the commonly held impression.

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PURPOSE: This study had two main goals: to determine which rhabdomyolysis patients need haemodialysis; and to highlight the significance of blood gas parameters, particularly base excess, as predictors of the need for haemodialysis. METHOD: A total of 270 patients were included in this multicentre, retrospective study. Among the patients who were transferred in from the earthquake region and developed rhabdomyolysis, those with creatine kinase (CK) values >1000 U/L were included in our study. The need for renal replacement in these patients was determined via laboratory tests, urine output monitoring and clinical follow-up. FINDINGS: A total of 270 patients were included in our study. Univariate and multivariate regression analyses of laboratory parameters were performed to identify predictors of HD treatment. According to the univariate regression analysis, BE, HCO3, creatinine, CK, lactate, alanine transaminase (ALT) and aspartate transaminase (AST) levels were found to be significantly associated with receiving HD treatment. According to multivariate regression analysis, only BE (p = 0.003) was found to be a significant predictor of HD treatment. ROC analysis revealed that the optimal cutoff value for BE was -2.6; at this value, the sensitivity and specificity of BE for predicting HD treatment were 89% and 77.1%, respectively (AUC: 0.912; 95% CI: 0.872-0.943; p < 0.001). CONCLUSION: Base excess is an effective predictor of the need for haemodialysis in patients with crush-related injuries that cause rhabdomyolysis and in patients who develop acute renal failure due to elevated CK.

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This article highlights local Indonesian wisdom in the psychosocial treatment of female earthquake survivors, including interaction with nature, God and fellow humans, which helps reduce the psychological impact through activities such as reading the Koran, praying and cooking together in the refugee camp's public kitchen.

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There is an ongoing discussion about how to forecast the maximum magnitudes of induced earthquakes based on operational parameters, subsurface conditions and physical process understanding. Although the occurrence of damage caused by induced earthquakes is rare, some cases have caused significant economic loss, injuries and even loss of life. We analysed a global compilation of earthquakes induced by hydraulic fracturing, geothermal reservoir stimulation, water disposal, gas storage and reservoir impoundment. Our analysis showed that maximum magnitudes scale with the characteristic length of pressure diffusion in the brittle Earth's crust. We observed an increase in the nucleation potential of larger-magnitude earthquakes with time and explained it by diffusion-controlled growth of the pressure-perturbed part of faults. Numerical and analytical fault size modelling supported our findings. Finally, we derived magnitude scaling laws to manage induced seismic hazard of upcoming energy projects prior to operation. This article is part of the theme issue 'Induced seismicity in coupled subsurface systems'.

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The Haiyuan fault system plays a crucial role in accommodating the eastward expansion of the Tibetan Plateau (TP) and is currently slipping at a rate of several centimeters per year. However, limited seismic activities have been observed using geodetic techniques in this area, impeding the comprehensive investigation into regional tectonics. In this study, the geometric structure and source models of the 2022 Mw 6.7 and the 2016 Mw 5.9 Menyuan earthquakes were investigated using Sentinel-1A SAR images. By implementing an atmospheric error correction method, the signal-to-noise ratio of the 2016 interferometric synthetic aperture radar (InSAR) coseismic deformation field was significantly improved, enabling InSAR observations with higher accuracy. The results showed that the reliability of the source models for those events was improved following the reduction in observation errors. The Coulomb stress resulting from the 2016 event may have promoted the strike-slip movement of the western segment of the Lenglongling fault zone, potentially expediting the occurrence of the 2022 earthquake. The coseismic slip distribution and the spatial distribution of aftershocks of the 2022 event suggested that the seismogenic fault may connect the western segment of the Lenglongling fault (LLLF) and the eastern segment of the Tuolaishan fault (TLSF). Additionally, the western segment of the surface rupture zone of the northern branch may terminate in the secondary branch close to the Sunan-Qilian fault (SN-QL) strike direction, and the earthquake may have triggered deep aftershocks and accelerated stress release within the deep seismogenic fault.

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Background: Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD.Objective: This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families.Method: After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes.Results: The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels.Conclusions: The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.

This is the first systematic review to identify PTSD risk factors from children to elderly earthquake survivors using secondary studies.Considering the complexity of the joint effects at individual, relational, and contextual levels, several socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic risk factors for PTSD were identified in the age groups considered. Moreover, the consideration of these factors could help the identification of at-risk families.The identification of risk factors for PTSD across the lifespan could provide helpful knowledge for prevention and intervention programmes.

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BACKGROUND: Earthquakes disproportionately affect women and exacerbate gender and social inequalities. This study aims to investigate the psychological impact of the earthquake in Türkiye on women and the associated factors. METHODS: This is a survey-based study. We collected data from 498 women residing in cities most affected by the earthquake. RESULTS: Participants' mean age was 27.72 ± 5.4. Over 78% of the participants lost at least one family member, and 43.7% lost at least one child due to the earthquake. The mean average of Brief Symptom Inventory (BSI) scores was 100.8 (SD = 8.37), and the Global Severity Index was 1.9 (SD = 0.16). Regression analysis showed that higher education levels predicted poor outcomes across most BSI dimensions. Losing a family member and shelter and injury status were also predictors for several mental health outcomes of the BSI subscales. CONCLUSIONS: Earthquakes significantly impact women's well-being and may have a broader impact on the whole family. There is an urgent need to provide psycho-social interventions in the response and recovery phases of the crisis to meet the affected women's needs. This includes providing basic needs with attention to women-specific needs, restoring social networks, addressing gender-based violence and providing gender-sensitive specialized interventions for those who need further support.

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Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze the best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations, to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; and Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: (a) immediate care, (b) intermediate care, (c) psychosocial care, and (d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork, and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed, and the reinforcement of these advanced practices through the systematization of nurses' skills, in order to promote victims' rehabilitation, minimize their suffering, and improve their quality of life during and after an earthquake.

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We present the use of interconnected optical mesh networks for early earthquake detection and localization, exploiting the existing terrestrial fiber infrastructure. Employing a waveplate model, we integrate real ground displacement data from seven earthquakes with magnitudes ranging from four to six to simulate the strains within fiber cables and collect a large set of light polarization evolution data. These simulations help to enhance a machine learning model that is trained and validated to detect primary wave arrivals that precede earthquakes' destructive surface waves. The validation results show that the model achieves over 95% accuracy. The machine learning model is then tested against an M4.3 earthquake, exploiting three interconnected mesh networks as a smart sensing grid. Each network is equipped with a sensing fiber placed to correspond with three distinct seismic stations. The objective is to confirm earthquake detection across the interconnected networks, localize the epicenter coordinates via a triangulation method and calculate the fiber-to-epicenter distance. This setup allows early warning generation for municipalities close to the epicenter location, progressing to those further away. The model testing shows a 98% accuracy in detecting primary waves and a one second detection time, affording nearby areas 21 s to take countermeasures, which extends to 57 s in more distant areas.

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OBJECTIVE: This study was conducted to reveal the relationship between nursing students' disaster response self-efficacy and their disaster preparedness perceptions. METHODS: This cross-sectional study was conducted on nursing students after a major earthquake that occurred in Turkey on February 6, 2023 (n = 302). Data collection took place from June 2023 to October 2023, using the Disaster Response Self-Efficacy Scale (DRSES) and Disaster Preparedness Perception Scale (DPPS). Descriptive statistics, independent samples t-test, correlation, and multiple linear regression analysis were used to analyze the data. RESULTS: Nursing students' DRSES mean score was 63.35 ± 10.83 (moderate level) and DPPS mean score was 3.41 ± 0.50 (high level). A positive and moderate correlation was found between nursing students' DRSES and DPPS scores (r = 0.515; P = 0.000). Predictors affecting nursing students' disaster preparedness are disaster response self-efficacy score, being male, and making a family disaster plan. CONCLUSIONS: The results of this study highlight the importance of increasing the disaster response self-efficacy needed by nursing students to successfully assist patients in disaster situations.

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INTRODUCTION / OBJECTIVES: Stressful events like earthquakes might worsen the symptoms of fibromyalgia, although the influence of medications on these consequences is yet uncertain. The objective of this study was to examine the influence of an earthquake on the symptoms of fibromyalgia and evaluate the impacts of medications used to treat fibromyalgia on the clinical picture. METHOD: Ninety-five fibromyalgia patients were enrolled in a comparative study and divided into two groups: medication and non-medication. Three subcategories of medication groups were established: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentinoid drugs (GDs). Before and after the earthquake, clinical evaluations were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Rating Scale (JSS). Statistical analyses were conducted to compare the scores before and after the earthquake and evaluate the differences between the groups. RESULTS: Statistically significant increases were observed in FIQ, HADS-anxiety, HADS-depression, and JSS scores in the medication and non-medication groups before and after the earthquake comparisons (p < 0.05). Non-medication group reported significantly higher post-earthquake changes in FIQ, HADS-anxiety, HADS-depression, and JSS compared to the medication group (p < 0.05). While HADS-anxiety, HADS-depression, and JSS changes after the earthquake differed according to the drug subgroups (p < 0.05), no statistically significant difference was observed in FIQ values (p > 0.05). The highest scores were detected in the GD subgroup. CONCLUSIONS: This study highlights the substantial impact of earthquakes on fibromyalgia patients. Medication use may assist in reducing the detrimental effects of stresses like earthquakes on fibromyalgia symptomatology. Future research with larger sample sizes and more extended follow-up periods is needed to explain these findings and optimize treatment regimens for fibromyalgia patients experiencing significant stressors.

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