RESUMEN

Alzheimer's Disease (AD) causes slow death in brain cells due to shrinkage of brain cells which is more prevalent in older people. In most cases, the symptoms of AD are mistaken as age-related stresses. The most widely utilized method to detect AD is Magnetic Resonance Imaging (MRI). Along with Artificial Intelligence (AI) techniques, the efficacy of identifying diseases related to the brain has become easier. But, the identical phenotype makes it challenging to identify the disease from the neuro-images. Hence, a deep learning method to detect AD at the beginning stage is suggested in this work. The newly implemented "Enhanced Residual Attention with Bi-directional Long Short-Term Memory (Bi-LSTM) (ERABi-LNet)" is used in the detection phase to identify the AD from the MRI images. This model is used for enhancing the performance of the Alzheimer's detection in scale of 2-5%, minimizing the error rates, increasing the balance of the model, so that the multi-class problems are supported. At first, MRI images are given to "Residual Attention Network (RAN)", which is specially developed with three convolutional layers, namely atrous, dilated and Depth-Wise Separable (DWS), to obtain the relevant attributes. The most appropriate attributes are determined by these layers, and subjected to target-based fusion. Then the fused attributes are fed into the "Attention-based Bi-LSTM". The final outcome is obtained from this unit. The detection efficiency based on median is 26.37% and accuracy is 97.367% obtained by tuning the parameters in the ERABi-LNet with the help of Modified Search and Rescue Operations (MCDMR-SRO). The obtained results are compared with ROA-ERABi-LNet, EOO-ERABi-LNet, GTBO-ERABi-LNet and SRO-ERABi-LNet respectively. The ERABi_LNet thus provides enhanced accuracy and other performance metrics compared to such deep learning models. The proposed method has the better sensitivity, specificity, F1-Score and False Positive Rate compared with all the above mentioned competing models with values such as 97.49%.97.84%,97.74% and 2.616 respective;y. This ensures that the model has better learning capabilities and provides lesser false positives with balanced prediction.

Asunto(s)

RESUMEN

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.

RESUMEN

OBJECTIVE: We aimed to investigate the neural mechanisms underlying the inhibitory function performance of maritime Search and Rescue (SAR) personnel in states of physical exhaustion. BACKGROUND: SAR missions pose serious challenges to the cognitive function of SAR personnel, especially in extreme environments and physical exhaustion. It is important to understand SAR personnel's cognitive performance and neural activity under exhaustion to improve the efficiency of task execution and ensure work safety. METHOD: Twenty-six maritime SAR personnel were recruited to simulate boat operations until they reached a self-imposed state of exhaustion. The exhaustion state was monitored by maximum heart rate and subjective fatigue scale. Two event-related potentials, N200 and P300, were measured during a Go-Nogo task before and after a session of acute exhaustive tasks. RESULTS: After exhaustion, a marked reduction in accuracy, a notable increase in N200 amplitude, and a substantial decline in P300 amplitude under the Nogo condition were observed compared to the baseline phase. Pre- and post-exhaustion comparisons using standardized low-resolution brain electromagnetic tomography revealed reduced activations in the right middle temporal gyrus's N200 component after exhaustion in SAR personnel during the Nogo condition. CONCLUSION: The results suggest that acute physical exhaustion significantly impacts the inhibition ability of SAR personnel, prolonging the conflict monitoring phase and weakening the response inhibition phase. These findings provide valuable insights into how physical exhaustion affects cognitive functions critical to the safety and effectiveness of SAR operations, and can inform strategies to improve training and equipment to enhance performance under extreme conditions.

Asunto(s)

RESUMEN

INTRODUCTION: Rural emergency prehospital care in British Columbia is conducted primarily by the British Columbia Ambulance Services or ground search and rescue volunteers. Since 2014, the volunteer Air Rescue One (AR1) program has provided helicopter emergency winch rescue services to rural British Columbia. The aim of this research was to describe the activity of the AR1 program and to make recommendations to improve future operations. METHODS: Data were collected retrospectively from September 2014 to May 2021, and parameters of emergency callout statistics from the organization's standard operating guidelines, rescue reports, and interviews were summarized and reviewed. RESULTS: Of 152 missions within the study period, 105 were medically related rescues involving trauma or cardiac events. Snowmobiling, mountain biking, and hiking were the most common activities requiring rescue. The 38 medical callouts that were not completed by AR1 were reviewed for contributing factors. Response time varied due to the vast service area, but median time from request to takeoff was 55 min (interquartile range 47-69 min), and median on-scene time was 21 min (interquartile range 11-33 min). CONCLUSIONS: AR1 provides advanced medical care into British Columbia's remote and difficult-to-access areas, minimizing delays in treatment and risk to patients and responders. Callout procedures should be streamlined enabling efficient AR1 activation. Collection of medical and flight information should be improved with standardized documentation, aiding in internal education and future research into the program's impact on emergency prehospital care. Future directions for improvement of care include the possibility of introducing portable ultrasound technology.

Asunto(s)

RESUMEN

The aim of this study was to observe electric cardiac activity in real working conditions, with the application of Holter and the electrocardiogram in search and rescue dogs. Thirty-one handlers of search and rescue dogs voluntarily participated in this study. Nine dogs were selected to wear the Holter, and twenty-three were submitted to electrocardiographic recordings (one dog, excluded by Holter examination, was then included in the ECG group). Our results showed few cardiac rhythm alterations, such as escape beats, premature ventricular beat, and depression and elevation of the ST segment, particularly during the working phase in the Holter group and during recovery time immediately after activity in the electrocardiographic group. Detected alterations in real working conditions may provide more information than routine checks, and Holter monitoring can be more functional. However, not all dogs tolerate wearing the Holter harness, and more time is thus needed to apply the equipment. In addition, the results are not immediate, and the absence of water is essential because it would damage the equipment.

RESUMEN

BACKGROUND: Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations after large incidents may include civil protection, military forces, non-governmental organizations and other resources, but the initial rescue effort must be performed by the emergency services as time often is of essence. The central area of an accident where special training and personal protection equipment is necessary or mandatory is called the Hot Zone. This study examines Urban Search And Rescue (USAR) firefighters and police officers reported experiences from ambulance personnel's contribution in the Hot Zone. METHODS: We conducted five focus group interviews with USAR-trained firefighters and police officers. The interviewees were those on duty on the agreed dates. The interviews were taped, transcribed, and analysed using thematic analysis as described by Braun & Clarke. RESULTS: Three themes were identified; Feeling safe during missions, Building USAR capacity, and Trust-building within USAR-teams. The firefighters and police officers reported their and the patients' safety are best managed by EMS-personnel, whose presence strongly contributes to their own feeling of safety in a dangerous area. When EMS handles victims and injured emergency workers, firefighters and police officers can focus on their own primary tasks. Indeed, interviewees reported that building a USAR capacity depends on having USAR-trained EMS-personnel in the Hot Zone. The interviewees have clear and consistent opinions on how to establish an interagency USAR capacity effectively. Trust is paramount to the interviewees, and they express a high degree of trust within USAR Oslo. CONCLUSIONS: Firefighters and police officers regard USAR-trained EMS-personnel as a natural and integrated part in urban search and rescue teams. EMS-personnel in the dangerous area deliver safety and medical professional assistance to both rescue workers and patients. Informants in this study had clear opinions on how to establish and maintain such a service.

Asunto(s)

RESUMEN

Cobots are robots that are built for human-robot collaboration (HRC) in a shared environment. In the aftermath of disasters, cobots can cooperate with humans to mitigate risks and increase the possibility of rescuing people in distress. This study examines the resilient and dynamic synergy between a swarm of snake robots, first responders and people to be rescued. The possibility of delivering first aid to potential victims dispersed around a disaster environment is implemented. In the HRC simulation framework presented in this study, the first responder initially deploys a UAV, swarm of snake robots and emergency items. The UAV provides the first responder with the site planimetry, which includes the layout of the area, as well as the precise locations of the individuals in need of rescue and the aiding goods to be delivered. Each individual snake robot in the swarm is then assigned a victim. Subsequently an optimal path is determined by each snake robot using the A* algorithm, to approach and reach its respective target while avoiding obstacles. By using their prehensile capabilities, each snake robot adeptly grasps the aiding object to be dispatched. The snake robots successively arrive at the delivering location near the victim, following their optimal paths, and proceed to release the items. To demonstrate the potential of the framework, several case studies are outlined concerning the execution of operations that combine locomotion, obstacle avoidance, grasping and deploying. The Coppelia-Sim Robotic Simulator is utilised for this framework. The analysis of the motion of the snake robots on the path show highly accurate movement with and without the emergency item. This study is a step towards a holistic semi-autonomous search and rescue operation.

RESUMEN

Early recovery of human bodies from the water requires an understanding of how a body acts in the water. However, there is currently a lack of baseline data surrounding body movement in British Columbian (B.C.) waters. This study aims to assist Canadian response agencies with understanding and predicting body movement in outdoor waterbodies in B.C. One hundred and eighty-six water-related fatalities in B.C. waters, including lakes, rivers, and the coastal Pacific Ocean, were examined to determine the recovery times and displacement patterns of submerged decedents. Cases between 2010 and 2021 were extracted from the Police Records Information Management Environment (PRIME-BC) for analysis. Most deaths were unintentional, followed by suicide and homicide, and most often occurred in rivers, followed by lakes and the ocean. Regardless of waterbody, the first day was the most successful recovery period, with decedents most often recovered close to the incident location. Nearly 16% of individuals in this study were not recovered. Recovery success was greatest in lakes, followed by rivers and the ocean. Body displacement was the least in lakes, while rivers resulted in the furthest and most variable displacement. Low recovery success in the ocean is likely due to decedents being quickly displaced out of the search area, never to be found. The results of this study suggest that knowledge of body movement in outdoor aquatic environments remains incomplete. Further empirical research based on known data is necessary to continue improving prediction of body movement and increase early recovery success.

Asunto(s)

RESUMEN

Many aspects of humans' dynamic decision-making (DDM) behaviors have been studied with computer-simulated games called microworlds. However, most microworlds only emphasize specific elements of DDM and are inflexible in generating a variety of environments and experimental designs. Moreover, despite the ubiquity of gridworld games for Artificial Intelligence (AI) research, only some tools exist to aid in the development of browser-based gridworld environments for studying the dynamics of human decision-making behavior. To address these issues, we introduce Minimap, a dynamic interactive game to examine DDM in search and rescue missions, which incorporates all the essential characteristics of DDM and offers a wide range of flexibility regarding experimental setups and the creation of experimental scenarios. Minimap specifically allows customization of dynamics, complexity, opaqueness, and dynamic complexity when designing a DDM task. Minimap also enables researchers to visualize and replay recorded human trajectories for the analysis of human behavior. To demonstrate the utility of Minimap, we present a behavioral experiment that examines the impact of different degrees of structural complexity coupled with the opaqueness of the environment on human decision-making performance under time constraints. We discuss the potential applications of Minimap in improving productivity and transparent replications of human behavior and human-AI teaming research. We made Minimap an open-source tool, freely available at  https://github.com/DDM-Lab/MinimapInteractiveDDMGame .

Asunto(s)

RESUMEN

OBJECTIVE: A longitudinal study followed search-and-rescue (SAR) dogs for 15 years to determine the incidence of health events and whether factors of deployment during 9/11, breed, or sex altered the risk of specific events. ANIMALS: 150 SAR dogs: 95 dogs deployed to the September 11 terrorist attack sites and 55 SAR dogs not deployed. METHODS: Each year, a survey was sent to the handler to collect health information until the dog died or the handler withdrew from the study. The reported health events were then categorized according to the body system affected and etiology. Incidence risk rates, with 95% CIs, were calculated for the most common types of health events. Incidence rate ratios were calculated stratified by deployment status, sex, and breed and significance assessed. RESULTS: 1 or more health event was recorded in 96 of the 150 enrolled dogs. The most affected systems were the musculoskeletal (31%; CI, 24 to 39), integumentary (22%; CI, 15 to 29), and gastrointestinal (20%; CI, 14 to 26). The health events were most commonly reported as inflammatory (45%; CI, 37 to 53) and degenerative (28%; CI, 21 to 35) in nature. There were no significant differences in incidence of health events based on deployment status to the September 11, 2001, terrorist attacks. Additionally, there was no significant effect of breed or sex on incidence of health events. CLINICAL RELEVANCE: To improve the health and longevity of SAR dogs, disease prevention and management programs should focus on reducing the health problems involving the musculoskeletal system as well as the integumentary and gastrointestinal systems.

Asunto(s)

RESUMEN

Helicopter rescue operations in the mountains or at high altitude are well-known as strenuous tasks often associated with some risk. However, there is no standardized procedure for preventive checkups of rescue personnel by occupational care professionals. Therefore, the Medical Commission of the International Climbing and Mountaineering Federation (UIAA MedCom) suggests the procedure presented in this study. This comprehensive recommendation is based on more than 2 decades of research of MedCom members and extensive literature search. A total of 248 references were selected by the committee as relevant for the topic. To keep the recommendation handy, the complete list is available as supplemental material (see online Supplemental Material). This article recommends standardized procedures for occupational screening and better health of search and rescue personnel.

Asunto(s)

RESUMEN

BACKGROUND: Very little data is available about the involvement of lifeboat crews in medical emergencies at sea. The aim of this study is to analyze the medical operations at sea performed by the Royal Netherlands Sea Rescue Institution (KNRM). METHODS: This is a retrospective descriptive analysis of all medical operations at sea performed by the KNRM between January 2017 and January 2020. The operations were divided in three groups: with ambulance crew aboard the lifeboat, ambulance crew on land waiting for the arrival of the lifeboat, and autonomous operations (without ambulance crew involvement). The main outcome measures were circumstances, encountered medical problems, follow-up and crew departure time. RESULTS: The KNRM performed 282 medical operations, involving 361 persons. Operations with ambulance crew aboard the lifeboat (n = 39; 42 persons) consisted mainly of persons with serious trauma or injuries; 32 persons (76.2%) were transported to a hospital. Operations with ambulance crew on land (n = 153; 188 persons) mainly consisted of situations where time was essential, such as persons who were still in the water, with risk of drowning (n = 45, 23.9%), on-going resuscitations (n = 9, 4.8%) or suicide attempts (n = 7, 3.7%). 101 persons (53,7%) were transported to a hospital. All persons involved in the autonomous operations (n = 90; 131 persons) had minor injuries. 38 persons (29%) needed additional medical care, mainly for (suspected) fractures or stitches. In 115 (40.8%) of all operations lifeboat crews did not know that there was a medical problem at the time of departure. Crew departure time in operations with ambulance crew aboard the lifeboat (13.7 min, min. 0, max. 25, SD 5.74 min.) was significantly longer than in operations with ambulance crew on land (7.7 min, min. 0, max 21, SD 4.82 min., p < 0.001). CONCLUSION: This study provides new information about the large variety of medical emergencies at sea and the way that lifeboat and ambulance crews are involved. Crew departure time in operations with ambulance crew aboard the lifeboat was significantly longer than in operations with ambulance crew on land. This study may provide useful indications for improvement of future medical operations at sea, such as triage, because in 40.8% of operations, it was not known at the time of departure that there was a medical problem.

Asunto(s)

RESUMEN

The occurrence of disasters has the potential to impede the progress of sustainable urban development. For instance, it has the potential to result in significant human casualties and substantial economic repercussions. Sustainable cities, as outlined in the United Nations Sustainable Development Goal 12, prioritize the objective of disaster risk reduction. According to the Gesi Smarter 2030, the Internet of Things (IoT) assumes a pivotal role in the context of smart cities, particularly in domains including smart grids, smart waste management, and smart transportation. IoT has emerged as a crucial facilitator for the management of disasters, contributing to the development of cities that are both resilient and sustainable. This systematic literature analysis seeks to demonstrate the sensors utilized in IoT for the purpose of urban catastrophe management. The review encompasses both the pre-disaster and post-disaster stages, drawing from a total of 72 articles. During each stage, we presented the characteristics of sensors employed in IoT. Additionally, we engaged in a discourse regarding the various communication technologies and protocols that can be utilized for the purpose of transmitting the data obtained from sensors. Furthermore, we have demonstrated the methodology for analyzing and implementing the data within the application layer of IoT. In conclusion, this study addresses the existing research deficiencies within the literature and presents potential avenues for future exploration in the realm of IoT-enabled urban catastrophe management, drawing upon the findings of the evaluated publications.

RESUMEN

Operating in extreme environments is often challenging due to the lack of perceptual knowledge. During fire incidents in large buildings, the extreme levels of smoke can seriously impede a firefighter's vision, potentially leading to severe material damage and loss of life. To increase the safety of firefighters, research is conducted in collaboration with Dutch fire departments into the usability of Unmanned Ground Vehicles to increase situational awareness in hazardous environments. This paper proposes FirebotSLAM, the first algorithm capable of coherently computing a robot's odometry while creating a comprehensible 3D map solely using the information extracted from thermal images. The literature showed that the most challenging aspect of thermal Simultaneous Localization and Mapping (SLAM) is the extraction of robust features in thermal images. Therefore, a practical benchmark of feature extraction and description methods was performed on datasets recorded during a fire incident. The best-performing combination of extractor and descriptor is then implemented into a state-of-the-art visual SLAM algorithm. As a result, FirebotSLAM is the first thermal odometry algorithm able to perform global trajectory optimization by detecting loop closures. Finally, FirebotSLAM is the first thermal SLAM algorithm to be tested in a fiery environment to validate its applicability in an operational scenario.

RESUMEN

Los terremotos ocurridos en Turquía en febrero de 2023 han sido unos de los de mayor impacto en los últimos años. Las autoridades del país, tras activar sus recursos locales y nacionales, hicieron una solicitud de ayuda internacional. Dentro de la Organización de Naciones Unidas (ONU) se encuentra el Grupo Asesor Internacional de Búsqueda y Rescate (INSARAG), cuyos objetivos son establecer las normas internacionales mínimas para los equipos de rescate e implementar una metodología para la coordinación internacional ante terremotos, maremotos y otros desastres naturales, especialmente la coordinación operativa sobre el terreno. El objetivo de este trabajo es ofrecer una visión sobre la epidemiología de los terremotos, la gestión de los equipos de emergencias, la Asociación de Ayuda a Desastres y Emergencias (AFAD) de Turquía, y abordar cómo es el rescate en estructuras colapsadas. Además, se expone la experiencia de Bomberos Unidos Sin Fronteras (BUSF) en dicho terremoto y se describe un rescate que duró 14 horas. (AU)

The earthquakes that occurred in February 2023 in Türkiye had some of the worst consequences of recent years. The Turkish authorities first deployed local resources and then appealed for international help. The International Search and Rescue Group of the United Nations aims to establish minimum international standards for search and rescue teams and a methodology for coordinating responses to earthquakes, tsunamis, and other natural disasters. A main concern of the group is to coordinate operations on the ground. This article offers perspectives on the epidemiology of earthquakes, the management of emergency response teams and Türkiye’s disaster management agency (AFAD); it also explains how rescues are carried out in collapsed buildings. The experience of Firefighters Without Borders after the recent earthquakes and a rescue that took 14 hours are also described. (AU)

Asunto(s)

RESUMEN

We report on the case of a 28-y-old man with both legs and left arm trapped for nearly 6 h after falling and subsequently being trapped by a boulder during a hike in the wilderness. Extrication required equipment designed for urban environments and was operated by an unconventional team of rescue professionals. The patient experienced multiple right lower-extremity orthopedic injuries, acute kidney injury secondary to rhabdomyolysis, and bilateral segmental pulmonary emboli. In this article, we detail the extrication and review the treatment guidelines for crush injuries that focus on aggressive fluid resuscitation prior to and during extrication and medication administration only if hyperkalemia presents. Wilderness rescuers should plan for the use of unconventional rescue equipment in austere prolonged rescue scenarios.

Asunto(s)

RESUMEN

TEXT: The earthquakes that occurred in February 2023 in Türkiye had some of the worst consequences of recent years. The Turkish authorities first deployed local resources and then appealed for international help. The International Search and Rescue Group of the United Nations aims to establish minimum international standards for search and rescue teams and a methodology for coordinating responses to earthquakes, tsunamis, and other natural disasters. A main concern of the group is to coordinate operations on the ground. This article offers perspectives on the epidemiology of earthquakes, the management of emergency response teams and Türkiye's disaster management agency (AFAD); it also explains how rescues are carried out in collapsed buildings. The experience of Firefighters Without Borders after the recent earthquakes and a rescue that took 14 hours are also described.

TEXTO: Los terremotos ocurridos en Turquía en febrero de 2023 han sido unos de los de mayor impacto en los últimos años. Las autoridades del país, tras activar sus recursos locales y nacionales, hicieron una solicitud de ayuda internacional. Dentro de la Organización de Naciones Unidas (ONU) se encuentra el Grupo Asesor Internacional de Búsqueda y Rescate (INSARAG), cuyos objetivos son establecer las normas internacionales mínimas para los equipos de rescate e implementar una metodología para la coordinación internacional ante terremotos, maremotos y otros desastres naturales, especialmente la coordinación operativa sobre el terreno. El objetivo de este trabajo es ofrecer una visión sobre la epidemiología de los terremotos, la gestión de los equipos de emergencias, la Asociación de Ayuda a Desastres y Emergencias (AFAD) de Turquía, y abordar cómo es el rescate en estructuras colapsadas. Además, se expone la experiencia de Bomberos Unidos Sin Fronteras (BUSF) en dicho terremoto y se describe un rescate que duró 14 horas.

Asunto(s)

RESUMEN

The application of movement-detection sensors is crucial for understanding surface movement and tectonic activities. The development of modern sensors has been instrumental in earthquake monitoring, prediction, early warning, emergency commanding and communication, search and rescue, and life detection. There are numerous sensors currently being utilized in earthquake engineering and science. It is essential to review their mechanisms and working principles thoroughly. Hence, we have attempted to review the development and application of these sensors by classifying them based on the timeline of earthquakes, the physical or chemical mechanisms of sensors, and the location of sensor platforms. In this study, we analyzed available sensor platforms that have been widely used in recent years, with satellites and UAVs being among the most used. The findings of our study will be useful for future earthquake response and relief efforts, as well as research aimed at reducing earthquake disaster risks.

Asunto(s)

RESUMEN

van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.

Asunto(s)

RESUMEN

Image segmentation has been one of the most active research areas in the last decade. The traditional multi-level thresholding techniques are effective for bi-level thresholding because of their resilience, simplicity, accuracy, and low convergence time, but these traditional techniques are not effective in determining the optimal multi-level thresholding for image segmentation. Therefore, an efficient version of the search and rescue optimization algorithm (SAR) based on opposition-based learning (OBL) is proposed in this paper to segment blood-cell images and solve problems of multi-level thresholding. The SAR algorithm is one of the most popular meta-heuristic algorithms (MHs) that mimics humans' exploration behavior during search and rescue operations. The SAR algorithm, which utilizes the OBL technique to enhance the algorithm's ability to jump out of the local optimum and enhance its search efficiency, is termed mSAR. A set of experiments is applied to evaluate the performance of mSAR, solve the problem of multi-level thresholding for image segmentation, and demonstrate the impact of combining the OBL technique with the original SAR for improving solution quality and accelerating convergence speed. The effectiveness of the proposed mSAR is evaluated against other competing algorithms, including the L'evy flight distribution (LFD), Harris hawks optimization (HHO), sine cosine algorithm (SCA), equilibrium optimizer (EO), gravitational search algorithm (GSA), arithmetic optimization algorithm (AOA), and the original SAR. Furthermore, a set of experiments for multi-level thresholding image segmentation is performed to prove the superiority of the proposed mSAR using fuzzy entropy and the Otsu method as two objective functions over a set of benchmark images with different numbers of thresholds based on a set of evaluation matrices. Finally, analysis of the experiments' outcomes indicates that the mSAR algorithm is highly efficient in terms of the quality of the segmented image and feature conservation, compared with the other competing algorithms.