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Published in: Journal of Medical Systems 12/2014

01-12-2014 | Mobile Systems

Use of an Agent-Based Simulation Model to Evaluate a Mobile-Based System for Supporting Emergency Evacuation Decision Making

Authors: Yu Tian, Tian-Shu Zhou, Qin Yao, Mao Zhang, Jing-Song Li

Published in: Journal of Medical Systems | Issue 12/2014

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Abstract

Recently, mass casualty incidents (MCIs) have been occurring frequently and have gained international attention. There is an urgent need for scientifically proven and effective emergency responses to MCIs, particularly as the severity of incidents is continuously increasing. The emergency response to MCIs is a multi-dimensional and multi-participant dynamic process that changes in real-time. The evacuation decisions that assign casualties to different hospitals in a region are very important and impact both the results of emergency treatment and the efficiency of medical resource utilization. Previously, decisions related to casualty evacuation were made by an incident commander with emergency experience and in accordance with macro emergency guidelines. There are few decision-supporting tools available to reduce the difficulty and psychological pressure associated with the evacuation decisions an incident commander must make. In this study, we have designed a mobile-based system to collect medical and temporal data produced during an emergency response to an MCI. Using this information, our system’s decision-making model can provide personal evacuation suggestions that improve the overall outcome of an emergency response. The effectiveness of our system in reducing overall mortality has been validated by an agent-based simulation model established to simulate an emergency response to an MCI.
Literature
2.
go back to reference Turegano-Fuentes, F., Perez-Diaz, D., Sanz-Sanchez, M., and Alonso, J. O., Overall asessment of the response to terrorist bombings in trains, Madrid, 11 March 2004. Eur. J. Trauma Emerg. Surg. 34(5):433–441, 2008. doi:10.1007/s00068-008-8805-2.CrossRef Turegano-Fuentes, F., Perez-Diaz, D., Sanz-Sanchez, M., and Alonso, J. O., Overall asessment of the response to terrorist bombings in trains, Madrid, 11 March 2004. Eur. J. Trauma Emerg. Surg. 34(5):433–441, 2008. doi:10.​1007/​s00068-008-8805-2.CrossRef
3.
go back to reference Aylwin, C. J., Konig, T. C., Brennan, N. W., Shirley, P. J., Davies, G., Walsh, M. S., and Brohi, K., Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet 368(9554):2219–2225, 2006. doi:10.1016/s0140-6736(06)69896-6.CrossRef Aylwin, C. J., Konig, T. C., Brennan, N. W., Shirley, P. J., Davies, G., Walsh, M. S., and Brohi, K., Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet 368(9554):2219–2225, 2006. doi:10.​1016/​s0140-6736(06)69896-6.CrossRef
4.
go back to reference D’Andrea, S. M., Goralnick, E., and Kayden, S. R., 2013 Boston marathon bombings: Overview of an emergency department response to a Mass Casualty Incident. Dis. Med. Public Health Prep 7(2):118–121, 2013. doi:10.1017/dmp.2013.53.CrossRef D’Andrea, S. M., Goralnick, E., and Kayden, S. R., 2013 Boston marathon bombings: Overview of an emergency department response to a Mass Casualty Incident. Dis. Med. Public Health Prep 7(2):118–121, 2013. doi:10.​1017/​dmp.​2013.​53.CrossRef
5.
go back to reference Raiter, Y., Farfel, A., Lehavi, O., Goren, O. B., Shamiss, A., Priel, Z., Koren, I., Davidson, B., Schwartz, D., Goldberg, A., and Bar-Dayan, Y., Mass casualty incident management, triage, injury distribution of casualties and rate of arrival of casualties at the hospitals: lessons from a suicide bomber attack in downtown Tel Aviv. Emerg. Med. J. 25(4):225–229, 2008. doi:10.1136/emj.2007.052399.CrossRef Raiter, Y., Farfel, A., Lehavi, O., Goren, O. B., Shamiss, A., Priel, Z., Koren, I., Davidson, B., Schwartz, D., Goldberg, A., and Bar-Dayan, Y., Mass casualty incident management, triage, injury distribution of casualties and rate of arrival of casualties at the hospitals: lessons from a suicide bomber attack in downtown Tel Aviv. Emerg. Med. J. 25(4):225–229, 2008. doi:10.​1136/​emj.​2007.​052399.CrossRef
10.
go back to reference Baker, S. P., O’Neill, B., Haddon, W., Jr., and Long, W. B., The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J. Trauma 14(3):187–196, 1974.CrossRef Baker, S. P., O’Neill, B., Haddon, W., Jr., and Long, W. B., The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J. Trauma 14(3):187–196, 1974.CrossRef
12.
go back to reference Demetriades, D., Chan, L. S., Velmahos, G., Berne, T. V., Cornwell, E. E., Belzberg, H., Asensio, J. A., Murray, J., Berne, J., and Shoemaker, W., TRISS methodology in trauma: the need for alternatives. Br. J. Surg. 85(3):379–384, 1998. doi:10.1046/j.1365-2168.1998.00610.x.CrossRef Demetriades, D., Chan, L. S., Velmahos, G., Berne, T. V., Cornwell, E. E., Belzberg, H., Asensio, J. A., Murray, J., Berne, J., and Shoemaker, W., TRISS methodology in trauma: the need for alternatives. Br. J. Surg. 85(3):379–384, 1998. doi:10.​1046/​j.​1365-2168.​1998.​00610.​x.CrossRef
13.
16.
go back to reference Jenkins, J. L., McCarthy, M. L., Sauer, L. M., Green, G. B., Stuart, S., Thomas, T. L., and Hsu, E. B., Mass-casualty triage: time for an evidence-based approach. Prehospital Disaster Med. 23(1):3–8, 2008. Jenkins, J. L., McCarthy, M. L., Sauer, L. M., Green, G. B., Stuart, S., Thomas, T. L., and Hsu, E. B., Mass-casualty triage: time for an evidence-based approach. Prehospital Disaster Med. 23(1):3–8, 2008.
18.
go back to reference Sacco, W. J., Navin, D. M., Fiedler, K. E., Waddell, R. K., II, Long, W. B., and Buckman, R. F., Precise formulation and evidence-based application of resource-constrained triage. Acad. Emerg. Med. 12(8):759–770, 2005. doi:10.1197/j.aem.2005.04.003.CrossRef Sacco, W. J., Navin, D. M., Fiedler, K. E., Waddell, R. K., II, Long, W. B., and Buckman, R. F., Precise formulation and evidence-based application of resource-constrained triage. Acad. Emerg. Med. 12(8):759–770, 2005. doi:10.​1197/​j.​aem.​2005.​04.​003.CrossRef
21.
go back to reference Cicero, M. X., Riera, A., Northrup, V., Auerbach, M., Pearson, K., and Baum, C. R., Design, validity, and reliability of a pediatric resident JumpSTART disaster triage scoring instrument. Acad Pediatr 13(1):48–54, 2013. doi:10.1016/j.acap.2012.09.002.CrossRef Cicero, M. X., Riera, A., Northrup, V., Auerbach, M., Pearson, K., and Baum, C. R., Design, validity, and reliability of a pediatric resident JumpSTART disaster triage scoring instrument. Acad Pediatr 13(1):48–54, 2013. doi:10.​1016/​j.​acap.​2012.​09.​002.CrossRef
22.
go back to reference Timbie, J. W., Ringel, J. S., Fox, D. S., Pillemer, F., Waxman, D. A., Moore, M., Hansen, C. K., Knebel, A. R., Ricciardi, R., and Kellermann, A. L., Systematic review of strategies to manage and allocate scarce resources during mass casualty events. Ann. Emerg. Med. 61(6):677–689.e101, 2013. doi:10.1016/j.annemergmed.2013.02.005.CrossRef Timbie, J. W., Ringel, J. S., Fox, D. S., Pillemer, F., Waxman, D. A., Moore, M., Hansen, C. K., Knebel, A. R., Ricciardi, R., and Kellermann, A. L., Systematic review of strategies to manage and allocate scarce resources during mass casualty events. Ann. Emerg. Med. 61(6):677–689.e101, 2013. doi:10.​1016/​j.​annemergmed.​2013.​02.​005.CrossRef
24.
go back to reference Hong, R., Sierzenski, P. R., O’Connor, R. E., Bollinger, M., and Durie, C. C., Does the simple triage and rapid treatment method appropriately triage patients based on trauma injury severity score? Ann. Emerg. Med. 50(3, Supplement):S13, 2007. doi:10.1016/j.annemergmed.2007.06.069.CrossRef Hong, R., Sierzenski, P. R., O’Connor, R. E., Bollinger, M., and Durie, C. C., Does the simple triage and rapid treatment method appropriately triage patients based on trauma injury severity score? Ann. Emerg. Med. 50(3, Supplement):S13, 2007. doi:10.​1016/​j.​annemergmed.​2007.​06.​069.CrossRef
28.
go back to reference Gao, T., and White, D., A next generation electronic triage to aid mass casualty emergency medical response. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Conference Suppl 6501–6504, 2006. doi:10.1109/iembs.2006.260881. Gao, T., and White, D., A next generation electronic triage to aid mass casualty emergency medical response. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Conference Suppl 6501–6504, 2006. doi:10.​1109/​iembs.​2006.​260881.
29.
go back to reference Gao, T., Massey, T., Selavo, L., Crawford, D., Chen, B. R., Lorincz, K., Shnayder, V., Hauenstein, L., Dabiri, F., Jeng, J., Chanmugam, A., White, D., Sarrafzadeh, M., and Welsh, M., The advanced health and disaster aid network: A light-weight wireless medical system for triage. IEEE Trans. Biomed. Circ. Syst. 1(3):203–216, 2007. doi:10.1109/tbcas.2007.910901.CrossRef Gao, T., Massey, T., Selavo, L., Crawford, D., Chen, B. R., Lorincz, K., Shnayder, V., Hauenstein, L., Dabiri, F., Jeng, J., Chanmugam, A., White, D., Sarrafzadeh, M., and Welsh, M., The advanced health and disaster aid network: A light-weight wireless medical system for triage. IEEE Trans. Biomed. Circ. Syst. 1(3):203–216, 2007. doi:10.​1109/​tbcas.​2007.​910901.CrossRef
30.
go back to reference Morris, T. J., Pajak, J., Havlik, F., Kenyon, J., and Calcagni, D., Battlefield Medical Information System-Tactical (BMIST): the application of mobile computing technologies to support health surveillance in the Department of Defense. Telemed. J. E-Health Off. J. Am. Telemed Assoc 12(4):409–416, 2006. doi:10.1089/tmj.2006.12.409.CrossRef Morris, T. J., Pajak, J., Havlik, F., Kenyon, J., and Calcagni, D., Battlefield Medical Information System-Tactical (BMIST): the application of mobile computing technologies to support health surveillance in the Department of Defense. Telemed. J. E-Health Off. J. Am. Telemed Assoc 12(4):409–416, 2006. doi:10.​1089/​tmj.​2006.​12.​409.CrossRef
31.
go back to reference Fry, E. A., Lenert, L. A., MASCAL: RFID tracking of patients, staff and equipment to enhance hospital response to mass casualty events. AMIA Annual Symposium proceedings / AMIA Symposium AMIA Symposium 261–265, 2005. Fry, E. A., Lenert, L. A., MASCAL: RFID tracking of patients, staff and equipment to enhance hospital response to mass casualty events. AMIA Annual Symposium proceedings / AMIA Symposium AMIA Symposium 261–265, 2005.
32.
go back to reference Jokela, J., Simons, T., Kuronen, P., Tammela, J., Jalasvirta, P., Nurmi, J., Harkke, V., and Castren, M., Implementing RFID technology in a novel triage system during a simulated mass casualty situation. Int. J. Electron. Healthc. 4(1):105–118, 2008.CrossRef Jokela, J., Simons, T., Kuronen, P., Tammela, J., Jalasvirta, P., Nurmi, J., Harkke, V., and Castren, M., Implementing RFID technology in a novel triage system during a simulated mass casualty situation. Int. J. Electron. Healthc. 4(1):105–118, 2008.CrossRef
33.
go back to reference Ingrassia, P. L., Carenzo, L., Barra, F. L., Colombo, D., Ragazzoni, L., Tengattini, M., Prato, F., Geddo, A., and Della Corte, F., Data collection in a live mass casualty incident simulation: automated RFID technology versus manually recorded system. Eur. J. Emerg. Med. 19(1):35–39, 2012. doi:10.1097/MEJ.0b013e328347a2c7.CrossRef Ingrassia, P. L., Carenzo, L., Barra, F. L., Colombo, D., Ragazzoni, L., Tengattini, M., Prato, F., Geddo, A., and Della Corte, F., Data collection in a live mass casualty incident simulation: automated RFID technology versus manually recorded system. Eur. J. Emerg. Med. 19(1):35–39, 2012. doi:10.​1097/​MEJ.​0b013e328347a2c7​.CrossRef
34.
go back to reference Lenert, L. A., Kirsh, D., Griswold, W. G., Buono, C., Lyon, J., Rao, R., and Chan, T. C., Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J. Am. Med. Inform. Assoc. 18(6):842–852, 2011. doi:10.1136/amiajnl-2011-000229.CrossRef Lenert, L. A., Kirsh, D., Griswold, W. G., Buono, C., Lyon, J., Rao, R., and Chan, T. C., Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J. Am. Med. Inform. Assoc. 18(6):842–852, 2011. doi:10.​1136/​amiajnl-2011-000229.CrossRef
35.
go back to reference Tollefsen, W. W., Gaynor, M., Pepe, M., Myung, D., Welsh, M., and Moulton, S., iRevive: a pre-hospital database system for emergency medical services. Int. J. Healthc. Technol. Manag. 6(4):454–469, 2005.CrossRef Tollefsen, W. W., Gaynor, M., Pepe, M., Myung, D., Welsh, M., and Moulton, S., iRevive: a pre-hospital database system for emergency medical services. Int. J. Healthc. Technol. Manag. 6(4):454–469, 2005.CrossRef
36.
go back to reference Poulymenopoulou, M., Malamateniou, F., and Vassilacopoulos, G., Emergency healthcare process automation using mobile computing and cloud services. J. Med. Syst. 36(5):3233–3241, 2012. doi:10.1007/s10916-011-9814-y.CrossRef Poulymenopoulou, M., Malamateniou, F., and Vassilacopoulos, G., Emergency healthcare process automation using mobile computing and cloud services. J. Med. Syst. 36(5):3233–3241, 2012. doi:10.​1007/​s10916-011-9814-y.CrossRef
37.
go back to reference Amailef, K., and Lu, J., Mobile-based emergency response system using ontology-supported information extraction. In: Lu, J., Jain, L., and Zhang, G. (Eds.), Handbook on decision making, vol. 33. Intelligent Systems Reference Library, Springer Berlin Heidelberg, pp. 429–449, 2012. doi:10.1007/978-3-642-25755-1_21.CrossRef Amailef, K., and Lu, J., Mobile-based emergency response system using ontology-supported information extraction. In: Lu, J., Jain, L., and Zhang, G. (Eds.), Handbook on decision making, vol. 33. Intelligent Systems Reference Library, Springer Berlin Heidelberg, pp. 429–449, 2012. doi:10.​1007/​978-3-642-25755-1_​21.CrossRef
39.
go back to reference Mears, G. D., Pratt, D., Glickman, S. W., Brice, J. H., Glickman, L. T., Cabañas, J. G., and Cairns, C. B., The North Carolina EMS data system: A comprehensive integrated emergency medical services quality improvement program. Prehospital Emerg. Care 14(1):85–94, 2010. doi:10.3109/10903120903349846.CrossRef Mears, G. D., Pratt, D., Glickman, S. W., Brice, J. H., Glickman, L. T., Cabañas, J. G., and Cairns, C. B., The North Carolina EMS data system: A comprehensive integrated emergency medical services quality improvement program. Prehospital Emerg. Care 14(1):85–94, 2010. doi:10.​3109/​1090312090334984​6.CrossRef
40.
go back to reference Amram, O., Schuurman, N., Hedley, N., and Hameed, S. M., A web-based model to support patient-to-hospital allocation in mass casualty incidents. J. Trauma Acute Care Surg. 72(5):1323–1328, 2012. doi:10.1097/TA.0b013e318246e879. Amram, O., Schuurman, N., Hedley, N., and Hameed, S. M., A web-based model to support patient-to-hospital allocation in mass casualty incidents. J. Trauma Acute Care Surg. 72(5):1323–1328, 2012. doi:10.​1097/​TA.​0b013e318246e879​.
41.
go back to reference Kondaveti, R., and Ganz, A., Decision support system for resource allocation in disaster management. In: Engineering in Medicine and Biology Society, 2009. EMBC 2009. Annual International Conference of the IEEE, 3–6 Sept. 2009. pp 3425–3428. doi:10.1109/IEMBS.2009.5332498. Kondaveti, R., and Ganz, A., Decision support system for resource allocation in disaster management. In: Engineering in Medicine and Biology Society, 2009. EMBC 2009. Annual International Conference of the IEEE, 3–6 Sept. 2009. pp 3425–3428. doi:10.​1109/​IEMBS.​2009.​5332498.
42.
go back to reference Reddy, M. C., Paul, S. A., Abraham, J., McNeese, M., DeFlitch, C., and Yen, J., Challenges to effective crisis management: Using information and communication technologies to coordinate emergency medical services and emergency department teams. Int. J. Med. Inform. 78(4):259–269, 2009. doi:10.1016/j.ijmedinf.2008.08.003.CrossRef Reddy, M. C., Paul, S. A., Abraham, J., McNeese, M., DeFlitch, C., and Yen, J., Challenges to effective crisis management: Using information and communication technologies to coordinate emergency medical services and emergency department teams. Int. J. Med. Inform. 78(4):259–269, 2009. doi:10.​1016/​j.​ijmedinf.​2008.​08.​003.CrossRef
43.
go back to reference Scheulen, J. J., Thanner, M. H., Hsu, E. B., Latimer, C. K., Brown, J., and Kelen, G. D., Electronic Mass Casualty Assessment and Planning Scenarios (EMCAPS): Development and application of computer modeling to selected national planning scenarios for high-consequence events. Ann. Emerg. Med. 53(2):226–232.e222, 2009. doi:10.1016/j.annemergmed.2008.09.014.CrossRef Scheulen, J. J., Thanner, M. H., Hsu, E. B., Latimer, C. K., Brown, J., and Kelen, G. D., Electronic Mass Casualty Assessment and Planning Scenarios (EMCAPS): Development and application of computer modeling to selected national planning scenarios for high-consequence events. Ann. Emerg. Med. 53(2):226–232.e222, 2009. doi:10.​1016/​j.​annemergmed.​2008.​09.​014.CrossRef
44.
go back to reference Hupert, N., Mushlin, A. I., and Callahan, M. A., Modeling the public health response to bioterrorism: Using discrete event simulation to design antibiotic distribution centers. Med. Decis. Mak. 22(5 suppl):S17–S25, 2002. doi:10.1177/027298902237709.CrossRef Hupert, N., Mushlin, A. I., and Callahan, M. A., Modeling the public health response to bioterrorism: Using discrete event simulation to design antibiotic distribution centers. Med. Decis. Mak. 22(5 suppl):S17–S25, 2002. doi:10.​1177/​027298902237709.CrossRef
47.
go back to reference Cohen, I., Mandelbaum, A., and Zychlinski, N., Minimizing mortality in a mass casualty event: Fluid networks in support of modeling and staffing. IIE Transs Null Null, 2013. doi:10.1080/0740817X.2013.855846. Cohen, I., Mandelbaum, A., and Zychlinski, N., Minimizing mortality in a mass casualty event: Fluid networks in support of modeling and staffing. IIE Transs Null Null, 2013. doi:10.​1080/​0740817X.​2013.​855846.
48.
go back to reference Rauner, M., Schaffhauser-Linzatti, M., and Niessner, H., Resource planning for ambulance services in mass casualty incidents: A DES-based policy model. Health Care Manag. Sci. 15(3):254–269, 2012. doi:10.1007/s10729-012-9198-7.CrossRef Rauner, M., Schaffhauser-Linzatti, M., and Niessner, H., Resource planning for ambulance services in mass casualty incidents: A DES-based policy model. Health Care Manag. Sci. 15(3):254–269, 2012. doi:10.​1007/​s10729-012-9198-7.CrossRef
49.
go back to reference Tian, Y., Zhou, T.-S., Wang, Y., Zhang, M., and Li, J.-S., Design and development of a mobile-based system for supporting emergency triage decision making. J. Med. Syst. 38(6):1–10, 2014. doi:10.1007/s10916-014-0065-6.CrossRef Tian, Y., Zhou, T.-S., Wang, Y., Zhang, M., and Li, J.-S., Design and development of a mobile-based system for supporting emergency triage decision making. J. Med. Syst. 38(6):1–10, 2014. doi:10.​1007/​s10916-014-0065-6.CrossRef
50.
51.
go back to reference Taylor, C. B., Curtis, K., Jan, S., and Newcombe, M., Helicopter emergency medical services (HEMS) over-triage and the financial implications for major trauma centres in NSW, Australia. BMC Emerg. Med. 13:11, 2013. doi:10.1186/1471-227x-13-11.CrossRef Taylor, C. B., Curtis, K., Jan, S., and Newcombe, M., Helicopter emergency medical services (HEMS) over-triage and the financial implications for major trauma centres in NSW, Australia. BMC Emerg. Med. 13:11, 2013. doi:10.​1186/​1471-227x-13-11.CrossRef
53.
go back to reference Sacco, W. J., Navin, D. M., Waddell, R. K. I., Fiedler, K. E., Long, W. B., and Buckman, R. F. J., A new resource-constrained triage method applied to victims of penetrating injury. J. Trauma Acute Care Surg. 63(2):316–325, 2007. doi:10.1097/TA.0b013e31806bf212.CrossRef Sacco, W. J., Navin, D. M., Waddell, R. K. I., Fiedler, K. E., Long, W. B., and Buckman, R. F. J., A new resource-constrained triage method applied to victims of penetrating injury. J. Trauma Acute Care Surg. 63(2):316–325, 2007. doi:10.​1097/​TA.​0b013e31806bf212​.CrossRef
54.
go back to reference North, M. J., Collier, N. T., and Vos, J. R., Experiences creating three implementations of the repast agent modeling toolkit. ACM Trans. Model. Comput. Simul. 16(1):1–25, 2006. doi:10.1145/1122012.1122013.CrossRef North, M. J., Collier, N. T., and Vos, J. R., Experiences creating three implementations of the repast agent modeling toolkit. ACM Trans. Model. Comput. Simul. 16(1):1–25, 2006. doi:10.​1145/​1122012.​1122013.CrossRef
57.
58.
go back to reference Martínez-Pérez, B., de la Torre-Díez, I., López-Coronado, M., Sainz-de-Abajo, B., Robles, M., and García-Gómez, J., Mobile clinical decision support systems and applications: A literature and commercial review. J. Med. Syst. 38(1):1–10, 2014. doi:10.1007/s10916-013-0004-y.CrossRef Martínez-Pérez, B., de la Torre-Díez, I., López-Coronado, M., Sainz-de-Abajo, B., Robles, M., and García-Gómez, J., Mobile clinical decision support systems and applications: A literature and commercial review. J. Med. Syst. 38(1):1–10, 2014. doi:10.​1007/​s10916-013-0004-y.CrossRef
Metadata
Title
Use of an Agent-Based Simulation Model to Evaluate a Mobile-Based System for Supporting Emergency Evacuation Decision Making
Authors
Yu Tian
Tian-Shu Zhou
Qin Yao
Mao Zhang
Jing-Song Li
Publication date
01-12-2014
Publisher
Springer US
Published in
Journal of Medical Systems / Issue 12/2014
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-014-0149-3

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