Search results for: narrative history

Authors: Anastasia Constantinou, Stephen Morris

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Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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Authors: Chia-Wen Yeh, Ting-Sheng Lin, Chih-Han Chang

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Pressure garment has been used to prevent and treat the hypertrophic scars following serious burns since 1970s. The use of pressure garment is believed to hasten the maturation process and decrease the highness of scars. Pressure garment is custom made by reducing circumferential measurement of the patient by 10%~20%, called Reduction Factor. However the exact reducing value used depends on the subjective judgment of the therapist and the feeling of patients throughout the try and error process. The Laplace Law can be applied to calculate the pressure from the dimension of the pressure garment by the circumferential measurements of the patients and the tension profile of the fabrics. The tension profile currently obtained neglects the stress relaxation and hysteresis effect within most elastic fabrics. The purpose of this study was to investigate the influence of the tension attenuation, from stress relaxation and hysteresis effect of the fabrics. Samples of pressure garment were obtained from Sunshine Foundation Organization, a nonprofit organization for burn patients in Taiwan. The wall tension profile of pressure garments were measured on a material testing system. Specimens were extended to 10% of the original length, held for 1 hour for the influence of the stress relaxation effect to take place. Then, specimens were extended to 15% of the original length for 10 seconds, then reduced to 10% to simulate donning movement for the influence of the hysteresis effect to take place. The load history was recorded. The stress relaxation effect is obvious from the load curves. The wall tension is decreased by 8.5%~10% after 60mins of holding. The hysteresis effect is obvious from the load curves. The wall tension is increased slightly, then decreased by 1.5%~2.5% and lower than stress relaxation results after 60mins of holding. The wall tension attenuation of the fabric exists due to stress relaxation and hysteresis effect. The influence of hysteresis is more than stress relaxation. These effect should be considered in order to design and evaluate the pressure of pressure garment more accurately.

Keywords: hypertrophic scars, hysteresis, pressure garment, stress relaxation

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Authors: Saboor Saeed, Chunming Jiang

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Eosinophilic Granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic vasculitis of small and medium-sized vessels that primarily develops in middle-aged individuals. It is characterized by asthma, blood eosinophilia, and extra pulmonary manifestations. In childhood, EGPA is extremely rare. Pulmonary and cardiac involvement is predominant in pediatric EGPA, and mortality is substantial. Generally, EGPA will develop in three stages: a) The allergic phase is commonly associated with asthma, allergic rhinitis, and sinusitis, b) the eosinophilic phase, in which the main pathology is related to the infiltration of eosinophilic organs, i.e., lung, heart, and gastrointestinal system, c) vasculitis phase involved purpura, peripheral neuropathy, and some constitutional symptoms. The key to the treatment of EGPA lies in the early diagnosis of the disease. Early application of glucocorticoids and immunosuppressants can improve symptoms and the overall prognosis of EGPA. Case Description: We presented a case of an 8-year-old boy with a history of short asthma, marked eosinophilia, and multi-organ involvement. The extremely high eosinophil level in the blood (72.50%) prompted the examination of eosinophilic leukemia before EGPA diagnosis was made. Subsequently, this disease was successfully treated. This case report shows a typical case of CSS in childhood because of the extreme eosinophilia. It emphasizes the importance of EGPA is a life-threatening cause of children's eosinophilia. Conclusion: EGPA in children has unique clinical, imaging, and histological characteristics different from those of adults. In pediatric patients, the development and diagnosis of systemic symptoms are often delayed, mainly occurring in the eosinophilic phase, which will lead to specific manifestations. At the same time, we cannot detect a genetic relationship related to EGPA.

Keywords: Churg Strauss syndrome, asthma, vasculitis, hypereosinophilia, eosinophilic granulomatosis polyangiitis

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Authors: Shahira El Shafie, Hanaa Eldash, Engy Ghabbour, Mohamed Eid

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Several immunologic defects can be found in patients with beta-thalassemia, among which the impairment of neutrophil phagocytic function is of utmost importance. Attention has been directed to the role of proinflammatory cytokines in neutrophil chemotaxis and phagocytosis. Interleukin-8 (IL-8) is an important chemotactic and activation peptide for neutrophils; changes in IL-8 level and potential correlation with neutrophil function can be relevant to immunomodulation pathophysiology in beta-thalassemia patients. This case-control study aimed to evaluate IL-8 level and to assess granulocyte recruitment, as markers of immunomodulation, in poly-transfused thalassemia patients attending Fayoum University Hospitals. The study was conducted on 50 patients with ß thalassemia and 32 age-matched controls. 21/50 patients were transfused more than ten times, and 29/50 were transfused in a lower frequency. Patients and controls were subjected to thorough history taking and clinical examination, measurement of IL-8 level using human IL-8 ELISA kit, and Rebuck skin window technique (RSWT) to assess granulocyte recruitment. Our data showed statistically significant higher levels of IL-8 in ß thalassemia patients compared to control with a much higher difference in patients transfused more than ten times. Neutrophil recruitment was significantly lower in ß thalassemia patients compared to control at 4 hours and 24 hours test time. Although IL-8, the main chemotactic pro-inflammatory cytokine showed a higher level in thalassemia patients, neutrophils recruitment was significantly lower, especially in those receiving more than ten transfusion times. Our findings suggest a possible role of other neutrophil chemotactic factors, defective neutrophil response, or increased IL-8 as compensation of abnormal function. We recommend the use of IL-8 and Rebuck skin window technique as useful markers of immunomodulation in thalassemia and further study for these biomarkers to assess their clinical implications and impact on the management of thalassemia patients.

Keywords: beta-thalassemia, Interleukin-8, Rebuck skin window technique, immunomodulation

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Authors: Indrani Chattopadhyaya

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This paper seeks to examine how identity – a cultural self-image of a group of people develops – how they live, they think, they celebrate and express their world view through language, gesture, symbols, and rituals. 'Culture' is a way of life and 'identity' is assertion of that cultural self-image practiced by the group. The way in which peoples live varies from time to time and from place to place. This variation is important for their identity. Archaeologists have classified these patterns of spacial variations as 'archaeological culture.' These cultures are identified 'self-consciously' with a particular social group indicating ethnicity. The ethnic identity as archaeological cultures also legitimizes the claims of modern groups to territory. In prehistoric research problems of ethnicity and multiculturalism, stylistic attributes significantly reflect both group membership and individuality. In India, anthropologists feel that though tribes have suffered relative isolation through history, they have remained an integral part of Indian civilization. The term 'tribe' calls for substitution with a more meaningful name with an indigenous flavour 'Adivasi' (original inhabitants of the land).While studying prehistoric rock paintings from central India - Sonbhadra (Uttar Pradesh) and Bhimbetka (Madhya Pradesh), one is struck by the similarity between stylistic attributes of painted motifs in the prehistoric rock shelters and the present day indigenous art of Kol and Bhil tribes in the area, who have not seen these prehistoric rock paintings, yet are carrying on with the tradition of painting and decorating their houses in the same way. They worship concretionary sandstone blocks with triangular laminae as Goddess, Devi, Shakti. This practice is going on since Upper Palaeolithic period confirmed by archaeological excavation. The past is legitimizing the role of the present groups by allowing them to trace their roots from earlier times.

Keywords: ethnic identity, hermeneutics, semiotics, Adivasi

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Authors: N. Anand, P. S. Nayyer, V. Rana, S. Verma

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Background: Diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular and macrovascular complications. Among the lesser known complications is the involvement of respiratory system. Changes in pulmonary volume, diffusion and elastic properties of lungs as well as the performance of the respiratory muscles lead to a restrictive pattern in lung functions. The present study was aimed to determine the changes in various parameters of pulmonary function tests amongst patients with Type 2 Diabetes Mellitus and also try to study the effect of duration of Diabetes Mellitus on pulmonary function tests. Methods: It was a cross sectional study performed at Dr Baba Saheb Ambedkar Hospital and Medical College in, Delhi, A Tertiary care referral centre which included 200 patients divided into 2 groups. The first group included diagnosed patients with diabetes and the second group included controls. Cases and controls symptomatic for any acute or chronic Respiratory or Cardiovascular illness or a history of smoking were excluded. Both the groups were subjected to spirometry to evaluate for the pulmonary function tests. Result: The mean Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) was found to be significantly decreased ((P < 0.001) as compared to controls while the mean ratio of Forced Expiratory Volume in First second to Forced Vital Capacity was not significantly decreased( p>0.005). There was no correlation seen with duration of the disease. Conclusion: Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) were found to be significantly decreased in patients of Diabetes mellitus while ratio of Forced Expiratory Volume in First second to Forced Vital Capacity (FEV1/FVC) was not significantly decreased. The duration of Diabetes mellitus was not found to have any statistically significant effect on Pulmonary function tests (p > 0.005).

Keywords: diabetes mellitus, pulmonary function tests, forced vital capacity, forced expiratory volume in first second

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Authors: Ying-Hsiang Ho, Hsiao-Tseng Lin

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Mudan Township is a remote mountainous area in Taiwan. In recent years, due to the migration of the population, inconvenient transportation, digital divide, and low production, agricultural products marketing have become a major issue. This research aims to develop the marketing strategy suitable for the agricultural products of the rural areas. The main objective of this work is to conduct in-depth interviews with scholars and experts in the marketing field, combined with the marketing 4P combination, to analyze and summarize the possible marketing strategies for agricultural products for remote districts. The interviews consist of seven experts from industry who have practical experience in producing, marketing, and selling agricultural products and three professors that have experience in teaching marketing management. The in-depth interviews are conducted for about an hour using a pre-drafted interview outline. The results of the interviews are summarized by semantic analysis and presented in a marketing 4P combination. The results indicate that in terms of products, high-quality products with original characteristics can be added through the implementation of production history, organic certification, and cultural packaging. In the place part, we found that the use of emerging communities, the emphasis on cross-industry alliances, the improvement of information application capabilities of rural households, production and marketing group, and contractual farming system are the development priorities. In terms of promotion, it should be an emphasis on the management of internet social media and word-of-mouth marketing. Mudan Township may consider promoting agricultural products through special festivals such as farmer's market, wild ginger flower season and hot spring season. This research also proposes relevant recommendations for the government's public sector and related industry reference for the promotion of agricultural products for remote area.

Keywords: marketing strategy, remote districts, agricultural products, in-depth interviews

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Authors: Emrehan Ozcan, Dilek Beyazlı

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The development of tourism depends on an accurate planning approach as well as on the right planning process. This dependency is also a key factor in ensuring sustainability of tourism. The types of tourism, social expectations, planning practice, the socio-economic and the cultural structure of the region are determinants of planning approaches for tourism development. The tourism plans prepared for the historic city centers are usually based on the revitalization of cultural and historical values. The preservation and development of the tourism potentials of the historic city centers are important for providing an economic contribution to the locality, creating livable solutions for local residents and also the sustainability of tourism. This research is about experiencing and discussing a planning approach that will provide tourism development based on historical and cultural values. Historical and cultural values in the historical city center of Trabzon -which has a settlement history of approximately 4000 years, is located on the Black Sea coast of Turkey- wear out over years and lose their tourism potential. A planning study has been experienced with strategic spatial planning approach for Trabzon, which has not done a tourism-oriented planning study until now. The stages of the planning process provided by strategic spatial planning approach are an assessment of the current situation; vision, strategies, and actions; action planning; designing and implementation of actions and monitoring-evaluation. In the discussion section, the advantages, planning process, methods and techniques of the approach are discussed for the possibilities and constraints in terms of tourism planning. In this context, it is aimed to put forth tourism planning process, stages, and implementation tools within the scope of strategic spatial planning approach by comparing approaches used in the tourism-oriented/priority planning of historical city centers. Suggestions on the position and effect of the preferred planning approach in the existing spatial planning practice are the outputs of the study.

Keywords: cultural heritage, tourism oriented planning, Trabzon, strategic spatial Planning

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Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata, Korczak Józef

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Cereal products, including mainly bread is a staple food known from the beginning of history throughout the world. It is now believed that there is no replacement of the basic food. Bread, due to the high content of starch is the energy source for the proper functioning of our body. It also contains proteins, fats, vitamins, especially of the B group and vitamin E, a number of minerals, and fiber. The aim of the study was to evaluate the antioxidant activity of new developed bread premixes with mulberry fruits for people with anemia, diabetes, obesity and cardiovascular disease. From the finished product-bread, aqueous and methanol extracts was prepared, which in next step were analyzed to assess the activity of the radical DPPH test, ABTS, chelating activity, the ability to reduce metals. Extracts were prepared from bread were acquired with premixes directly after production and stored for three months. The resulting trial breads effect by different mechanisms of antioxidant. They showed the ability to scavenge radicals ABTS and DPPH and chelating activity. Methanol extracts showed significantly greater antioxidant activity in comparison with aqueous extracts, and the largest effect was estimated for sample of bread for anemia, diabetes and cardiovascular disease. The greatest ability to scavenging ABTS radicals showed breads for anemia, diabetes and cardiovascular disease, while smaller for anemia and control sample. It was shown that the methanol extracts of the breads samples showed no ability to chelate iron (II). These properties are observed only in the aqueous extracts. The greatest ability attempt had anemia while the lowest control sample. Financial supported by the UE Project no POIG 01.01.02-00-061/09.

Keywords: morus alba, antioxidant activity, free radicals, polyphenols

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Authors: David Ugalde, Arturo Castillo, Leopoldo Breschi

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The Tuned Mass Dampers (TMDs) are an effective system for mitigating vibrations in building structures. These dampers have traditionally focused on the protection of high-rise buildings against earthquakes and wind loads. The Camara Chilena de la Construction (CChC) building, built in 2018 in Santiago, Chile, is a 21-story RC wall building equipped with a 150-ton TMD and instrumented with six permanent accelerometers, offering an opportunity to monitor the dynamic response of this damped structure. This paper presents the system identification of the CChC building using power spectral density plots of ambient vibration and two seismic events (5.5 Mw and 6.7 Mw). Linear models of the building with and without the TMD are used to compute the theoretical natural periods through modal analysis and simulate the response of the building through response history analysis. Results show that natural periods obtained from both ambient vibrations and earthquake records are quite similar to the theoretical periods given by the modal analysis of the building model. Some of the experimental periods are noticeable by simple inspection of the earthquake records. The accelerometers in the first story better captured the modes related to the building podium while the upper accelerometers clearly captured the modes related to the tower. The earthquake simulation showed smaller accelerations in the model with TMD that are similar to that measured by the accelerometers. It is concluded that the system identification through power spectral density shows consistency with the expected dynamic properties. The structural health monitoring of the CChC building confirms the advantages of seismic protection technologies such as TMDs in seismic prone areas.

Keywords: system identification, tuned mass damper, wall buildings, seismic protection

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Authors: Enes Gunaltili, Burak Dam

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The airplane history started with the Wright brothers' aircraft and improved day by day. With the help of this advancements, big aircrafts replace with small and unmanned air vehicles, so in this study we design this type of air vehicles. First of all, aircrafts mainly divided into two main parts in our day as a rotary and fixed wing aircrafts. The fixed wing aircraft generally use for transport, cargo, military and etc. The rotary wing aircrafts use for same area but there are some superiorities from each other. The rotary wing aircraft can take off vertically from the ground, and it can use restricted area. On the other hand, rotary wing aircrafts generally can fly lower range than fixed wing aircraft. There are one kind of aircraft consist of this two types specifications. It is named as VTOL (vertical take-off and landing) type aircraft. VTOLs are able to takeoff and land vertically and fly horizontally. The VTOL aircrafts generally can fly higher range from the rotary wings but can fly lower range from the fixed wing aircraft but it gives beneficial range between them. There are many other advantages of VTOL aircraft from the rotary and fixed wing aircraft. Because of that, VTOLs began to use for generally military, cargo, search, rescue and mapping areas. Within this framework, this study answers the question that how can we design VTOL as a small unmanned aircraft systems for search and rescue application for benefiting the advantages of fixed wing and rotary wing aircrafts by eliminating the disadvantages of them. To answer that question and design VTOL aircraft, multidisciplinary design optimizations (MDO), some theoretical terminologies, formulations, simulations and modelling systems based on CFD (Computational Fluid Dynamics) is used in same time as design methodology to determine design parameters and steps. As a conclusion, based on tests and simulations depend on design steps, suggestions on how the VTOL aircraft designed and advantages, disadvantages, and observations for design parameters are listed, then VTOL is designed and presented with the design parameters, advantages, and usage areas.

Keywords: airplane, rotary, fixed, VTOL, CFD

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Authors: John Hardy

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Over the last decade, the increasing utility of extremist narratives to the operational effectiveness of terrorist organizations has been evidenced by the proliferation of inspired or affiliated attacks across the world. Famous examples such as regional al-Qaeda affiliates and the self-styled “Islamic State” demonstrate the effectiveness of leveraging communication technologies to disseminate propaganda, recruit members, and orchestrate attacks. Terrorist organizations with the capacity to harness the communicative power offered by digital communication technologies and effective political narratives have held an advantage over their targets in recent years. Terrorists have leveraged the perceived legitimacy of grass-roots actors to appeal to a global audience of potential supporters and enemies alike, and have wielded a proficiency in profile-raising which remains unmatched by counter terrorism narratives around the world. In contrast, many attempts at propagating official counter-narratives have been received by target audiences as illegitimate, top-down and impersonally bureaucratic. However, the benefits provided by widespread communication and extremist narratives have come at an operational cost. Terrorist organizations now face a significant challenge in protecting their access to communications technologies and authority over the content they create and endorse. The dissemination of effective narratives has emerged as a core function of terrorist organizations with international reach via inspired or affiliated attacks. As such, it has become a critical function which can be targeted by intelligence and security forces. This study applies network targeting principles which have been used by coalition forces against a range of non-state actors in the Middle East and South Asia to the communicative function of terrorist organizations. This illustrates both a conceptual link between functional targeting and operational disruption in the abstract and a tangible impact on the operational effectiveness of terrorists by degrading communicative ability and legitimacy. Two case studies highlight the utility of applying functional targeting against terrorist organizations. The first case is the targeted killing of Anwar al-Awlaki, an al-Qaeda propagandist who crafted a permissive narrative and effective propaganda videos to attract recruits who committed inspired terrorist attacks in the US and overseas. The second is a series of operations against Islamic State propagandists in Syria, including the capture or deaths of a cadre of high profile Islamic State members, including Junaid Hussain, Abu Mohammad al-Adnani, Neil Prakash, and Rachid Kassim. The group of Islamic State propagandists were linked to a significant rise in affiliated and enabled terrorist attacks and were subsequently targeted by law enforcement and military agencies. In both cases, the disruption of communication between the terrorist organization and recruits degraded both communicative and operational functions. Effective functional targeting on member recruitment and operational tempo suggests that narratives are a critical function which can be leveraged against terrorist organizations. Further application of network targeting methods to terrorist narratives may enhance the efficacy of a range of counter terrorism techniques employed by security and intelligence agencies.

Keywords: countering violent extremism, counter terrorism, intelligence, terrorism, violent extremism

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Authors: Reem Saad Alqahtani

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Drawing on minority literature, this research highlights the role of three contemporary Arab American writers, considering the significance of the historical and cultural contexts of the brutal attacks of 9/11. The focus of the research is to draw attention to the poetry of Samuel Hazo, Nathalie Handal, and Naomi Shihab Nye as representatives of the identity crisis, whose experiences left them feeling marginalized and alienated in both societies, and reflected as one of the ethnic American minority groups, as demonstrated in their poetry, with a special focus on hybridity, resistance, identity, and empowerment. The study explores the writers’ post-9/11 experience, affected by the United States’ long history of marginalization and discrimination against people of colour, placing Arab American literature with that of other ethnic American groups who share the same experience and contribute to composing literature characterized by the aesthetics of cultural hybridity, cultural complexity, and the politics of minorities to promote solidarity and coalition building. Indeed, the three selected Arab American writers have found a link between their narration and the identity of the exiled by establishing an identity that is a kind of synthesis of diverse identities of Western reality and Eastern nostalgia. The approaches applied in this study will include historical/biographical, postcolonial, and discourse analysis. The first will be used to emphasize the influence of the biographical aspects related to the community, identity, and resistance of the three poets on their poetry. The second is used to investigate the effects of postcolonialism on the poets and their responses to it, while the third understand the sociocultural, political, and historical dimensions of the texts, establishing these poets as representative of the Arab American experience. This study is significant because it will help shed light on the importance of the Arabic hybrid identity in creating resistance to minority communities within American society.

Keywords: Arab American, identity, hybridity, post-9/11

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Authors: Daniele Losanno, H. A. Hadad, Giorgio Serino

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This paper presents a numerical investigation on the seismic performance of a benchmark bridge with different optimal isolation systems under near fault ground motion. Usually, very large displacements make seismic isolation an unfeasible solution due to boundary conditions, especially in case of existing bridges or high risk seismic regions. Hence, near-fault ground motions are most likely to affect either structures with long natural period range like isolated structures or structures sensitive to velocity content such as viscously damped structures. The work is aimed at analyzing the seismic performance of a three-span continuous bridge designed with different isolation systems having different levels of damping. The case study was analyzed in different configurations including: (a) simply supported, (b) isolated with lead rubber bearings (LRBs), (c) isolated with rubber isolators and 10% classical damping (HDLRBs), and (d) isolated with rubber isolators and 70% supplemental damping ratio. Case (d) represents an alternative control strategy that combines the effect of seismic isolation with additional supplemental damping trying to take advantages from both solutions. The bridge is modeled in SAP2000 and solved by time history direct-integration analyses under a set of six recorded near-fault ground motions. In addition to this, a set of analysis under Italian code provided seismic action is also conducted, in order to evaluate the effectiveness of the suggested optimal control strategies under far field seismic action. Results of the analysis demonstrated that an isolated bridge equipped with HDLRBs and a total equivalent damping ratio of 70% represents a very effective design solution for both mitigation of displacement demand at the isolation level and base shear reduction in the piers also in case of near fault ground motion.

Keywords: isolated bridges, near-fault motion, seismic response, supplemental damping, optimal design

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Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: In carbon monoxide (CO) intoxication, the pathophysiology of delayed neurological sequelae (DNS) is very complex and remains poorly understood. And predicting whether patients who exhibit resolved acute symptoms have escaped or will experience DNS represents a very important clinical issue. Brain magnetic resonance (MR) imaging has been conducted to assess the severity of brain damage as an objective method to predict prognosis. And co-ingestion of a second poison in patients with intentional CO poisoning occurs in almost one-half of patients. Among patients with co-ingestions, 66% ingested ethanol. We assessed the effects of ethanol on neurologic sequelae prevalence in acute CO intoxication by means of abnormal lesion in brain MR. Method: This study was conducted retrospectively by collecting data for patients who visited an emergency medical center during a period of 5 years. The enrollment criteria were diagnosis of acute CO poisoning and the measurement of the serum ethanol level and history of taking a brain MR during admission period. Official readout data by radiologist are used to decide whether abnormal lesion is existed or not. The enrolled patients were divided into two groups: patients with abnormal lesion and without abnormal lesion in Brain MR. A standardized extraction using medical record was performed; Mann Whitney U test and logistic regression analysis were performed. Result: A total of 112 patients were enrolled, and 68 patients presented abnormal brain lesion on MR. The abnormal brain lesion group had lower serum ethanol level (mean, 20.14 vs 46.71 mg/dL) (p-value<0.001). In addition, univariate logistic regression analysis showed the serum ethanol level (OR, 0.99; 95% CI, 0.98 -1.00) was independently associated with the development of abnormal lesion in brain MR. Conclusion: Ethanol could have neuroprotective effect in acute CO intoxication by sedative effect in stressful situation and mitigative effect in neuro-inflammatory reaction.

Keywords: carbon monoxide, delayed neuropsychological sequelae, ethanol, intoxication, magnetic resonance

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Authors: Nantale Prossy Nabatte, Josephat Nyagero, Elizabeth Kemigisha

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Background: Human Papilloma Virus (HPV) is a prevalent sexually transmitted infection (STI) in the world. It is important to screen for HPV so that women found positive receive early treatment to prevent the development of cervical cancer. The broad aim of the research was to explore the types, occurrence, and associated correlates of HPV infection by genotyping Human papillomavirus among a cohort of WLHIV attending an antiretroviral therapy clinic in Mukono, Uganda. Methods: A cross-sectional study was used to collect data for socio-demographic, sexual practices, and medical history factors associated with HPV genotypes using a pretested interview guide subjected to 342 WLHIV. The respondents’ results for HPV genotypes were obtained retrospectively from respective laboratory records. Data was entered in Epidata v4.6 and analysed using STATA V14. The prevalence of hr-HPV was estimated as a proportion of the entire sample size. Analysis for the correlates of hr-HPV infection was done using a modified Poisson regression model. Results: Slightly more than a half of respondents were aged below 35 years (56.7%), married (52.6%), and with a primary level of education (51.2%). The prevalence of hr-HPV was 39.8% at a 95% confidence interval (CI: 34.40- 44.78). The hr-HPV was higher among those between 30-34 years of age (n= 41, 30.2%) than those between the age of 45-49 years (n=16, 11.8%). In terms of associated correlates, age 45-49 years (aPR: 1.95, 95% CI: 1.41- 2.69), being married (aPR: 1.30, 95% CI: 1.00, 1.69), use of condoms (aPR: 1.31, 95% CI: 1.00 -1.71) and age of sexual debut (aPR: 1.42, 95% CI: 1.08-1.87) were significantly associated with Human papillomavirus genotypes. Conclusion and Recommendation: The prevalence of hr-HPV infection was high, indicative of a risk to the health of WLHIV in Mukono, Uganda, and worldwide at large. The correlates are age 45-49 years, being married, use of condoms, and age of sexual debut. Based on the results, it is recommended that the implementing teams in such projects put more emphasis on the diagnosis of hr-HPV infection and monitoring the treatment. More research is required to determine the effect of ART therapy on hr-HPV persistence.

Keywords: human papillomavirus genotypes, and their correlates, among women living with HIV, attending antiretroviral clinic

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Authors: Ziwei Guo, Liangping Hong, Zhiguo Ye

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The exogenous modernization process in China and other late-coming countries, is not resulted from a gradual growth of their own modernity features, but a conscious response to external challenges. Under this context, it had been equally important for Chinese cities to make themselves ‘Chinese’ as well as ‘modern’. Wuhan was the first opened inland treaty port in late Qing Dynasty. In the following one hundred years, Wuhan transferred from a feudal town to a modern industrial city. It is a good example to illustrate the urban construction and cultural heritage through the process and impact of social transformation. An overall perspective on transformation will contribute to develop the city`s uniqueness and enhance its inclusive development. The study chooses the history of Wuhan from 1861 to 1957 as the study period. The whole transformation process will be divided into four typical periods based on key historical events, and the paper analyzes the changes on urban structure and constructions activities in each period. Then, a lot of examples are used to compare the features of Wuhan modern city heritage in the four periods. In this way, three characteristics of Wuhan modern city heritage are summarized. The paper finds that globalization and localization worked together to shape the urban physical space environment. For Wuhan, social transformation has a profound and comprehensive impact on urban construction, which can be analyzed in the aspects of main construction, architecture style, location and actors. Moreover, the three towns of Wuhan have a disparate cityscape that is reflected by the varied heritages and architecture features over different transformation periods. Lastly, the protection regulations and conservation planning of heritage in Wuhan are discussed, and suggestions about the conservation of Wuhan modern heritage are tried to be drawn. The implications of the study are providing a new perspective on modern city heritage for cities like Wuhan, and the future local planning system and heritage conservation policies can take into consideration the ‘Modern Cultural Transformation Route’ in this paper.

Keywords: modern city heritage, transformation, identity, Wuhan

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Authors: Farhat Imtiaz, Umar Farooq

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In this work, we developed a computational model to predict ply level failure in impacted composite laminates. Data obtained from physical testing from flat and round nose impacts of 8-, 16-, 24-ply laminates were considered. Routine inspections of the tested laminates were carried out to approximate ply by ply inflicted damage incurred. Plots consisting of load–time, load–deflection, and energy–time history were drawn to approximate the inflicted damages. Impact test generated unwanted data logged due to restrictions on testing and logging systems were also filtered. Conventional filters (built-in, statistical, and numerical) reliably predicted load thresholds for relatively thin laminates such as eight and sixteen ply panels. However, for relatively thick laminates such as twenty-four ply laminates impacted by flat nose impact generated clipped data which can just be de-noised using oscillatory algorithms. The literature search reveals that modern oscillatory data filtering and extrapolation algorithms have scarcely been utilized. This investigation reports applications of filtering and extrapolation of the clipped data utilising fast Fourier Convolution algorithm to predict load thresholds. Some of the results were related to the impact-induced damage areas identified with Ultrasonic C-scans and found to be in acceptable agreement. Based on consistent findings, utilizing of modern data filtering and extrapolation algorithms to data logged by the existing machines has efficiently enhanced data interpretations without resorting to extra resources. The algorithms could be useful for impact-induced damage approximations of similar cases.

Keywords: fibre reinforced laminates, fast Fourier algorithms, mechanical testing, data filtering and extrapolation

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Authors: Shiv Jyoti Pandey, Shveta Puri, G. M. Bhat, Neha Raina

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The Jammu and Kashmir (J&K) region of Northwest Himalaya has a long history of earthquake activity which falls within Seismic Zones IV and V. To know the crustal structure beneath this region, we utilized teleseismic receiver function method. This paper presents the results of the analyses of the teleseismic earthquake waves recorded by 10 seismic observatories installed in the vicinity of major thrusts and faults. The teleseismic waves at epicentral distance between 30o and 90o with moment magnitudes greater than or equal to 5.5 that contains large amount of information about the crust and upper mantle structure directly beneath a receiver has been used. The receiver function (RF) technique has been widely applied to investigate crustal structures using P-to-S converted (Ps) phases from velocity discontinuities. The arrival time of the Ps, PpPs and PpSs+ PsPs converted and reverberated phases from the Moho can be combined to constrain the mean crustal thickness and Vp/Vs ratio. Over 500 receiver functions from 10 broadband stations located in the Jammu & Kashmir region of Northwest Himalaya were analyzed. With the help of H-K stacking method, we determined the crustal thickness (H) and average crustal Vp/Vs ratio (K) in this region. We also used Neighbourhood algorithm technique to verify our results. The receiver function results for these stations show that the crustal thickness under Jammu & Kashmir ranges from 45.0 to 53.6 km with an average value of 50.01 km. The Vp/Vs ratio varies from 1.63 to 1.99 with an average value of 1.784 which corresponds to an average Poisson’s ratio of 0.266 with a range from 0.198 to 0.331. High Poisson’s ratios under some stations may be related to partial melting in the crust near the uppermost mantle. The crustal structure model developed from this study can be used to refine the velocity model used in the precise epicenter location in the region, thereby increasing the knowledge to understand current seismicity in the region.

Keywords: H-K stacking, Poisson’s ratios, receiver function, teleseismic

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Authors: Kholoud Abdelmaksoud, Mahmoud Emam, Wael Al-Metwaly

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Egypt is known as cradle of civilization due to its ancient history and archeological sites, but Egypt possess also a cradle of Geo-sites, which qualify it to be listed as one of the most important Geo-heritage sites all over the country. Geology and landscape in Abu-Roash area is considered as one of the most important geological places (geo-sites) inside Cairo which help us to know and understand geology and geologic processes, so the area is used mainly for geological education purposes, also the area contain an archeological sites; pyramid complex, tombs, and Coptic monastery which give the area unique importance. Abu-Roash area is located inside Cairo 9 km north of the Giza Pyramids, which make the accessibility to the area easy and safe, the geology of Abu-Roash constitutes a complex Cretaceous sedimentary succession mass with showing outstanding tectonic features (Syrian Arc system event), these features are considered as a Geo-heritage, which will be the main designation of ‘Geo-parks’ establishing. The research is dealing with the numerous geo-sites found in the area, and its geologic and archeological importance, the relation between geo-sites and archeology, also the research proposed a detailed maps for these sites depicting Geo-routes and the hazardous places surrounding Abu-Roash area. The research is proposing a new proposal not applied in Egypt before, establishing a Geo-park, to promote this unique geo-heritage from hazardous factors and anthropogenic effects, also it will offer geo-educational opportunities to the general public and to the scientific community, enhancement of Geo-tourism which will be linked easily with the Ancient Egyptian tourism, it will also provide a significant economic benefit to Abu-Roash residential area. Finally, the research recommends that The United Nations Educational, Scientific and Cultural Organizations promote conservation of geological and geo-morphological heritage to list this area for its importance under the umbrella of geo-parks.

Keywords: geo-park, geo-sites, Abu-roash, archaeological sites, geo-tourism

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Authors: Angelis P. Barlampas

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Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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Authors: Chinwe Juliana Abara, Dayo Keshi

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Through cultural heritage materials, nations witness significant boom in the world of art and tourism as well as attract foreign investors and tourists to the benefit of the regions and countries where they are located. There are notable heritage sites which record visits by tourists in their thousands annually. According to UNESCO the cultural heritage reflects the life of the community, its history and its identity. Its preservation helps to rebuild broken communities, re-establish their identities, and link their past with their present and future. During any form of conflict or war, a lot happen. People die, houses destroyed and every other thing in the society suffers. Wars and conflicts in various countries have claimed antiquities, heritage materials, contemporary Arts, Galleries, Museums, Archives and very important Monuments and Heritage sites. My Paper deals with the effects of insurgencies and conflicts on cultural heritage and tourism industries in Nigeria and how they can be protected and restored so as to yield the desirable economic gains. Preceding from the premise that conflict of any type puts our cultural heritage at risk; this paper also explores the practical challenges and opportunities available to us in the face of incessant ethnic and Boko Haram (western education is abomination) insurgents and their wanton destruction of lives and properties. There will be a review of relevant literature and documents on the effects of violence on heritage materials and tourism industries in Nigeria particularly and other parts of the world in generally .My paper also highlights the activities the National Council for Arts and Culture as well as other Cultural Agencies in Nigeria have employed to sensitize the stakeholders, the youth, the elderly, and the community at large on the need for peaceful co-existence so as to collectively strive to safeguard and secure our cultural heritage in the face of all these challenges for posterity and desirable economic gains.

Keywords: cultural heritage, conflict, tourism, insurgency, challenges

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Authors: Mohammad Moridzadeh, Mohammad Djavid, Barry Doyle

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An assessment of the long-term stability of a cavern in Chagrin shale excavated by the sequential excavation method was performed during and after construction. During the excavation of the cavern, deformations of rock mass were measured at the surface of excavation and within the rock mass by surface and deep measurement instruments. Rock deformations were measured during construction which appeared to result from the as-built excavation sequence that had potentially disturbed the rock and its behavior. Also some additional time dependent rock deformations were observed during and post excavation. Several opinions have been expressed to explain this time dependent deformation including stress changes induced by excavation, strain softening (or creep) in the beddings with and without clay and creep of the shaley rock under compressive stresses. In order to analyze and replicate rock behavior observed during excavation, including current and post excavation elastic, plastic, and time dependent deformation, Finite Element Analysis (FEA) was performed. The analysis was also intended to estimate long term deformation of the rock mass around the excavation. Rock mass behavior including time dependent deformation was measured by means of rock surface convergence points, MPBXs, extended creep testing on the long anchors, and load history data from load cells attached to several long anchors. Direct creep testing of Chagrin Shale was performed on core samples from the wall of the Pump Room. Results of these measurements were used to calibrate the FEA of the excavation. These analyses incorporate time dependent constitutive modeling for the rock to evaluate the potential long term movement in the roof, walls, and invert of the cavern. The modeling was performed due to the concerns regarding the unanticipated behavior of the rock mass as well as the forecast of long term deformation and stability of rock around the excavation.

Keywords: Cavern, Chagrin shale, creep, finite element.

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Authors: Tunde Puskas, Anita Andersson

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In Swedish early childhood education research, the issues related to religious identifications and practices have often been marginalized or relegated either to the realm of diversity and multiculturalism or to the realm of national traditions. This paper is part of a research project about whether religion is considered as part of Swedish cultural heritage in Swedish preschools. Our aim in this paper is to explore how a Swedish preschool balance between keeping the education non-confessional and at the same time introducing the traditions associated with advent and Christmas. Christmas was chosen because of the religious background of the holiday and because it is a tradition widely celebrated in Swedish preschools. In Swedish education system, the concept of freedom of religion is understood in the sense that education is declared to be non-confessional. Nevertheless, as the major state holidays in Sweden are tied to Lutheran Christian traditions, and according to the curriculum preschool educators, are given the task to pass on a cultural heritage, defined in terms of values, traditions, history, language, and knowledge, it is the preschool teams or individual preschool teachers who determine whether and to what extent religious considerations are/ought to be seen as part of the cultural heritage the preschool passes on. The data consists of ten video taped observations from two preschools. The video data was transcribed and the transcripts were thereafter analysed through content analysis. In the analysis, we draw on the concept of banal religiosity that has helped us to draw attention to the workings of religious considerations that are so familiar that they rarely are noticed as religious and on Ninian Smart’s theory on the dimensions of religion. The analysis shows that what the adults actually do with religion fulfils six of seven dimensions common to religious traditions as outlined by Smart. At the same time, Christmas is performed as a lived tradition within which the commercial and religious rituals intersect and result in a banal, national religiosity.

Keywords: secular advent, banal religiosity, dimensions of religion, rites

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Authors: Deyu Yuan

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Discourse analysis as an interdisciplinary approach has more than 60-years-history since it was first named by Zellig Harris in 'Discourse Analysis' on Language in 1952. Ferdinand de Saussure differentiated the 'parole' from the 'langue' that established the principle of focusing on language but not speech. So the rising of discourse analysis can be seen as a discursive turn for the entire language research that closely related to the theory of Speech act. Critical discourse analysis becomes the mainstream of contemporary language research through drawing upon M. A. K. Halliday's socio-semiotic theory and Foucault, Barthes, Bourdieu's views on the sign, discourse, and ideology. So in contrast to general semiotics, social semiotics mainly focuses on parole and the application of semiotic theories to some applicable fields. The article attempts to discuss this applicable sociosemiotics and show the features of it that differ from the Saussurian and Peircian semiotics in four aspects: 1) the sign system is about meaning-generation resource in the social context; 2) the sign system conforms to social and cultural changes with the form of metaphor and connotation; 3) sociosemiotics concerns about five applicable principles including the personal authority principle, non-personal authority principle, consistency principle, model demonstration principle, the expertise principle to deepen specific communication; 4) the study of symbolic functions is targeted to the characteristics of ideational, interpersonal and interactional function in social communication process. Then the paper describes six features which characterize this sociosemiotics as applicable semiotics: social, systematic, usable interdisciplinary, dynamic, and multi-modal characteristics. Thirdly, the paper explores the multi-modal choices of sociosemiotics in the respects of genre, discourse, and style. Finally, the paper discusses the relationship between theory and practice in social semiotics and proposes a relatively comprehensive theoretical framework for social semiotics as applicable semiotics.

Keywords: discourse analysis, sociosemiotics, pragmatics, ideology

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Authors: A. Khan, I. Khan, M. Younus, S. E. Haque, U. Waheed, H. Neubauer, A. A. Anjum, S. A. Muhammad, A. Idrees T. Abbas, S. Raza, M. A. Ali, M. Farooq, M. Mahmood, A. Hussain, H. Danish, U. Tayyab, M. Zafar, M. Aslam.

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Brucellosis is one of the major problems of milk producing animals in our country which deteriorate the health of livestock. It is a disease of zoonotic significance which is capable of producing disease in humans leading to infertility, orchitis, abortions, and synovitis. In this particular study, milk and serum samples of cattle and buffalo (n=402) were collected from different districts of Punjab including Narowal, Gujranwala and Gujrat. Milk samples were analyzed by Milk Ring Test (MRT), while serum samples were tested through Rose Bengal Plate agglutination Test (RBPT) and Indirect Enzyme Linked Immunosorbant Assay (i-ELISA). The sample tested with MRT were 9.5% positive, including cattle 9.6% and buffalo 9.3%. While using the RBPT test for the detection of serum samples and for screening purpose it was observed that 16.4% animals were seropositive, cattle were 18.8% and buffalo were 13.9% seropositive. The higher prevalence of brucellosis indicates the danger of the disease to human population. The serum samples positive by RBPT were further confirmed by the use of most specific and sensitive serological test known as i-ELISA. 11.4% animals were confirmed as seropositive by i-ELISA including cattle 13.5% seropositive and buffalo 9.3%. The results indicated high seroprevalence of brucellosis in cattle as compared to buffalos. Different risk factors were also studied to know the association between disease and their spread. Advanced age, larger herds, history of abortion and pregnancy of the animals is considered to be the important factors for the prevalence and spread of the hazardous zoonotic disease. It is a core issue of developing countries like Pakistan and has major public health impact.

Keywords: humans, bovines, infertility, orchitis, abortions, seroprevalence, brucellosis

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Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

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Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

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Authors: Maryam Umar Ladan, Arshad Munir

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Poverty has always been a constant feature of society throughout history. It has existed in the lives of people and it is a fact that although the majority of people lives in poverty, the remaining minority lives in luxury. While some countries called the first World countries lives in luxury, the third World countries lives in poverty. It remains an undesirable phenomenon affecting a vast number of people across the globe despite governmental, institutional and private organizations’ interventions with measures aimed at cushioning its adverse effects. Unequal distribution of societal resources, accumulated wealth in the hands of few, lack of access to education and employment, individual responsibility among others, were highlighted as factors associated with poverty. Poverty predisposes the poor individual to malnutrition and starvation, exposure to disease, thereby resulting to violence, crimes, and experiencing lifelong problems. Evidence show that about 50 percent of the world population lives on less than 2.50 dollar a day, 90 percent of whom are from Sub-Saharan Africa and South Asia including countries where Islam is the major if not one adherent religion. As a solution to poverty, Islam prescribes a system of annual Zakat (charity). The Islamic law prescribes that every person who has a saving that reaches a certain limit should give out 2.5 percent of the total annual earning (as in income, money, farm produce) to deserving and prescribed citizens. This is to, among others; reduce the level of inequality through distribution of wealth among the Muslim Ummah (community). Furthermore, Islam encourages the rich in several places in the Qur’an to spend their wealth on poor people other than the compulsory 2.5%. Therefore, it is inarguable that the Islamic system of distribution of resources (as zakat) is the best strategy to poverty eradication. Thus, strongly recommended for desired results in poverty eradication efforts. If every rich person gives Zakat sincerely, poverty will be eradicated in the world, and not a single person will die of want of food or material things.

Keywords: Islam, charity, poverty, zakat

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Authors: Emmanuel Kamal Aziz Saba, Gihan Abd El-Lateif Younis El-Tantawi, Mohammed Hamdy Zahran, Ibrahim Khalil Ibrahim, Mohammed Abd El-Salam Shehata, Hussein Al-Moghazy Sultan, Medhat

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Pelvic floor electrophysiological tests are essential for assessment of patients with obstructed defecation. The present study was conducted to determine the different patterns of pelvic floor electrophysiology that are associated with obstructed defecation. The present cross sectional study included 25 patients with obstructed defecation. A control group of 20 apparently healthy subjects were included. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, lateral proctography (evacuation proctography), dynamic pelvic magnetic resonance imaging, anal manometry and electrophysiological studies. Electrophysiological studies were including pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which included pudendal nerve motor conduction study, pudendo-anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristics of obstructed defecation was pudendal neuropathy, denervation and anismus of external anal sphincter and puborectalis with complete interference pattern of external anal sphincter and puborectalis at squeezing and cough and no localized defect in external anal sphincter. In conclusion, there were characteristic pelvic floor electrodiagnostic patterns associated with obstructed defecation.

Keywords: obstructed defecation, pudendal nerve terminal motor latency, pudendoanal reflex, sphincter electromyography

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Authors: Chi-Ying Yu

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In real life, the occurrence of disasters is always dreadful and heartbreaking, yet paradoxically, disaster film is a genre that has been popular at periodic intervals in motion picture history. This study attempts to compare the disaster film cycles of the 1970s, 1990s, and the early 21st century. Two research questions are addressed: First, how this genre has responded to the existing conditions of society in different periods in terms of the disaster proposition? Second, how this genre reflects a certain eternal substance of the human mind in light of its lasting appeal? Through cinematic textual analysis and literature review, this study finds that the emergence of disaster films in the 1970s reflected the turmoil in international relations and domestic politics situation in contemporary American society, and cinema screens showed such disaster stories as shipwrecks, air accidents, and skyscraper blazes due to human negligence. The 1990s saw the fervor of millennial apocalypse legends, and the awakening of environmental consciousness, which, together with the rapid advances in digital technology, once again gave rise to a frenzy of disaster films, with natural disasters and threats from aliens as the major themes of disasters. Since the beginning of the 21st century, the 911 Incident and natural disasters around the world have generated a consciousness of imminent crisis. Cinematic images simulated actual disasters, while aesthetic techniques focused on creating a kind of ‘empathetic’ experience in their exploration of the essence of the disaster experience. At the same time, post-apocalypse films that focus on post-disaster reconstruction have become an even more popular theme. Taking the approach of Jungian/post-Jungian film study, this study also reviews and interprets the commonly exhibited subliminal feelings in the disaster films of the three different periods. The imagination of disaster seems to serve as an underlying state of the human mind.

Keywords: disaster film, Jungian/post-Jungian film studies, stimulation, sublime

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