BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The ...BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.展开更多
Background:The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds,resulting in drop-hand syndrome.The aim of this study was to evaluate the outco...Background:The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds,resulting in drop-hand syndrome.The aim of this study was to evaluate the outcomes of tendon transfer in patients with drop-hand syndrome who had been injured in the Syrian Civil War.Methods:This level-II,prospective,comparative study included 13 civilians injured in the Syrian Civil War 2015 and 2017.The palmaris longus tendon was used for transfer to the extensor pollicis longus for thumb extension.The pronator teres was transferred to the extensor carpi radialis brevis for wrist extension.The flexor carpi radialis was transferred to the extensor digiti communis for 2 nd,3 rd,4 th,and 5 th finger extension.All outcomes of thumb abduction and extension,wrist extension,wrist flexion,and finger extension were assessed.Results:There was a high level of radial nerve injury in all patients included in the study.The time from injury to treatment ranged from 1.5 months to 9 months.The mechanism of injury most commonly observed was a gunshot wound,which was observed in 8 patients(61.5%),followed by a penetrating cutting tool injury(n=3;23.1%)and humerus fracture(n=2;15.4%).Conclusions:In radial nerve injuries,successful results can be achieved with tendon transfer.All patients regained thumb abduction of up to approximately 60°.All the patients were able to bend the wrist,grip,and extend the fingers while in wrist flexion,neutral wrist and wrist extension positions.Although the reason for the radial injury varied,the postoperative outcomes were good for all patients,and the rehabilitation period progressed successfully in patients who underwent tendon transfer repair within 90 days of injury.展开更多
In tandem with the offensive and defensive exertions of the Vicksburg Campaign,this study focused on the relationship between the American Civil War and local landscape changes at Vicksburg,before,after,and during the...In tandem with the offensive and defensive exertions of the Vicksburg Campaign,this study focused on the relationship between the American Civil War and local landscape changes at Vicksburg,before,after,and during the war.Additionally,this study took advantage of first hand materials including official archives,soldiers’ diaries,letters,and memoirs,in order to explore specific changes of Vicksburg’s local landscape in long-term historical contexts.Prior to the American Civil War,Vicksburg was a prosperous commercial port located in the lower Mississippi River.During the Vicksburg Campaign,both sides attempted to utilise or modify their local environment to gain an upper hand.Meanwhile,the environment played a fundamental role during the war.After the period of hostilities,the establishment of the military park was a direct intervention in the natural recovery process,which arose from two people’s conception of peace based on national unity.展开更多
Theories of civil war onset are adjuncts to extant literature on the“correlates of war”.The theories are fresh efforts at explaining and examining the evolution of empirical research on the causes of internal confli...Theories of civil war onset are adjuncts to extant literature on the“correlates of war”.The theories are fresh efforts at explaining and examining the evolution of empirical research on the causes of internal conflict onset.These theories serve as frameworks to analyse the structural and psychological conditions responsible for the fragility of war within the state,particularly in respect of mobilization and strategic confrontation.This article reviews the theories in light of the Nigerian experience and contends that some of the underlying issues that precipitated the Nigerian Civil War(1967-1970)still exist and need to be de-established in order to attenuate their resurgent capability.The article makes a case for constructive and functional integration of the multiple nationalities that make up the Nigerian state as a way of preserving the corporate existence of the country.It also submits that perceived injustice is not just injurious to a system;it is capable of causing a dysfunction within the state because of its inflammatory war potential.展开更多
Sino-US relationship is one of the most important bilateral relationships in theworld.Among the various factors that influence Sino-US relations,the Tai-wan issue is of particular importance.The Chinese government and...Sino-US relationship is one of the most important bilateral relationships in theworld.Among the various factors that influence Sino-US relations,the Tai-wan issue is of particular importance.The Chinese government and its people willnever allow the current rampant ever-growing separatist activities in Taiwan totake its own course.As the US is bound to interfere with Taiwan Question when Chi-展开更多
基金Supported by the UNC UNAN FGID Epidemiology Study Project,No.54-1808958.
文摘BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.
文摘Background:The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds,resulting in drop-hand syndrome.The aim of this study was to evaluate the outcomes of tendon transfer in patients with drop-hand syndrome who had been injured in the Syrian Civil War.Methods:This level-II,prospective,comparative study included 13 civilians injured in the Syrian Civil War 2015 and 2017.The palmaris longus tendon was used for transfer to the extensor pollicis longus for thumb extension.The pronator teres was transferred to the extensor carpi radialis brevis for wrist extension.The flexor carpi radialis was transferred to the extensor digiti communis for 2 nd,3 rd,4 th,and 5 th finger extension.All outcomes of thumb abduction and extension,wrist extension,wrist flexion,and finger extension were assessed.Results:There was a high level of radial nerve injury in all patients included in the study.The time from injury to treatment ranged from 1.5 months to 9 months.The mechanism of injury most commonly observed was a gunshot wound,which was observed in 8 patients(61.5%),followed by a penetrating cutting tool injury(n=3;23.1%)and humerus fracture(n=2;15.4%).Conclusions:In radial nerve injuries,successful results can be achieved with tendon transfer.All patients regained thumb abduction of up to approximately 60°.All the patients were able to bend the wrist,grip,and extend the fingers while in wrist flexion,neutral wrist and wrist extension positions.Although the reason for the radial injury varied,the postoperative outcomes were good for all patients,and the rehabilitation period progressed successfully in patients who underwent tendon transfer repair within 90 days of injury.
文摘In tandem with the offensive and defensive exertions of the Vicksburg Campaign,this study focused on the relationship between the American Civil War and local landscape changes at Vicksburg,before,after,and during the war.Additionally,this study took advantage of first hand materials including official archives,soldiers’ diaries,letters,and memoirs,in order to explore specific changes of Vicksburg’s local landscape in long-term historical contexts.Prior to the American Civil War,Vicksburg was a prosperous commercial port located in the lower Mississippi River.During the Vicksburg Campaign,both sides attempted to utilise or modify their local environment to gain an upper hand.Meanwhile,the environment played a fundamental role during the war.After the period of hostilities,the establishment of the military park was a direct intervention in the natural recovery process,which arose from two people’s conception of peace based on national unity.
文摘Theories of civil war onset are adjuncts to extant literature on the“correlates of war”.The theories are fresh efforts at explaining and examining the evolution of empirical research on the causes of internal conflict onset.These theories serve as frameworks to analyse the structural and psychological conditions responsible for the fragility of war within the state,particularly in respect of mobilization and strategic confrontation.This article reviews the theories in light of the Nigerian experience and contends that some of the underlying issues that precipitated the Nigerian Civil War(1967-1970)still exist and need to be de-established in order to attenuate their resurgent capability.The article makes a case for constructive and functional integration of the multiple nationalities that make up the Nigerian state as a way of preserving the corporate existence of the country.It also submits that perceived injustice is not just injurious to a system;it is capable of causing a dysfunction within the state because of its inflammatory war potential.
文摘Sino-US relationship is one of the most important bilateral relationships in theworld.Among the various factors that influence Sino-US relations,the Tai-wan issue is of particular importance.The Chinese government and its people willnever allow the current rampant ever-growing separatist activities in Taiwan totake its own course.As the US is bound to interfere with Taiwan Question when Chi-
