The harmonious relationship between natural, social, and cultural landscapes for sustainable use represents an interaction between sites and surrounding communities. This research focuses on natural and cultural tourism allocations in forest resource management within the utilization zone of West Bali National Park (TNBB). Qualitative data analysis was conducted in the utilization zone designated for natural and cultural tourism, involving local communities around the conservation area. The findings indicate that the landscape in the utilization zone can maintain TNBB's conservation area sustainability through nature and culture-based tourism sites. This is supported by community involvement, which fosters harmonious relationships between TNBB management and village communities while improving local welfare through conservation efforts. The natural conditions and cultural aspects of six buffer villages directly bordering the National Park serve as powerful tourist attractions, contributing to the area's preservation and sustainable development.
Mostafa Ebrahimi, Ali Nazemianfard, Momammad Taghi Imanpour
Abstract
The historical port of Siraf located along the Persian Gulf coast is recognized as a significant Sasanian-era site based on archaeological evidence. Historical sources indicate that this port flourished throughout the Islamic period and continued to prosper until the late Buyid era. Geographically, Siraf occupies a narrow strip of land extending from the mountains to the seashore, which enhances its strategic significance. Numerous studies have concentrated on Siraf, particularly regarding its maritime trade with various regions. As the largest archaeological excavation site on the northern shores of the Persian Gulf, it has been the subject of extensive scholarly articles. However, research addressing the reasons for its specific location remains limited. Given the constrained space between the mountains and the sea at Siraf, alongside the availability of more expansive coastal areas nearby, a critical question arises: why was this port established in such a restricted environment? Moreover, what roles did natural and human geographical factors play in determining the port location? This study employed a descriptive-analytical method, incorporating library research, field observations, and interviews. The findings indicated that the natural characteristics of Siraf, such as its port position, surrounding highlands, water resources, and nearby stone and gypsum mines, along with human geographical elements like its hinterland cities and trade routes, were instrumental in the selection of this port site.
Keywords: Siraf, Persian Gulf, Natural Phenomena, Human Phenomena.
Introduction
Since ancient times, the interplay between humans and geography has profoundly influenced both. Geographical features and phenomena have shaped human livelihoods, architectural styles, and cultural practices. In turn, humans have employed their intelligence and creativity to navigate geographical constraints and leverage their environment to their advantage. This dynamic interaction known as possibilism in geography illustrates how human actions can transform and adapt to their surroundings.
Historical geography is an interdisciplinary field that examines the relationship between humans and their environment, focusing on their mutual influence throughout historical events. This includes significant occurrences like the establishment of settlements and cities in the past. Situated on the Persian Gulf coast, Siraf is one of Iran's historical ports and a key site for archaeological excavations and research. While numerous studies have been published about Siraf, there remains a notable lack of research addressing the reasons for its specific location and the impacts of natural and human geographical phenomena in this context.
Given the importance of Siraf in Iranian history, its designation as a pivotal hub for natural and historical tourism along the Persian Gulf, and its proximity to the South Pars Gas facilities, it serves as a crucial foundation for historical and archaeological inquiry. Furthermore, the need to preserve its historical artifacts underscores the significance of investigating its historical geography.
Materials & Methods
This interdisciplinary study explored historical geography by employing a descriptive-analytical method to investigate the influence of both natural and human geographical factors on the location of Siraf Port. For data collection, we began by consulting primary library sources and recent research. Acknowledging the importance of field visits and observations, we conducted a comprehensive exploration of the natural and historical sites in and around Siraf. Additionally, we interviewed individuals knowledgeable about the local history to gain deeper insights into the region's past.
Research Findings
Our findings indicated that both natural and human factors were instrumental in the selection of the site for Siraf Port. While being influenced by their natural environment, the people of the Sasanian era creatively leveraged these conditions to establish an ideal location for the new port. This setting not only facilitated daily life, but also boosted the nation's economy through maritime trade. Natural attributes significantly contributed to the establishment of Siraf as a bustling port. The town was flanked by the Zagros Mountains, which provided a natural barrier and strategic advantage against potential invasions. This elevated terrain allowed for the construction of fortifications, which were crucial for securing the port. Additionally, the mountains supplied essential resources, including stone and gypsum, necessary for construction and trade. Water resources also played a pivotal role in the port development. The nearby mountains harbored springs and streams that ensured a reliable water supply. The residents of Siraf dug wells and constructed hand-carved cisterns to store water, providing vital hydration for both the local population and maritime activities. The availability of fresh water in such arid regions was a significant factor in attracting settlers and traders alike. Geographical elements were equally influential in determining Siraf location. The port served as a crucial link between the interior of Iran and the wider world. Its proximity to cities, such as Gur, Jam, and Koran, facilitated the easy transport of goods and resources. These hinterland regions supplied essential foodstuffs and materials, making Siraf a vital hub for commerce. The connectivity provided by the port enhanced trade routes, establishing Siraf as a center of economic activity.
Moreover, the port location strategically positioned it along major maritime trade routes. Siraf became a primary point of departure and destination for merchants traveling between the Persian Gulf and other regions, including the Indian subcontinent and the Arabian Peninsula. These geographical advantages enabled Siraf to thrive as a trading post, significantly contributing to the region's economic landscape.
Discussion of Results & Conclusion
The builders of Siraf adeptly utilized both natural and human geographical phenomena to establish the port in a way that effectively addressed their commercial and economic needs. The emphasis on maritime trade combined with the necessity for a port along the Persian Gulf coast led them to seek a strategically advantageous location. Considering the geographical position of Gur City, they identified a coastal site well-suited for port development. Beyond serving as a maritime port, Siraf evolved into a significant marketplace.
Constructing this new port required not only logistical planning, but also effective supervisory, observational, and defensive capabilities. The nearby highlands provided an ideal setting for fortifications, enhancing the port security. Establishment of any settlements depended critically on access to water. The proximity of vital water sources in the mountains near Siraf, along with digging of numerous wells and construction of hand-carved cisterns, ensured a reliable water supply for inhabitants of the port.
The selected location for Siraf was further influenced by its closeness to Gur and other hinterland regions, such as Jam and Koran, which supplied essential foodstuffs. Siraf functioned as a key hub, serving as both a point of departure and a destination for several roads within Fars Province, effectively connecting it to the interior of Iran. Moreover, the sea route provided a crucial link between the port and other parts of the world.
In conclusion, the historical port of Siraf exemplifies the intricate relationship between geography and human activity. Its strategic location, natural resources, and trade routes have combined to create a thriving center of commerce and cultural exchange. Future research should continue to explore these dynamics, examining how other historical ports were influenced by similar geographical factors. Understanding the elements that contributed to Siraf establishment can provide valuable insights into broader patterns of maritime trade and settlement in the Persian Gulf region.
By protecting and preserving the historical artifacts and archaeological sites of Siraf, we can ensure that this important piece of history remains a source of knowledge and inspiration for future generations. The study of Siraf not only enhances our understanding of Iranian history, but also underscores the significance of geography in shaping human civilization. As we continue to explore the past, we must remain mindful of the lessons it offers for our present and future.
History (General) and history of Europe, History of Asia
Vitis L. belongs to Vitaceae family. Vitis can be divided into Subgenus Euvitis Planch and Subgenus Muscadinia Planch. Subgenus Euvitis Planch has more than 70 species whose chromosome number is 2n=38. Within the subgenus, the interspecies cross is easy, and they are mainly distributing in the temperate regions of Northern Hemisphere. They are intensively originated from three centers of West Asia, North America and East Asia: Europe-West Asia distribution center, North America distribution center and East Asia distribution center and form 3 species group according to geographic origin. Eurasian population originated from the center of Europe-West Asia only has a V. vinifear L. and 3 wild subspecies ssp. sativa D.C., ssp. silvestris Gm. and ssp. caucasica Vav.. V. vinifear L. is the only cultispecies in Vitis species. The region between the Black Sea and the Caspian Sea is the origin of European grape. The European grape spread to Europe from this region and further spread around the world by European. By long-term introduction, domestication, breeding and clonal selection, the culti species has different characteristics and the diverse resources. At present, in the world, more than 90% production of grape are made from this species and more than 80% grape varieties are evolved from this species. It is widely cultivated in Mediterranean climate conditions around the world. There are about 30 species originated from North America Dstribution Center, which includes America, Canada and Mexico, to form South America species group. They are important disease-resistant grape germplasm resources, and play an important role in grape resistance breeding against phylloxera and downy mildew. East Asia Distribution Center includes China, Japan, Korea, Russia Far East and the northern area of Southeast Asia. It has about 40 species to form East Asia Species Group, which has extremely abundant diversity and resistant types. Each species of East Asia Species Group has a distribution in China, and all species of South America population mainly distribute in America. Therefore, China is one of the centers of origin with the most abundant wild grape resources in the world, including all the wild grape species from the East Asian origin center. The resistance types are extremely rich, providing important material support for grape breeding and industrial development. There are many cultivated varieties of grape. Long time ago, the description and recordation of grape varieties arose. With the extension of cultivation area and the escalation of varieties, more variety populations formed with different regional characteristics. Because Vitis plants have the wide origins, the activities of artificial introduction to exchange, breeding, clonal selection and so on, have made wide grape varieties and rich genotypes. Grape is one of the cultivated plants that have the most varieties. After a long time of natural selection and industrious breeding by human, it forms extremely abundant grape variety resources. Grape has been cultivated in China for over 2000 years, it was developed from west to east, and from north to south step-by-step. Nowadays, grape is cultivated all over China. China is a major producer of grapes and also a major consumer of grapes in the world, with grapes occupying an important position in our country. With the development of grape industry in China, the work of grape genetic resource and breeding is highly regarded than before. In 1978, the Chinese Agricultural Ministry planned to establish National Fruit Tree Germplasm Repositories. This plan was started in 1981 and finished in 1989. Good results are achieved in identification, evaluation and utilization of grape genetic resources to a certain extent. The National Grape and Peach Germplasm Repository (Zhengzhou) is the primary unit for preserving grape germplasm resources in China, and is currently one of the most abundant nurseries for preserving grape germplasm resources in the world. By December 2024, the National Grape and Peach Germplasm Repository (Zhengzhou) had collected and preserved 2140 grape germplasm resources. More than 30 000 hybrid off-springs were established using the selected excellent germplasm, and multiple new grape varieties such as Zhengyan Seedless, Hongyan Seedless, and Zhong Pu Jin Xiang were bred. Since 2000, the Zhengzhou Grape Germplasm Repository has cumulatively provided resources for utilization to 356 entities, including Nanjing Agricultural University, Northwest A&F University, China Agricultural University, Institute of Botany, Chinese Academy of Sciences, Shanghai Jiao Tong University, and other universities and research institutes, as well as agricultural technology extension departments, cooperatives, and planting enterprises at the provincial, municipal, and county levels in Henan, Hebei, Xinjiang, Hubei, Yunnan, and other provinces. A total of 16 349 resource utilizations have been provided, primarily for basic research, new variety breeding, production, and science popularization education, effectively supporting the development of grape scientific research, breeding, and the industry in China. This article introduces the development history of the National Grape Germplasm Resources Repository (Zhengzhou), summarizes and reviews the current status of grape germplasm resource collection and preservation in the past 20 years, as well as their innovative utilization. It also looks forward to future research directions, in order to provide a reference for the effective utilization and industrial development of grape germplasm resources in China.
Khadi, the fabric, and charkha, the instrument, were powerful symbols of the anti-colonial resistance movement in India and continued to be treated with regard by the post-colonial nation-state. However, in recent times, these artefacts have undergone substantial transformation. From being symbolic of rural resurgence and self-help in Gandhian nationalist rhetoric and of an inspired vision of ethical living based on alternate concepts of modernity, khadi and charkha have now become fused with economic and cultural goals of a distinctively capitalist order. In order to trace the shifts in khadi and charkha’s symbolism, we chose to examine two particular domains in the twin cities of Ahmedabad and Gandhinagar where a historical continuity has been claimed with the Gandhian legacies. We examined the evolving representation of the charkha in two museums, one each in the two cities, and the emergence of khadi as a fashion fabric in Ahmedabad. The article concludes with a reflection on the indifferent state of the much-vaunted khadi programme of the government in the country and in the state of Gujarat.
The archaeological direction in the Japanese studies in Russia originated at the end of the 19th century on the basis of the first trips and acquaintance with the antiquities of Japan (M.I. Venyukov, A.V. Grigoriev, I.S. Polyakov, D.M. Pozdneev), and transformed into an original direction in the Soviet period. The fruitful dialogue between Russian and Japanese archaeologists is largely due to both the territorial proximity and common roots of ancient cultures, starting from the Stone Age, as well as mutual interest in the archaeology of the Pacific basin as a whole. Since the early 1960s, one of the leading roles in this collaboration is played by the Novosibirsk Scientific Center (Institute of History, Philology and Philosophy, Siberian Branch of the Academy of Sciences of the USSR, Faculty of Humanities of NSU) and such specialists as A.P. Okladnikov, A.P. Derevyanko, R.S. Vasilevsky, and V.E. Larichev. In the first post-Soviet decade, there was a transition to new formats – long-term joint projects and archaeological expeditions, which are carried out on the basis of bilateral agreements between research organizations in Japan and Russian institutes (universities, museums) from a number of cities in Siberia and the Russian Far East. Cooperation reached its peak in 2007/8–2019, enjoying the support of Russian (RSFH, RFBR, RSF) and Japanese scientific foundations, and was implemented in a variety of formats (projects, exchanges, internships, symposiums, exhibitions, publications, etc.) and in a variety of geographical areas, both in Russia and Japan, as well as third countries – in Central Asia (Mongolia) and South America (Ecuador). One of the striking examples of such interaction is the fruitful cooperation of the Division of Foreign Archaeology (Institute of Archaeology and Ethnography SB RAS, Novosibirsk) and the Laboratory of Archaeology (Tohoku University, Sendai), resulting in a large number of publications in leading scientific journals and several dissertation studies on the Jomon and Kofun periods.
Elaine Cheung, Maggie Wang, Juliana C N Chan
et al.
Introduction We designed and implemented a patient-centered, data-driven, holistic care model with evaluation of its impacts on clinical outcomes in patients with young-onset type 2 diabetes (T2D) for which there is a lack of evidence-based practice guidelines.Research design and methods In this 3-year Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes-Randomized Controlled Trial, we evaluate the effects of a multicomponent care model integrating use of information and communication technology (Joint Asia Diabetes Evaluation (JADE) platform), biogenetic markers and patient-reported outcome measures in patients with T2D diagnosed at ≤40 years of age and aged ≤50 years. The JADE-PRISM group received 1 year of specialist-led team-based management using treatment algorithms guided by biogenetic markers (genome-wide single-nucleotide polymorphism arrays, exome-sequencing of 34 monogenic diabetes genes, C-peptide, autoantibodies) to achieve multiple treatment goals (glycated hemoglobin (HbA1c) <6.2%, blood pressure <120/75 mm Hg, low-density lipoprotein-cholesterol <1.2 mmol/L, waist circumference <80 cm (women) or <85 cm (men)) in a diabetes center setting versus usual care (JADE-only). The primary outcome is incidence of all diabetes-related complications.Results In 2020–2021, 884 patients (56.6% men, median (IQR) diabetes duration: 7 (3–12) years, current/ex-smokers: 32.5%, body mass index: 28.40±5.77 kg/m2, HbA1c: 7.52%±1.66%, insulin-treated: 27.7%) were assigned to JADE-only (n=443) or JADE-PRISM group (n=441). The profiles of the whole group included positive family history (74.7%), general obesity (51.4%), central obesity (79.2%), hypertension (66.7%), dyslipidemia (76.4%), albuminuria (35.4%), estimated glomerular filtration rate <60 mL/min/1.73 m2 (4.0%), retinopathy (13.8%), atherosclerotic cardiovascular disease (5.2%), cancer (3.1%), emotional distress (26%–38%) and suboptimal adherence (54%) with 5-item EuroQol for Quality of Life index of 0.88 (0.87–0.96). Overall, 13.7% attained ≥3 metabolic targets defined in secondary outcomes. In the JADE-PRISM group, 4.5% had pathogenic/likely pathogenic variants of monogenic diabetes genes; 5% had autoantibodies and 8.4% had fasting C-peptide <0.2 nmol/L. Other significant events included low/large birth weight (33.4%), childhood obesity (50.7%), mental illness (10.3%) and previous suicide attempts (3.6%). Among the women, 17.3% had polycystic ovary syndrome, 44.8% required insulin treatment during pregnancy and 17.3% experienced adverse pregnancy outcomes.Conclusions Young-onset diabetes is characterized by complex etiologies with comorbidities including mental illness and lifecourse events.Trial registration number NCT04049149.
Diseases of the endocrine glands. Clinical endocrinology
Today, female managers in organizations face numerous challenges from gender discrimination to the glass ceiling. To face such challenges, it is essential to develop resilience capacity for female managers and resilience capacity is increasingly considered as a distinct advantage for female managers with the aim of turning adversity into evolution and progress in the workplace. Therefore, the current research was conducted with the aim of helping to develop the resilience capacity of female managers to break the glass ceiling. This research is applied in terms of purpose and descriptive-correlation in terms of data collection. The statistical population of the research consists of female managers of government offices in Khuzestan province, according to the latest statistics of the Management and Planning Organization of Khuzestan province, the total number of these managers is 205, based on Cochran's formula, the number of 128 people was obtained as a sample, and the questionnaire was conducted by a simple random method in It was distributed among the sample. Due to the possibility of returning incomplete questionnaires, 150 questionnaires were distributed, of which 130 questionnaires were returned. The findings of the research showed that the variables of interaction with the work environment, job adaptability and human resources management measures as independent variables with path coefficients of 0.12, 0.53 and 0.30 and significant numbers of 2.01, 8.40 and 3/15 have a positive and significant effect on the resilience of female managers. Among the three mentioned variables, the variable of job adaptability showed the greatest effect on the resilience of female managers. Also, the findings of the research showed that the resilience variable of female managers with a path coefficient of 0.58 and a significant number of 12.46 has a positive and significant effect on the ability to break the glass ceiling, and this effect is relatively strong.This research has helped to identify and understand the antecedents affecting the development of resilience capacity of female managers and shows how resilience can help to break the glass ceiling, as a challenge faced by women in the workplace. Keywords Glass Ceiling, Human Resource Management, Interaction with the Work Environment, Job Compatibility, Resilience of Female Managers IntroductionThe history of the world has witnessed the enormous and undeniable role of women in various events; But in the past centuries, the role of women as half of the world's active population, especially in developing countries, has been neglected, which shows the existence of gender discrimination and inequality in various political, economic and social fields (Carmeli and Markman, 2011). In order to achieve balance, equality and eliminate discrimination, and as a result, better development of society, it is necessary that women can participate in the decision-making process at different levels of society, especially management levels. Today, female managers in organizations face numerous challenges from gender discrimination to the glass ceiling. To face such challenges, it is essential to develop resilience capacity for female managers and resilience capacity is increasingly considered as a distinct advantage for female managers with the aim of turning adversity into evolution and progress in the workplace. Therefore, the current research was conducted with the aim of helping to develop the resilience capacity of female managers to break the glass ceiling.Rindova et al. (2009) believe that interaction with the work environment can bring benefits such as reducing stress, increasing communication with colleagues, and being equipped with resilience capacity and ultimately better performance.Job adaptability means that a person manipulates his attitudes, competencies and behaviors in the work environment to optimally align himself with suitable work environments (Jiang, 2012). In other words, a person has job adaptability who is able to handle job duties and assignments well and is compatible with them (Ramos and Lopez, 2018). Career adaptability is defined as the ability to adjust oneself to fit new and changed conditions in one's career through planning, exploring and deciding one's future (Brown, 2002). Career counseling, teacher-apprentice relationship and flexibility and adaptation to changes over time as components of career adaptation can be useful in developing and strengthening resilience in women.Hanga et al. (2016) believe that human resource management practices increase the ability of employees to deal with adversity. Ayed (2019) showed in research that human resources management measures have a positive and significant effect on the resilience of employees. The results of the research of Khan et al. (2017) showed that the four measures of human resource management, including job design, knowledge sharing, job rotation, and opportunities for employee career development, provide the basis for strengthening the resilience of employees. Cooper et al. (2015) found that resilience training as one of the human resource management practices can improve personal resilience and is a useful tool for developing mental health and subjective well-being in employees (Arnets et al., 2009; Glanaki et al., 2009; Pip et al., 2012). The persistence of the gender gap in management is considered an important issue at the global level. Although women are increasingly praised for having excellent management skills and effective management styles (Eagly, 2007), the lack of women in leadership positions is attributed to traditional attitudes, the glass ceiling, and the old boys' network (Stevens, 2010). Ragins et al. (1998) believe that the glass ceiling represents prejudices and attitudinal and organizational biases that prevent women from occupying senior executive positions. Morrison et al. (2020) believe that the women's glass ceiling consists of artificial barriers based on attitudinal or organizational biases that cause women and minorities to fail to reach higher levels of hierarchies, while this concept acknowledges that gender superiority at the top of the organizational hierarchy is much stronger than at the lower levels. MethodologyThis research is applied in terms of purpose and based on the method of data collection in the category of descriptive-correlational research. In this research, library method was used to collect information related to theoretical literature and research background, and questionnaire was used to collect data related to research variables. The statistical population of the research consists of female managers of government offices in Khuzestan province, according to the latest statistics of the Management and Planning Organization of Khuzestan province, the total number of these managers is 205, based on Cochran's formula, the number of 128 people was obtained as a sample, and the questionnaire was randomly selected among the sample was distributed. Due to the possibility of returning incomplete questionnaires, 150 questionnaires were distributed, of which 130 questionnaires were returned. The validity of the measuring instrument of this research was investigated in three ways: face validity, convergent validity and divergent validity. Face validity refers to whether items that are ostensibly designed to measure a latent variable actually measure that variable. Experts' opinions were used to measure face validity in this research. Convergent validity means that the items designed to measure a hidden variable have a high correlation with each other. Divergent validity means that the items of one latent variable are not highly correlated with the items of other latent variables and are different from each other. To calculate convergent and divergent validity, we must calculate the values of average variance extracted (AVE) and average squared common variance (ASV).Therefore, for convergent validity, the AVE value of the variables should be greater than 0.5, and for divergent validity, the AVE value of the variables should be greater than their ASV (Rahimi, 2017), which according to Table 1, the AVE value of each of the variables is greater than 0.5 and the AVE value is greater than It is from ASV that it can be said that measurement tools have construct validity. The reliability of the measurement tool in this research was also examined through Cronbach's alpha and composite reliability. FindingsThe findings of the research showed that the variables of interaction with the work environment, job adaptability and human resource management measures as antecedent variables have a positive and significant effect on the resilience of female managers. Among the three mentioned variables, the variable of job adaptability showed the greatest effect on the resilience of female managers. Also, the findings of the research showed that the resilience of female managers has a positive and significant effect on the ability to break the glass ceiling, and this effect is relatively strong. ConclusionsThis research has helped to identify and understand the antecedents affecting the development of resilience capacity of female managers and shows how resilience can help to break the glass ceiling, as a challenge faced by women in the workplace. According to the results, the following suggestions can be useful for developing women's resilience and strengthening their ability to break the glass ceiling in the workplaceSuggestions at the individual level: improving women's individual knowledge on the subject of management in educational systems, demanding women in society within the framework of the law and developing a sense of demand, cultivating individual independence, improving constructive communication in the organization, strengthening self-confidence and self-confidence.Suggestions at the organizational level: providing career counseling programs to women, promoting coaching programs in the workplace, supporting the organization in giving women equal opportunities with men, giving women sufficient financial and material resources, aligning organizational policies with women's development structures, establishing Organizational justice, transparency in organizational rules, and compilation of desirable indicators for qualifying management positions.Suggestions at the macro level: general culture building and creating a positive attitude towards the ability of human beings away from discrimination, policy making in the field of women's advancement by formulating programs and monitoring the implementation of these programs, serious attention in the field of justice in society, public effort and participation Social in order to increase public awareness of women's entry into various fields, especially the country's management field, creating equal opportunities for education, opportunities to improve and develop skills, strengthening women's organizations in society.References Al-Ayed, S. 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Abstract Background Patients with chronic obstructive pulmonary disease (COPD) often require hospital readmission because of exacerbation of their condition. These frequent exacerbations reduce quality of life, work performance, and emotional health. However, few studies have investigated the risk factors for readmission and readmission rates in Asian patients with COPD. We conducted a systematic review to identify and understand the major risk factors for readmission in patients with COPD in Asia and the readmission rate. Method We searched PubMed, MEDLINE, Embase, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and China Biomedical Literature Database from database inception to September 2023 to identify studies on the readmission rate and risk factors for COPD in Asian patients. Chinese search terms included “COPD,” “chronic obstructive pulmonary disease,” “risk factors,” “recurrence,” “readmission,” and “acute exacerbation.” English search terms included “chronic obstructive pulmonary disease,” “COPD,” “lung emphysema,” “hospital admission,” “patient readmission,” and “readmission.” We extracted first author, publication year, research area, sample size, sex, risk factors, and readmission rates. The included studies’ quality was evaluated using the Agency of Healthcare Research and Quality. Meta-synthesis was conducted on readmission rates and risk factors for readmission. Subgroups were formed by age, research area, sample size, and research type, and meta-regression analysis was conducted on the 30-day, 90-day, and 365-day readmission rates of patients to determine the source of heterogeneity. Finally, the results’ robustness was evaluated using sensitivity analysis. Begg and Egger tests were used to evaluate publication bias. Results Meta-analysis of 44 studies, with 169,255 participants, indicated that risk factors for COPD readmission in Asia included: history of multiple hospital admissions, ≥ 3 comorbidities, male sex, ratio of eosinophils percentage ≥ 2%, body mass index < 18.5, smoking history, pulmonary heart disease comorbidity, COPD assessment test score > 20, nutritional disorder, Neutrophil-to-Lymphocyte ratio > 7, and FEV1 < 50. The 30-, 90-, and 365-day readmission rates of patients were 19%, 31%, and 42%, respectively. Conclusions Patients with COPD in Asia generally have high readmission rates and different risk factors. To reduce healthcare, economic, and social burdens, interventions should address major risk factors, early prevention, and screening.
Objective To understand the domestication and spread of horses in history, genetic information is essential. However, mitogenetic traits of ancient or medieval horses have yet to be comprehensively revealed, especially for East Asia. This study thus set out to reveal the maternal lineage of skeletal horse remains retrieved from a 15th century archaeological site (Gongpyeongdong) at Old Seoul City in South Korea. Methods We extracted DNA from the femur of Equus caballus (SNU-A001) from Joseon period Gongpyeongdong site. Mitochondrial (mt) DNA (HRS 15128-16116) of E. caballus was amplified by polymerase chain reaction. Cloning and sequencing were conducted for the mtDNA amplicons. The sequencing results were analyzed by NCBI/BLAST and phylogenetic tool of MEGA7 software. Results By means of mtDNA cytochrome b and D-loop analysis, we found that the 15th century Korean horse belonged to haplogroup Q representing those horses that have historically been raised widely in East Asia. Conclusion The horse is unique among domesticated animals for the remarkable impact it has on human civilization in terms of transportation and trade. Utilizing the Joseon-period horse remains, we can obtain clues to reveal the genetic traits of Korean horse that existed before the introduction of Western horses.
Yen-Feng Wang, Yung-Tai Chen, Ching-Wen Tsai
et al.
Abstract Background Pregabalin is approved for the treatment of neuropathic pain, fibromyalgia, and seizure disorders, although the pivotal trials were mostly carried out in Europe or North America. The prescribing patterns among different indications in Asia have rarely been explored. Methods This was a population-based retrospective cohort study based on the National Health Insurance Research Database in Taiwan. Prescriptions of pregabalin were identified, and data regarding demographics, indications, co-existing diagnoses, and concomitant medications were extracted. Pregabalin users were followed for at least one year, and factors associated with persistence at one year were determined by using multivariate logistic regression analysis. Results Between June 2012 and December 2016, 114,437 pregabalin users (mean age 60.7 ± 15.4 years, 57.8% female) were identified. The indications included post-herpetic neuralgia (PHN) (30.5%), musculoskeletal diseases other than fibromyalgia (21.2%), fibromyalgia (18.4%), diabetic peripheral neuropathic pain (DPNP) (11.7%) and epilepsy (2.9%). Overall, 62.5% and 6.4% of patients achieved a maximum dose of ≥150 and ≥ 300 mg/day, respectively. The median duration of persistent pregabalin use was 28 days (interquartile range 14–118 days). The one-year persistence rate was 12.1%, and the indications associated with the highest and lowest persistence rates were epilepsy (42.4%) and PHN (6.1%), respectively. Male gender (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.09–1.18), older age (OR 1.01 per year, 95% CI 1.01–1.01), indications other than PHN, especially epilepsy (OR 8.04, 95% CI 7.33–8.81, PHN as reference), and a higher initial dose (OR 1.12 per 75 mg, 95% CI = 1.10–1.15) were associated with persistence at one year, whereas the initial concomitant use of antiviral agents decreased the likelihood (OR 0.41, 95% CI 0.35–0.47). Conclusions Pregabalin prescriptions for pain disorders were limited to short-term use, which is consistent around the world. However, the average prescribed dose in Taiwan was lower than those in Western countries, and was frequently below the recommended ranges. Potential causes included the duration of natural history of PHN, and off-label prescriptions for pain in acute herpes zoster, rather than PHN, as well as intolerance to the side effects.
Despite some modest improvements described recently, anaemia remains a significant global public health concern affecting both developed and developing countries. It affects a quarter of the global population, including 293 million (47%) children who are younger than five years of age. A prevalence of 42% and 30% has been described in pregnant and non-pregnant women, respectively. Children and women of reproductive age are at high risk, partly because of physiological vulnerability, followed by the elderly. Africa and Asia are the most heavily affected regions, accounting for 85% of the absolute anaemia burden in highrisk groups. According to the World Health Organization global database on anaemia (1993–2005), this disorder was considered to be a moderate public health problem in South African preschool children, pregnant women and non-pregnant women of reproductive age.
There has been an increased awareness of anaemia and its consequences on the health and development of women and children in the past few decades. The many underlying causes of the various types of anaemia seen in general practice means it is essential that practitioners’ clinical decisions be underpinned by a sound knowledge of the pathological processes involved. Thorough history-taking will guide practitioners to request specific tests to confirm or refute differential diagnoses. Management must be developed around the specific type of anaemia and the potential physical and psychological effects it may have on the individual.
Learning from ancient times to the present were over complex system in which the Proportional to the degree of civilization, governmental, political, social and religious change circumstances in any period. One of these periods is the reign of Timur's successor’s era (912-807AH.). In this era gained momentum educational institution and the kings, princes, rulers, scholars Khavatin and each had their share in the growth of the institution concerned Following the death of Timur in the territory of his successor , Shahrukh, Despite the relative peace, political stability and security was to improve the of livelihoods. Then, the scientific and cultural movement was prepared, and the schools, libraries and learning circles was built underlying to the efforts of many kings Khavatin and Rulers. Timurid sultan, the one hand, providing educational facilities and for the welfare of teachers and students on the strides of science and the improvement and the other hand, pursued the legitimate government. The most striking feature of Timurid rule was penchant of some these sultans for the growth of science, literature and built the educational centers. The multitude construction of the educational institutions It was so, that Jami claimed, has not made the school size in any period of Iran history .In this study, the authors were focused on library resources and used a descriptive and analytical method .One of the most important findings of this study was the significant role of the kings, ministers and Khavatin on the construction of schools and the educational institutions, function of libraries , writing the books and follow to a systemic educational system.
History and principles of religions, History of Asia
Paul Vijay Kingsley, Mark Leader, Nandika Suranjith Nagodawithana
et al.
<h4>Background</h4>Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis.<h4>Objective</h4>We sought to review case reports of melioidosis from Malaysia.<h4>Methods</h4>We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome.<h4>Results</h4>Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common-genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among children.<h4>Conclusions</h4>The clinical patterns of cases reported from Malaysia are consistent for the most part from previous case reports from South and Southeast Asia with regard to common primary presentations of pneumonia and soft tissue abscesses, and diabetes as a major risk factor. Bacteremic melioidosis carried a poor prognosis and septic shock was strong predictor of mortality. Differences included the occurrence of: primary neurological infection was higher in Malaysia compared to reports outside Malaysia; internal foci of infection such as abscesses of the liver, spleen, prostate, and mycotic pseudoaneurysms were higher than previously reported in the region. No parotid abscess was reported among children. Early recognition of the disease is the cornerstone of management. In clinical situations of community-acquired sepsis and/or pneumonia, where laboratory bacteriological confirmation is not possible, empirical treatment with antimicrobials for B. pseudomallei is recommended.
Arctic medicine. Tropical medicine, Public aspects of medicine
The debate over ‘Differences’ and ‘Disadvantage’ in the Constituent Assembly which has shaped the mainstream political discourse on the abrogation of the preferential treatment policies for the religious minorities represents the de facto narrative of their restriction to the Scheduled Castes (SCs) and Scheduled Tribes (STs). This article shatters this de facto narrative to arrive at an actual one and argues that reservation in the public employment for the religious minorities was not abrogated because they were considered socially and economically less backward than SCs and STs but was abrogated in a surreptitious manner; a manner which did not take cognisance of the nationalist deliberations in the Constituent Assembly and the debate over the ‘Differences’ and ‘Disadvantage’, with no particular reflective influence of these deliberations and debates upon the form which the preferential treatment policies in India were to finally assume. The article establishes this disconnect between the deliberations of the Constituent Assembly and the form the preferential treatment policies finally assume in India.
The late nineteenth and early twentieth century India witnessed the rise and growth of cultural and political nationalism with its unflinching support to revive ‘indigenous’ culture, system or tradition. A sudden interest in the revival of ‘indigenous’ medical systems of India during the same period was a natural corollary to the aforesaid phenomenon. This led to the growth of a medical revivalist movement centred largely around the portrayal of Ayurveda as an ‘indigenous’ self. Ayurveda in such a discourse became a true representative of a ‘time-tested’, ‘authentic’, ‘indigenous’ healing culture of India. However, a close analysis of the contemporaneous Ayurvedic discourse reflects gender-oriented concerns and predilections. The present article explores some of these gendered concerns and predilections of Ayurveda thereby showing how the Ayurvedic discourse on health and medicine, despite its claim to rationality and scientificity, was not separate from its social surroundings. Set in the early twentieth century United Provinces, this article reflects on the ideas and notions of the Ayurvedic practitioners who, in many ways, became handy in reinforcing patriarchy. Even Yashoda Devi, the famous female Ayurvedic practitioner from Allahabad who had expertise on women-oriented diseases, cannot be cleared of this blame. Thus, this article attempts a gender-sensitive analysis of the late colonial Ayurvedic discourse.