Numerical modeling of unsaturated layered soil for rainfall-induced shallow landslides

In this paper, a pioneer study on numerical modeling of rainfall-induced shallow landslides in unsaturated layered soil using the variably saturated flow equation is presented. To model the shallow landslides, the infinite slope stability analysis coupled with the hydrological model with the consideration of the fluctuation of time-dependent pore water pressure and Gardner equation for soil water characteristic curve was developed. A linearization process for the nonlinear Richards equation to deal with groundwater flow in unsaturated layered soil is derived using the Gardner model. To solve one-dimensional flow in the unsaturated zone of layered soil profiles, flux conservation and the continuity of pressure potential at the interface between two consecutive layers are considered in the numerical discretization of the finite difference method. The validity of the proposed model is established in three numerical problems by comparing the results with the analytical and other numerical solutions. Application examples have also been conducted. Obtained results demonstrate that the fluctuation of pore water pressure in unsaturated layered soil dominates slope stability of landslides and the lowest factor of safety may occur at the interface between two consecutive layers. The findings observed in this study are a fundamental contribution to environmental protection engineering for landslides in areas with higher occurrence and vulnerability to extreme precipitation

Psoas Abscess Caused by Non-Typhoid Salmonella in a Patient with Severe Aplastic Anemia

The clinical spectrum of infections caused by non-typhoid Salmonella spp. includes gastroenteritis, enteric fever, bacteremia, and extraintestinal localized complications, especially in immunocompromised hosts. Here we report a patient with severe aplastic anemia developing left iliopsoas abscess caused by non-typhoid Salmonella (NTS), which was successfully treated by prolonged antibiotic treatment and repeated debridement. Our data indicate that aplastic anemia is a risk factor for infection caused by NTS

Multiculturalism and multicultural education approaches to Indigenous people’s education in Taiwan

Taiwan has cast multicultural policies as a remedy for inequalities and injustices its 16 Indigenous groups face. Such policies aim to revive Indigenous languages and cultures and create a more welcoming and inclusive environment in schools. Despite the fact that Indigenous people are expected to be primary beneficiaries of these policies, not much is known about how they have affected Indigenous students and communities, if at all. Relying on in-depth semi-structured interviews with 16 Indigenous participants, this paper explores whether the policies have accomplished or are on the way to accomplishing the goals set, as seen by Indigenous people. The findings show that the multicultural approach to education is still informed by assimilationist logic that expects Indigenous people to adjust to the culture and orientations of the dominant group, and as such, does not redress the existing injustices and inequalities

Clinical and Microbiological Characteristics of Bacteremia Caused by Acinetobacter Lwoffii

A retrospective study was conducted to analyze the clinical features and pathogenic roles of bacteremia caused by Acinetobacter lwoffii during a 4- year period. Acinetobacter lwoffii (formerly Acinetobacter calcoaceticus var. lwoffii) is recognized as normal flora of the skin, oropharynx and perineum of healthy individuals. There are few reports of Acinetobacter lwoffii bacteremia associated with indwelling catheters in humans, particularly in immunocompromised hosts . The records of 18 patients with Acinetobacter lwoffii bacteremia whose underlying conditions included cancer (11 patients), systemic lupus erythematosus (n =1), chronic obstructive-pulmonary disease (n = 2) and other diseases (n= 4), all but one of whom had indwelling catheters during the bacteremic episode, were examined. The clinical syndromes were classified as probable catheter- related bacteremia (n = 14), definite catheter-related bacteremia (n= 2), primary bacteremia (n =1) or biliary tract infection(n = 1). The infections improved after removal of the catheter and/or appropriate antimicrobial therapy. One death was attributable to the bacteremic event. The results of this study show that indwelling catheter-related Acinetobacter lwoffii bacteremia in immunocompromised hosts appears to be associated with a low risk of mortality

Pulmonary Tuberculosis in Allogeneic Hematopoietic Stem Cell Transplantation

Pulmonary tuberculosis (TB) is an endemic infectious disease in Taiwan. A retrospective study was conducted to define clinical manifestations and outcomes of patients with pulmonary TB among hematopoietic stem cell transplantation ( HSCT) recipients. We identified eight out of 350 HSCT recipients as having pulmonary TB over a 6-year period. The relative risk of having pulmonary TB after HSCT was 13.1- fold higher than in the general population. There was a trend toward increased risk of having pulmonary Tn in allogeneic HSCT as compared to autologous HSCT (4.8 +/-1.8 % vs 0, P = 0.067). All the eight patients with pulmonary Tn received allogeneic HSCT and most (seven of eight patients) developed the infection during treatment for GVHD. Computed tomography of the chest was normal in one patient, with the rest showing either interstitial (two patients) or alveolar infiltrates (five patients) at the onset of pulmonary Tn, The four fatal cases had an obviously shorter duration between HSCT and onset of infection. Our data suggest that pulmonary TB in HSCT recipients is not uncommon in this endemic area, Therefore, an effective strategy of prophylactic treatment for candidates and recipients of allogeneic HSCT, who may have latent pulmonary TB infection, must be developed

Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation

Purpose: Although the medical decision-making process can be overwhelming for some surrogates, there is a lack of understanding regarding their experiences. The objectives of this study were to examine the decision self-efficacy and decisional conflict experienced by surrogates in intensive care units (ICUs) when faced with the decision of whether to reintubate patients with respiratory failure after a planned extubation. In addition, predictors and mediators influencing these decision-making processes were identified. Methods: This study utilized a cross-sectional design to investigate the decision-making processes of 174 surrogates who were faced with the decision of whether to reintubate patients with respiratory failure after a planned extubation in the internal ICU of a medical center between August 2021 and February 2022. Structured questionnaires were administered to collect data on the surrogates' background information, decision self-efficacy, decisional conflict, and positive and negative affect. The patients’ background information was also collected. Univariate and multivariate analyses were performed to model the data. Results: The mean decision self-efficacy score of the surrogates was 82.41 points, and 20.7% surrogates had decisional conflict scores exceeding 37.5 points, suggesting that they faced challenges in the decision-making process. Surrogates' employment status and negative affect significantly predicted their decision self-efficacy. In addition, patients' activities of daily living prior to hospitalization and the decision self-efficacy of the surrogate significantly predicted surrogate decisional conflict. The impact of surrogates’ negative affect on decisional conflict was fully mediated by decision self-efficacy. Conclusions: Surrogate decision self-efficacy mediates the relationship between negative affect and decisional conflict. Providing clinical care interventions that focus on enhancing surrogate self-efficacy and reducing negative affect can help alleviate decisional conflict in this population

A Theme Park Tourist Service System with a Personalized Recommendation Strategy

In general, there exists numerous attractions installed in a theme park, and tourists in a theme park dynamically change their locations during a tour. Thus, a tourist may cope with the issues of selecting the attractions to visit while planning the tour route. This paper, based on the concept of location awareness, proposes a novel waiting time, called the personalized waiting time, to introduce a location-aware recommendation strategy. In addition, this paper presents an architecture of tourist service system using the proposed recommendation strategy to relieve the pressure on tourists and create the pleasant experience in their tours. The proposed location-based system consists of mobile app, ticket-reader, detecting/counting, and central subsystems, and the whole system was implemented in this study. We conducted numerous experiments and field testing results validated that the entire proposed system can correctly provide information, such as attraction introduction, recommended session time, estimated moving and waiting time, tour map, and the number of reservations. The system functions, including dynamical scheduling, attraction reservation, ticket verification, visitor detection, and visitor counting, also worked well