Evacuation Difficulties Research Articles

PROGRESS AND CHALLENGES IN PLUNGE MILLING: A REVIEW OF CURRENT PRACTICES AND FUTURE DIRECTIONS

This review examines recent advancements and ongoing challenges in plunge milling. It is an increasingly utilised machining process renowned for its high material removal rates, particularly with hard-to-machine materials like hardened steels and titanium alloys. Plunge milling’s unique perpendicular tool path offers enhanced stability and reduced lateral cutting forces, making it valuable for applications that demand precision and efficiency, such as aerospace and automotive manufacturing. The paper systematically analyses and synthesises research on critical areas of plunge milling optimization, including tool geometry, material selection, coating technologies, and process parameters, highlighting strategies to mitigate common issues like rapid tool wear and chip evacuation difficulties. In this comprehensive overview, the review introduces theoretical and experimental findings on optimizing plunge milling tools and process parameters—such as cutting speed, feed rate, and coolant delivery—that are essential for improving performance and achieving desirable surface finishes. The paper also explores innovative trends, including AI-driven optimization algorithms and hybrid machining systems, which hold promise for addressing persistent limitations and enhancing plunge milling’s industrial applicability. By consolidating findings from recent studies, this review contributes to a deeper understanding of plunge milling’s role in high-precision manufacturing and identifies future research directions for advancing the process. The insights presented offer practical and strategic implications, aiming to guide ongoing developments in plunge milling technology and its adoption across various precision-oriented industries.

Investigation of Fires Occurring in Hospitals between 2019-2023 in Türkiye: A Quantitative Content Analysis

Fires are one of the most important dangers for hospital buildings. The aim of the study is to examine the hospital fires occurred between 2019-2023 in Turkey. In the study, fires in public and private hospitals operating in Turkey between 2019 and 2023 were examined. In this cross-sectional study, news about fires in hospitals in Turkey were obtained from the archives of 7 national and 3 local news agencies using the search terms "fire" and "hospital" in Turkish. Quantitative content analysis was used to evaluate news texts. Out of a total of 76 hospital fires, 3 resulted in deaths caused by fire, leading to a total of 16 patient fatalities. Additionally, in all fires, a total of 99 individuals, including both patients and employees, required medical treatment due to the fire. In 19 of the fires, patients had to be evacuated due to exposure to either flames or smoke. The highest number of hospital fires occured in İstanbul. While the cause of 28 fires remains unknown, 27 fires were caused by electricity. Hospitals should prioritize fire prevention measures due to the potential losses and difficulties in evacuation. Regular checks of the hospital's electrical installations and devices should be carried out, as well as capacity assessments for new devices and expansions of the building. It is also recommended to keep emergency and disaster plans and teams updated for possible fire situations, increase employee knowledge, and conduct drills.

AHP-FCE를 활용한 중국 피난안내도 최적화 설계 연구 - Chung Hua University(CHU) 도서관을 중심으로

In large indoor public spaces such as office buildings and shopping malls, the complex architectural layout and dense population increase the difficulty of emergency evacuation. In the event of a fire or other disaster, the lack of effective evacuation measures can lead to significant casualties and property loss. This paper studies fire evacuation maps in China based on the Analytic Hierarchy Process (AHP) and Fuzzy Comprehensive Evaluation (FCE) methods, aiming to improve the cognitive efficiency and user experience of evacuation maps. The study first constructs a hierarchical index system for evacuation maps, determines the weights of various design elements, and forms a judgment matrix through evaluations by experts and users. Then, the optimized evacuation map undergoes a comprehensive evaluation analysis. The results show that clarity and functionality are the two aspects users are most concerned about, with the recognizability of signage and the accuracy of location information being particularly important. The optimized evacuation map shows significant improvements in clarity and information transmission, effectively guiding people to quickly escape in emergencies. This study validates the rationality and feasibility of the AHP-FCE method in the design of fire evacuation maps, providing new ideas and directions for further optimization of evacuation maps.

Сравнение мини-перкутанной нефролитотомии с супер-мини-перкутанной нефролитотомией: когортное исследование

Introduction. Over the past 20 years mini-percutaneous nephrolithotomy (mini-PCNL) is remaining an effective method non inferior to standard PCNL with lower rates of serious complication related to bigger nephrotomy tract size like bleeding. However, in comparison to standard PCNL miniPCNL diminishes visualization, leads to increase of intrarenal pressure (IRP), difficulties in stone fragments evacuation, and longer operative time. In 2016 Zeng has developed an innovative aspiration sheath. Novel modification of miniPCNL with suction was called superminiPCNL (SMP) [1]. We have modified this aspiration sheath. There is the lack of data regarding efficacy and safety of this innovative method. Objectives. The aim of the study is to compare efficacy and safety of miniPCNL with SMP using an innovative suction sheath in the treatment of kidney stone disease. Material and methods. Between September 2021 and March 2023, 140 underwent PCNL. Patient were divided into 2 groups 1:1, 70 patients in each group. MiniPCNL was used in control group, SMP using aspiration suction sheath – in intervention group. Operative time, stone-free rate (SFR), bleeding, postoperative complications were compared between two groups. Results. SFR didn`t significantly differ between the groups and was 91.3% and 98.4% respectively (p = 0.117). Mean operative time was less in SMP group with a mean shortening of the procedural time of 13 min (p < 0.001). Hemoglobin drop was comparable between the groups (p = 0.73). Fever was significantly less frequent in SMP group, 11.6% in miniPCNL vs. 1.6% in SMP group (p = 0.042). There were no serious complications (Clavien III and IV) in any group. Discussion. PSMP is not inferior to miniPCNL in terms of efficy and safety. Moreover, it leads to shorter operative ime, decreases complication rates, and thus is a preferable method of renal stone treatment. Keywords: Kidney stone disease, percutaneous nephrolithotomy, surgery, supermini-PCNL.

Analysis of the timing of evacuation and associated factors among home health care patients during flooding: A single-clinic-based mixed methods study

Home health care patients (HHPs) are vulnerable to flooding and may face evacuation difficulties. Previous studies reported that HHPs and their families are more susceptible to disasters than non-HHPs. Our prior research revealed that many HHPs in Fukui, Japan, were at risk for flooding and landslides, requiring evacuation assistance, yet few were aware of the exact risks. This study analyzed survey data to identify barriers to evacuation during floods and assess the assistance needed among HHPs. A concurrent nested design of mixed-method research was employed. We calculated the percentage of the 87 HHPs at risk likely to delay evacuation and constructed univariable and multivariable logistic regression models to identify factors associated with delayed evacuation, and employed a thematic analysis to identify concerns and needs during evacuation. Family members responded to the questionnaire for patients unable to respond. The study found that 69.0 % of patients delayed evacuation, with 61.7 % incorrectly perceiving disaster risks and 20.0 % considering evacuation unimportant. Those with incorrect risk perceptions were slower to evacuate than those with accurate perceptions (OR: 1.35, 95 % confidence interval: 1.06–6.99, p-value: 0.036). Seven themes about flood preparedness needs were extracted from open-ended statements. Factors contributing to delayed evacuation included assumptions of vertical evacuation due to mobility challenges and concerns about evacuation site environments. Few Japanese HHPs at risk of flooding and landslides would plan an early evacuation, often due to misperceived disaster risks. Specific measures are needed to address these issues, and further investigation is required as flooding may also affect patient supporters.

Analisis Keselamatan dan Risiko pada Pekerjaan Pengembangan Kilang Minyak dan Petrokimia dengan Metode JSA

Working at heights poses serious risks, including accidents and fatal injuries.Workers may also experience psychological stress and the physical and mental health impacts due to environmental conditions or psychological pressure. Restricted movement, difficulties in evacuation, and the use of safety equipment are also issues that require the implementation of effective safety measures and adequate training. This research aims to identify hazards through Job Safety Analysis (JSA) using descriptive analytical methods and field observations. The collected data is used as a basis to formulate control measures to prevent accidents or minimize risks. The results of the analysis of those activities serve as safety guidelines/procedures for all work activities.

Exercise, Dietary Habits, and Defecatory Dysfunction in Patients Living with Colorectal Cancer: A Preliminary Quantitative Study.

This study investigated the association of exercise and dietary habits with defecatory dysfunction in patients living with colorectal cancer. We recruited 61 adult patients who had undergone surgery within the past 20 years and attended outpatient clinics at designated cancer hospitals in Japan. Defecatory dysfunction was defined as any symptom caused by issues with colon and anal function, including fecal incontinence, evacuation difficulties, frequent stools, diarrhea, and constipation. Exercise and dietary habits were assessed via a quantitative questionnaire survey. Postoperative defecatory dysfunction occurred in all the patients. Multivariate analysis revealed no association between exercise habits and defecatory dysfunction; however, dietary fiber intake ≥4 times a week was associated with frequent stools (adjusted odds ratio, 5.11; 95% confidence interval, 1.10, 23.70). These findings suggest a need to alleviate defecatory dysfunction by improving one's dietary habits. Interventions aimed at alleviating defecatory dysfunction by improving the dietary habits in patients living with colorectal cancer are needed.

Impact of large-scale disasters on breast cancer care: A qualitative analysis of patient experiences during the 2011 triple disaster in Fukushima, Japan

Large-scale disasters can severely impact breast cancer care, leading to treatment disruptions and delays. While empirical studies on these effects are limited, patient narratives provide valuable insights. This study explored treatment continuity and medical access among local breast cancer patients affected by the 2011 triple disaster through qualitative research methods.The study involved 21 local breast cancer patients diagnosed before the disaster. After obtaining consent, semi-structured interviews ranging from 20 min to an hour were conducted, and data were analyzed using inductive thematic analysis.The analysis identified five key themes: medical challenges, family roles and burdens, information access and communication, mental health effects, and evacuation difficulties. These themes highlight the range of challenges from immediate response to long-term recovery, showcasing the profound impacts of infrastructure damage and treatment disruptions, exacerbated by familial constraints and the need for reliable information, contributing to psychological and logistical complexities during evacuation.The findings underscore the critical need for ongoing care and address key challenges for breast cancer patients during disasters. Future research should focus on developing practical and prompt solutions to address these issues in disaster settings.

Earthquake scenario-specific framework for spatial accessibility analysis (SAA) of emergency shelters: a case study in Xichang City, Sichuan Province, China

The spatial accessibility of emergency shelters, indicating the difficulty of evacuation and rescue, is crucial for disaster mitigation and emergency management. To analyze accessibility, an effective approach is to evaluate the service capacity of emergency shelters. Multifaceted factors were employed to enhance the quantitative accuracy of accessibility indicators. However, scenario-specific analysis has not been emphasized. Considering the devastating potential of great earthquake disasters, we cannot ignore the impact of these scenarios on emergency shelter accessibility, especially in areas with high seismic risk. In this study, we developed an earthquake scenario-specific framework for spatial accessibility analysis (SAA), which integrates the service capacity of emergency shelters and the impact of strong ground motion and fault rupturing. We applied this framework to the urban area of Xichang City in Sichuan Province, western China. Xichang City, located in the linked area of the Anninghe fault and Zemuhe fault with many extreme historical earthquake disaster records, is prone to high seismic risk. We firstly collected emergency shelter and road network data in Xichang City. We then applied SAA based on the road network, using the network analysis method. After that, we analyzed the impact of strong ground motion on accessibility and generated the setback zone of fault rupturing. We integrated the effect of strong ground motion on accessibility within the setback zone of active faults. Finally, we generated a comprehensive accessibility map, considering both the predicted strong ground motion and potential fault rupturing. Our results show that the accessibility level changed in several towns of urban Xichang City due to strong ground motion and fault rupturing. The accessibility level decreased in Lizhou, Xingsheng, and Anning Towns. For areas with mapped fault lines, the accessibility level is Very-Low. Our results demonstrate the impact of earthquake damage on the accessibility of emergency shelters and the complexity of evacuation in earthquake scenarios. In general, we added earthquake rupturing and ground motion characteristics into the SAA framework. This framework will help us enhance the reliability of SAA and the feasibility of seismic vulnerability evaluation.

Pedestrian evacuation planning under dam-break flood disaster considering road risk and road pedestrian demand

When facing disasters, a well-planned evacuation of people can significantly reduce casualties and disaster losses. Hurricane Katrina struck New Orleans in 2005, causing multiple dam failures and resulting in Lake Pontchartrain flooding back into the city. Taking this disaster as an example, this paper evaluates the risk of pedestrian evacuation on roads during dam-break flood disasters. The evaluation considers three aspects: road evacuation difficulty, disaster risk and road pedestrian demand. The fuzzy VIKOR model was used to evaluate 8 indicators for 50 candidate shelters. A dual-objective planning model was proposed to consider the time-varying and diverse emergency needs of disaster victims. By assessing the risk of pedestrian evacuation on the road and delineating restricted areas, the optimal path distance is calculated. Pareto optimality is then employed to achieve a trade-off between the convenience, cost, and applicability of the evacuation plan. In a complex post-disaster environment, the model can adapt flexibly to emergency rescue situations at various stages by adjusting the parameters in the objective and constraint equation. The Pareto optimal frontier can assist in determining the most suitable solution for the current scenario. In the case of New Orleans, 22 and 18 shelters were respectively selected from 34 candidate shelters for evacuation based on the simulated scenarios.

Defining priorities for wildfire mitigation actions at the local scale: insights from a novel risk analysis method applied in Portugal

IntroductionIn Portugal, the 2017 fire season was particularly extreme, leading to an unprecedented large number of fatalities, injured people, destruction of houses and infrastructures. These dramatic outcomes have contributed to raise awareness regarding the importance of ensuring the safety of people and assets from high intensity uncontrollable wildfires. It is crucial to identify the settlements at higher risk and the most suitable mitigation actions that can maximize the protection of people and assets.MethodsWe developed a simple methodology that combines exposure and vulnerability to estimate wildfire risk at the local level. Exposure was estimated using a fire spread simulation approach that was used to determine the probability of (i) a wildfire generating firebrands that could affect a settlement and (ii) a high intensity wildfire occurring adjacent to a settlement. Exposure was estimated using two fuel scenarios created to represent the current year of 2023 (short-term scenario) and 2030, assuming that no fuel management nor large fires occur in the meantime (medium-term worst-case scenario). Vulnerability was determined by the (i) Index of Total Dependence (IDT), and (ii) evacuation difficulty. Exposure and vulnerability metrics were normalized in percentiles, distributed into quadrants and combined to provide six levels of wildfire risk. For each vulnerability\exposure combination, we proposed a set of priority mitigation actions. The methodology was applied to three areas in Portugal where the risk estimates were analyzed and compared with the implementation rate of two risk mitigation programs already in place.ResultsResults showed that 8.7% of the settlements had “very high” wildfire risk and about 19.5% had “high” wildfire risk, potentially affecting 8,403 and 34,762 inhabitants, respectively. The spatial distribution of settlements at higher risk was very heterogeneous across the study areas and the total fraction ranged between 14% in Coimbra to 36% in Barlavento Algarvio. The overall implementation of mitigation programs in the study areas is very low, with only around 1% of the settlements in “very high” risk having any of the mitigation programs implemented. Conversely, our results also suggest that the implementation rate in settlements classified in lower risk classes is disproportionately high.DiscussionThe application of this risk analysis methodology can be used to assess the implementation status of mitigation actions, and contribute to tailor the actions that maximize the protection of people and assets according to the specific conditions found in each targeted area.

Preventive strategies for low anterior resection syndrome: a protocol for systematic review and evidence mapping

IntroductionRectal cancer is one of the top 10 cancers worldwide. Up to 80% of patients with rectal tumours have had sphincter-saving surgery, mainly due to the large expectation of anal...

Организация оказания первой помощи раненым военнослужащим в зоне вооруженного конфликта

Summary. The objectives of the study are to analyze the role of knowledge and skills acquired by servicemen when they render first aid to the wounded in combat conditions; to study the structure of sanitary losses in a military unit in the zone of Special Military Operation. Materials and research methods. Materials of the study are the experience of first aid in combat conditions. On the battlefield, various medical means of defense were used to provide first aid to the wounded. Soldiers, who were wounded, used first aid kits individual medical AI-3-1BC as a means of self-help. Sanitary straps, cloak tents and improvised means were used for medical evacuation of the wounded to a safe zone. Belts, ropes and other available materials were used as improvised means. In the field, the servicemen were trained to: search for the wounded; in case of various external bleeding — to apply hemostatic tourniquets, tourniquets, compression bandages, aseptic bandages on wounds; in case of injuries — to immobilize limbs. In case of wounds and traumas, intramuscular injection of anesthetic agents contained in a syringe-tube was performed. Medical evacuation of the wounded to a safe zone was carried out with observance of safety measures — both for the wounded and for the first aid provider. Research methods were analytical, statistical and field observation methods. Results of the study and their analysis. In the zone of the Special Military Operation the enemy actively uses remote and combined methods of defeat, which creates difficulties in the medical evacuation of wounded servicemen from the battlefield. During the first two hours after being wounded, about 11.0% of the wounded were received at triage points; between two and 6 hours, no more than 11.0% of the wounded were received. Most of the wounded arrived at triage points at later dates. In the structure of sanitary losses, the share of shrapnel wounds was 79.0%; bullet wounds — 10.0%; non-combat-related injuries and somatic diseases — 11.0%. The wounds were mixed and combined by nature. The share of severe wounds amounted to 23.0%; the share of moderate wounds — 50.0; the share of light wounds — 27.0%. It is concluded that timely and competent rendering of first aid to the wounded on the line of contact with the enemy is of paramount importance for saving lives of servicemen.

Iot Based Flood Detection, Alarm and Monitoring System Using Multilayer Perceptron and Regression

Flooding is a common natural event caused by heavy rainfall and high tides in the Philippines. While this disaster cannot be prevented, people can prepare themselves to face it. The City of Ilagan in the province of Isabela is one of the highly prone areas to flooding caused by the welling of the Cagayan River. Many communities are living in low-lying areas which most likely experiencing floods. An analysis of the location is conducted including the people living in the area. The analysis resulted in the development of an IoT-based technology for detection and early warning signals to people using sms notifications that can help lessen the difficulty of evacuation. The system uses Arduino UNO as a microcontroller where sensors are attached. These sensors are Light Detection and Ranging (LiDAR) for flood level measurement in feet (ft), Rain Gauge to measure the precipitation rate (mm/hr), and Flow Rate Meter to measure the fluctuation flow of the river in (L/hr). Data gathered from these sensors are processed and sent immediately to people living nearby to monitor the flood level in real-time. The predictive models are developed using the Pinacanauan River dataset taken from the river stations. The multilayer perceptron is used to develop the predictive model with 99% accuracy. The data from sensors are used also and processed using linear regression and calculated as 88% accurate and significant for prediction.

Pathophysiological basis, clinical assessment, investigation and management of patients with obstruction defecation syndrome.

Obstructed defecation syndrome (ODS) is a clinical syndrome manifest as difficulty in faecal evacuation despite no mechanical obstruction. It is the final clinical pathway of a number of anatomical and physiological pathologies they can result in considerable misery to the lives of the patients it afflicts. Herein, the authors seek to breakdown the syndrome into its component parts, looking first at normal pelvic floor anatomy and physiology; followed by each pathological element; clinical features and investigation; individual management and management of the patient as a whole. It must be stated that correction of anatomy is not the sine qua non, as this does not always correlate to improvement of symptoms. There is a complex interplay of all elements, and a holistic approach appreciating the gestalt principle of "the whole is greater than the sum of its parts" is paramount. Causes of pelvic pain (levator ani syndrome, coccygodynia, proctalgia fugax and pudendal neuralgia) do not fall into ODS and are beyond the scope of this paper.

تأثير المساحة الفاصلة بين الشقق على سرعة انتشار الحريق في الأبنية السكنية العالية

Fire accidents in high-rise residential buildings lead to great loss of life and property and constitute a serious threat to the difficulty of safe evacuation due to the presence of various flammable materials and high population density, so there are great challenges facing architects and specialists in order to improve and develop design methods to protect from fire and reduce losses. The space separating apartments can be a factor influencing the spread of fire, its development, and the speed of its transmission in tall residential buildings. To clarify this, the spread of fire was followed vertically and systematically by simulating the characteristics of fire spread for a 12-story building using the pyrosim program. The simulation results showed that the risk of fire spreading in tall residential buildings increases with the space separating apartments and that the effect of the depth of space is more obvious the greater the width of the space separating apartments. For separating spaces, and thus the research can contribute to choosing the optimal design to increase the chance of safe evacuation in the event of a fire in high-rise residential buildings.

Mortality risk associated with nuclear disasters depends on the time during and following evacuation of hospitals near nuclear power plants: An observational and qualitative study

This study aimed to examine the factors correlated with emergency evacuations on patients’ prognosis in hospitals severely affected by the Fukushima Daiichi nuclear power plant (FDNPP) accident in March 2011, and to recommend measures mitigating potential health risks among them in future disasters. Seven hospitals within a 20-km radius of the FDNPP were designated as the evacuation zone, of which three hospitals located within a 5-km radius were examined. Information regarding hospital emergency evacuation among the three hospitals from previous literature and official reports were integrated and interview outcomes of staff at each hospital were qualitatively analyzed using thematic analysis. Our thematic analysis identified four themes: insufficient preparedness for disaster, difficulty of patient evacuation, insufficient materials, and insufficient information. Comparison of the three hospitals located within a 5-km radius of the FDNPP revealed that hospitals with several patients or those with a high proportion of bedridden or critically ill patients faced more difficulty in emergency evacuation and experienced higher fatalities. In addition to individual evacuation plans, for future preparedness, external and public organizations should prepare disaster responses such as procedures to integrate information on the status of each medical facility and measures to support them individually.

Colonic pouch reconstruction after low anterior rectal resection

For many decades the coloanal anastomosis was traditionally created as an end-to-end anastomosis. Despite successful surgical restoration of the intestinal passage after low rectal resection and total mesorectal excision (TME), physiological continence and evacuation function cannot be achieved in many cases using end-to-end anastomosis. Subsequent complaints, such as fecal incontinence and urge problems, evacuation difficulties and high stool frequency (so-called low anterior resection syndrome, LARS) are the result. The combination of symptoms after TME known as LARS is described in the literature in up to 60% of cases. The increased occurrence of the imperative urge to defecate, frequent bowel movements and problems with fecal incontinence motivated surgeons to look for alternative anastomosis techniques. Side-to-end anastomosis, coloplasty pouch and colonic J‑pouch have been shown in various studies to be superior to end-to-end anastomosis in terms of functional results. Current studies could show that the side-to-end anastomosis (even if this is not apouch in the actual sense) and the two pouch techniques show comparable results in terms of functional outcome and the rate of anastomotic leakage. The alternative to coloanal anastomosis after TME is the abdominoperineal resection. Most, especially younger patients, prefer to try to maintain continence with the risk of the described functional problems. If the patients are well selected, TME can be carried out with the current techniques in such away that continuity is maintained and agood defecation function is achieved for alarge proportion of patients using the pouch-anal anastomosis or the side-to-end techniques.

S3370 Chronic Intestinal Obstruction in Surgically Treated Hirschsprung’s Disease: A Rare Presentation

Introduction: Hirschsprung’s Disease (HD) is exceedingly rare and represents a failure of ganglion cell migration to the gut. Longitudinal studies examining long-term outcomes of surgically treated HD are extremely limited. We discuss a patient who underwent surgical treatment for HD as an infant and presented in adulthood with severe abdominal pain and weight loss. Case Description/Methods: A 34-year-old female presented with severe abdominal pain and 15-pound weight loss over 1 month. She had a history of HD that involved the entire colon diagnosed at 6 months which was treated with the Duhamel procedure at age 1. Her postoperative course was complicated by recurrent small bowel obstruction (SBO) requiring multiple surgeries for adhesiolysis. She continued to pass gas; bowel movements were at baseline. Physical exam revealed mild distention and tenderness in the periumbilical region. CT showed marked small bowel dilation proximal to the anastomosis, multiple areas of focal narrowing, and significant stool burden (Figure A). Endoscopy revealed nonobstructive ileal stenosis proximal to the anastomosis and ileal ulcerations with biopsies showing acute and chronic inflammation with cryptitis (Figure B). Empiric treatment for small intestinal bacterial overgrowth and Hirschsprung-associated enterocolitis were initiated without improvement. She was also trialed on mesalamine with no benefit. Manometry revealed impaired recto-anal inhibitory reflex possibly due to residual HD and Type 1 dyssynergic defecation. She was started on prucalopride with some improvement of her abdominal pain. Providing non-invasive venting options remains an ongoing challenge. Discussion: The curative treatment for HD is surgical resection and the limited studies on long-term outcomes of these patients have demonstrated that constipation or diarrhea are common, and obstructive symptoms or dyssynergia are rare. Potential reasons for the complications presented in this case include mechanical obstruction from strictures and possible residual aganglionosis from insufficient resection. Additionally, prolonged bowel dilation may lead to impaired motility, evacuation difficulties, chronic dilation, and ischemic changes. There is a need for longitudinal studies at dedicated colorectal centers to provide effective transition of care from childhood to adulthood as well as a formalized approach to the management of postoperative complications of HD in adulthood, especially as these issues closely relate to functional status and quality of life.Figure 1.: A: CT demonstrating areas of narrowing and marked dilation proximal to the anastomosis B: Endoscopic view of the ileum demonstrating ulceration and stenosis at the anastomosis site.

Evaluation of evacuation difficulty of urban resident during storm water‐logging based on walking experiment

Frequent water-logging disasters in cities are serious threats to urban residents. When a water-logging disaster occurs, it is essential for residents to evacuate, taking refuge to reduce losses and to ensure safety. This project studied evacuation difficulty for residents in the Daoli District of Harbin during storm water-logging. Starting from external factors and internal factors influencing resident evacuation, the study screened indicators for assessing the difficulty of evacuation during urban rainstorm water-logging, constructed an evaluation index system and evaluation models to assess the difficulty of evacuation of residents. Results showed that residents in the vicinity of the three streets, Xinyang Road and Minqing Street, Zhaolin Street and Anfeng Street in the study area have difficulty in evacuation in the case of a 5-year torrential rain disaster. Other areas had little impact. In a 100-year torrential rain situation, it is more difficult for residents in Stone Road Bridge, the intersection of Market Street and Toulong Street, the intersection of Touloing Street and Zhaolin Street, the intersection of Anfa Street and JingweiErdao Street, and Anguo Street, while other areas were not seriously affected. The research results can provide new ideas for the study of evacuation of residents during urban water-logging, and can also provide decision-making basis for disaster prevention and mitigation for urban emergency departments.