Search results for: multiple trauma

Authors: Asish Subedi, Krishna Pokharel, Birendra Prasad Sah, Pashupati Chaudhary

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Objectives: To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. Methods: In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1 to 3) and a moderate-severe pain group (NRS 4-10). The Spearman correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. Results: As four patients violated the protocol, the data of 131 patients were analysed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ±9.50 compared to 18.64 ±10 mean N-PCS scores by the no-mild pain group (p<0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r =0.39, [95% CI 0.23-0.52], p<0.001) and total tramadol consumption (r =0.32, [95% CI 0.16-0.47], p<0.001). An increase in catastrophizing scores was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p=0.006) after adjusting for gender, ethnicity and preoperative anxiety. Conclusion: Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain.

Keywords: nepali, pain catastrophizing, postoperative pain, trauma

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

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Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

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Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

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Authors: Hannah M. Russell

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‘The Attach Project’ (TAP), is an educational intervention aimed at improving educational and socio-emotional outcomes for children who are looked after. TAP is underpinned by Attachment Theory and is adapted from Dyadic Developmental Psychotherapy (DDP), which is a treatment for children and young people impacted by complex trauma and disorders of attachment. TAP has been implemented in primary schools in Northern Ireland throughout the 2018/19 academic year. During this time, a design and implementation study has been conducted to assess the promise of effectiveness for the future dissemination and ‘scaling-up’ of the programme for a larger, randomised control trial. TAP has been designed specifically for implementation in a school setting and is comprised of a whole school element and a more individualised Key Adult-Key Child pairing. This design and implementation study utilises a mixed-methods research design consisting of quantitative, qualitative, and observational measures with stakeholder input and involvement being considered an integral component. The use of quantitative measures, such as self-report questionnaires prior to and eight months following the implementation of TAP, enabled the analysis of the strengths and direction of relations between the various components of the programme, as well as the influence of implementation factors. The use of qualitative measures, incorporating semi-structured interviews and focus groups, enabled the assessment of implementation factors, identification of implementation barriers, and potential methods of addressing these issues. Observational measures facilitated the continual development and improvement of ‘TAP training’ for school staff. Preliminary findings have provided evidence of promise for the effectiveness of TAP and indicate the potential benefits of introducing this type of attachment-based intervention across other educational settings. This type of intervention could benefit not only children who are looked after but all children who may be impacted by complex trauma or disorders of attachment. Furthermore, findings from this study demonstrate that it is possible for children to form a secondary attachment relationship with a significant adult in school. However, various implementation factors which should be addressed were identified throughout the study, such as the necessity of protected time being introduced to facilitate the development of a positive Key Adult- Key Child relationship. Furthermore, additional ‘re-cap’ training is required in future dissemination of the programme, to maximise ‘attachment friendly practice’ in the whole staff team. Qualitative findings have also indicated that there is a general opinion across school staff that this type of Key Adult- Key Child pairing could be more effective if it was introduced as soon as children begin primary school. This research has provided ample evidence for the need to introduce relationally based interventions in schools, to help to ensure that children who are looked after, or who are impacted by complex trauma or disorders of attachment, can thrive in the school environment. In addition, this research has facilitated the identification of important implementation factors and barriers to implementation, which can be addressed prior to the ‘scaling-up’ of TAP for a robust, randomised controlled trial.

Keywords: attachment, complex trauma, educational interventions, implementation

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Authors: Siqi Fang, Man Cheung Chung

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This study examined the inter-relationship between childhood maltreatment, cognitive distortion, alexithymia, eudemonic well-being, and psychological distress. One hundred and eighty-two university students participated in the study and completed an online survey comprising the Childhood Trauma Questionnaire, Cognitive Distortion Scale, Toronto Alexithymia Scale, Psychological Well-Being Scale, and General Health Questionnaire-28. Hierarchical multiple regression analysis showed that child maltreatment, perceptions of hopelessness and helplessness, preoccupation with danger, personal growth, and purpose in life predicted psychological distress. However, alexithymia was not a significant predictor. Further analysis using the regression models with bootstrapping procedure showed that feeling hopeless, helpless and preoccupation with danger mediated the path between child maltreatment and psychological distress. Meanwhile, coping with beliefs in personal growth and life purpose moderated the mediation effects of distorted cognition on psychological distress. To conclude, childhood maltreatment is associated with psychological distress. This relationship is influenced by people’s perceptions of life being hopeless, helpless or dangerous. At the same time, the effect of hopelessness, helplessness, and feelings of danger also depends on the degree of using coping strategies of positive psychological functioning.

Keywords: alexithymia, childhood maltreatment, cognitive distortion, eudemonic well-being, psychological distress

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Authors: Chao-xun Liu, Shi-hong Lu

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In spite of its importance to the aerospace and automobile industries, little or no attention has been devoted to the accurate modeling of the ultrasonic shot peening (USP) process. It is therefore the purpose of this study to conduct finite element analysis of the process using a realistic multiple pin impacts model with the explicit solver of ABAQUS. In this paper, we research the effect of several key parameters on the residual stress distribution within the target, including impact velocity, incident angle, friction coefficient between pins and target and impact number of times were investigated. The results reveal that the impact velocity and impact number of times have obvious effect and impacting vertically could produce the most perfect residual stress distribution. Then we compare the results with the date in USP experiment and verify the exactness of the model. The analysis of the multiple pin impacts date reveal the relationships between peening process parameters and peening quality, which are useful for identifying the parameters which need to be controlled and regulated in order to produce a more beneficial compressive residual stress distribution within the target.

Keywords: ultrasonic shot peening, finite element, multiple pins, residual stress, numerical simulation

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Authors: Sandra K. Enriquez, Claudia Camargo, Jesús E. Olguín, Juan A. López, German Galindo

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Currently companies have increased the number of disorders of cumulative trauma (CTDs), these are increasing significantly due to the Highly Repetitive Movements (HRM) performed in workstations, which causes economic losses to businesses, due to temporary and permanent disabilities of workers. This analysis focuses on the prevention of disorders caused by: repeatability, duration and effort; And focuses on reducing cumulative trauma disorders such as occupational diseases using sensory thermography as a noninvasive method, the above is to evaluate the injuries could have workers to perform repetitive motions. Objectives: The aim is to define rest periods or job rotation before they generate a CTD, this sensory thermography by analyzing changes in temperature patterns on wrists and elbows when the worker is performing HRM over a period of time 2 hours and 30 minutes. Information on non-work variables such as wrist and elbow injuries, weight, gender, age, among others, and work variables such as temperature workspace, repetitiveness and duration also met. Methodology: The analysis to 4 industrial designers, 2 men and 2 women to be specific was conducted in a business in normal health for a period of 12 days, using the following time ranges: the first day for every 90 minutes continuous work were asked to rest 5 minutes, the second day for every 90 minutes of continuous work were asked to rest 10 minutes, the same to work 60 and 30 minutes straight. Each worker was tested with 6 different ranges at least twice. This analysis was performed in a controlled room temperature between 20 and 25 ° C, and a time to stabilize the temperature of the wrists and elbows than 20 minutes at the beginning and end of the analysis. Results: The range time of 90 minutes working continuous and a rest of 5 minutes of activity is where the maximum temperature (Tmax) was registered in the wrists and elbows in the office, we found the Tmax was 35.79 ° C with a difference of 2.79 ° C between the initial and final temperature of the left elbow presented at the individual 4 during the 86 minutes, in of range in 90 minutes continuously working and rested for 5 minutes of your activity. Conclusions: It is possible with this alternative technology is sensory thermography predict ranges of rotation or rest for the prevention of CTD to perform HRM work activities, obtaining with this reduce occupational disease, quotas by health agencies and increasing the quality of life of workers, taking this technology a cost-benefit acceptable in the future.

Keywords: sensory thermography, temperature, cumulative trauma disorder (CTD), highly repetitive movement (HRM)

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Authors: Ye Jiang

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To examine how the relationships among multiple institutional logics vary over time and the factors that may impact this process, we conducted a 15-year in-depth longitudinal case study of a Higher Education Institution to examine its exploration in college student management. By employing constructive grounded theory, we developed a four-stage process model comprising separation, formalization, selective bridging, and embeddedness that showed how two contradictory logics become complementary, and finally become a new hybridized logic. We argue that selective bridging is an important step in changing inter-logic relations. We also found that ambidextrous leadership and situational sensemaking are two key factors that drive this process. Our contribution to the literature is threefold. First, we enhance the literature on the changing relationships among multiple institutional logics and our findings advance the understanding of relationships between multiple logics through a dynamic view. While most studies have tended to assume that the relationship among logics is static and persistently in a contentious state, we contend that the relationships among multiple institutional logics can change over time. Competitive logics can become complementary, and a new hybridized logic can emerge therefrom. The four-stage logic hybridization process model offers insights on the logic hybridization process, which is underexplored in the literature. Second, our research reveals that selective bridging is important in making conflicting logics compatible, and thus constitutes a key step in creating new hybridized logic dynamics. Our findings suggest that the relations between multiple logics are manageable and can thus be manipulated for organizational innovation. Finally, the factors influencing the variations in inter-logic relations enrich the understanding of the antecedents of these dynamics.

Keywords: institutional theory, institutional logics, ambidextrous leadership, situational sensemaking

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Authors: Yu Chen, Seong-Jin Kim, Jaehoon Chung

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High throughput cells counting and sizing are often required for biomedical applications. Here we report design, fabrication and validating of a micro-machined Coulter counter device with multiple-channel to realize such application for low cost. Multiple vertical through-holes were fabricated on a silicon chip, combined with the PDMS micro-fluidics channel that serves as the sensing channel. In order to avoid the crosstalk introduced by the electrical connection, instead of measuring the current passing through, the potential of each channel is monitored, thus the high throughput is possible. A peak of the output potential can be captured when the cell/particle is passing through the microhole. The device was validated by counting and sizing the polystyrene beads with diameter of 6 μm, 10 μm and 15 μm. With the sampling frequency to be set at 100 kHz, up to 5000 counts/sec for each channel can be realized. The counting and enumeration of MCF7 cancer cells are also demonstrated.

Keywords: Coulter counter, cell enumeration, high through-put, cell sizing

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Authors: Efnie Indrianie

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Potential Intelligence constitutes one essential factor in every individual. This intelligence can be a provision for the development of Performance Intelligence if it is supported by surrounding environment. Fingerprint analysis is a method in recognizing this Potential Intelligence. This method is grounded on pattern and number of finger print outlines that are assumed symmetrical with the number of nerves in our brain, in which these areas have their own function among another. These brain’s functions are later being transposed into intelligence components in accordance with the Multiple Intelligences theory. This research tested the correlation between Potential Intelligence and the components of its Performance Intelligence. Statistical test results that used Pearson correlation showed that five components of Potential Intelligence correlated with Performance Intelligence. Those five components are Logic-Math, Logic, Linguistic, Music, Kinesthetic, and Intrapersonal. Also, this research indicated that cultural factor had a big role in shaping intelligence.

Keywords: potential intelligence, performance intelligence, multiple intelligences, fingerprint, environment, brain

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Authors: Kinneret Segal

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Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

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Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

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Authors: L. Mtibaa, N. Baccouchi, S. Hannechi, R. Abid, R. Battikh, B. Jemli

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Cryptococcosis is an opportunistic fungal infection which is commonly associated with an immune-compomised state, especially HIV infection. Rare cases of cryptococcosis have been reported in patients with multiple myeloma (MM), and they are all at a late stage of the disease. However, the inaugural character of cryptococcosis revealing the MM at an early stage has never been reported to our best knowledge. We presented here a case of neuromeningeal cryptococcosis in a patient without any apparent underlying conditions, who has revealed IgA-λ MM. Early detection and treatment of cryptococcosis are essential to reduce morbidity and for a better outcome.

Keywords: Cryptococcosis, Cryptococcus, hematologic, malignancy

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Authors: Yaou Zhang

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Background: Relatively little scholarly attention has been paid to the production of Benjamin Britten’s chamber opera The Turn of the Screw. As one of Britten’s most remarkable operas. The story of the libretto was from Henry James’s novella of the same name. The novella was created in 1898 and one of the primary questions addressed to people in the story is “how real the ghosts are,” which leads the story to a huge ambiguity in readers’ minds. Aims: This research focuses on the experience of seeing the opera on stage over several decades. This study of opera productions over time not only provides insight into how stage performances can alter audience members' perceptions of the opera in the present but also reveals a landscape of shifting aesthetics and receptions. Methods: To examine the hypotheses in interpretation and reception, the qualitative analysis is used to examine the figures of ghosts in different productions across the time from 1954 to 2021 in the UK: by accessing recordings, newspapers, and reviews for the productions that are sourced from online and physical archives. For instance, the field research is conducted on the topic by arranging interviews with the creative team and visiting Opera North in Leeds and Britten-Pears Foundation. The collected data reveals the “hidden identity” in creative teams’ interpretations, social preferences, and rediscover that have previously remained unseen. Results: This research presents an angle of Britten’s Screw by using the third position; it shows how the attention moved from the stage of “do the ghosts really exist” to “traumatised children.” Discussion: Critics and audiences have debated whether the governess hallucinates the ghosts in the opera for decades. While, in recent years, directors of new productions have given themselves the opportunity to go deeper into Britten's musical structure and offer the opera more space to be interpreted, rather than debating if "ghosts actually exist" or "the psychological problems of the governess." One can consider and reflect that the questionable actions of the children are because they are suffering from trauma, whether the trauma comes from the ghosts, the hallucinating governess, or some prior experiences: various interpretations cause one result that children are the recipients of trauma. Arguably, the role of the supernatural is neither simply one of the elements of a ghost story nor simply one of the parts of the ambiguity between the supernatural and the hallucination of the governess; rather, the ghosts and the hallucinating governess can exist at the same time - the combination of the supernatural’s and the governess’s behaviours on stage generates a sharper and more serious angle that draws our attention to the traumatized children.

Keywords: benjamin britten, chamber opera, production, reception, staging, the turn of the screw

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Authors: S. Ilakkiya, A. Merline

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A multiple-input multiple-output (MIMO) radar systems use modulated waveforms and directive antennas to transmit electromagnetic energy into a specific volume in space to search for targets. This paper deals with the design of transmit beamspace matrix and DOA estimation for multiple-input multiple-output (MIMO) radar with collocated antennas.The design of transmit beamspace matrix is based on minimizing the difference between a desired transmit beampattern and the actual one while enforcing the constraint of uniform power distribution across the transmit array elements. Rotational invariance property is established at the transmit array by imposing a specific structure on the beamspace matrix. Semidefinite programming and spatial-division based design (SDD) are also designed separately. In MIMO radar systems, DOA estimation is an essential process to determine the direction of incoming signals and thus to direct the beam of the antenna array towards the estimated direction. This estimation deals with non-adaptive spectral estimation and adaptive spectral estimation techniques. The design of the transmit beamspace matrix and spectral estimation techniques are studied through simulation.

Keywords: adaptive and non-adaptive spectral estimation, direction of arrival estimation, MIMO radar, rotational invariance property, transmit, receive beamforming

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Authors: Abdelouahab Errida, Bouchra Lotfi, Elalami Semma

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In this paper, we try to address the topic of multiple change management by adopting an engineered research methodology, conducted within a Moroccan company during its implementation of several change projects that aim at improving its supply chain management performance. Firstly, we present the key concepts related to our research, namely change management, multiproject management and supply chain management. Then, we try to assess how the change management and multi-project management are applied in this company. Finally, we try to propose an approach that will help managers in dealing with multiple change projects. This approach proposes to integrate change management, project management and multi-project management for managing change projects according to three organizational levels: executive level, project portfolio level and change project level.

Keywords: change management, multi-project management, project management, change portfolio, supply chain management,

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Authors: Grace Rademacher

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Trauma” of the Kingdom of Hungary and the “Lost Cause” of the American Confederacy. Applying Nicole Maurantonio’s articulation of “confederate exceptionalism” and Svetlana Boym’s definition of “restorative nostalgia”, this article argues that, via memorialization and public discourse, both far right bodies flood their constituencies with narratives of nostalgia and martyrdom to sow existential anxieties about past and prophetic victimhood, all under the guise of protecting or restoring heritage. Linking this practice to gamification and conspiracy theorizing and following the work of Patrick Jagoda, this article identifies such industries of nostalgia as means by which the far right in both nations can partake in the “immanent and improvisational process of problem making.” Reified through monuments and references to the Trianon Trauma and the American confederacy, political actors “problem make” by alleging that they are victims of the West or the Left, subject to the cruel whims of liberalism and denial of historical legitimacy. In both nations, relying on their victimhood, pundits and politicians can appeal to white supremacists and distract citizens from legitimate active conflicts, such as wars or democratic rollbacks, redirecting them to fictional, mythical attacks on Hungarian or American society and civilization. This article will examine memorials and monuments as “lieux de memoire” and identify the purposeful similarities between the discourse of public figures and politicians such as María Schmidt, János Lázár, and Viktor Orbán, with that of Donald Trump and pundits such as Tucker Carlson.

Keywords: nationalism, political memory, white supremacy, trianon

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Authors: Ksenija Dumičić, Anita Čeh Časni, Irena Palić

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This paper examines economic and Information and Communication Technology (ICT) development influence on recently increasing Internet purchases by individuals for European Union member states. After a growing trend for Internet purchases in EU27 was noticed, all possible regression analysis was applied using nine independent variables in 2011. Finally, two linear regression models were studied in detail. Conducted simple linear regression analysis confirmed the research hypothesis that the Internet purchases in analysed EU countries is positively correlated with statistically significant variable Gross Domestic Product per capita (GDPpc). Also, analysed multiple linear regression model with four regressors, showing ICT development level, indicates that ICT development is crucial for explaining the Internet purchases by individuals, confirming the research hypothesis.

Keywords: European union, Internet purchases, multiple linear regression model, outlier

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Authors: Rama Debbarma, Debanjan Das

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The performance of multiple tuned mass dampers to mitigate the seismic vibration of structures considering real time history data is investigated in this paper. Three different real earthquake time history data like Kobe, Imperial Valley and Mammoth Lake are taken in the present study. The multiple tuned mass dampers (MTMD) are distributed at each storey. For comparative study, single tuned mass damper (STMD) is installed at top of the similar structure. This study is conducted for a fixed mass ratio (5%) and fixed damping ratio (5%) of structures. Numerical study is performed to evaluate the effectiveness of MTMDs and overall system performance. The displacement, acceleration, base shear and storey drift are obtained for both combined system (structure with MTMD and structure with STMD) for all earthquakes. The same responses are also obtained for structure without damper system. From obtained results, it is investigated that the MTMD configuration is more effective for controlling the seismic response of the primary system with compare to STMD configuration.

Keywords: Earthquake, multiple tuned mass dampers, single tuned mass damper, Time history.

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Authors: Chi-Chang Lin, Jiun-Yan Chiu

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Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

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Authors: Jocelyn Cohen

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This paper identifies a powerful synchronicity of two traditions of life-story writing in the autobiographies of ritual abuse (RA) survivors, the Christian conversion narrative and the memoir of healing from childhood sexual trauma. Using methodologies from literary studies, history, and psychology, a close reading of three RA memoirs sheds light on a taboo and deeply suspect form of violence. Treatment of RA survivors and the unique role of psychotherapists, in particular, deserve far greater attention from multi-disciplinary scholars. Each story reflects salient characteristics of the Christian conversion narrative, a genre which originated in the US in the early 19th century with the serendipitous confluence of the simultaneous emergence of print culture and the basic structures of evangelicalism during the Second Great Awakening. The impulse of writing is thus to give testimony against the sin they witnessed and endured as young children during ritual violence perpetrated within the church. Importantly, RA is seen as an inherent if obscure aspect of Christian discourse itself, not in opposition to it, and not as an aberration. In RA's memoir, healing comes in part from the Christian narrative praxis of personal redemption, framed as prevailing in a war between good and evil. In other words, storytelling itself affects the healing, much as it does by means of each writer’s 'talking cure,' in the relationship with a psychotherapist who guides her through a repair of the life-story through the excavation of traumatic memories and their integration into the writer’s psyche. Integrating literary techniques into the psychotherapeutic relationship, therapists leverage the deep linguistic structures that clients possess as a resource to aid in their healing.

Keywords: memoir, psychotherapy, religion, trauma

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Authors: Ignacio Sanchez Cohen, Aurelio Pedroza Sandoval, Ricardo Trejo Calzada

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Water harvesting systems (WHS) has become the unique alternative that farmers in dry areas accounts for surviving dry periods. Nevertheless, technicians, agronomists, and users, in general, have to cope with the difficulty of finding suitable technology for optimal design of WHS. In this paper, we describe a user-friendly computer program that uses readily available information for the design of multiple WHS depending upon the water final use (agriculture, household, conservation, etc). The application (APP) itself contains several links to help the user complete the input requirements. It is not a prerequisite to have any computer skills for the use of the APP. Outputs of the APP are the dimensions of the WHS named terraces, micro-catchments, cisterns, and small household cisterns for roof water catchment. The APP also provides guidance on crops for backyard agriculture. We believe that this tool may guide users to better optimize WHS for multiple purposes and to widen the possibility of copping with dry spells in arid lands.

Keywords: rainfall-catchment, models, computer aid, arid lands

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Authors: Zaid Almahmoud, Rana Mahmoud

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To mitigate the environmental impacts of throwing away plastic waste, there has been a recent interest in manufacturing and producing biodegradable plastics. Here, we study a new class of biodegradable plastics which are mixed with external natural additives, including catalytic additives that lead to a successful degradation of the resulting material. To recommend the best alternative among multiple materials, we propose a multi-objective AI model that evaluates the material against multiple objectives given the material properties. As a proof of concept, the AI model was implemented in an expert system and evaluated using multiple materials. Our findings showed that Polyethylene Terephalate is potentially the best biodegradable plastic substitute based on its material properties. Therefore, it is recommended that governments shift the attention to the use of Polyethylene Terephalate in the manufacturing of bottles to gain a great environmental and sustainable benefits.

Keywords: plastic bottles, expert systems, multi-objective model, biodegradable substitutes

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Authors: Selma Sbit, Mohamed Bechir Dadi, Belgacem Chibani Rhaimi

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Incorporating Home eNodeB (HeNB) in cellular networks, e.g. Long Term Evolution Advanced (LTE-A), is beneficial for extending coverage and enhancing capacity at low price especially within the non-line-of sight (NLOS) environments such as homes. HeNB or femtocell is a small low powered base station which provides radio coverage to the mobile users in an indoor environment. This deployment results in a heterogeneous network where the available spectrum becomes shared between two layers. Therefore, a problem of Inter Cell Interference (ICI) appears. This issue is the main challenge in LTE-A. To deal with this challenge, various techniques based on frequency, time and power control are proposed. This paper deals with the impact of carrier aggregation and higher order MIMO (Multiple Input Multiple Output) schemes on the LTE-Advanced performance. Simulation results show the advantages of these schemes on the system capacity (4.10⁹ b/s/Hz when bandwidth B=100 MHz and when applying MIMO 8x8 for SINR=30 dB), maximum theoretical peak data rate (more than 4 Gbps for B=100 MHz and when MIMO 8x8 is used) and spectral efficiency (15 b/s/Hz and 30b/s/Hz when MIMO 4x4 and MIMO 8x8 are applying respectively for SINR=30 dB).

Keywords: capacity, carrier aggregation, LTE-Advanced, MIMO (Multiple Input Multiple Output), peak data rate, spectral efficiency

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Authors: Kamyar Kildashti, Rasoul Mirghaderi

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This paper describes the three-dimensional seismic performance assessment of a high-rise steel moment-frame setback tower, designed and detailed per the 2010 ASCE7, under multiple support excitations. The vulnerability analyses are conducted based on nonlinear history analyses under a set of multi-directional strong ground motion records which are scaled to design-based site-specific spectrum in accordance with ASCE41-13. Spatial variation of input motions between far distant supports of each part of the tower is considered by defining time lag. Plastic hinge monotonic and cyclic behavior for prequalified steel connections, panel zones, as well as steel columns is obtained from predefined values presented in TBI Guidelines, PEER/ATC72 and FEMA P440A to include stiffness and strength degradation. Inter-story drift ratios, residual drift ratios, as well as plastic hinge rotation demands under multiple support excitations, are compared to those obtained from uniform support excitations. Performance objectives based on acceptance criteria declared by TBI Guidelines are compared between uniform and multiple support excitations. The results demonstrate that input motion discrepancy results in detrimental effects on the local and global response of the tower.

Keywords: high-rise building, nonlinear time history analysis, multiple support excitation, performance-based design

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Authors: Barbara Papp

Abstract:

Purpose: This article aims to rethink the relationship between the trauma and the choice of professions. By studying a homogenous sample of respondents, it seeks answers to the following question: how did personal losses that were caused by historical upheavals motivate people to enter the helping professions. By becoming helping professionals, the respondents of the survey sought to handle both historical representation and self-representation. How did psychotherapists working in the second half of the 20th century (Kádár-era in Hungary) shape their course of life? How did their family members respond to their choice of career? What forces supported or hindered them? How did they become professional helpers? Methodology: When interviewing 40 psychotherapists, the interviewer used the oral history technique. In-depth interviews were made with a focus on motivation. First, the collected material was examined using traditional content analysis tools: searching for content patterns, applying a word frequency analysis, and identifying the connections between key events and key persons. Second, a narrative psychological content analysis (NarrCat) was made. Findings: Interconnections were established between attachment, family and historical traumas and career choices. The history of the mid-20th-century period was traumatic and full of losses for the families of most of the psychotherapists concerned. Those experiences may have considerably influenced their choice of career. Working as helping therapists, they could get the opportunity to revise their losses. Conclusion: The results revealed core components that play a role in the psychotherapists’ choice of career, and also emphasized the importance of post-traumatic growth.

Keywords: biography, identity, narrative psychological content analysis, psychotherapists, trauma

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Authors: Jernice S. Y. Tan

Abstract:

Introduction: Reliability within and between testers is vital to ensure the accuracy of any motor assessment instrument. However, reliability checks of the Movement Assessment Battery for Children-2 (MABC-2) age band 3 using multiple testers assigned to different MABC-2 tasks for the same group of participants are uncommon. Multiple testers were not stated as a choice in the MABC-2 manual. Therefore, the purpose of this study was to determine the inter- and intra-tester reliability for using multiple testers to administer the test protocols of MABC-2 age band 3. Methods: Thirty volunteered adolescents (n = 30; 15 males, 15 females; age range: 13 – 16 years) performed the eight tasks in a randomised sequence at three different test stations for the MABC-2 task components (Manual Dexterity, Aiming and Catching, Balance). Ethics approval and parental consent were obtained. The participants were videotaped while performing the test protocols of MABC-2 age band 3. Five testers were involved in the data collection process. They were Sports Science graduating students doing their final year project and were supervised by experienced motor assessor. Inter- and intra-tester reliability checks using intra-class coefficient (ICC) were carried out using the videotaped data. Results: The inter-tester reliability between the five testers for the eight tasks ranged from rᵢcc = 0.705 to rᵢcc = 0.995. This suggests that the average agreement between them was considered good to excellent. With the exception of one tester who had rᵢcc = 0.687 for one of the eight tasks (i.e. zip-zap hopping), the intra-tester reliability within each tester ranged from rᵢcc = 0.728 to rᵢcc = 1.000, and this also suggested good to excellent consistency within testers. Discussion: The use of multiple testers with good intra-tester reliability for different test stations is feasible. This method allows several participants to be assessed concurrently at different test stations and saves overall data collection time. Therefore, it is recommended that the administering of MABC-2 with multiple testers should be extended to other age bands ensuring the feasibility of such method for other age bands.

Keywords: adolescents, MABC, motor assessment, motor skills, reliability

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Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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Authors: Sina Mahdavi

Abstract:

Background and Objective: Multiple sclerosis (MS) is the most common inflammatory autoimmune disease of the central nervous system (CNS) that affects the myelination process in the CNS. Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially the John Cunningham virus (JCV) and MS is one potential cause that is not well understood. This study aims to summarize the available data on JCV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", " John Cunningham virus ", and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2019 and 2022 were searched, and 12 articles were chosen, studied, and analyzed. Results: MS patients are candidates for natalizumab therapy, which inhibits lymphocyte migration and increases the risk of progressive multifocal leukoencephalopathy (PML), a rare lytic infection of glial cells caused by JCV. Oligodendrocytes may be the target of JCV infection in the central nervous system (CNS). Conclusion: There is a high expression of JCV during the natalizumab treatment period for MS patients, suggesting that the virus may play a role in the development of MS by inducing an inflammatory state. Therefore, it is necessary to evaluate anti-JCV antibody serum as an important risk factor for the development of PML before deciding on the treatment course for these patients.

Keywords: multiple sclerosis, John Cunningham virus, central nervous system, autoimmunity

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