Search results for: indigenous trauma

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: Rodrigo M. Falleiro, Joaquim P. L. Parime, Luciano C. Santos, Rodrigo D. Silva

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The Cerrado biome is the most biodiverse savanna on the planet. Located in central Brazil, its preservation is seriously threatened by the advance of intensive agriculture and livestock. Conservation Units and Indigenous Lands are increasingly isolated and subject to mega wildfires. Among the characteristics of this savanna, we highlight the high rate of primary biomass production and the reduced occurrence of large grazing animals. In this biome, the predominant fauna is more dependent on the fruits produced by the dicotyledonous species in relation to other tropical savannas. Fire is a key element in the balance between mono and dicotyledons or between the arboreal and herbaceous strata. Therefore, applying fire regimes that maintain the balance between these strata without harming fruit production is essential in the conservation strategies of Cerrado's biodiversity. Recently, Integrated Fire Management has started to be implemented in Brazilian protected areas. As a result, management with prescribed burns has increasingly replaced strategies based on fire exclusion, which in practice have resulted in large wildfires, with highly negative impacts on fruit and fauna production. In the Indigenous Lands, these fires were carried out respecting traditional knowledge. The indigenous people showed great concern about the effects of fire on fruit plants and important animals. They recommended that the burns be carried out between April and May, as it would result in a greater production of edible fruits ("fruiting burning"). In other tropical savannas in the southern hemisphere, the preferential period tends to be later, in the middle of the dry season, when the grasses are dormant (June to August). However, in the Cerrado, this late period coincides with the flowering and sprouting of several important fruit species. To verify the best burning season, the present work evaluated the effects of fire on flowering and fruit production of theByrsonima sp., Mouriri pusa, Caryocar brasiliense, Anacardium occidentale, Pouteria ramiflora, Hancornia speciosa, Byrsonima verbascifolia, Anacardium humille and Talisia subalbens. The evaluations were carried out in the field, covering 31 Indigenous Lands that cover 104,241.18 Km², where 3,386 prescribed burns were carried out between 2015 and 2018. The burning periods were divided into early (carried out during the rainy season), modal or “fruiting” (carried out during the transition between seasons) and late (carried out in the middle of the dry season, when the grasses are dormant). The results corroborate the traditional knowledge, demonstrating that the modal burns result in higher rates of reproduction and fruit production. Late burns showed intermediate results, followed by early burns. We conclude that management strategies based mainly on forage production, which are usually applied in savannas populated by grazing ungulates, may not be the best management strategy for South American savannas. The effects of fire on fruit plants, which have a particular phenologicalsynchronization with the fauna cycle, also need to be observed during the prescription of burns.

Keywords: cerrado biome, fire regimes, native fruits, prescribed burns

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Authors: Abraha Hatsey, Nesibu Yahya, Abeje Eshete

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Ethiopian Orthodox Tewahido Church has a long tradition of conserving the Church vegetation and is an area treated as a refugee camp for many endangered indigenous tree species in Northern Ethiopia. Though around 36,000 churches exist in Ethiopia, only a few churches have been studied so far. Thus, this study assessed the land use land cover change of 3km buffer (1986-2018) and the woody species diversity and regeneration status of Tsimur St. Gebriel monastery in Tigray region, Northern Ethiopia. For vegetation study, systematic sampling was used with 100m spacing between plots and between transects. Plot size was 20m*20m for the main plot and 2 subplots (5m*5m each) for the regeneration study. Tree height, diameter at breast height(DBH) and crown area were measured in the main plot for all trees with DBH ≥ 5cm. In the subplots, all seedlings and saplings were counted with DBH < 5cm. The data was analyzed on excel and Pass biodiversity software for diversity and evenness analysis. The major land cover classes identified include bare land, farmland, forest, shrubland and wetland. The extents of forest and shrubland were declined considerably due to bare land and agricultural land expansions within the 3km buffer, indicating an increasing pressure on the church forest. Regarding the vegetation status, A total of 19 species belonging to 13 families were recorded in the monastery. The diversity (H’) and evenness recorded were 2.4 and 0.5, respectively. The tree density (DBH ≥ 5cm) was 336/ha and a crown cover of 65%. Olea europaea was the dominant (6.4m2/ha out of 10.5m2 total basal area) and a frequent species (100%) with good regeneration in the monastery. The rest of the species are less frequent and are mostly confined to water sources with good site conditions. Juniperus procera (overharvested) and the other indigenous species were with few trees left and with no/very poor regeneration status. The species having poor density, frequency and regeneration (Junperus procera, Nuxia congesta Fersen and Jasminium abyssinica) need prior conservation and enrichment planting. The indigenous species could also serve as a potential seed source for the reproduction and restoration of nearby degraded landscapes. The buffer study also demonstrated expansion of agriculture and bare land, which could be a threat to the forest of the isolated monastery. Hence, restoring the buffer zone is the only guarantee for the healthy existence of the church forest.

Keywords: church forests, regeneration, land use change, vegetation status

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Authors: Barbara Papp

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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: 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: Asaduzzaman Rimon, Pankaj Kumar Jha, Abdullah Al Mansur, Mohammad Mofizul Islam, Nasrin Sultana Juyena, Farida Yeasmin Bari

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This study was conducted to determine the effects of multi-species skim milk based extenders on sperm quality at 5ºC with the advancement of preservation time. Altogether forty ejaculates, 8 ejaculates for each of the 5 home-made semen extenders: cow skim milk (CSM), goat skim milk (GSM), sheep skim milk (SSM), buffalo skim milk (BSM) and commercial dried skim milk (CDSM) were examined for motility, plasma membrane integrity and normal morphology % of sperm at 0, 24, 48, 72, 96 and 120 hours, respectively. Sperm motility was significantly decreased (P < 0.05) with the increase of preservation time. There were no significant difference in motility % among CSM (84.0±1.4, 82.3±2.1), GSM (84.5±1.0, 82.5±0.6) and CDSM (85.0±80.3±1.3) extenders at 0 and 24 hours, respectively. However, the motility in GSM extender was significantly higher than BSM, SSM and CDSM extender at 48, 72, 96 and 120 hours. The plasma membrane integrity % at 0 hour had no significant difference among the extenders. But, the plasma membrane integrity % in GSM (84.3±0.9, 81.8±1.3, 78.0±2.2, 74.8±0.5, 72.0±1.4) and CSM (82.8±0.5, 80.8±1.0, 78.0±1.4, 73.5±1.7, 70.3±0.5) extenders were significantly higher than BSM (81.0±1.4, 76.3±2.5, 72.5±1.7, 63.8±2.5, 54.0±4.6), SSM (78.5±1.5, 75.0±1.6, 71.5±2.4, 64.3±1.7, 56.5±2.4) and CDSM extenders (78.3±2.4, 75.8±3.9, 72.5±3.3, 64.8±1.0, 60.5±3.3) at 24, 48, 72, 96 and 120 hours, respectively. The sperm morphology % had no significant difference at 0 hour among the extenders but were significantly higher in GSM (83.0±0.8, 81.3±1.5, 79.3±1.3, 73.0±2.2, 70.3±1.3) and CSM (81.5±1.7, 79.3±1.5, 75.8±1.5, 70.3±1.3, 66.3±1.5) than BSM (79.0±1.2, 75.0±1.4, 69.5±1.7, 64.5±3.1, 56.8±2.2), SSM (79.8±1.3, 76.8±2.1, 71.3±3.0, 66.0±2.7, 60.3±4.5) and CDSM (80.0±1.6, 77.0±2.2, 72.0±2.5, 66.3±2.5, 62.0±4.0) extenders at 24, 48, 72, 96 and 120 hours, respectively. The motility, plasma membrane integrity and normal morphology % of sperm had shown no significant difference between GSM and CSM but were found to be higher in GSM extenders. In the end, we concluded from the above study that the goat milk based extenders (GSM) had optimum sperm preserving quality. However, further studies are required to validate followed by fertility rate.

Keywords: chilled semen, indigenous ram, multi-species skim milk based extenders, preservation

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Authors: James Ponniah

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Christianity is the largest religious tradition of the world. What makes Christianity a world religion is its characteristics of universality and particularity. Its universality and particularity are closely interrelated. Its university is realized and embodied in its particularities and its particularity is recognized and legitimized through its universality. This paper focuses on the dimension of the particularity of Christianity in that it looks at the particularized ideas and discourses of Christian thinking in India in the 20th century and pays attention to the differing shifts and new shades of meaning in Indian Christian notion of God. Drawing upon the writings of select Indian theologians such as Brahmabandhab Upadhyaya, Sundar Sing, A.J Appasamy, Raymond Panikkar, Amalorpavadass and George Soares Prabhhu, this paper delves into how the contexts—be it personal, political, historical or ecclesial—bear upon the way Indian theologians have conceived and constructed the notion of God in their work. Focusing upon how they responded to the signs of their time through their theological narratives, the paper argues that the religion of Christianity can sustain its universality only when it translates its key notions such as God into indigenous categories and local idioms and thus makes itself relevant to the people among whom it is spread. Monotheistic God of Christianity has to accommodate plurality of expressions if Christian idea God has to capture and convey everyone’s experience of God. The case of Indian Christianity then reveals that a monolithic world religion will be experienced and recognised as truly universal only when it sheds its homogeneity and assumes a heterogeneous portrait through the acquisition of local idioms. Allowing culturally diverse idioms to influence theological categories is not inconsequential to—‘accommodating differences and accepting diversities,’ an issue we encounter within and beyond religious domains in our contemporary times.

Keywords: concept of God, heterogeneity, Indian Christianity, indigenous categories

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Authors: Claire Stafford, John Lewis, Ashley Stripling

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The aim of this study is to examine the relationship between both the independent effects and intersection between COVID-19 and the Black Lives Matter (BLM) movement simultaneously to investigate how the two events have coincided with impacting race-based traumatic stress in Black Americans. Four groups will be surveyed: Black Americans who participated in BLM-related activism, Black Americans who did not participate in BLM-related activism, White Americans who participated in BLM-related activism, and White Americans who did not participate in BLM-related activism. Participants are between the ages of 30 and 50. All participants will be administered a Brief Trauma Questionnaire with an additional question asking whether or not they have ever tested positive for COVID-19. Based on prior findings, it is expected that Black Americans will have significantly higher levels of COVID-19 contraction, with Black Americans who participated in BLM-related activism having the highest levels of contractions. Additionally, Black Americans who participated in BLM-related activism will likely have the highest self-reported rates of traumatic experiences due to the compounding effect of both the pandemic and the BLM movement. With the development of the COVID-19 pandemic, stark racial disparities between Black and White Americans have become more defined. Compared to White Americans, Black Americans have more COVID-19-related cases and hospitalizations. Researchers must investigate and attempt to mitigate these disparities while simultaneously critically questioning the structure of our national health care system and how it serves our marginalized communities. Further, a critical gaze must be directed at the geopolitical climate of the United States in order to holistically look at how both the COVID-19 pandemic and the Black Lives Matter (BLM) movement have interacted and impacted race-based stress and trauma in African Americans.

Keywords: COVID-19, black lives matter movement, race-based traumatic stress, activism

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Authors: Ammar Said Ahmed, M. Reissmann, R. Bortfeldt, G. A. Brockmann

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Milk protein genetic variants are of interest for characterizing domesticated mammalian species and breeds, and for studying associations with economic traits. The aim of this work was to analyze milk protein genetic variation in the Sudanese native cattle breeds, which have been gradually declining in numbers over the last years due to the breed substitution, and indiscriminate crossbreeding. The genetic variation at three milk protein genes αS1-casein (CSN1S1), αS2-casein (CSN1S2) and ƙ-casein (CSN3) was investigated in 250 animals belonging to five Bos indicus cattle breeds of Sudan (Butana, Kenana, White-nile, Erashy and Elgash). Allele specific primers were designed for five SNPs determine the CSN1S1 variants B and C, the CSN1S2 variants A and B, the CSN3 variants A, B and H. Allele, haplotype frequencies and genetic distances (D) were calculated and the phylogenetic tree was constructed. All breeds were found to be polymorphic for the studied genes. The CSN1S1*C variant was found very frequently (>0.63) in all analyzed breeds with highest frequency (0.82) in White-nile cattle. The CSN1S2*A variant (0.77) and CSN3*A variant (0.79) had highest frequency in Kenana cattle. Eleven haplotypes in casein gene cluster were inferred. Six of all haplotypes occurred in all breeds with remarkably deferent frequencies. The estimated D ranged from 0.004 to 0.049. The most distant breeds were White-nile and Kenana (D 0.0479). The results presented contribute to the genetic knowledge of indigenous cattle and can be used for proper definition and classification of the Sudanese cattle breeds as well as breeding, utilization, and potential development of conservation strategies for local breeds.

Keywords: milk protein, genetic variation, casein haplotype, Bos indicus

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Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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Authors: Mohammad Hossein Panahi

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Modern social sciences developed in Western Europe, and from there, it disseminated to the rest of the world, including Muslim World. Within the hierarchical world social science system that emerged in the 19th and 20th centuries, the West occupied the center, and the Third and Muslim Worlds fell into its periphery. Many social scientists, especially sociologists, in the Third and Muslim World since the 1970s have criticized this worldwide unequal division of scientific labor and have called for the development of independent/indigenous social sciences relevant to their own social conditions. Based on the conceptual framework of the World Social Science System, this paper studied the encounter of Muslim social scientists/sociologists with the Western social sciences. Using inductive thematic content analysis as the method of research, the author analyzed 32 purposefully selected articles from among over 500 collected articles from the 1970s to 2018 and categorized the obtained themes. The findings revealed three main types of encounters: reception, indigenization, and Islamization. ‘Reception’ refers to the encounter of those Muslim social scientists who embrace the positivist approach and believe that Western social sciences are valid and applicable worldwide, including the Muslim World. ‘Indigenization’ refers to the approach of those Muslim social scientists who, along with many critical Third World social scientists, reject the universality of Western social sciences and call for the development of indigenous social sciences. ‘Islamization’ refers to the position of those religious Muslim social scientists who believe that Muslim nations should Islamize social sciences based on the Islamic value and knowledge systems, in order to attain viable social sciences and free themselves from Western domination. Discussing these encounters, their supporters and opponents, the paper concludes that despite various efforts, none of the two alternatives to the Western social sciences have been able to replace it so far.

Keywords: indigenization, Islamization, Muslim world, social sciences, world social science system

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Authors: Bernard Eze Orji

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The masquerade, which is the most popular indigenous art form in Africa, is obviously identified by its elaborate, weird, and opulent costumes. The costume is the major essential accouterments in the art of the masquerade. From time past, masquerades have performed and enjoyed the freedom associated with its inscrutability and mystification solely because of its costumes. Noninitiates and women watched masquerades from a distance due to the reverence attached to its costumes and performances. In fact, whether in performance or as an item of art, the masquerade costume was seen as an embodiment of a tradition of liveliness, showiness, secrecy, and sacredness. This liveliness and showiness transformed masked characters who are believed to be possessed by spirits of ancestors and animals that inhabited the costumes. However, with the translocation of masquerade in new festivals such as carnival and state-sponsored cultural days, its costumes have been reduced to a mere item of entertainment and aesthetic values. The sacredness and reverence which hitherto elevated masquerade art to the point of wonderment have given way to an aesthetic appreciation of ingenious and individual creativity deployed in these festivals. This is as a result of the realistic and artistic creations that pervade masquerade costumes and masks in these festivals. It is a common sight to see such masquerades of animal and human genera like a lion, elephant, hippopotamus, and antelope; Agbogho Mmuo, Adamma, and Nchiekwa, respectively. This creative flair has emerged to expunge the ritual narratives associated with masquerades in the past. The study utilized performance analysis and aesthetic theory to establish that the creative ingenuity deployed by fine artists and mask designers who combine traditional artifacts to achieve modern masterpieces for the masquerades of the new festivals have reduced the ritual trappings and hype ascribed to masquerades in indigenous societies.

Keywords: costume and mask designs, entertainment, masquerade, ritual

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Authors: Elma C. Sultan

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The study concentrated on Vernacular Language Origin and Students’ Accent Neutralization of the College of Arts and Sciences fourth students in Samar State University, Catbalogan City answering respondent’s locale profile, vernacular language origin in terms of local dialect/s and domestic language/s used; the significant relationship between vernacular language origin and accent neutralization of the respondents; and the proposed activities to adopt in neutralizing students’ accent. It utilized the descriptive-correlational method of research determining the significant relationship between vernacular language origin and students’ accent neutralization. The researcher used: (1) questionnaire divided into three parts: the first part identified the students’ locale; the second part determined the respondents’ domestic language/s used while the third part identified their local language/s used, (2) validated accent neutralization assessment tool, (3) statistical treatments in the analysis of data: percentage to determine the profile of the students; chi-square test for independence to determine the significant relationship between vernacular language origin and students’ accent neutralization. Findings of the study showed that vowel and diphthong sound production, domestic and local languages in indigenous, and native dialects are significantly related to accent neutralization. While, slow reading speed has a higher possibility in affecting accent neutralization. These caused designing a 50-hour short-term program for accent neutralization focusing in the correct vowel and diphthong sounds production and appropriate reading speed in preparation for the respondents’ search for BPO employment. This short-term program ran for 5 hours in a day for five days in a week.

Keywords: accent neutralization, dialect, diphthongs, indigenous, language origin, language, native, reading speed, vernacular, vowels

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Authors: Lou Gargouri

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This paper examines how Fanny Cabon's solo performance, Gardiennes (2018) strategically crafts empathetic witnessing through the artist's vocal and physical embodiment of her female ancestors' testimonies, dramatizing the cyclical inheritance of reproductive trauma across generations. Drawing on affect theory and the concept of ethical co-presence, we argue that Cabon's raw voicing of illegal abortions, miscarriages, and abuse through her shape-shifting presence generates an intimate energy loop with the audience. This affective resonance catalyzes recognition of historical injustices, consecrating each singular experience while building collective solidarity. Central to Cabon's political efficacy is her transparent self-revelation through intimate impersonation, which fosters identification with diverse characters as interconnected subjects rather than objectified others. Her solo form transforms the isolation often associated with women's marginalization into radical inclusion, repositioning them from victims to empowered survivors. Comparative analysis with other contemporary works addressing abortion rights illuminates how Gardiennes subverts the traditional medical and clerical gazes that have long governed women's bodies. Ultimately, we contend Gardiennes models the potential of solo performance to harness empathy as a subversive political force. Cabon's theatrical alchemy circulates the effects of injustice through the ethical co-presence of performer and spectator, forging intersubjective connections that reframe marginalized groups traditionally objectified within dominant structures of patriarchal power. In dramatizing how the act of witnessing another's trauma can generate solidarity and galvanize resistance, Cabon's work demonstrates the role of embodied performance in catalyzing social change through the recuperation of women's voices and lived experiences. This paper thus aims to contribute to the emerging field of feminist solo performance criticism by illuminating how Cabon's innovative dramaturgy bridges the personal and the political. Her strategic mobilization of intimacy, identification, and co-presence offers a model for how the affective dynamics of autobiographical performance can be harnessed to confront gendered oppression and imagine more equitable futures. Gardiennes invites us to consider how the circulation of empathy through ethical spectatorship can foster the collective alliances necessary for advancing the unfinished project of women's liberation.

Keywords: gender and sexuality studies, solo performance, trauma studies, affect theory

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Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

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Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: acute scrotum, test torsion, newborns, clinical presentation

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Biva Samadder, Samita Manna

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India is a melting pot of races, tribes, castes and communities. The population of India can be roughly branched into the huge majority of “Civilized” Indians of the Plains and the minority of Tribal population of the hill area and the forest who constituting almost 16 percent of total population of India. The Kirat community composed of four ethnic tribes: Limbu, Lepcha, Dhimal, and Rai. These Kirat people were found to be rich in indigenous knowledge, skill and practices especially for the use on medicinal plants and livelihood purposes. The “Mundhum" is the oral scripture or the “Bible of the Limbus” which serves as the canon of the codes of the Limbu socialization, their moral values and the very orientation of their lifestyle. From birth till death the Limbus are disciplined in the life with full of religious rituals, traditions and culture governed by community norms with a rich legacy of indigenous knowledge and traditional practices. The present study has been conducted using both secondary as well as primary data by applying social methodology consisting of the social survey, questionnaire, interviews and observations in the Kalimpong Block-I of Darjeeling District of west Bengal of India, which is a heterogeneous zone in terms of its ethnic composition and where the Limbus are pre-dominantly concentrated. Due to their close contact with other caste and communities Limbus are now adjusted with the changing situation by borrowing some cultural traits from the other communities and changes that have taken place in their cultural practices, religious beliefs, economic aspects, languages and in social roles and relationships which is bringing the change in their material culture. Limbu language is placed in the Tibeto- Burman Language category. But due to the political and cultural domination of educationally sound and numerically dominant Bengali race, the different communities in this area forced to come under the one umbrella of the Nepali or Gorkhali nation (nation-people). Their respective identities had to be submerged in order to constitute as a strong force to resist Nepali domination and ensure their common survival. As Nepali is a lingua-franca of the area knowing and speaking Nepali language helps them in procuring economic and occupational facilities. Ironically, present day younger generation does not feel comfortable speaking in their own Limbu tongue. The traditional knowledge about medicinal plants, healing, and health culture is found to be wear away due to the lack of interest of young generation. Not only poverty, along with exclusion due to policies they are in the phase of extinction, but their capabilities are ignored and not documented and preserved especially in the case of Limbus who having a great cultural heritage of an oral tradition. Attempts have been made to discuss the persistence and changes in socioeconomic pattern of life in relation to the social structure, material culture, cultural practices, social relationships, indigenous technology, ethos and their values and belief system.

Keywords: changing social relationship, cultural transition, identity, indigenous knowledge, language

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Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

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Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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Authors: Muhammad Shahid, Kafait Ullah, Kashif Imran, Arshad Mahmood, Maarten Arentsen

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Poor planning and governance in the power sector of Pakistan have generated several issues ranging from gradual reliance on thermal-based expensive energy mix, supply shortages, unrestricted demand, subsidization, inefficiencies at different levels of the value chain and resultantly, the circular debt. This situation in the power sector has also hampered the growth of allied economic sectors. This study uses the Long-range Energy Alternative Planning (LEAP) system for electricity modelling of Pakistan from the period of 2016 to 2040. The study has first time in Pakistan forecasted the electricity demand at the provincial level. At the supply side, five scenarios Business as Usual Scenario (BAUS), Coal Scenario (CS), Gas Scenario (GS), Nuclear Scenario (NS) and Renewable Scenario (RS) have been analyzed based on the techno-economic and environmental parameters. The study has also included environmental externality costs for evaluating the actual costs and benefits of different scenarios. Contrary to the expectations, RS has a lower output than even BAUS. The study has concluded that the generation from RS has five times lesser costs than BAUS, CS, and GS. NS can also be an alternative for the sustainable future of Pakistan. Generation from imported coal is not a good option, however, indigenous coal with clean coal technologies should be promoted. This paper proposes energy planners of the country to devise incentives for the utilization of indigenous energy resources including renewables on priority and then clean coal to reduce the energy crises of Pakistan.

Keywords: economic evaluation, externality cost, penetration of renewable energy, regional electricity supply-demand planning

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Authors: L. Sun, O. Bloom, K. Anderson

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The medial and lateral sural artery perforator flaps (MSAP and LSAP, respectively) are two recently described flaps that are less commonly used in lower limb trauma reconstructive surgeries compared to flaps such as the anterolateral thigh (ALT) flap or the gastrocnemius flap. The LSAP flap has several theoretical benefits over the MSAP, including the ability to be sensate and being more easily manoeuvred into position as a local flap for coverage of lateral knee or leg defects. It is less commonly used in part due to a lack of documented studies of the anatomical reliability of the perforator, and an unquantified average length of the pedicle used for microsurgical anastomosis (if used as a free flap) or flap rotation (if used as a pedicled flap). It has been shown to have significantly lower donor site morbidity compared to other flaps such as the ALT, due to the decreased need for intramuscular dissection and resulting in less muscle loss at the donor site. 11 cadaveric lower limbs were dissected, with a mean of 1.6 perforators per leg, with an average pedicle length of 45mm to the sural artery and 70mm to the popliteal artery. While the majority of perforating arteries lay close to the midline (average of 19mm lateral to the midline), there were patients whose artery was significantly lateral and would have been likely injured by the initial incision during an operation. Adding to the literature base of documented LSAP dissections provides a greater understanding of the anatomical basis of these perforator flaps, and the authors hope this will establish them as a more commonly used and discussed option when managing complicated lower limb trauma requiring soft tissue reconstruction.

Keywords: cadaveric, dissection, lateral, perforator flap, sural artery, surface anatomy

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Authors: Zanele Ntshidi, Sebinasi Dzikiti, Dominic Mazvimavi

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South Africa is a dry country and yet it is ranked as the 8th largest exporter of fresh apples (Malus Domestica) globally. Prime apple producing regions are in the Eastern and Western Cape Provinces of the country where all the fruit is grown under irrigation. Climate change models predict increasingly drier future conditions in these regions and the frequency and severity of droughts is expected to increase. For the sustainability and growth of the fruit industry it is important to minimize non-beneficial water losses from the orchard floor. The aims of this study were firstly to compare the water use of cover crop species used in South African orchards for which there is currently no information. The second aim was to investigate how orchard water use (evapotranspiration) was partitioned into beneficial (tree transpiration) and non-beneficial (orchard floor evaporation) water uses for micro-sprinkler irrigated orchards with different canopy covers. This information is important in order to explore opportunities to minimize non-beneficial water losses. Six cover crop species (four exotic and two indigenous) were grown in 2 L pots in a greenhouse. Cover crop transpiration was measured using the gravimetric method on clear days. To establish how water use was partitioned in orchards, evapotranspiration (ET) was measured using an open path eddy covariance system, while tree transpiration was measured hourly throughout the season (October to June) on six trees per orchard using the heat ratio sap flow method. On selected clear days, soil evaporation was measured hourly from sunrise to sunset using six micro-lysimeters situated at different wet/dry and sun/shade positions on the orchard floor. Transpiration of cover crops was measured using miniature (2 mm Ø) stem heat balance sap flow gauges. The greenhouse study showed that exotic cover crops had significantly higher (p < 0.01) average transpiration rates (~3.7 L/m2/d) than the indigenous species (~ 2.2 L/m²/d). In young non-bearing orchards, orchard floor evaporative fluxes accounted for more than 60% of orchard ET while this ranged from 10 to 30% in mature orchards with a high canopy cover. While exotic cover crops are preferred by most farmers, this study shows that they use larger quantities of water than indigenous species. This in turn contributes to a larger orchard floor evaporation flux. In young orchards non-beneficial losses can be minimized by adopting drip or short range micro-sprinkler methods that reduce the wetted soil fraction thereby conserving water.

Keywords: evapotranspiration, sap flow, soil evaporation, transpiration

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Authors: Martin Mundo-Molina

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In Mexico, there are many small rural communities with serious water supply deficiencies. In Chiapas, Mexico, there are 19,972 poor rural communities, 15,712 of which have fewer than 100 inhabitants. The lack of a constant water supply is most severe in the highlands of Chiapas where the population is made up mainly of indigenous groups. The communities are on mountainous terrain with a widely dispersed population. These characteristics combine to make the provision of public utilities, such as water, electricity and sewerage, difficult with conventional means. The introduction of alternative, low-cost technologies represents means of supplying water such as through fog and rain catchment with zero greenhouse emissions. In this paper is presented the rainwater harvesting system (RWS) constructed in Yalentay, Chiapas Mexico. The RWS is able to store 1.2 M liters of water to provide drinking water to small rural indigenous communities of 500 people in the drought stage. Inside the system of rainwater harvesting there isn't photosynthesis in order to conserve water for long periods. The natural filters of the system of rainwater harvesting guarantee the drinking water for using to the community. The combination of potability and low cost makes rain collection a viable alternative for rural areas, weather permitting. The Mexican Institute of Water Technology and Chiapas University constructed a rainwater harvesting system in Yalentay Chiapas, it consists of four parts: 1. Roof of aluminum, for collecting rainwater, 2. Underground-cistern, divided in two tanks, 3. Filters, to improve the water quality and 4. The system of rainwater harvesting dignified the lives of people in Yalentay, saves energy, prevents the emission of greenhouse gases into the atmosphere, conserves natural resources such as water and air.

Keywords: appropriate technologies, climate change, greenhouse gases, rainwater harvesting

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Authors: Sunday Paul Bako, Augustine Uwanekwu Ezealor, Yahuza Tanimu

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In a study to evaluate the response of indigenous ruderal plants to the metal deposition regime imposed by anthropogenic modification in the Southern Guinea Savanna of north Western Nigeria during the dry and wet seasons, herbaceous plants and samples of soils were collected in three 5m by 5m quadrats laid around the environs of the Kaduna Refinery and Petrochemical Company and the banks of River Kaduna. Heavy metal concentration (Cd, Ni, Cr, Cu, Fe, Mn and Zn) in soil and plant samples was determined using Energy Dispersive X-ray Fluorescence. Concentrations of heavy metals in soils were generally observed to be higher during the wet season in both locations although the differences were not statistically significant (P > 0.05). Concentrations of Cd, Zn, Cr, Cu and Ni in all the plants observed were found to be below levels described as phytotoxic to plants. However, above ‘normal’ concentrations of Cr was observed in most of the plant species sampled. The concentrations of Cr, Cu, Ni and Zn in soils around the KRPC and RKB were found to be above the acceptable limits. Although no hyper accumulator plant species was encountered in this study, twenty (20) plant species were identified to have high bioconcentration (BCF > 1.0) of Cd and Cu, which indicated tolerance of these plants to excessive or phytotoxic concentrations of these metals. In addition, they generally produce high above ground biomass, due to rapid vegetative growth. These are likely species for phytoextraction. Elevated concentration of metals in both soil and plant materials may cause a decrease in biodiversity due to direct toxicity. There are also risks to humans and other animals due to bioaccumulation across the food chain. There are further possibilities of further evaluating and genetically improving metal tolerance traits in some of these plant species in relation to their potential use in phytoremediation programmes in metal polluted sites.

Keywords: bioprospecting, phytoremediation, heavy metals, Nigeria

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Authors: Fhulufhelo Ramukhithi, Kgothatso Masethe, Tlou Chokoe, Ayanda Maqhashu, Julius Sebei, Tshililo Raphulu, Joseph Mugwabana

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Phenotypic characterisation ensures that the physical appearance of an animal is well documented. The information provided by this phenotypic characterisation study is important for planning management and the use of animal genetic resources. The aim of this study was to characterise the phenotypic characteristics of Bapedi sheep. Bapedi sheep are at risk of extinction like most of the indigenous breeds. As a result, a total of 196 Bapedi ewes and 35 rams were used. Phenotypic-qualitative characteristics were evaluated through visual appraisal. Phenotypic-quantitative characteristics such as body parts measurements were obtained using a flexible tape (cm), while body weight were obtained by using a weighing scale (kg). Bapedi rams (97 %) had higher satisfactory body condition when compared to ewes (75 %). A higher proportion of Bapedi sheep that did not have ticks observed (ewes = 87 % and rams = 91 %). Brown and white colour combination (head x body) was dominating in Bapedi sheep (80 % ewes and 91 % rams). Bapedi ewes did not have any horns; however, 3 % of rams had them. Bapedi sheep had a higher proportion of brown eyes, moderate neck, stiff sideways ears and normal front legs. Bapedi rams had a higher proportion of well-balanced and good attached testicles. Bapedi ewes had average (45 %), small (40 %) and big udders (15 %). Bapedi rams had a significantly higher body weight, height, depth, hearth girth circumference, rump width, hind leg width and length compared to ewes. However, both Bapedi rams and ewes had similar age, body condition score, tail length, length below hock and knee. In conclusion, Bapedi sheep had a higher satisfactory body condition and brown and white colour combination. Some of Bapedi rams’ quantitative characteristics were higher compared to ewes.

Keywords: extinction, indigenous, phenotypic, smallstock

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Authors: Tali Capua, Karin Hermon, Miguel Glatstein, Oren Tavor, Ayelet Rimon

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Background: Electric bicycles (E-bikes) are one of a wide range of light electric vehicles that provide convenient local transportation and attractive recreational opportunities. Along with their growing use worldwide, the E-bike related injury rate increases. To the best of our knowledge, this study is the first to specifically compare E-bike with classic bicycle related injuries in children. Methods: Data of all pediatric ( < 16 years of age) bicycle related injuries presenting to an urban level I trauma center between 2014 and 2015 were collected and analyzed. The recorded data included age, gender, details of the accident, as well severity of injury, medical diagnosis, and the outcome. Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) were calculated for each patient. Data of E-bike related injuries and classic bicycle were then compared. Results: A total of 124 bicycle related injuries and 97 E-bike related injuries presented to the emergency department. Once pedestrians and bicycle passengers were removed, the groups of riders consisted of 111 bikers and 85 E-bikers. The mean age of bikers was 9.9 years (range 3-16 years) and of E-bikers was 13.7 years (range 7.5-16 years). Injuries to the head and the extremities were common in both groups. Compared to bikers, E-bikers had significantly more injuries to intra-abdominal organs (p = 0.04). Twenty patients (16%) with bicycle related injuries were admitted, and 13 (15%) patients with E-bike related injuries, of the latter group four underwent surgical intervention. ISS scores were low overall, but the injuries of higher severity (ISS > 9) were among the E-bikers. Conclusions: This study provides unique information which suggests that injuries in E-bikers tend to be more severe than in classic bikers. There is a need for regulation regarding the use of E-bikes to enhance the safety of both bikers and other road and pavement users.

Keywords: bicycle, electric bicycle, injury, pediatric, trauma

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Authors: Gerald Amatre, Julius Bunny Lejju, Morgan Andama

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Despite several interventions, jigger flea infestations continue to be reported in the Busoga sub-region in Eastern Uganda. The purpose of this study was to identify factors that expose the indigenous people to jigger flea infestations and evaluate the effectiveness of any indigenous materials used in flea control by the affected communities. Flea compositions in residences were described, factors associated with flea infestation and indigenous materials used in flea control were evaluated. Field surveys were conducted in the affected communities after obtaining preliminary information on jigger infestation from the offices of the District Health Inspectors to identify the affected villages and households. Informed consent was then sought from the local authorities and household heads to conduct the study. Focus group discussions were conducted with key district informants, namely, the District Health Inspectors, District Entomologists and representatives from the District Health Office. A GPS coordinate was taken at central point at every household enrolled. Fleas were trapped inside residences using Kilonzo traps. A Kilonzo Trap comprised a shallow pan, about three centimetres deep, filled to the brim with water. The edges of the pan were smeared with Vaseline to prevent fleas from crawling out. Traps were placed in the evening and checked every morning the following day. The trapped fleas were collected in labelled vials filled with 70% aqueous ethanol and taken to the laboratory for identification. Socio-economic and environmental data were collected. The results indicate that the commonest flea trapped in the residences was the cat flea (Ctenocephalides felis) (50%), followed by Jigger flea (Tunga penetrans) (46%) and rat flea (Xenopsylla Cheopis) (4%), respectively. The average size of residences was seven squire metres with a mean of six occupants. The residences were generally untidy; with loose dusty floors and the brick walls were not plastered. The majority of the jigger affected households were headed by peasants (86.7%) and artisans (13.3%). The household heads mainly stopped at primary school level (80%) and few at secondary school level (20%). The jigger affected households were mainly headed by peasants of low socioeconomic status. The affected community members use soil-cow dung-ash mixture to smear floors of residences as the only measure to control fleas. This method was found to be ineffective in controlling the insects. The study recommends that home improvement campaigns be continued in the affected communities to improve sanitation and hygiene in residences as one of the interventions to combat flea infestations. Other cheap, available and effective means should be identified to curb jigger flea infestations.

Keywords: cow dung-soil-ash mixture, infestations, jigger flea, Tunga penetrans

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: M. Dezyani, R. Ezzati bbelvirdi, M. Shakerian, H. Mirzaei

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Sodium Hexametaphosphate (SHMP) is commonly used as an Emulsifying Salt (ES) in process cheese, although rarely as the sole ES. It appears that no published studies exist on the effect of SHMP concentration on the properties of process cheese when pH is kept constant; pH is well known to affect process cheese functionality. The detailed interactions between the added phosphate, Casein (CN), and indigenous Ca phosphate are poorly understood. We studied the effect of the concentration of SHMP (0.25-2.75%) and holding time (0-20 min) on the textural and Rheological properties of pasteurized process Cheddar cheese using a central composite rotatable design. All cheeses were adjusted to pH 5.6. The meltability of process cheese (as indicated by the decrease in loss tangent parameter from small amplitude oscillatory rheology, degree of flow, and melt area from the Schreiber test) decreased with an increase in the concentration of SHMP. Holding time also led to a slight reduction in meltability. Hardness of process cheese increased as the concentration of SHMP increased. Acid-base titration curves indicated that the buffering peak at pH 4.8, which is attributable to residual colloidal Ca phosphate, was shifted to lower pH values with increasing concentration of SHMP. The insoluble Ca and total and insoluble P contents increased as concentration of SHMP increased. The proportion of insoluble P as a percentage of total (indigenous and added) P decreased with an increase in ES concentration because of some of the (added) SHMP formed soluble salts. The results of this study suggest that SHMP chelated the residual colloidal Ca phosphate content and dispersed CN; the newly formed Ca-phosphate complex remained trapped within the process cheese matrix, probably by cross-linking CN. Increasing the concentration of SHMP helped to improve fat emulsification and CN dispersion during cooking, both of which probably helped to reinforce the structure of process cheese.

Keywords: Iranian processed cheese, emulsifying salt, rheology, texture

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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