Search results for: spatial trauma

Authors: Sarita Kumari, Ranjit Kumar Upadhyay

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This paper deals with plankton-fish dynamics where the fish population is growing logistically and nonlinearly harvested. The interaction between phytoplankton and zooplankton population is considered to be Crowley-Martin type functional response. It has been assumed that phytoplankton grows logistically and is affected by a space-dependent growth rate. Conditions for the existence of a positive equilibrium point and their stability analysis (both local and global) have been discussed for the non-spatial system. We have discussed maximum sustainable yields as well as optimal harvesting policy for maximizing the economic gain. The stability and existence of Hopf –bifurcation analysis have been discussed for the spatial system. Different conditions for turning pattern formation have been established through diffusion-driven instability analysis. Numerical simulations have been carried out for both non-spatial and spatial models. Phase plane analysis, the largest Lyapunov exponent, and bifurcation theory are used to numerically analyzed the non-spatial system. Our study shows that spatial heterogeneity, the mortality rate of phytoplankton, and constant harvesting of the fish population each play an important role in the dynamical behavior of the marine system.

Keywords: optimal harvesting, pattern formation, spatial heterogeneity, Crowley-Martin functional response

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Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

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Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

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Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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Authors: Yi-You Hung

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Relational trauma has garnered significant attention recently, as it can create barriers in the personal, interpersonal, and professional realms. Without proper intervention, its psychological impact can be profound. In psychotherapy, the demand for culturally adaptive intervention models is growing. This article compares two therapeutic approaches focused on ‘self’ and ‘non-self’. It then incorporates Buddhist concepts of ‘dukkha’ (suffering), ‘samudaya’ (origin), ‘nirodha’ (cessation), and ‘magga’ (path) to develop culturally sensitive psychological interventions. Unlike Western psychotherapy, which often focuses on self, symptom relief, and restoring self-functioning, the ‘non-self’ approach encourages therapists to embody the principles of the Four Noble Truths. This perspective aims to help individuals reconstruct their internal relational state through shared suffering, compassion, wisdom, mindfulness, and righteous conduct. By understanding these concepts, therapists can guide individuals to ‘return to their inherent emptiness and non-self,’ resonating with the Buddhist belief that realizing this emptiness is a fundamental human goal. However, the model's limitations include individuals' need to embrace this cultural discourse and for therapists to learn Buddhist concepts deeply. Further research is essential to validate the effectiveness of this model in treating relational trauma cases.

Keywords: buddhism, buddhist principles, culturally adaptive interventions, relational trauma

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Authors: Katie-Beth Webster

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Mucormycosis is a rare opportunistic fungal infection that, if left untreated, can cause large scale tissue necrosis and death. There are a number of cases of this in the literature, most commonly in the head and neck region arising from sinuses. It is also usually found in immunocompromised patient subgroups. This study reviewed a number of cases of mucormycosis in previously fit and healthy young trauma patients to assess predisposing factors for infection and adequacy of current treatment paradigms. These trauma patients likely contracted the fungal infection from the soil at the site of the incident. Despite early washout and debridement of the wounds at the scene of the injury and on arrival in hospital, both these patients contracted mucormycosis. It was suspected that inadequate early debridement of soil contaminated limbs was one of the major factors that can lead to catastrophic tissue necrosis. In both cases, this resulted in the patients having a higher level of amputation than would have initially been required based on the level of their injury. This was secondary to cutaneous and soft tissue necrosis secondary to the fungal infiltration leading to osteomyelitis and systemic sepsis. In the literature, it appears diagnosis is often protracted in this condition secondary to inadequate early treatment and long processing times for fungal cultures. If fungal cultures were sent at the time of first assessment and adequate debridements are performed aggressively early, it could lead to these critically unwell trauma patients receiving appropriate antifungal and surgical treatment earlier in their episode of care. This is likely to improve long term outcomes for these patients.

Keywords: mucormycosis, plastic surgery, osteomyelitis, trauma

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Authors: Daijun Chen

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Affordable housing is subsidized by the government to meet the housing demand of low and middle-income urban residents in the process of urbanization and to alleviate the housing inequality caused by market-based housing reforms. It is a recognized fact that the living conditions of the insured have been improved while constructing the subsidized housing. However, the choice of affordable housing is mostly in the suburbs, where the surrounding urban functions and infrastructure are incomplete, resulting in the spatial mismatch of "jobs-housing" in affordable housing. The main reason for this problem is that the residents of affordable housing are more sensitive to the spatial location of their residence, but their selectivity and controllability to the housing location are relatively weak, which leads to higher commuting costs. Their real cost of living has not been effectively reduced. In this regard, 92 subsidized housing communities in Nanjing, China, are selected as the research sample in this paper. The residents of the affordable housing and their commuting Spatio-temporal behavior characteristics are identified based on the LBS (location-based service) data. Based on the spatial mismatch theory, spatial mismatch indicators such as commuting distance and commuting time are established to measure the spatial mismatch degree of subsidized housing in different districts of Nanjing. Furthermore, the geographically weighted regression model is used to analyze the influencing factors of the spatial mismatch of affordable housing in terms of the provision of employment opportunities, traffic accessibility and supporting service facilities by using spatial, functional and other multi-source Spatio-temporal big data. The results show that the spatial mismatch of affordable housing in Nanjing generally presents a "concentric circle" pattern of decreasing from the central urban area to the periphery. The factors affecting the spatial mismatch of affordable housing in different spatial zones are different. The main reasons are the number of enterprises within 1 km of the affordable housing district and the shortest distance to the subway station. And the low spatial mismatch is due to the diversity of services and facilities. Based on this, a spatial optimization strategy for different levels of spatial mismatch in subsidized housing is proposed. And feasible suggestions for the later site selection of subsidized housing are also provided. It hopes to avoid or mitigate the impact of "spatial mismatch," promote the "spatial adaptation" of "jobs-housing," and truly improve the overall welfare level of affordable housing residents.

Keywords: affordable housing, spatial mismatch, commuting characteristics, spatial adaptation, welfare benefits

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Authors: Jean Pierre Hagenimana, Paulin Ruhato Banguti, Rebecca Lynn Churchill Anderson, Jean de Dieu Tuyishime, Gaston Nyirigira, Eugene Tuyishime

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Background: Little is known regarding the effectiveness of pain protocols and guidelines used in Emergency Departments (ED) in Sub-Saharan Africa (SSA). Therefore, to shed light on this research gap, this study aimed to evaluate the quality of pain management following the implementation of both the WHO pain ladder-based trauma pain management protocol in two Rwandan teaching hospitals. Methods: This was a pre-and post-intervention study. The intervention was a 1-day acute pain course training for ED clinical staff followed by 1 week of mentorship on the use of the WHO pain ladder-based trauma pain management. Results: 261 participants were enrolled in the study (124 before the intervention and 137 after the intervention). The number of patients with undocumented pain scores decreased from 58% to 24% after the intervention (p-value > 0.001), and most patients (62%) had mild pain. In addition, patients who were satisfied with the quality of pain management increased significantly from 42% before the intervention to 80% (p-value > 0.001). Barriers were identified, however, including inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Conclusion: The implementation of the WHO pain ladder-based trauma pain management protocol significantly improved the quality of pain management in both CHUK and CHUB referral Hospital emergency departments. Despite this, some barriers remain, such as inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Appropriate interventions should be implemented to address the identified barriers and ensure adequate pain management for patients admitted at the emergency departments in referral hospitals in Rwanda.

Keywords: pain management, trauma, emergency departments, Rwanda

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Authors: Lucie Pospíšilová, Robert Osman, Hana Porkertová

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The scholarly literature demonstrates disability and masculinity in conflict with each other. While disability is associated with dependence, weakness, or helplessness, masculinity is associated with independence, strength, and power. Thus, disabled masculinity might be a dilemma experienced on a personal level. The relationship between masculinity and disability is also interesting from a geographical point of view because the conception of space is gendered. In our society, the skills like spatial orientation, working with the maps, and navigation technologies as same as with scale are associated with masculinity. And because these skills are related to the visual imagination, it is the blindness that is associated with the limitation or even the absence of them. Thus, the conflict of masculinity and disability in the spatial experience is very well apparent in the case of visually impaired men. To study this conflict can tell us a lot not only about the experience of visually impaired men but also about the conception of space in geography and in our society. The paper uses Henri Lefebvre's theory of space based on a triad of spatial practice, representations of space, and representational space. It answers the question: How masculinity and disability intersect in the spatial experience of visually impaired men? The data come from research conducted in Brno and Prague (Czechia) in 2020 and 2021 and include 7 interviews and 6 go-alongs with visually impaired men.

Keywords: disability, masculinity, abstract space, spatial experience, visually impaired men

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Authors: Cindy Davis, Samantha Rayner

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Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers; STS is found to be a prevalent risk in mental health occupations. Various factors impact the development of STS within the literature; including the level of trauma individuals are exposed to and their level of empathy. Research is limited on STS in mental health workers in Australia; therefore, this study examined STS and related factors of empathetic behavior and trauma caseload among mental health workers. The research utilized an online survey quantitative research design with a purposive sample of 190 mental health workers (176 females) recruited via professional websites and unofficial social media groups. Participants completed an online questionnaire comprising of demographics, the secondary traumatic stress scale and the empathy scale for social workers. A standard hierarchical regression analysis was conducted to examine the significance of covariates, traumatized clients, traumatic stress within workload and empathy in predicting STS. The current research found 29.5% of participants to meet the criteria for a diagnosis of STS. Age and past trauma within the covariates were significantly associated with STS. Amount of traumatized clients significantly predicted 4.7% of the variance in STS, traumatic stress within workload significantly predicted 4.8% of the variance in STS and empathy significantly predicted 4.9% of the variance in STS. These three independent variables and the covariates accounted for 18.5% of the variance in STS. Practical implications include a focus on developing risk strategies and treatment methods that can diminish the impact of STS.

Keywords: mental health, PTSD, social work, trauma

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Authors: Raymond C. Hawkins II, Catherine A. Hawkins

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The System Contextual Integrated Model (SCIM), developed as a trans-theoretical framework for selecting measures for psychotherapy process and outcome, is reformulated for behavioral health applications. The SCIM “healing cycle” is an allostatic hedonic affective-cognitive right-hemisphere–left-hemisphere coordinated process involving positive alliesthesia that mitigates traumatic pain and generates psychological flexibility. The SCIM “trauma cycle” is an allostatic overload alliesthesia opponent process with long-lasting pathology sequelae. The social ecological context moderates the “healing cycle” and the “trauma cycle.” Repeated evocation of the “healing cycle” in a therapeutic relationship can gradually relieve trauma sequelae. The SCIM is applied to pain, obese binge eating, and substance use disorders.

Keywords: allostasis, alliesthesia, opponent process, behavioral health, assessment

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Authors: Guangtong Xu, Yi He

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Like most historic and cultural cities in China, the historic urban area of Jingmen city is facing a typical spatial problem of fragmentation and fuzzification. This study focuses on exploring a method for evaluating the existing values of historic urban area based on spatial prototype, a concept introduced into urban morphology from 'Archetype' in architectural typology. As the spatial elements and built-up relationship of historic city, spatial prototype has habitual structural characteristics and formal modulus. It is the inherent logic and order rules behind the scattered historic environment, providing a clue to understand the spatial characteristics and a basis for guiding the construction and conservation in historic urban areas. Three criteria, the resolution of historical elements, the completeness of historical structure and the renewal potential of associated land, were selected to construct the integrated assessment system. These three dimensions are linked to the spatial prototype and its constituent elements, as well as the transformation relationship in ancient and present day. The results showed that historic urban areas have changed from a holistic city to different existing types dominated by their historic structure elements. It is necessary to improve the pertinence of planning strategies and develop diversified management measures in the conservation scope of historic urban area. Moreover, a constructive-conservation strategy should be put forward to enhance the integrity of historic urban area based on the trace of spatial prototype and evaluation results.

Keywords: constructive conservation, existing value, historic urban area, spatial prototype

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Authors: Zohra Mekranfar, Ahmed Saidi, Abdellah Mebrek

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This work aims to develop multi-criteria decision making (MCDM) and spatial data warehouse (SDW) methods, which will be integrated into a GIS according to a ‘GIS dominant’ approach. The GIS operating tools will be operational to operate the SDW. The MCDM methods can provide many solutions to a set of problems with various and multiple criteria. When the problem is so complex, integrating spatial dimension, it makes sense to combine the MCDM process with other approaches like data mining, ascending analyses, we present in this paper an experiment showing a geo-decisional methodology of SWD construction, On-line analytical processing (OLAP) technology which combines both basic multidimensional analysis and the concepts of data mining provides powerful tools to highlight inductions and information not obvious by traditional tools. However, these OLAP tools become more complex in the presence of the spatial dimension. The integration of OLAP with a GIS is the future geographic and spatial information solution. GIS offers advanced functions for the acquisition, storage, analysis, and display of geographic information. However, their effectiveness for complex spatial analysis is questionable due to their determinism and their decisional rigor. A prerequisite for the implementation of any analysis or exploration of spatial data requires the construction and structuring of a spatial data warehouse (SDW). This SDW must be easily usable by the GIS and by the tools offered by an OLAP system.

Keywords: data warehouse, GIS, MCDM, SOLAP

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Authors: Caiwei Zhu, Remke Klapwijk

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Spatial thinking, a way of thinking based on the understanding and reasoning of spatial concepts and representations, is embedded in science, technology, engineering, arts, and mathematics (STEAM) learning. Aside from many studies that successfully used targeted training to improve students’ spatial thinking skills, few have closely examined how spatial thinking can be trained in classroom settings. Design and technology education, which receives increasing attention towards its integration into formal curriculums, inherently encompasses a wide range of spatial activities, such as constructing mental representations of design ideas, mentally transforming objects and materials to form designs, visually communicating design plans through annotated drawings, and creating 2D and 3D design artifacts. Among different design topics, biomimicry offers a unique avenue for students to recognize and analyze the shapes and structures in nature. By mapping the forms of plants and animals onto functions, students gain inspiration to solve human design challenges. This study is one of the first to highlight opportunities for training spatial thinking in a biomimicry design project for primary school students. Embracing methodological principles of educational design-based research, this case study is conducted along with iterations in the design of the intervention and collaboration with teachers. Data are harvested from small groups of 10- to 12-year-olds at an international school in the Netherlands. Classroom videos, semi-structured interviews with students, design drawings and artifacts, formative assessment, and the pre- and post-intervention spatial test triangulate evidence for students' spatial thinking. In addition to contributing to a theory of integrating spatial thinking in the primary curriculum, mechanisms underlying such improvement in spatial thinking are explored and discussed.

Keywords: biomimicry, design and technology education, primary education, spatial thinking

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Authors: Pierre F. Gerard, Frederic F. Leymarie, William Latham

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Architects have developed a series of objective evaluations, using spatial analysis tools such as Isovist, that show how certain spatial qualities are beneficial to specific human activities hosted in the built environments. In return, they can build more adapted environments by tuning those spatial qualities in their design. In parallel, virtual reality technologies have been developed by engineers with the dream of creating a system that immerses users in a new form of spatial experiences. They already have demonstrated a useful range of benefits not only in simulating critical events to assist people in acquiring new skills, but also to enhance memory retention, to name just a few. This paper investigates the effects of two spatial qualities, openness, and complexity, on cognitive performance within immersive virtual environments. Isovist measure is used to design a series of room settings with different levels of each spatial qualities. In an empirical study, each room was then used by every participant to solve a navigational puzzle game and give a rating of their spatial experience. They were then asked to fill in a questionnaire before solving the visual-spatial memory quiz, which addressed how well they remembered the different rooms. Findings suggest that those spatial qualities have an effect on some of the measures, including navigation performance and memory retention. In particular, there is an order effect for the navigation puzzle game. Participants tended to spend a longer time in the complex room settings. Moreover, there is an interaction effect while with more open settings, participants tended to perform better when in a simple setting; however, with more closed settings, participants tended to perform better in a more complex setting. For the visual-spatial memory quiz, participants performed significantly better within the more open rooms. We believe this is a first step in using virtual environments to enhance participant cognitive performances through better use of specific spatial qualities.

Keywords: architecture, navigation, spatial cognition, virtual reality

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Authors: Oscar Covarrubias, Diane Ghanem, Christopher Murdock, Babar Shafiq

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Introduction: ChatGPT is an advanced language AI tool designed to understand and generate human-like text. The aim of this study is to assess the ability of ChatGPT-4 to re-write orthopaedic trauma patient education materials at the recommended 6th-grade level. Methods: Two independent reviewers accessed ChatGPT-4 (chat.openai.com) and gave identical instructions to simplify the readability of provided text to a 6th-grade level. All trauma-related articles by the Orthopaedic Trauma Association (OTA) and American Academy of Orthopaedic Surgeons (AAOS) were sequentially provided. The academic grade level was determined using the Flesh-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE). Paired t-tests and Wilcox-rank sum tests were used to compare the FKGL and FRE between the ChatGPT-4 revised and original text. Inter-rater correlation coefficient (ICC) was used to assess variability in ChatGPT-4 generated text between the two reviewers. Results: ChatGPT-4 significantly reduced FKGL and increased FRE scores in the OTA (FKGL: 5.7±0.5 compared to the original 8.2±1.1, FRE: 76.4±5.7 compared to the original 65.5±6.6, p < 0.001) and AAOS articles (FKGL: 5.8±0.8 compared to the original 8.9±0.8, FRE: 76±5.5 compared to the original 56.7±5.9, p < 0.001). On average, 14.6% of OTA and 28.6% of AAOS articles required at least two revisions by ChatGPT-4 to achieve a 6th-grade reading level. ICC demonstrated poor reliability for FKGL (OTA 0.24, AAOS 0.45) and moderate reliability for FRE (OTA 0.61, AAOS 0.73). Conclusion: This study provides a novel, simple and efficient method using language AI to optimize the readability of patient education content which may only require the surgeon’s final proofreading. This method would likely be as effective for other medical specialties.

Keywords: artificial intelligence, AI, chatGPT, patient education, readability, trauma education

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Authors: Htet Khaing Lin

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This study explores the relationship between a diverse set of variables, encompassing both environmental and socio-economic factors, and poverty levels in the Philippines for the years 2012, 2015, and 2018. Employing Ordinary Least Squares (OLS), Spatial Lag Models (SLM), and Spatial Error Models (SEM), this study delves into the dynamics of key indicators, including daytime and nighttime land surface temperature, cropland surface, urban land surface, rainfall, population size, normalized difference water, vegetation, and drought indices. The findings reveal consistent patterns and unexpected correlations, highlighting the need for nuanced policies that address the multifaceted challenges arising from the interplay of environmental and socio-economic factors.

Keywords: poverty analysis, OLS, spatial lag models, spatial error models, Philippines, google earth engine, satellite data, environmental dynamics, socio-economic factors

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Authors: Rahma Fitriani, Zerlita Fahdha Pusdiktasari, Herman Cahyo Diartho

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Spatial panel model is commonly used to specify more complicated behavior of economic agent distributed in space at an individual-spatial unit level. There are several spatial panel models which can be adapted based on certain assumptions. A package called splm in R has several functions, ranging from the estimation procedure, specification tests, and model selection tests. In the absence of prior assumptions, a comprehensive procedure which utilizes the available functions in splm must be formed, which is the objective of this study. In this way, the best specification and model can be fitted based on data. The implementation of the procedure works well. It specifies SARAR-FE as the best model for agricultural productivity growth of the 38 East Java’s Regencies/Municipalities.

Keywords: spatial panel, specification, splm, agricultural productivity growth

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: Alicia Carranza, Hildemar Dos Santos, W. Lawrence Beeson, R. Patti Herring, Kimberly R. Freeman, Adam Arechiga

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Early exposure to trauma can impact health-related behaviors later in life, which poses a considerable challenge for young adults transitioning into independence when they are lacking the necessary skills and support to live a healthy life. The study will be a non-experimental, mixed methods pre- and post-test (where subjects will serve as their own controls) to determine the impact of an eight-week trauma-informed healthy lifestyle program on self-efficacy for adopting health-promoting behaviors and health outcomes among young adults. Forty-two adults, ages 18-24 who are living in Orange County, CA will be recruited to participate in the eight-week trauma-informed healthy living program. Baseline and post-intervention assessments will be conducted to assess changes in self-efficacy for nutrition and physical exercise, sleep quality and quantity, body mass index (kg/m2), and coping skills used by comparing pre- to post-intervention. Some of the planned activities include cooking demonstrations, mindful eating activities and media literacy using Instagram. Frequencies analyses, paired t-test, and multiple regression will be used to determine if there was a change in coping skills. The results of this study can serve to assess the potential for mitigating the effects of Adverse Childhood Experiences (ACEs), or other toxic stress, experienced during adolescence across the lifespan. Young adults who learn how to cope with stress in a healthy way and engage in a healthy lifestyle can be better prepared to role model that behavior to their children.

Keywords: nutrition, healthy lifestyle, trauma-informed, stress management

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Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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Authors: I. Brezeanu, J. Mackrill, A. Cajo, C. Mogollon

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Modern Slavery is a serious crime, where often the victims are unable to leave their situation of exploitation, being controlled by threats, punishment, violence, coercion, and deception. In the UK, this term encompasses both Slavery and Human Trafficking. The number of potential victims who were referred to the National Referral Mechanism (NRM) increased exponentially in the past decade, passing from fewer than 700 potential victims referred in 2010 to more than 12.000 in 2021. Our study aims to explore how the concept of Trauma-Informed Care (TIC) approach can be adopted by services working with survivors of Modern Slavery and Trafficking (MST). Notably, in this paper, we will elaborate on how the complex needs of survivors are related to their traumatic experiences and what are the necessary steps and resources for implementing a Modern Slavery Trauma-Informed model. While there are relatively few services in the UK that have a deep understanding of the survivors’ and practitioners’ views of how trauma impacts their daily life, there is a strong need for developing services that are organised and delivered in ways that prevent retraumatisation and enable trauma survivors to engage safely with the right professionals at the right time, promoting healing through positive relationships. Such models, known as Trauma-Informed Approaches (TIAs), are seen as crucial to the empowerment of survivors, yet they remain a marginal implementation model by governments, law enforcement, judiciary, or care providers, who are frequently survivors’ first point of contact in the recovery process. In order to understand better how to provide best practice and to adopt the concept, this study is based on a multi-disciplinary approach, encompassing both theoretical perspectives and co-production. By combining qualitative and quantitative research and comparing different analysis of applied examples of TIC in the US and the UK, we gained important insights about the prevention and impact of trauma on survivors’ life. The articulation between more general expertise on Trauma-Informed Care developed by other institutions operating in the field, and the SJOG delivery, based on the Salvation Army’s Modern Slavery Victim Care and Coordination Contract (MSVCC) and the Care Quality Commission regulations, allowed to identify on one side what are the complex needs of survivors derived from their traumatic experiences, and on the other side, how could MST services prevent retraumatisation. Additional, two in-depth interviews with survivors, who receive support from one of our services at Olallo House in London, and a survey shared among all colleagues working with MST services completed the findings of the research with their personal experience and knowledge. Ultimately, we developed an evidence-based Trauma-Informed Care Pathway that aims to improve the wellbeing of survivors and to support them to live a meaningful life. The establishedpathway delivers three main outcomes belonging to the social determinants of health criteria – health and wellbeing, purpose and relationship, and covers key themes of the context of trauma, needs of individuals, and service support.

Keywords: trauma-informed care, modern slavery, human trafficking, trauma, retraumatisation

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Authors: Cormac Reale, Luke J. Prendergast, Kenneth Gavin

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While significant improvements have been made in axial pile design methods over recent years, the influence of soils natural variability has not been adequately accounted for within them. Soil variability is a crucial parameter to consider as it can account for large variations in pile capacity across the same site. This paper seeks to address this knowledge deficit, by demonstrating how soil spatial variability can be accommodated into existing cone penetration test (CPT) based pile design methods, in the form of layered non-homogeneous random fields. These random fields model the scope of a given property’s variance and define how it varies spatially. A Monte Carlo analysis of the pile will be performed taking into account parameter uncertainty and spatial variability, described using the measured scales of fluctuation. The results will be discussed in light of Eurocode 7 and the effect of spatial averaging on design capacities will be analysed.

Keywords: pile axial design, reliability, spatial variability, CPT

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Authors: Elżbieta Antczak

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Cities offer important opportunities for economic development and for expanding access to basic services, including health care and education, for large numbers of people. Moreover, green areas (as an integral part of sustainable urban development) present a major opportunity for improving urban environments, quality of lives and livelihoods. This paper examines, using spatial concentration and spatial taxonomic measures, regional diversification of greenery in the cities of Poland. The analysis includes location quotients, Lorenz curve, Locational Gini Index, and the synthetic index of greenery and spatial statistics tools: (1) To verify the occurrence of strong concentration or dispersion of the phenomenon in time and space depending on the variable category, and, (2) To study if the level of greenery depends on the spatial autocorrelation. The data includes the greatest Polish cities, categories of the urban greenery (parks, lawns, street greenery, and green areas on housing estates, cemeteries, and forests) and the time span 2004-2015. According to the obtained estimations, most of cites in Poland are already taking measures to become greener. However, in the country there are still many barriers to well-balanced urban greenery development (e.g. uncontrolled urban sprawl, poor management as well as lack of spatial urban planning systems).

Keywords: greenery, urban areas, regional spatial diversification and concentration, spatial taxonomic measure

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Authors: Kayla Renteria

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This study explored the role animal-assisted psychotherapy (AAP) can play in treating Post-Traumatic Stress Disorder (PTSD) when incorporated into Trauma-informed cognitive behavioral therapy (TF-CBT). A review of the literature was performed to show how incorporating AAP could benefit TF-CBT since this treatment model often presents difficulties, such as client motivation and avoidance of the exposure element of the intervention. In addition, the fluidity of treatment goals during complex trauma cases was explored, as this issue arose in the case study. This study follows the course of treatment of a 12-year-old female presenting with symptoms of PTSD. Treatment consisted of traditional components of the TF-CBT model, with the added elements of AAP to address typical treatment obstacles in TF-CBT. A registered therapy dog worked with the subject in all sessions throughout her treatment. The therapy dog was incorporated into components such as relaxation and coping techniques, narrative therapy techniques, and psychoeducation on the cognitive triangle. Throughout the study, the client’s situation and clinical needs required the therapist to switch goals to focus on current safety and stability. The therapy dog provided support and neurophysiological benefits to the client through AAP during this shift in treatment. The client was assessed quantitatively using the Child PTSD Symptom Scale Self Report for DSM-5 (CPSS-SR-5) before and after therapy and qualitatively through a feedback form given after treatment. The participant showed improvement in CPSS-SR-V scores, and she reported that the incorporation of the therapy animal improved her therapy. The results of this study show how the use of AAP provided the client a solid, consistent relationship with the therapy dog that supported her through processing various types of traumas. Implications of the results of treatment and for future research are discussed.

Keywords: animal-assisted therapy, trauma-focused cognitive behavioral therapy, PTSD in children, trauma treatment

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Authors: Shannon L. Stewart, Ashley Toohey, Natalia Lapshina

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There is a well-established relationship between childhood maltreatment and negative outcomes (e.g., physical and mental health problems, social skill deficits, poor quality of life). The goal of this study was to examine the relationship between polyvictimization (multiple types of trauma) and risk of harm to self and others, taking into account possible age and sex differences. A total of 8980 children and youth were recruited from over 50 mental health facilities across Ontario, Canada. Among this sample, 29% of children and youth had experienced polyvictimization. Results showed that female children and youth who had experienced trauma were at greater risk of harm to themselves, while their male counterparts were at greater risk of harming others. Further, findings from this study highlight that experiencing polyvictimization, regardless of age or sex, increased the risk of harm to self and others. These findings add to extant literature as to the cumulative relationship between polyvictimization and risk in relation to harming oneself or others. Further, results from this study have significant implications for assessment and care-planning for those children and youth presenting with a trauma background.

Keywords: children's mental health, polyvictimization, risk of harm, sex differences

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Authors: Jiawei Li

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How cooperation emerges and persists in a population of selfish agents is a fundamental question in evolutionary game theory. Our research shows that Collective Strategies with Master-Slave Mechanism (CSMSM) defeat Tit-for-Tat and other well-known strategies in spatial iterated prisoner’s dilemma. A CSMSM identifies kin members by means of a handshaking mechanism. If the opponent is identified as non-kin, a CSMSM will always defect. Once two CSMSMs meet, they play master and slave roles. A mater defects and a slave cooperates in order to maximize the master’s payoff. CSMSM outperforms non-collective strategies in spatial IPD even if there is only a small cluster of CSMSMs in the population. The existence and performance of CSMSM in spatial iterated prisoner’s dilemma suggests that cooperation first appears and persists in a group of collective agents.

Keywords: Evolutionary game theory, spatial prisoners dilemma, collective strategy, master-slave mechanism

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Authors: Rania Ajmi, Faiza Allouche Khebour, Aude Nuscia Taibi, Sirine Essasi

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Urban green spaces (UGS) as an important contributor can be a significant part of sustainable development. A spatial method was employed to assess and map the spatial distribution of UGS in five districts in Sousse, Tunisia. Ecological management of UGS is an essential factor for the sustainable development of the city; hence the municipality of Sousse has decided to support the districts according to different green spaces characters. And to implement this policy, (1) a new GIS web application was developed, (2) then the implementation of the various green spaces was carried out, (3) a spatial mapping of UGS using Quantum GIS was realized, and (4) finally a data processing and statistical analysis with RStudio programming language was executed. The intersection of the results of the spatial and statistical analyzes highlighted the presence of an imbalance in terms of the spatial UGS distribution in the study area. The discontinuity between the coast and the city's green spaces was not designed in a spirit of network and connection, hence the lack of a greenway that connects these spaces to the city. Finally, this GIS support will be used to assess and monitor green spaces in the city of Sousse by decision-makers and will contribute to improve the well-being of the local population.

Keywords: distributions, GIS, green space, imbalance, spatial analysis

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Authors: Nora Geczy

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In today’s architectural practice, during the process of designing public, educational, healthcare and cultural space, human-centered architectural designs helping spatial orientation, safe space usage and the appropriate spatial sequence of actions are gaining increasing importance. Related to the methodology of designing public buildings, several scientific experiments in spatial recognition, spatial analysis and spatial psychology with regard to the components of space producing mental and physiological effects have been going on at the Department of Architectural Design and the Interdisciplinary Student Workshop (IDM) at the Széchenyi István University, Győr since 2013. Defining the creation of preventive, anticipated spatial design and the architectural tools of spatial comfort of public buildings and their practical usability are in the limelight of our research. In the experiments applying eye-tracking cameras, we studied the way public spaces are used, especially concentrating on the characteristics of spatial behaviour, orientation, recognition, the sequence of actions, and space usage. Along with the role of mental maps, human perception, and interaction problems in public spaces (at railway stations, galleries, and educational institutions), we analyzed the spatial situations influencing psychological and ergonomic factors. We also analyzed the eye movements of the experimental subjects in dynamic situations, in spatial procession, using stairs and corridors. We monitored both the consequences and the distorting effects of the ocular dominance of the right eye on spatial orientation; we analyzed the gender-based differences of women and men’s orientation, stress-inducing spaces, spaces affecting concentration and the spatial situation influencing territorial behaviour. Based on these observations, we collected the components of creating public interior spaces, which -according to our theory- contribute to the optimal usability of public spaces. We summed up our research in criteria for design, including 10 points. Our further goals are testing design principles needed for optimizing orientation and space usage, their discussion, refinement, and practical usage.

Keywords: architecture, eye-tracking, human-centered spatial design, public interior spaces, visual perception

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Authors: Hang Yang, Jichao Li, Kewei Yang, Tianyang Lei

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Multivariate time series anomaly detection is a significant research topic in the field of data mining, encompassing a wide range of applications across various industrial sectors such as traffic roads, financial logistics, and corporate production. The inherent spatial dependencies and temporal characteristics present in multivariate time series introduce challenges to the anomaly detection task. Previous studies have typically been based on the assumption that all variables belong to the same spatial hierarchy, neglecting the multi-level spatial relationships. To address this challenge, this paper proposes a multi-scale spatial and unified temporal feature fusion network, denoted as MSUT-Net, for multivariate time series anomaly detection. The proposed model employs a multi-level modeling approach, incorporating both temporal and spatial modules. The spatial module is designed to capture the spatial characteristics of multivariate time series data, utilizing an adaptive graph structure learning model to identify the multi-level spatial relationships between data variables and their attributes. The temporal module consists of a unified temporal processing module, which is tasked with capturing the temporal features of multivariate time series. This module is capable of simultaneously identifying temporal dependencies among different variables. Extensive testing on multiple publicly available datasets confirms that MSUT-Net achieves superior performance on the majority of datasets. Our method is able to model and accurately detect systems data with multi-level spatial relationships from a spatial-temporal perspective, providing a novel perspective for anomaly detection analysis.

Keywords: data mining, industrial system, multivariate time series, anomaly detection

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Authors: John Michael Weber

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The following research results spanned six months and 175 people addicted to some form of substance, from alcohol to heroin. One question was asked, and the answers were amazing and consistent. The following work is the detailed results of this writer’s answer to his own question and the 175 that followed. A constant pattern took shape throughout the bio-psycho-social assessments, these addicts had “first memories,” the memories were vivid and took place between the ages of three to six years old, to a person those first memories were traumatic. This writer’s personal search into his childhood was not to find an excuse for the way he became, but to explain the reason for becoming an addict. To treat addiction, these memories that have caused Post Traumatic Stress Disorder (PTSD), must be recognized as the catalyst that sparked a predisposition. Cognitive Behavioral Therapy (CBT), integrated with treatment specifically focused on PTSD, gives the addict a better chance at recovery sans relapse. This paper seeks to give the findings of first memories of the addicts assessed and provide the best treatment plan for such an addict, considering, the childhood trauma in congruence with treatment of the Substance Use Disorder (SUD). The question posed was concerning what their first life memory wa It is the hope of this author to take the knowledge that trauma is one of the main catalysts for addiction, will allow therapists to provide better treatment and reduce relapse from abstinence from drugs and alcohol. This research led this author to believe that if treatment of childhood trauma is not a priority, the twelve steps of Alcoholics Anonymous, specifically steps 4 and 5, will not be thoroughly addressed and odds for relapse increase. With this knowledge, parents can be educated on childhood trauma and the effect it has on their children. Parents could be mindful of the fact that the things they perceive as traumatic, do not match what a child, in the developmental years, absorbs as traumatic. It is this author’s belief that what has become the status quo in treatment facilities has not been working for a long time. It is for that reason this author believes things need to change. Relapse has been woven into the fabric of standard operating procedure and that, in this authors view, is not necessary. Childhood Trauma is not being addressed early in recovery and that creates an environment of inevitable relapse. This paper will explore how to break away from the status -quo and rethink the current “evidencebased treatments.” To begin breaking away from status-quo, this ends the Abstract, with hopes an interest has been peaked to read on.

Keywords: childood, trauma, treatment, addiction, change

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