Search results for: Multiple trauma

Authors: Naser Ojaroudi Parchin, Haleh Jahanbakhsh Basherlou, Raed A. Abd-Alhameed, Peter S. Excell

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In this paper, a multiple-input/multiple-output (MIMO) antenna design with polarization and radiation pattern diversity is presented for future smartphones. The configuration of the design consists of four double-fed circular-ring antenna elements located at different edges of the printed circuit board (PCB) with an FR-4 substrate and overall dimension of 75×150 mm². The antenna elements are fed by 50-Ohm microstrip-lines and provide polarization and radiation pattern diversity function due to the orthogonal placement of their feed lines. A good impedance bandwidth (S₁₁ ≤ -10 dB) of 3.4-3.8 GHz has been obtained for the smartphone antenna array. However, for S₁₁ ≤ -6 dB, this value is 3.25-3.95 GHz. More than 3 dB realized gain and 80% total efficiency are achieved for the single-element radiator. The presented design not only provides the required radiation coverage but also generates the polarization diversity characteristic.

Keywords: cellular communications, multiple-input/multiple-output systems, mobile-phone antenna, polarization diversity

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Authors: Alireza Pirkhaefi

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Background: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). Given the importance of cognitive disorders in patients with multiple sclerosis, the present study was in order to compare cognitive functions (Working memory, Attention and Centralization, and Visual-spatial perception) in patients with relapsing- remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). Method: Present study was performed as a retrospective study. This research was conducted with Ex-Post Facto method. The samples of research consisted of 60 patients with multiple sclerosis (30 patients relapsing-retrograde and 30 patients secondary progressive), who were selected from Tehran Community of MS Patients Supported as convenience sampling. 30 normal persons were also selected as a comparison group. Montreal Cognitive Assessment (MOCA) was used to assess cognitive functions. Data were analyzed using multivariate analysis of variance. Results: The results showed that there were significant differences among cognitive functioning in patients with RRMS, SPMS, and normal individuals. There were not significant differences in working memory between two groups of patients with RRMS and SPMS; while significant differences in these variables were seen between the two groups and normal individuals. Also, results showed significant differences in attention and centralization and visual-spatial perception among three groups. Conclusions: Results showed that there are differences between cognitive functions of RRMS and SPMS patients so that the functions of RRMS patients are better than SPMS patients. These results have a critical role in improvement of cognitive functions; reduce the factors causing disability due to cognitive impairment, and especially overall health of society.

Keywords: multiple sclerosis, cognitive function, secondary-progressive, normal subjects

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Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

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Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

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Authors: Hakan Akgul

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Purpose: The use of firecrackers (i.e., Ramadan Cannon) during the month of Ramadan is a traditional way of indicating that the fasting period is over in Muslim countries. Here, we report the rehabilitation of a case of hand injury with pluridigital fractures due to premature explosion of a Ramadan cannon. Materials and Methods: A 48-year old man admitted to the Emergency Department due to left hand injury as a result of a premature explosion of a Ramadan cannon. The patient was immediately taken to operation room because of the multiple fractures, tendon loss, and soft tissue loss in the left hand. Range of motion (ROM) of joints was measured with goniometer, pain and oedema were measured and splinting was performed. Results: Rehabilitation team took over the patient at postoperative 9th week. During the 3 month rehabilitation, range of motion increased, oedema was taken under control, pain was reduced, the colour of the skin turned to the normal tone. According to the visual analog scale (VAS), pain decreased from 9 to 4. Oedema, around the metacarpofalangeal (MCP) joints, decreased from 27,5 cm to 23,5 cm. Total active range of motion of the wrist increased from 5 degrees to 50 degrees.Total active range of motion of supination and pronation increased from 55 degrees to 70 degrees. Discussion: The rehabilitation of multiple hand injury is quite difficult. Different aspects of trauma should be taken into consideration when rehabilitation is planned. Factors such as waiting for the bone union, wound healing, and use of external fixators may delay rehabilitation process. Joint mobilization, massage for reducing oedema and preventing scar tissue, exercise within the range of motion are efficient measures. Poor patient compliance to treatment may lead to poor outcome. First of all, oedema and scar formation must be taken under control. Removing fixators should not be delayed depending on the bone union, and exercise within the range of motion should be started.

Keywords: explosion, fracture, hand, injury

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Authors: Salma Kaouthar Letaief

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This article investigates the experience of diaspora in the writings of Algerian diasporic writers, namely: Leila Sebbar’s Silence on the Shores (2000), Keltoum Staali’ December’s Mimosa (2012). The study discusses the collective trauma of violence in Algeria and overseas. The experience of displacement of the characters to an alien territory compel their journey with issues related to nostalgia, identity crisis, alienation, racism, and in-betweeness. The focus in this research is, thus, on Algerian immigrants’ experience in the host country and their psychological conflicts. The theories Multiculturalism and Psychoanalysis are used to analyse the novels in this paper. While Multiculturalism examines how characters negotiate and navigate their identities in multicultural settings, Psychoanalysis enables the analysis of how characters in diasporic novels grapple with issues of identity, belonging, and self-discovery. Hence, interweaving multiculturalism and psychoanalysis provides an interdisciplinary framework that addresses both the socio-cultural and psychological aspects of the diasporic experience. Accordingly, this paper is an attempt to examine the diasporic experience and cultural dialectics.

Keywords: diaspora, algerian diasporic writers, trauma, algeria, displacement, identity crisis, cultural dialects

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Authors: Sungkyung Kim, Jee-Hyeon Na, Dong-Seung Kwon

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Future mobile networks following 5th generation will be characterized by one thousand times higher gains in capacity; connections for at least one hundred billion devices; user experience capable of extremely low latency and response times. To be close to the capacity requirements and higher reliability, advanced technologies have been studied, such as multiple connectivity, small cell enhancement, heterogeneous networking, and advanced interference and mobility management. This paper is focused on the multiple connectivity in heterogeneous cellular networks. We investigate the performance of coverage and user throughput in several deployment scenarios. Using the stochastic geometry approach, the SINR distributions and the coverage probabilities are derived in case of dual connection. Also, to compare the user throughput enhancement among the deployment scenarios, we calculate the spectral efficiency and discuss our results.

Keywords: heterogeneous networks, multiple connectivity, small cell enhancement, stochastic geometry

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Authors: Tetsuki Taniguchi, Yoshio Karasawa

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This paper describes a node pair selection scheme in relay-aided multiple source multiple destination communication system based on stable marriage problem. A general case is assumed in which all of source, relay and destination nodes are equipped with multiantenna and carry out multistream transmission. Based on several metrics introduced from inter-node channel condition, the preference order is determined about all source-relay and relay-destination relations, and then the node pairs are determined using Gale-Shapley algorithm. The computer simulations show that the effectiveness of node pair selection is larger in multihop communication. Some additional aspects which are different from relay-less case are also investigated.

Keywords: relay, multiple input multiple output (MIMO), multiuser, amplify and forward, stable marriage problem, Gale-Shapley algorithm

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Authors: Dongjae Kang, Sokho Son, Jinmee Kim

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Cloud service brokering is a new service paradigm that provides interoperability and portability of application across multiple Cloud providers. In this paper, we designed cloud service brokerage system, any broker, supporting integrated service provisioning and SLA based service life cycle management. For the system design, we introduce the system concept and whole architecture, details of main components and use cases of primary operations in the system. These features ease the Cloud service provider and customer’s concern and support new Cloud service open market to increase cloud service profit and prompt Cloud service echo system in cloud computing related area.

Keywords: cloud service brokerage, multiple Clouds, Integrated service provisioning, SLA, network service

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Authors: Maiko Kiyohara, Toshiki Ito

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In this study, we used a psychotherapy process for patient with dissociative disorder and the graphic Rorschach (Digital version) (GRD). A dissociative disorder is a type of dissociation characterized by multiple alternating personalities (also called alternate identity or another identity). "dissociation" is a state in which consciousness, memory, thinking, emotion, perception, behavior, body image, and so on are divided and experienced. Dissociation symptoms, such as lack of memory, are seen, and the repetition of blanks in daily events causes serious problems in life. Although the pathological mechanism of dissociation has not yet been fully elucidated, it is said that it is caused by childhood abuse or shocking trauma. In case of Japan, no reliable data has been reported on the number of patients and prevalence of dissociative disorders, no drug is compatible with dissociation symptoms, and no clear treatment has been established. GRD is a method that the author revised in 2017 to a Graphic Rorschach, which is a special technique for subjects to draw language responses when enforce Rorschach. GRD reduces the burden on both the subject and the examiner, reduces the complexity of organizing data, improves the simplicity of organizing data, and improves the accuracy of interpretation by introducing a tablet computer during the drawing reaction. We are conducting research for the purpose. The patient in this case is a woman in her 50s, and has multiple personalities since childhood. At present, there are about 10 personalities whose main personality is just grasped. The patients is raising her junior high school sons as single parent, but personal changes often occur at home, which makes the home environment inferior and economically oppressive, and has severely hindered daily life. In psychotherapy, while a personality different from the main personality has appeared, I have also conducted psychotherapy with her son. In this case, the psychotherapy process and the GRD were performed to understand the personality characteristics, and the possibility of therapeutic significance to personality integration is reported.

Keywords: GRD, dissociative disorder, a case study of psychotherapy process, dissociation

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Authors: Masood Beheshtirad

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Identification of regions having potential for landslide occurrence is one of the basic measures in natural resources management. Different landslide hazard mapping models are proposed based on the environmental condition and goals. In this research landslide hazard map using multiple regression model were provided and applicability of this model is investigated in Baghdasht watershed. Dependent variable is landslide inventory map and independent variables consist of information layers as Geology, slope, aspect, distance from river, distance from road, fault and land use. For doing this, existing landslides have been identified and an inventory map made. The landslide hazard map is based on the multiple regression provided. The level of similarity potential hazard classes and figures of this model were compared with the landslide inventory map in the SPSS environments. Results of research showed that there is a significant correlation between the potential hazard classes and figures with area of the landslides. The multiple regression model is suitable for application in the Baghdasht Watershed.

Keywords: landslide, mapping, multiple model, regression

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Authors: Merrylord Harb-Azar

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Traditionally, PTSD treatment has involved trauma-focused cognitive behaviour therapy (TF CBT) to consolidate traumatic memories. A piloted integrated treatment of TF CBT and eye movement desensitisation reprocessing therapy (EMDR) of eight phases will fasten the rate memory is being consolidated and enhance cognitive functioning in patients with PTSD. Patients spend a considerable amount of time in treatment managing their traumas experienced firsthand, or from aversive details ranging from war, assaults, accidents, abuse, hostage related, riots, or natural disasters. The time spent in treatment or as inpatient affects overall quality of life, relationships, cognitive functioning, and overall sense of identity. EMDR is being offered twice a week in conjunction with the standard prolonged exposure as an inpatient in a private hospital. Prolonged exposure for up to 5 hours per day elicits the affect response required for EMDR sessions in the afternoon to unlock unprocessed memories and facilitate consolidation in the amygdala and hippocampus. Results are indicating faster consolidation of memories, reduction in symptoms in a shorter period of time, reduction in admission time, which is enhancing the quality of life and relationships, and improved cognition. The impact of events scale (IES) results demonstrate a significant reduction in symptoms, trauma symptoms inventory (TSI), and posttraumatic stressor disorder check list (PCL) that demonstrates large effect sizes to date. An integrated treatment approach for PTSD achieves a faster resolution of memories, improves cognition, and reduces the amount of time spent in therapy.

Keywords: EMDR enhances cognitive functioning, faster consolidation of trauma memory, integrated treatment of TF CBT and EMDR, reduction in inpatient admission time

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Authors: Thinh Ngo, Paul Rad, Brian Kelley

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Noise estimation is essential in today wireless systems for power control, adaptive modulation, interference suppression and quality of service. Deep learning (DL) has already been applied in the physical layer for modulation and signal classifications. Unacceptably low accuracy of less than 50% is found to undermine traditional application of DL classification for SNR prediction. In this paper, we use divide-and-conquer algorithm and classifier fusion method to simplify SNR classification and therefore enhances DL learning and prediction. Specifically, multiple CNNs are used for classification rather than a single CNN. Each CNN performs a binary classification of a single SNR with two labels: less than, greater than or equal. Together, multiple CNNs are combined to effectively classify over a range of SNR values from −20 ≤ SNR ≤ 32 dB.We use pre-trained CNNs to predict SNR over a wide range of joint channel parameters including multiple Doppler shifts (0, 60, 120 Hz), power-delay profiles, and signal-modulation types (QPSK,16QAM,64-QAM). The approach achieves individual SNR prediction accuracy of 92%, composite accuracy of 70% and prediction convergence one order of magnitude faster than that of traditional estimation.

Keywords: classification, CNN, deep learning, prediction, SNR

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Authors: Veerpaul Maan, Gaurav Mishra

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The evolution of omnichannel has revolutionized the supply chain of the organizations by enhancing customer shopping experience. For these organizations need to develop well-integrated multiple distribution channels to leverage the benefits of omnichannel. To adopt an omnichannel system in the supply chain has resulted in structuring and reconfiguring the practices of the traditional supply chain distribution network. In this paper a multiple distribution supply chain network (MDSCN) have been proposed which integrates online giants with a local retailers distribution network in uncertain environment followed by sustainability. To incorporate sustainability, an additional objective function is added to reduce the carbon content through minimizing the travel distance of the product. Through this proposed model, customers are free to access product and services as per their choice of channels which increases their convenience, reach and satisfaction. Further, a numerical illustration is being shown along with interpretation of results to validate the proposed model.

Keywords: sustainable supply chain network, omnichannel, multiple distribution supply chain network, integrate multiple distribution channels

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Authors: Anat Achiron

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Background: Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system in young adults. It involves the immune system attacking the protective covering of nerve fibers (myelin), leading to inflammation and damage. MS can result in various neurological symptoms, such as muscle weakness, coordination problems, and sensory disturbances. Seizures are not common in MS, and the frequency is estimated between 0.4 to 6.4% over the disease course. Objective: Investigate the frequency of seizures in individuals with multiple sclerosis and to identify associated risk factors. Methods: We evaluated the frequency of seizures in a large cohort of 5686 MS patients followed at the Sheba Multiple Sclerosis Center and studied associated risk factors and comorbidities. Our research was based on data collection using a cohort study design. We applied logistic regression analysis to assess the strength of associations. Results: We found that younger age at onset, longer disease duration, and prolonged time to immunomodulatory treatment initiation were associated with increased risk for seizures. Conclusions: Our findings suggest that seizures in people with MS are directly related to the demyelination process and not associated with other factors like medication side effects or comorbid conditions. Therefore, initiating immunomodulatory treatment early in the disease course could reduce not only disease activity but also decrease seizure risk.

Keywords: epilepsy, seizures, multiple sclerosis, white matter, age

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Authors: Byron Malaela Sotiata Seiuli

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When a disaster strike, the resultant impact and devastation forces many people, particularly those directly affected, to re-examine the core dimensions of life that do not come from other life events. The way people respond to and try give meaning to their experiences resultant from the ruptures of trauma remains vital in grief recovery. On 29 October 2009, an earthquake of 8.3 magnitudes generated a galulolo (tsunami) wave that destroyed parts of American Samoa, Tonga and Samoa (previously Western Samoa). Aside from the physical and natural devastation, many people lost their lives and their livelihood. For health professionals who were called upon to provide psychosocial support, this calamity provided an ideal setting to examine and explore how those directly impacted recovered from the calamity. The experiences of a Samoan couple, Fia and Ola, becomes the key focus of this article, one that situates their mourning patterns and recovery journey in the context of Samoan culture. Examining grief from this perspective creates a cultural space to extend indigenous understanding on the complexities of grieving and customarily responses of Samoan people, like this couple, to disaster recovery.

Keywords: Fa'asamoa, galulolo, tsunami disaster, trauma and grief recovery, pacific psychology

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Authors: Seyede Sanaz Seyedebrahimi, Shima Rahimi, Shohreh Fakhari, Ali Jalili

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Background: CXCR4, as a chemokine receptor, plays well-known roles in various types of cancers. Several studies have been conducted to overcome CXCR4 axis acts in multiple myeloma (MM) pathogenesis and progression. Dexamethasone, a standard treatment for multiple myeloma, has been shown to increase CXCR4 levels in multiple myeloma cell lines. Herein, we focused on the effects of metformin and dexamethasone on CXCR4 at the cellular level and the migration rate of cell lines after exposure to a combination compared to single-agent models. Materials and Method: Multiple myeloma cell lines (U266 and RPMI8226) were cultured with different metformin and dexamethasone concentrations in single-agent and combination models. The simultaneous combination doses were calculated by CompuSyn software. Cell surface and mRNA expression of CXCR4 were determined using flow cytometry and the quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay, respectively. The Transwell cell migration assay evaluated the migration ability. Results: In concurred with previous studies, our results showed a dexamethasone up-regulation effect on CXCR4 in a dose-dependent manner. Although, the metformin single-agent model could reduce CXCR4 expression of U266 and RPMI8226 in cell surface and mRNA expression level. Moreover, the administration of metformin and dexamethasone simultaneously exerted a higher suppression effect on CXCR4 expression than the metformin single-agent model. The migration rate through the combination model's matrigel membrane was remarkably lower than the metformin and dexamethasone single-agent model. Discussion: According to our findings, the combination of metformin and dexamethasone effectively inhibited dexamethasone-induced CXCR4 expression in multiple myeloma cell lines. As a result, metformin may be counted as an alternative medicine combined with other chemotherapies to combat multiple myeloma. However, more research is required.

Keywords: CXCR4, dexamethasone, metformin, migration, multiple myeloma

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Authors: T. Yu, L. Audibert, J. F. Chaix, D. Komatitsch, V. Garnier, J. M. Henault

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Linear Ultrasonic Techniques play a major role in Non-Destructive Evaluation (NDE) for civil engineering structures in concrete since they can meet operational requirements. Interpretation of ultrasonic measurements could be improved by a better understanding of ultrasonic wave propagation in a multiple scattering medium. This work aims to develop a 2D numerical model of ultrasonic wave propagation in a heterogeneous medium, like concrete, integrating the multiple scattering phenomena in SPECFEM software. The coherent field of multiple scattering is obtained by averaging numerical wave fields, and it is used to determine the effective phase velocity and attenuation corresponding to an equivalent homogeneous medium. First, this model is applied to one scattering element (a cylinder) in a homogenous medium in a linear-elastic system, and its validation is completed thanks to the comparison with analytical solution. Then, some cases of multiple scattering by a set of randomly located cylinders or polygons are simulated to perform parametric studies on the influence of frequency and scatterer size, concentration, and shape. Also, the effective properties are compared with the predictions of Waterman-Truell model to verify its validity. Finally, the mortar viscoelastic behavior is introduced in the simulation in order to considerer the dispersion and the attenuation due to porosity included in the cement paste. In the future, different steps will be developed: The comparisons with experimental results, the interpretation of NDE measurements, and the optimization of NDE parameters before an auscultation.

Keywords: attenuation, multiple-scattering medium, numerical modeling, phase velocity, ultrasonic measurements

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Authors: Amy Pullen, Samantha Rodrigues, David Kieser, Brian Shaw

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The aim of the study was to determine if a projectile interacting with the lungs increases the severity of injury in comparison to a projectile interacting with the ribs or intercostal muscle. This comparative study employed a 10% gelatine based model with either porcine ribs or balloons embedded to represent a lung. Four sample groups containing five samples were evaluated; these were control (plain gel), intercostal impact, rib impact, and lung impact. Two ammunition natures were evaluated at a range of 10m; these were 5.56x45mm and 7.62x51mm. Aspects of projectile behavior were quantified including exiting projectile weight, location of yawing, projectile fragmentation and distribution, location and area of the temporary cavity, permanent cavity formation, and overall energy deposition. Major findings included the cavity showing a higher percentage of the projectile weight exit the block than the intercostal and ribs, but similar to the control for the 5.56mm ammunition. However, for the 7.62mm ammunition, the lung was shown to have a higher percentage of the projectile weight exit the block than the control, intercostal and ribs. The total weight of projectile fragments as a function of penetration depth revealed large fluctuations and significant intra-group variation for both ammunition natures. Despite the lack of a clear trend, both plots show that the lung leads to greater projectile fragments exiting the model. The lung was shown to have a later center of the temporary cavity than the control, intercostal and ribs for both ammunition types. It was also shown to have a similar temporary cavity volume to the control, intercostal and ribs for the 5.56mm ammunition and a similar temporary cavity to the intercostal for the 7.62mm ammunition The lung was shown to leave a similar projectile tract than the control, intercostal and ribs for both ammunition types. It was also shown to have larger shear planes than the control and the intercostal, but similar to the ribs for the 5.56mm ammunition, whereas it was shown to have smaller shear planes than the control but similar shear planes to the intercostal and ribs for the 7.62mm ammunition. The lung was shown to have less energy deposited than the control, intercostal and ribs for both ammunition types. This comparative study provides insights into the influence of the lungs on thoracic gunshot trauma. It indicates that the lungs limits projectile deformation and causes a later onset of yawing and subsequently limits the energy deposited along the wound tract creating a deeper and smaller cavity. This suggests that lung impact creates an altered pattern of local energy deposition within the target which will affect the severity of trauma.

Keywords: ballistics, lung, trauma, wounding

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Authors: Cho-Liang Chung

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Uniform and rapid drug release are important for trauma dressing application. Low glass transition polymer system and non-woven nanofiber structures as the designs conduct rapid-release characteristics. In this study, polyvinylpyrrolidone, polysulfone, and polystyrene were dissolved in dimethylformamide to form precursor solution. These solutions were blended with vitamin C to form the electrospinning solutions. The non-woven nanofibers structures were successfully prepared using an electrospinning process. The following instruments were used to analyze the characteristics of non-woven nanofibers structures: Atomic force microscopy (AFM), Field Emission Scanning Electron Microscope (FE-SEM), and X-ray Diffraction (XRD). The AFM was used to scan the nanofibers. 3D Graphics were applied to explore the surface morphology of nanofibers. FE-SEM was used to explore the morphology of non-woven structures. XRD was used to identify crystal structures in the non-woven structures. The evolution of morphology of non-woven structures was changed dramatically in different durations, because of the moisture absorption and decreasing glass transition temperature; the non-woven nanofiber structures can be applied to uniform and rapid drug release for trauma dressing application.

Keywords: nanofibers, non-woven, electrospinning process, rapid drug releasing

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Authors: Tuji Mohammed Sani

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Back ground: An open tibial fracture is an injury where the fractured bone directly communicates with the outside environment. Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. Objective: The main objective of the study was to determine Prevalence of infection and its associated factors in surgically treated open tibial fracture in Addis Ababa Burn Emergency and Trauma (AaBET) center. Method: A facility based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET center from September 2018 to September 2021. The data was collected from patient’s chart using structured data collection form, and Data was entered and analyzed using SPSS version 26. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor and tolerance, which were less than 5 and greater than 0.2, respectively. Model adequacy were tested using Hosmer-Lemeshow goodness of fitness test (P=0.711). AOR at 95% CI was reported, and P-value < 0.05 was considered statistically significant. Result: This study found that 33.9% of the study participants had an infection. Initial IV antibiotic time (AOR=2.924, 95% CI:1.160- 7.370) and time of wound closure from injury (AOR=3.524, 95% CI: 1.798-6.908), injury to admission time (AOR=2.895, 95% CI: 1.402 – 5.977). and definitive fixation method (AOR=0.244, 95% CI: 0.113 – 0.4508) were the factors found to have a statistically significant association with the occurrence of infection. Conclusion: The rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fracture treated at AaBET center. Time from injury to admission, time from injury to first debridement, wound closure time, and initial Intra Venous antibiotic time from the injury are an important factor that can be readily amended to improve the infection rate. Whether wound closed before seven days or not were more important factor associated with occurrences of infection.

Keywords: infection, open tibia, fracture, magnitude

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Authors: H. Pegram, R. Stevens, L. De Girolamo

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Aligned electrospun nanofibres act as effective neuronal and glial cell scaffolds that can be layered to contain multiple sheets harboring different cell populations. This allows personalised biofunctional prostheses to be manufactured with both acellular and cellularised layers for the treatment of spinal cord injury. Additionally, the manufacturing route may be configured to produce in-vitro 3D cell based model of spinal cord injury to aid drug development and enhance prosthesis performance. The goal of this investigation was to optimise the multi-layer scaffold design parameters for prosthesis manufacture, to enable the development of multi-layer patient specific implant therapies. The work has also focused on the fabricating aligned nanofibre scaffolds that promote in-vitro neuronal and glial cell population growth, cell-to-cell interaction and long-term survival following trauma to mimic an in-vivo spinal cord lesion. The approach has established reproducible lesions and has identified markers of trauma and regeneration marked by effective neuronal migration across the lesion with glial support. The investigation has advanced the development of an in-vitro model of traumatic spinal cord injury and has identified a route to manufacture prostheses which target the repair spinal cord injury. Evidence collated to investigate the multi-layer concept suggests that physical cues provided by nanofibres provide both a natural extra-cellular matrix (ECM) like environment and controls cell proliferation and migration. Specifically, aligned nanofibre layers act as a guidance system for migrating and elongating neurons. On a larger scale, material type in multi-layer systems also has an influence in inter-layer migration as cell types favour different material types. Results have shown that layering nanofibre membranes create a multi-level scaffold system which can enhance or prohibit cell migration between layers. It is hypothesised that modifying nanofibre layer material permits control over neuronal/glial cell migration. Using this concept, layering of neuronal and glial cells has become possible, in the context of tissue engineering and also modelling in-vitro induced lesions.

Keywords: electrospinning, layering, lesion, modeling, nanofibre

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Authors: Young Hee Geum

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In this paper,we develop the complex dynamics of a family of optimal fourth-order multiple-root solvers and plot their basins of attraction. Mobius conjugacy maps and extraneous fixed points applied to a prototype quadratic polynomial raised to the power of the known integer multiplicity m are investigated. A 300 x 300 uniform grid centered at the origin covering 3 x 3 square region is chosen to visualize the initial values on each basin of attraction in accordance with a coloring scheme based on their dynamical behavior. The illustrative basins of attractions applied to various test polynomials and the corresponding statistical data for convergence are shown to confirm the theoretical convergence.

Keywords: basin of attraction, conjugacy, fourth-order, multiple-root finder

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Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

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Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

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Authors: Heidi Ahonen

Abstract:

Since antiquity, many cultures have seemingly known the power of low frequencies, incorporating them in healing practices through drumming, singing, humming, etc. Many music therapists recognize there is something in music that is transformative enough to make a difference in people’s lives. This paper summarizes the key findings of several low-frequency research with various client populations conducted by the author. Utilizing low-frequency sound (30 or 40 Hz) may have diverse therapeutic impacts: (1) Calming effect – decreased agitation (autism, brain injury, AD, dementia) (2) Muscle relaxation (CP & spasticity & pain/after surgery patients, MS, fibromyalgia) (3) Relaxation/stress release (anxiety, stress, PTSD, trauma, insomnia) (4) Muscular/motor functioning/ decrease of tremor (CP, MS, Parkinson) (5) Increase in alertness, cognitive awareness & short-term memory function (brain injury, severe global developmental delay, AD) (6) Increased focus (AD, PTSD, trauma). The paper will conclude by presenting ideas informing the clinical practice. Future studies need to investigate what frequencies are effective for particular client populations and why, what theories can explain the effect, and finally, something that has been long debated - is it auditive or kinaesthetic stimulation or the combination of both that is effective?

Keywords: low frequency, 40 Hz, sound, neuro disability

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Authors: Ayesha S. Rahman, Khaled Haddad, Ataur Rahman

Abstract:

At-site flood frequency analysis is used to estimate flood quantiles when at-site record length is reasonably long. In Australia, FLIKE software has been introduced for at-site flood frequency analysis. The advantage of FLIKE is that, for a given application, the user can compare a number of most commonly adopted probability distributions and parameter estimation methods relatively quickly using a windows interface. The new version of FLIKE has been incorporated with the multiple Grubbs and Beck test which can identify multiple numbers of potentially influential low flows. This paper presents a case study considering six catchments in eastern Australia which compares two outlier identification tests (original Grubbs and Beck test and multiple Grubbs and Beck test) and two commonly applied probability distributions (Generalized Extreme Value (GEV) and Log Pearson type 3 (LP3)) using FLIKE software. It has been found that the multiple Grubbs and Beck test when used with LP3 distribution provides more accurate flood quantile estimates than when LP3 distribution is used with the original Grubbs and Beck test. Between these two methods, the differences in flood quantile estimates have been found to be up to 61% for the six study catchments. It has also been found that GEV distribution (with L moments) and LP3 distribution with the multiple Grubbs and Beck test provide quite similar results in most of the cases; however, a difference up to 38% has been noted for flood quantiles for annual exceedance probability (AEP) of 1 in 100 for one catchment. These findings need to be confirmed with a greater number of stations across other Australian states.

Keywords: floods, FLIKE, probability distributions, flood frequency, outlier

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Kasamon Aramvanitch, Karn Suttapanit, Yahya Mankong, Nussareen Yaemluksanalert, Sansanee Meesawad

Abstract:

Introduction : Application of a rigid cervical collar may interfere with the laryngeal view, and potentially lead to failed endotracheal intubation (ETI). This study aimed to compare intubation success rates while performing inline stabilization with and without cervical hard collar. Methods : This randomized prospective comparative study included paramedics working in the Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand to compare the success rates of endotracheal intubation on manikin using inline stabilization with and without cervical hard collar. Results : 125 participants were evaluated; 63 in the rigid cervical collar and 62 in the non-cervical hard collar group. The rate of successful intubation was significantly higher using manual stabilization without cervical hard collar (61 (96.8%) vs. 55 (88.7%); p=0.048). The time required to successfully perform intubation was also shorter, with manual stabilization only (14.1 ±20.9 vs. 18.9±29.0; p = 0.081). Conclusion : It seems that, removal of the rigid cervical collar during ETI in patients with suspected traumatic spine injury could increase the intubation success rate.

Keywords: ntubation, Intratracheal, Spinal Injuries, Multiple trauma

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Authors: Rubén Manrique, Delio Balcázar, José Parrado, Sebastián Rodríguez

Abstract:

Hand in hand with the evolution of technology, education systems have moved to virtual environments to provide increased coverage and facilitate the access to education. However, measuring student performance in virtual environments presents significant challenges to ensure students are acquiring the expected skills. In this study, the confidence and performance of engineering students in virtual environments is analyzed through different evaluation strategies. The effect of the assessment strategy in student confidence is identified using educational data mining techniques. Four assessment strategies were used. First, a conventional multiple choice test; second, a multiple choice test with feedback; third, a multiple choice test with a second chance; and fourth; a multiple choice test with feedback and second chance. Our results show that applying testing with online feedback strategies can influence positively student confidence.

Keywords: assessment strategies, educational data mining, student performance, student confidence

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Authors: Elizabeth Laguaite, Alexandria Purdy

Abstract:

Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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Authors: Harald Haas, Andrea Plaschke

Abstract:

Many of the contemporary major conflicts on this earth could not be solved so far, they either are perpetuated, or they are reflated again and again. Efforts of purely political conflict management or -resolution aim merely at the symptoms of conflict, not its roots. These roots are, in almost every case, also psychological ones. Thus, this contribution aims to shed light on the roots of one of the best known and longest-lasting conflicts: the Palestinian-Israeli one. Methodologies used were the compilation of existing scientific resources, field research in Palestine and Israel, as well as tests conducted with the Adult Attachment Projective in Palestine and Israel. Findings show that the majority of Palestinian, as well as Israeli test participants, show a disorganised attachment pattern which, in connection with the assumption of collective traumatization, seem to be a major obstacle to a lasting and peaceful conflict-resolution between these two peoples. There appears to be no short-term solution for this conflict, especially not within the range of usual Western legislative periods. Both sides ought to be provided with a kind of 'safe haven' over a long period of time, accompanied by a framework of various arrangements of coping with trauma, building lasting and secure relationships, as well as raising and educating present and future generations of Palestinians and Israelis for peace and co-operation with each other.

Keywords: conflict-management, trauma, political psychology, attachment theory

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Authors: Seung-Jun Yu, Yeong-Seop Ahn, Young-Min Ko, Hyoung-Kyu Song

Abstract:

In order to achieve high data rate and increase the spectral efficiency, multiple input multiple output (MIMO) system has been proposed. However, multiple antennas are limited by size and cost. Therefore, recently developed cooperative diversity scheme, which profits the transmit diversity only with the existing hardware by constituting a virtual antenna array, can be a solution. However, most of the introduced cooperative techniques have a common fault of decreased transmission rate because the destination should receive the decodable compositions of symbols from the source and the relay. In this paper, we propose a cooperative cyclic delay diversity (CDD) scheme that uses hierarchical modulation. This scheme is free from the rate loss and allows seamless cooperative communication.

Keywords: MIMO, cooperative communication, CDD, hierarchical modulation

Procedia PDF Downloads 522