Search results for: traumatic patellar dislocation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 464

Search results for: traumatic patellar dislocation

224 Ankle Arthroscopy: Indications, Patterns of Admissions, Surgical Outcomes, and Associated Complications Among Saudi Patients at King Abdul-Aziz Medical City in Riyadh

Authors: Mohammad Abdullah Almalki

Abstract:

Background: Despite the frequent usage of ankle arthroscopy, there is limited medical literature regarding its indications, patterns of admissions, surgical outcomes, and associated complicated at Saudi Arabia. Hence, this study would highlight the surgical outcomes of such surgical approach that will assist orthopedic surgeons to detect which surgical procedure needs to be done as well as to help them regarding their diagnostic workups. Methods: At the Orthopedic Division of King Abdul‑Aziz Medical City in Riyadh and through a cross‑sectional design and convenient sampling techniques, the present study had recruited 20 subjects who fulfill the inclusion and exclusion criteria between 2016 and 2018. Data collection was carried out by a questionnaire designed and revised by an expert panel of health professionals. Results: Twenty patients were reviewed (11M and 9F) with an average age of 40.1 ± 12.2. Only 30% of the patients (5M, 1F) have no comorbidity, but 70% of patients (7M, 8F) were having at least one comorbidity. The most common indications were osteochondritis dissecans (n = 7, 35%), ankle fracture without dislocation (n = 4, 20%), and tibiotalar impingement (n = 3, 15%). Patients recorded pain in all cases (100%). The top four symptoms after pain were instability (30%, n = 6), muscle weakness (15%, n = 3) swelling (15%, n = 3), and stiffness (5%, n = 1). Two‑third of cases reached to their full healthy status and toe‑touch weight‑bearing was seen in two patients (10%). Conclusion: Ankle arthroscopy improved the rehabilitation rates in our tertiary care center. In addition, the surgical outcomes are favorable in our hospital since it has a very short length of stay, unexpended surgery, and fewest physiotherapy sessions.

Keywords: ankle, arthroscopy, indications, patterns

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223 The Relationship Between Spirituality and Quality of Life in Patients with Spinal Cord Injury, Iran

Authors: Khadije Khazaeli, Farzane Saberi

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Spinal cord injury is one of the traumatic events which has a great impact on the quality of life. spirituality has been used to improve many disorders and abnormalities in recent years and positive results have been seen; accordingly, the present study investigated the relationship between spirituality and quality of life in these patients. This study is a cross-sectional study of the correlation type was conducted on 100 people with spinal cord injury in Isfahan province in 2016 by the available sample method. Spirituality was assessed through the Spiritual Attitude Questionnaire and quality of life through the World Health Organization Quality of Life Questionnaire. Pearson correlation and regression tests were used to analyze the data. The results of this study showed that spirituality has a significant relationship with the quality of life of patients with spinal cord injury. It was also proved that all sub-units of spirituality, including attitude and spiritual ability, can affect all components of quality of life. The findings suggest that spirituality, along with other factors, can lead to a significant improvement in quality of life and, ultimately, general health of patients with SCI.

Keywords: spinal cord injury, quality of life, spirituality, patients

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222 A Hyperflexion Hallux Mallet Injury: A Case Report

Authors: Tan G. K. Y., Chew M. S. J., Sajeev S., Vellasamy A.

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Injuries of the extensor hallucis longus (EHL) tendon are a rare phenomenon, with most occurring due to lacerations or penetrating injuries. Closed traumatic ruptures of the EHL are described as “Mallet injuries of the toe”. These can be classified as bony or soft mallet injuries depending on the presence or absence of a fracture at the insertion site of the EHL tendon in the distal phalanx. We present a case of a 33-year-old woman who presented with a hyperflexion injury to the left big toe with an inability to extend the big toe. Ultrasound showed a complete rupture of the EHL tendon with retraction proximal to the hallucal interphalangeal joint of the big toe. The patient was treated through transarticular pinning and repair using the Arthrex Mini Bio-Suture Tak with a 2-0 fibre wire. Six months postoperatively, the patient had symmetrical EHL power and full range of motion of the toe. The lessons to be drawn from this case report are that isolated hallux mallet injuries are rare and can be easily missed in the absence of penetrating wounds. Patients who have such injuries should be investigated early with the appropriate imaging techniques, such as ultrasound or MRI, and treated surgically.

Keywords: hallux mallet, extensor hallucis longus tendon, extensor hallucis longus

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221 Physical-Mechanical Characteristics of Monocrystalline Si1-xGex(X 0,02) Solid Solutions

Authors: I. Kurashvili, A. Sichinava, G. Bokuchava, G. Darsavelidze

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Si-Ge solid solutions (bulk poly- and monocrystalline samples, thin films) are characterized by high perspectives for application in semiconductor devices, in particular, optoelectronics and microelectronics. In this light complex studying of structural state of the defects and structural-sensitive physical properties of Si-Ge solid solutions depending on the contents of Si and Ge components is very important. Present work deals with the investigations of microstructure, electrophysical characteristics, microhardness, internal friction and shear modulus of Si1-xGex(x≤0,02) bulk monocrystals conducted at a room temperatures. Si-Ge bulk crystals were obtained by Czochralski method in [111] crystallographic direction. Investigated monocrystalline Si-Ge samples are characterized by p-type conductivity and carriers concentration 5.1014-1.1015cm-3, dislocation density 5.103-1.104cm-2, microhardness according to Vickers method 900-1200 Kg/mm2. Investigate samples are characterized with 0,5x0,5x(10-15) mm3 sizes, oriented along [111] direction at torsion oscillations ≈1Hz, multistage changing of internal friction and shear modulus has been revealed in an interval of strain amplitude of 10-5-5.10-3. Critical values of strain amplitude have been determined at which hysteretic changes of inelastic characteristics and microplasticity are observed. The critical strain amplitude and elasticity limit values are also determined. Tendency to decrease of dynamic mechanical characteristics is shown with increasing Ge content in Si-Ge solid solutions. Observed changes are discussed from the point of view of interaction of various dislocations with point defects and their complexes in a real structure of Si-Ge solid solutions.

Keywords: Microhardness, internal friction, shear modulus, Monocrystalline

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220 Injury Pattern of Field Hockey Players at Different Field Position during Game and Practice

Authors: Sujay Bisht

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The purpose of the study was to assess and examines the pattern of injury among the field hockey players at different field position during practice & game. It was hypothesized that the backfield might have the height rate of injury, followed by midfield. Methods: university level and national level male field hockey (N=60) are selected as a subject and requested to respond an anon questionnaire. Personal characteristics of each and individual players were also collected like (age, height, weight); field hockey professional information (level of play, year of experience, playing surface); players injury history (site, types, cause etc). The rates of injury per athlete per year were also calculated. Result: Around half of the injury occurred were to the lower limbs (49%) followed by head and face (30%), upper limbs (19%) and torso region (2%). Injuries included concussion, wounds, broken nose, ligament sprain, dislocation, fracture, and muscles strain and knee injury. The ligament sprain is the highest rate (40%) among the other types of injuries. After investigation and evaluation backfield players had the highest rate of risk of injury (1.10 injury/athletes-year) followed by midfield players (0.70 injury/athlete-year), forward players (0.45 injury/athlete-year) & goalkeeper was (0.37 injury/athlete-year). Conclusion: Due to the different field position the pattern & rate of injury were different. After evaluation, lower limbs had the highest rate of injury followed by head and face, upper limbs and torso respectively. It also revealed that not only there is a difference in the rate of injury between playing the position, but also in the types of injury sustain at a different position.

Keywords: trauma, sprain, strain, astroturf, acute injury

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219 Immunohistochemical Evaluation of Moringa oleifera Seed Oil in Cadmium Induced Frontal Cortex Damage in Wistar Rats

Authors: Olusegun D. Omotoso

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The use of Moringa oleifera seed oil in the prevention and cure of many ailments particularly, neurodegenerative diseases have been on increasing trend in Nigeria. The study was aimed at investigating the ameliorative or reversal effects by the intervention of Moringa oleifera seed oil on the damage to frontal cortex of Wistar rats by cadmium. Twenty-eight Wistar rats of both sexes weighed between 73g-151g were used. The animals were acclimatized and were fed on rat chow and water ad libitum. The rats were randomly divided into four groups A, B, C and D of 7 rats each. Group A served as control which received 2.5mg/kgbw phosphate buffer intra-peritoneally, while group D served as Moringa-treated control and received oral administration of 2.0 mg/kgbw Moringa oleifera oil. Groups B and C were injected intra-peritoneally with 3.5mg/kgbw CdSO₄.8H₂O single dose. Group C received orally administration of 2.0mg/kgbw Moringa oleifera oil. The intervention lasted for four weeks after which the animals were sacrificed by cervical dislocation and the tissues processed histologically. The immuno-histoarchitecture of the frontal cortex was characterized by pyknosis of nuclei as well as activation of astrocytes which was evidence in group B rats, while those animals in group C showed ameliorative effect that were evidence in reduction in the number of pyknotic nuclei and reduction of activated astrocytes as compared with control group A and Moringa-treated group D. It can be deduced that Moringa oleifera seed oil has natural antioxidant constituents that might have ameliorated the immuno-histoarchitectural damage caused by cadmium.

Keywords: cadmium, immuno-histoarchitecture, Moringa oleifera, pyknotic nuclei

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218 High Temperature Deformation Behavior of Al0.2CoCrFeNiMo0.5 High Entropy alloy

Authors: Yasam Palguna, Rajesh Korla

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The efficiency of thermally operated systems can be improved by increasing the operating temperature, thereby decreasing the fuel consumption and carbon footprint. Hence, there is a continuous need for replacing the existing materials with new alloys with higher temperature working capabilities. During the last decade, multi principal element alloys, commonly known as high entropy alloys are getting more attention because of their superior high temperature strength along with good high temperature corrosion and oxidation resistance, The present work focused on the microstructure and high temperature tensile behavior of Al0.2CoCrFeNiMo0.5 high entropy alloy (HEA). Wrought Al0.2CoCrFeNiMo0.5 high entropy alloy, produced by vacuum induction melting followed by thermomechanical processing, is tested in the temperature range of 200 to 900oC. It is exhibiting very good resistance to softening with increasing temperature up to 700oC, and thereafter there is a rapid decrease in the strength, especially beyond 800oC, which may be due to simultaneous occurrence of recrystallization and precipitate coarsening. Further, it is exhibiting superplastic kind of behavior with a uniform elongation of ~ 275 % at 900 oC temperature and 1 x 10-3 s-1 strain rate, which may be due to the presence of fine stable equi-axed grains. Strain rate sensitivity of 0.3 was observed, suggesting that solute drag dislocation glide might be the active mechanism during superplastic kind of deformation. Post deformation microstructure suggesting that cavitation at the sigma phase-matrix interface is the failure mechanism during high temperature deformation. Finally, high temperature properties of the present alloy will be compared with the contemporary high temperature materials such as ferritic, austenitic steels, and superalloys.

Keywords: high entropy alloy, high temperature deformation, super plasticity, post-deformation microstructures

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217 Earthquake Forecasting Procedure Due to Diurnal Stress Transfer by the Core to the Crust

Authors: Hassan Gholibeigian, Kazem Gholibeigian

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In this paper, our goal is determination of loading versus time in crust. For this goal, we present a computational procedure to propose a cumulative strain energy time profile which can be used to predict the approximate location and time of the next major earthquake (M > 4.5) along a specific fault, which we believe, is more accurate than many of the methods presently in use. In the coming pages, after a short review of the research works presently going on in the area of earthquake analysis and prediction, earthquake mechanisms in both the jerk and sequence earthquake direction is discussed, then our computational procedure is presented using differential equations of equilibrium which govern the nonlinear dynamic response of a system of finite elements, modified with an extra term to account for the jerk produced during the quake. We then employ Von Mises developed model for the stress strain relationship in our calculations, modified with the addition of an extra term to account for thermal effects. For calculation of the strain energy the idea of Pulsating Mantle Hypothesis (PMH) is used. This hypothesis, in brief, states that the mantle is under diurnal cyclic pulsating loads due to unbalanced gravitational attraction of the sun and the moon. A brief discussion is done on the Denali fault as a case study. The cumulative strain energy is then graphically represented versus time. At the end, based on some hypothetic earthquake data, the final results are verified.

Keywords: pulsating mantle hypothesis, inner core’s dislocation, outer core’s bulge, constitutive model, transient hydro-magneto-thermo-mechanical load, diurnal stress, jerk, fault behaviour

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216 Slipping Through the Net: Women’s Experiences of Maternity Services and Social Support in the UK During the COVID-19 Pandemic

Authors: Freya Harding, Anne Gatuguta, Chi Eziefula

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Introduction Research shows the quality of experiences of pregnancy, birth, and postpartum impacts the health and well-being of the mother and baby. This is recognised by the WHO in their recommendations ‘Intrapartum care for a positive childbirth experience’. The COVID-19 pandemic saw the transformation of the NHS Maternity services to prevent the transmission of COVID-19. Physical and social isolation may have affected women’s experiences of pregnancy, birth and postpartum; especially those of healthcare. Examples of such changes made to the NHS include both the reduction in volume of face-to-face consultations and restrictions to visitor time in hospitals. One notable detriment due to these changes was the absence of a partner during certain stages of birth. The aim of this study was to explore women’s experiences of pregnancy, birth, and postnatal period during the COVID-19 pandemic in the UK. Methods We collected qualitative data from women who had given birth during the COVID-19 pandemic. In-depth, semi-structured interviews were conducted with twelve participants recruited from mother and baby groups in Southeast England. Data were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches. Ethics permission was granted from Brighton and Sussex Medical School (ER/BSMS9A83/1). Results Interviews were conducted with 12 women who gave birth between May 2020 and February 2021. Ages of the participants ranged between 28 and 42 years, most of which were white British, with one being Asian British. All participants were heterosexual and either married or co-habiting with their partner. Five participants worked in the NHS, and all participants had professional occupations. Women felt inadequately supported both socially and medically. An appropriate sense of control over their own birthing experience was lacking. Safety mechanisms, such as in-person visits from the midwife, had no suitable alternatives in place. Serious health issues were able to “slip through the net.” Mental health conditions in some of those interviewed worsened or developed. Similarly, reduced support from partners during birth and during the immediate postpartum period at the hospital, coupled with reduced ward staffing, resulted in some traumatic experiences; particularly for women who had undergone caesarean section. However, some unexpected positive effects were reported; one example being that partners were able to spend more time with their baby due to furlough schemes and working from home. Similarly, emergency care was not felt to have been compromised. Overall, six themes emerged: (1) Self-reported traumatic experiences, (2) Challenges of caring for a baby with reduced medical and social support, (3) Unexpected benefits to the parenting experience, (4) The effects of a sudden change in medical management (5) Poor communication from healthcare professionals (6) Social change; with subthemes of support accessing medical care, the workplace, family and friends, and antenatal & baby groups. Conclusions The results indicate that the healthcare system was unable to adequately deliver maternity care to facilitate positive pregnancy, birth, and postnatal experiences during the heights of the pandemic. The poor quality of such experiences has been linked an increased risk of long-term health complications in both the mother and child.

Keywords: pregnancy, birth, postpartum, postnatal, COVID-19, maternity, social support, qualitative, pandemic

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215 Mechanical Characterization of Brain Tissue in Compression

Authors: Abbas Shafiee, Mohammad Taghi Ahmadian, Maryam Hoviattalab

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The biomechanical behavior of brain tissue is needed for predicting the traumatic brain injury (TBI). Each year over 1.5 million people sustain a TBI in the USA. The appropriate coefficients for injury prediction can be evaluated using experimental data. In this study, an experimental setup on brain soft tissue was developed to perform unconfined compression tests at quasistatic strain rates ∈0.0004 s-1 and 0.008 s-1 and 0.4 stress relaxation test under unconfined uniaxial compression with ∈ 0.67 s-1 ramp rate. The fitted visco-hyperelastic parameters were utilized by using obtained stress-strain curves. The experimental data was validated using finite element analysis (FEA) and previous findings. Also, influence of friction coefficient on unconfined compression and relaxation test and effect of ramp rate in relaxation test is investigated. Results of the findings are implemented on the analysis of a human brain under high acceleration due to impact.

Keywords: brain soft tissue, visco-hyperelastic, finite element analysis (FEA), friction, quasistatic strain rate

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214 Macroscopic Study of Reproductive Pathologies in Cows at the Souk-Ahras Communal Slaughterhouse

Authors: Besma Abdeltif, Chebabhi Imen

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Introduction: it is important to define the genital pathologies encountered in Algeria in postpartum dairy cows. The objective was to identify the different pathologies of reproduction in cows found at the communal abattoir of Souk Ahras. Materials and Methods: Our study was carried at the communal slaughterhouse of Souk-Ahras on 63 genital tracts were examined macroscopically after slaughter. Results: The results obtained reveal a high frequency of pregnant females (14.28%), most of the gestations were at their beginning. Uterine anomalies ranked first in the genital lesions of the cow (20.37%). The frequencies of these abnormalities are in ascending order: aplasia of the horns = 1.85%, traumatic cervical = 1.85%, cervical tumors = 1.85%, chronic endometritis = 3.70% and Acute endometritis = 11.11%. The ovarian cyst is the most common lesion, with a frequency of 3.70%, followed by smooth ovaries (1.85%). These are single, thin-walled cysts more present on the right ovary than the left ovary. Salpingitis is the only tubal lesion found on 5.55% of the non-pregnant genital tract. Neoformation is the only vaginal lesion identified in this work (1.85%). Conclusion: Our result, in general, conforms to the data of the literature.

Keywords: genital tract, cow, slaughterhouse, pathology

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213 The Mediation Effect of PTSD and Aggression on the Relationship of Childhood Physical Abuse and Suicidal Behavior in Homeless People

Authors: Jina Hong, Seongeun Ryu, Sungeun You

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Suicide rate among homeless people are much higher than one in the general population. The purpose of this study was to examine the mediating effect of PTSD and aggression in the relationship between childhood physical abuse and suicidal behavior among homeless people. One hundred one homeless were recruited from street and shelters in Korea. Face-to-face interviews were conducted by master’s level graduate students or facility employees of shelters. All participants completed the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Life History of Aggression Questionnaire (LHAQ), Primary Care PTSD (PC-PTSD), and Traumatic Life Events Questionnaire (TLEQ). The average age of homeless people participated in the study was 55.2 years (SD = 10.7) with the age range of 30 to 87. Results indicated that PTSD symptoms and aggression fully mediated the relationship between childhood physical abuse and suicidal behavior among the homeless. These findings suggest the need for trauma-informed care for the homeless, and warrant the need for psychological services for PTSD and aggression in order to reduce suicide risk among homeless people.

Keywords: aggression, homeless, PTSD, suicidal behavior

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212 Microscopic and Mesoscopic Deformation Behaviors of Mg-2Gd Alloy with or without Li Addition

Authors: Jing Li, Li Jin, Fulin Wang, Jie Dong, Wenjiang Ding

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Mg-Li dual-phase alloy exhibits better combination of yield strength and elongation than the Mg single-phase alloy. To exploit its deformation behavior, the deformation mechanisms of Mg-2Gd alloy with or without Li addition, i.e., Mg-6Li-2Gd and Mg-2Gd alloy, have been studied at both microscale and mesoscale. EBSD-assisted slip trace, twin trace, and texture evolution analysis show that the α-Mg phase of Mg-6Li-2Gd alloy exhibits different microscopic deformation mechanisms with the Mg-2Gd alloy, i.e., mainly prismatic slip in the former one, while basal slip, prismatic slip and extension twin in the latter one. Further Schmid factor analysis results attribute this different intra-phase deformation mechanisms to the higher critical resolved shear stress (CRSS) value of extension twin and lower ratio of CRSSprismatic /CRSSbasal in the α-Mg phase of Mg-6Li-2Gd alloy. Additionally, Li addition can induce dual-phase microstructure in the Mg-6Li-2Gd alloy, leading to the formation of hetero-deformation induced (HDI) stress at the mesoscale. This can be evidenced by the hysteresis loops appearing during the loading-unloading-reloading (LUR) tensile tests and the activation of multiple slip activity in the α-Mg phase neighboring β-Li phase. The Mg-6Li-2Gd alloy shows higher yield strength is due to the harder α-Mg phase arising from solid solution hardening of Li addition, as well asthe strengthening of soft β-Li phase by the HDI stress during yield stage. Since the strain hardening rate of Mg-6Li-2Gd alloy is lower than that of Mg-2Gd alloy after ~2% strain, which is partly due to the weak contribution of HDI stress, Mg-6Li-2Gd alloy shows no obvious increase of uniform elongation than the Mg-2Gd alloy.But since the β-Li phase is effective in blunting the crack tips, the Mg-6Li-2Gd alloy shows ununiform elongation, which, thus, leads to the higher total elongation than the Mg-2Gd alloy.

Keywords: Mg-Li-Gd dual-phase alloy, phase boundary, HDI stress, dislocation slip activity, mechanical properties

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211 Migrant Youth: Trauma-Informed Interventions

Authors: Nancy Daly

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Migrant youth who have experienced traumatic events in their home countries or in their passage to the United States may require interventions or formal services to support varying levels and types of needs. The manner in which such youth are engaged and evaluated, as well as the framework of evaluation, can impact their educational services and placement. Evidenced-based trauma-informed practices that engage and support migrant youth serve as an important bridge to stabilization; however, ensuring long-term growth may require a range of integrated services, including special education and mental health services. Special education evaluations which consider the eligibility of Emotional Disturbance for migrant youth must carefully weigh issues of mental health needs against the exclusionary criteria of lack of access to education, limited language skills, as well as other environmental factors. Case studies of recently arrived migrant youth reveal both commonalities and differences in types and levels of need which underscores the importance of adept evaluation and case management to ensure the provision of services that support growth and resiliency.

Keywords: migrant youth, trauma-informed care, mental health services, special education

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210 The Environmental Effects of the Flood Disaster in Anambra State

Authors: U. V. Okpala

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Flood is an overflow of water that submerges or ‘drowns’ land. In developing countries it occurs as a result of blocking of natural and man-made drainages and poor maintenance of water dams/reservoirs which seldom give way after persistent heavy down pours. In coastal lowlands and swamp lands, flooding is aided mainly by blocked channels and indiscriminate sand fling of coastal swamp areas and natural drainage channel for urban development/constructions. In this paper, the causes of flood and possible scientific, technological, political, economic and social impacts of flood disaster on the environment a case study of Anambra State have been studied. Often times flooding is caused by climate change, especially in the developed economy where scientific mitigating options are highly employed. Researchers have identified Green Houses Gases (GHG) as the cause of global climate change. The recent flood disaster in Anambra State which caused physical damage to structures, social dislocation, contamination of clean drinking water, spread of water-borne diseases, shortage of crops and food supplies, death of non-tolerant tree species, disruption in transportation system, serious economic loss and psychological trauma is a function of climate change. There is need to encourage generation of renewable energy sources, use of less carbon intensive fuels and other energy efficient sources. Carbon capture/sequestration, proper management of our drainage systems and good maintenance of our dams are good option towards saving the environment.

Keywords: flooding, climate change, carbon capture, energy systems

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209 Supplementation of Annatto (Bixa orellana)-Derived δ-Tocotrienol Produced High Number of Morula through Increased Expression of 3-Phosphoinositide-Dependent Protein Kinase-1 (PDK1) in Mice

Authors: S. M. M. Syairah, M. H. Rajikin, A. R. Sharaniza

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Several embryonic cellular mechanism including cell cycle, growth and apoptosis are regulated by phosphatidylinositol-3-kinase (PI3K)/Akt signaling pathway. The goal of present study is to determine the effects of annatto (Bixa orellana)-derived δ-tocotrienol (δ-TCT) on the regulations of PI3K/Akt genes in murine morula. Twenty four 6-8 week old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) received tocopherol stripped corn oil, G2 was given 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers), G3 was given 60 mg/kg/day of pure δ-TCT (>98% purity) and G4 received 60 mg/kg/day α-TOC. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. About fifty morula from each group were used in the gene expression analyses using Affymetrix QuantiGene Plex 2.0 Assay. Present data showed a significant increase (p<0.05) in the average number (mean + SEM) of morula produced in G2 (26.0 + 0.45), G3 (23.0 + 0.63) and G4 (25.0 + 0.73) compared to control group (G1 – 16.0 + 0.63). This is parallel with the high expression of PDK1 gene with increase of 2.75-fold (G2), 3.07-fold (G3) and 3.59-fold (G4) compared to G1 (1.78-fold). From the present data, it can be concluded that supplementation with δ-TCT(s) and α-TOC induced high expression of PDK1 in G2-G4 which enhanced the PI3K/Akt signaling activity, resulting in the increased number of morula.

Keywords: delta-tocotrienol, embryonic development, nicotine, vitamin E

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208 Success Rate of Endotracheal Intubation Using Inline Stabilization with and without Cervical Hard Collar; A Comparative Study

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

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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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207 Neural Network Analysis Applied to Risk Prediction of Early Neonatal Death

Authors: Amanda R. R. Oliveira, Caio F. F. C. Cunha, Juan C. L. Junior, Amorim H. P. Junior

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Children deaths are traumatic events that most often can be prevented. The technology of prevention and intervention in cases of infant deaths is available at low cost and with solid evidence and favorable results, however, with low access cover. Weight is one of the main factors related to death in the neonatal period, so the newborns of low birth weight are a population at high risk of death in the neonatal period, especially early neonatal period. This paper describes the development of a model based in neural network analysis to predict the mortality risk rating in the early neonatal period for newborns of low birth weight to identify the individuals of this population with increased risk of death. The neural network applied was trained with a set of newborns data obtained from Brazilian health system. The resulting network presented great success rate in identifying newborns with high chances of death, which demonstrates the potential for using this tool in an integrated manner to the health system, in order to direct specific actions for improving prognosis of newborns.

Keywords: low birth weight, neonatal death risk, neural network, newborn

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206 The Social Construction of the Family among the Survivors of Sex Trafficking

Authors: Nisha James, Shubha Ranganathan

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Sex trafficking is a traumatic ongoing process which includes human rights violations against the victims. Majority of the trafficked individuals in India are from families with low socioeconomic status, from rural areas, unmarried or married off at a very young age. Many of the sex trafficked feel that it is necessary to make sacrifices, for the benefit of their families. The combination of these cultural family values with the stigma of rape and prostitution are manipulated and used as a tool in the abuse of power against the sex trafficked. The rescue, rehabilitation and reintegration of these individuals are usually difficult due to the stigma and social exclusion that they face. In these circumstances, social support is very effective in social inclusion of these individuals. The present study was a qualitative one, using semi-structured interviews with 29 Indian survivors of sex trafficking and a few sex workers. Thematic analysis was done on the data derived from the semi-structured interviews. The major findings indicate that the family can be seen as both the ‘cause’ for being sex trafficked, and the factor in victim continuing to be sex trafficked. At the same time, it can also become a driver for getting rescued, rehabilitated and reintegrated. The study also explores the social construction about ‘family’ among the survivors of sex trafficking, reflecting on who they refer to as ‘family’, what they mean by the term ‘family’ and how these families emerge. Therefore the analytic concept of ‘family’ is a crucial element in sex trafficking and cannot be defined only in terms of its conventional definition of a basic unit of society.

Keywords: sex-trafficking, survivor, family, social construction

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205 The Iconic Pink Donut Box: An Analysis of Memory and Identity Amongst Cambodian Refugees in California

Authors: Basmah Arshad

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In the aftermath of the Cambodian genocide, many refugees resettled in America. They carved out a distinctively Cambodian-American space in California with donut shops, establishing a tight-knit community that worked to achieve ‘the American dream’. Urged by traumatic memories of the genocide and American society directly encouraging (if not demanding) cultural assimilation, these refugees and successive generations continuously worked to re-identify themselves as Americans. Artist Phung Huynh grew up in this context of family-owned donut shops and the frantic scramble for stability and security. It is this community that she depicts in her artwork series from the late 2010s, ‘Khmerican: Drawing on Pink Donut Boxes’. Huynh's artwork challenges dominant Western narratives about the Cambodian genocide by pushing forward images of resilience, resistance, and joy, while also allowing for a discussion about issues of assimilation, identity, and nostalgia in the Cambodian-American community. It also provokes deeply relevant questions about how refugees and immigrants deliberately appropriate elements of the Americana (eg, donuts) to assimilate and re-fashion their identity as a tactic for financial stability and social survival.

Keywords: Cambodian diaspora, cultural identity, assimilation, food, artwork

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204 Nanostructure Formation and Characterization of Eco-Friendly Banana Peels Nanosorbent

Authors: Opeyemi Atiba-Oyewo, Maurice S. Onya, Christian Wolkersdorfer

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Nanostructure formation and characterization of eco-friendly banana peels nanosorbent are thoroughly described in this paper. The transformation of material during mechanical milling to enhance certain properties such as changes in microstructure and surface area to solve the current problems involving water pollution and water quality were studied. The mechanical milling was employed using planetary continuous milling machine and ethanol as process control agent, the sample were taken at time interval between 10 h to 30 h to examine the structural changes. The samples were characterised by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infra-red (FTIR), Transmission electron microscopy (TEM) and Brunauer Emmett and teller (BET). Results revealed that the three typical structures with different grain-size, lattice strain and shapes were observed, and the deformation mechanisms in these structures were found to be different, further particles fracturing results to surface area increment which was confirmed by Brunauer Emmett and teller (BET) analysis. X-ray diffraction (XRD) shows high densities of dislocations in large crystallites, implying that dislocation slip is the dominant deformation mechanism. Scanning electron microscopy revealed the morphological properties of the materials at different milling time, nanostructure of the particles and fibres were confirmed by Transmission electron microscopy and FT-IR identified the functional groups responsible for its capacity to coordinate and remove metal ions, such as the carboxylic and amine groups at absorption bands of 1730 and 889 cm-1, respectively. However, the choice of this sorbent material for the sorption of any contaminants will depend on the composition of the effluent to be treated.

Keywords: banana peels, eco-friendly, mechanical milling, nanosorbent, nanostructure water quality

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203 Record Peak Current Density in AlN/GaN Double-Barrier Resonant Tunneling Diodes on Free-Standing Gan Substrates by Modulating Barrier Thickness

Authors: Fang Liu, Jia Jia Yao, Guan Lin Wu, Ren Jie Liu, Zhuang Guo

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Leveraging plasma-assisted molecular beam epitaxy (PA-MBE) on c-plane free-standing GaN substrates, this work demonstrates high-performance AlN/GaN double-barrier resonant tunneling diodes (RTDs) featuring stable and repeatable negative differential resistance (NDR) characteristics at room temperature. By scaling down the barrier thickness of AlN and the lateral mesa size of collector, a record peak current density of 1551 kA/cm2 is achieved, accompanied by a peak-to-valley current ratio (PVCR) of 1.24. This can be attributed to the reduced resonant tunneling time under thinner AlN barrier and the suppressed external incoherent valley current by reducing the dislocation number contained in the RTD device with the smaller size of collector. Statistical analysis of the NDR performance of RTD devices with different AlN barrier thicknesses reveals that, as the AlN barrier thickness decreases from 1.5 nm to 1.25 nm, the average peak current density increases from 145.7 kA/cm2 to 1215.1 kA/cm2, while the average PVCR decreases from 1.45 to 1.1, and the peak voltage drops from 6.89 V to 5.49 V. The peak current density obtained in this work represents the highest value reported for nitride-based RTDs to date, while maintaining a high PVCR value simultaneously. This illustrates that an ultra-scaled RTD based on a vertical quantum-well structure and lateral collector size is a valuable approach for the development of nitride-based RTDs with excellent NDR characteristics, revealing their great potential applications in high-frequency oscillation sources and high-speed switch circuits.

Keywords: GaN resonant tunneling diode, peak current density, peak-to-valley current ratio, negative differential resistance

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202 An Empirical Assessment of the Effect of War Exposure on the Attitudes towards Violence

Authors: Anastasiia Kuptsevych, Robert J. Johnson, Olena Antonaccio, Ekaterina V. Botchkovar

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Ukraine has recently experienced one of the bloodiest conflicts taking place on the European continent. Many active duty personnel and civilians have died, and millions of people have been displaced. This situation can lead to disorder in the country characterized by acceptance of violence and crime. There is a gap in the literature addressing the issues related to attitudes towards violence resulting from war, as well as focusing on the world’s more vulnerable civilian populations – those that live in lower and middle-income countries, such as Ukraine. Using a random sample of 1200 adults from two major Ukrainian cities, this study explores the relationship between different types of war exposure (direct and vicarious) and attitudes to violence. Multivariate models reveal that multiple types of war exposure (e.g., being injured, being a witness of death, watching war events on TV) are significantly associated with the attitudes to political and interpersonal violence. In addition, the KHB decomposition procedure showed that experiencing certain mental illnesses serve as important mediating mechanisms between war exposure and attitudes towards violence. Finally, in order to prevent society from disorder and high levels of violence, future studies need to pay more attention to exploring how vital and traumatic life events can lead a population to find violent acts acceptable.

Keywords: attitudes, Ukraine, violence, war

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201 Between Fiction and Reality: Reading the Silences in Partition History

Authors: Shazia Salam

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This paper focuses on studying the literary reactions of selected Muslim women writers to the event of Partition of India in the north western region. It aims to explore how Muslim women experienced the Partition and how that experience was articulated through their writing. There is a serious dearth of research on the experience of Muslim women who had to witness the momentous event of the subcontinent. Since scholars have often questioned the silence around the historiography related to the experiences of Muslim women, this paper aims to explore if literature could provide insights that may be less readily available in other modes of narration. Using literature as an archival source, it aims to delve into the arenas of history that have been cloistered and closed. Muslim women have been silent about their experiences of Partition which at the cost of essentializing could be attributed to patriarchal constraints, and taboos, on speaking of intimate matters. These silences have consigned the question of their experience to a realm of anonymity. The lack of ethnographic research has in a way been compensated in the realm of literature, mainly poetry and fiction. Besides reportage, literature remains an important source of social history about Partition and how Muslim women lived through it. Where traditional history fails to record moments of rupture and dislocation, literature serves the crucial purpose. The central premise in this paper is that there is a need to revise the history of partition owing to the gaps in historiography. It looks into if literature can serve as a ground for developing new approaches to history since the question of the representation always confronts us--between what a text represents and how it represents it since imagination of the writer plays a great role in the construction of any text. With this approach as an entry point, this paper aims to unpack the questions of representation, the coalescing of history /literature and the gendered nature of partition history. It concludes that the gaps in the narratives of Partition and the memory of Partition can be addressed by way of suing literary as a source to fill in the cracks and fissures.

Keywords: gender, history, literature, partition

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200 Unlocking the Language of Dreams: Interpreting Trauma and Healing in Psychotherapy

Authors: Mehravar Javid

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This article delves straight into the fascinating role of dream interpretation in psychotherapy, particularly in the context of trauma and healing. By applying a detailed case study of a 19-year-old Iranian woman who has been undergoing therapy, it can explore to what extent her vivid and symbolic dreams – featuring mermaids, hanging fetuses, and themes of control and domination – serve as a reflection of her innermost fears, unresolved traumas, and struggles with identity and sexuality. Another fact to be highlighted is that the dreams, rich in metaphor and symbolism, offer a unique outlook into the patient's subconscious mind, revealing layers of her psychological state that might otherwise remain obscured and vague. On the other hand, the article examines how the therapist navigates these dreamscapes by utilizing them as a tool to understand and address the patient's deep-seated emotional conflicts, traumatic experiences, and identity issues. By analyzing these dreams, we can demonstrate how such dreams can be a crucial part of the healing process, providing insights that facilitate emotional recovery and self-discovery. This discovery underscores the significance of dreams in psychotherapy, highlighting their potential as a powerful medium for unraveling the complexities of the human psyche and aiding in the journey toward mental health and recovery.

Keywords: dream, interpreting, trauma, healing

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199 Hydroxyapatite from Biowaste for the Reinforcement of Polymer

Authors: John O. Akindoyo, M. D. H. Beg, Suriati Binti Ghazali, Nitthiyah Jeyaratnam

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Regeneration of bone due to the many health challenges arising from traumatic effects of bone loss, bone tumours and other bone infections is fast becoming indispensable. Over the period of time, some approaches have been undertaken to mitigate this challenge. This includes but not limited to xenografts, allografts, autografts as well as artificial substitutions like bioceramics, synthetic cements and metals. However, most of these techniques often come along with peculiar limitation and problems such as morbidity, availability, disease transmission, collateral site damage or absolute rejection by the body as the case may be. Hydroxyapatite (HA) is very compatible and suitable for this application. However, most of the common methods for HA synthesis are expensive and environmentally unfriendly. Extraction of HA from bio-wastes have been perceived not only to be cost effective, but also environment-friendly. In this research, HA was produced from bio-waste: namely bovine bones through a combination of hydrothermal chemical processes and ordinary calcination techniques. Structure and property of the HA was carried out through different characterization techniques (such as TGA, FTIR, DSC, XRD and BET). The synthesized HA was found to possess similar properties to stoichiometric HA with highly desirable thermal, degradation, structural and porous properties. This material is unique for its potential minimal cost, environmental friendliness and property controllability. It is also perceived to be suitable for tissue and bone engineering applications.

Keywords: biomaterial, biopolymer, bone, hydroxyapatite

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198 Causes of Death in Neuromuscular Disease Patients: 15-Year Experience in a Tertiary Care Hospital

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

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Background:Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods:From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results:Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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197 Trauma-Informed Applied Theatre: Using Performance to Connect with Mental Dysfunction Using Physical Embodiment Begins with Ancient Civilizations

Authors: Stephanie Elizabeth Talder

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Art therapy is a field that is growing exponentially with new groundbreaking discoveries that allow for embodying trauma and mental healing. Applied theatre and performance is a continuously growing and developing field that can help people who are struggling to work through traumatic experiences plaguing their life. By using performance, there is an ability to target sensitive topics in a manner that does not lead to re-traumatization. The use of theatre as a healing agent has been going on for centuries, with clear applications beginning in Greek theatre and tragedy. When working with complex mental illness, issues such as PTSD, anxiety, and depression can be managed and worked through. A central component of drama therapy is the connection to community and self. The ability to connect mind-body to stories as well as to other people allows for healing to occur. There is the opportunity for healing through emotional catharsis and community building. Applied theatre in connection to the medical field can allow for there to be a meaningful impact made on mental health. Though there is still a significant amount of progress to be made within the stigmatization of mental health problems, bringing in a varying option that allows for there to be movement and community building possesses a strong ability to impact people in a positive way.

Keywords: applied theatre, drama therapy, art therapy, performance, theatre

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196 The Effect of Expressive Therapies on Children and Youth Impacted by Refugee Trauma: A Meta-Analysis

Authors: Brian Kristopher Cambra

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Millions of displaced families are seeking refuge in countries that are not their own due to war, violence, persecution, political unrest, and natural disasters. This global crisis is forcing researchers and practitioners to consider how refugees are coping with the trauma associated with their migration process. Effective therapeutic approaches are needed in a global effort to address the traumatic impact of forced migration. This meta-analytical study investigates the effectiveness of expressive therapeutic modalities, including play, art, music, sandplay, theatre, and writing therapies, in helping children and adolescents cope with refugee trauma. Seventeen pre-post and between-group comparison studies were analyzed using a random-effects model. The combined effect size for pre-post comparisons was medium (g = 0.58), whereas the combined effect size for between-group comparisons was small (g = 0.32). Overall, art therapy was found to be most effective in treating stress symptoms. Heterogeneity tests, however, suggest effect sizes cannot be interpreted as meaningful due to substantial variance. Nevertheless, findings of this meta-analysis indicate that expressive therapies may be among beneficial modalities to integrate with other trauma-informed approaches.

Keywords: expressive therapies, forced migration, meta-analysis, refugees, trauma

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195 Tangible Losses, Intangible Traumas: Re-envisioning Recovery Following the Lytton Creek Fire 2021 through Place Attachment Lens

Authors: Tugba Altin

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In an era marked by pronounced climate change consequences, communities are observed to confront traumatic events that yield both tangible and intangible repercussions. Such events not only cause discernible damage to the landscape but also deeply affect the intangible aspects, including emotional distress and disruptions to cultural landscapes. The Lytton Creek Fire of 2021 serves as a case in point. Beyond the visible destruction, the less overt but profoundly impactful disturbance to place attachment (PA) is scrutinized. PA, representing the emotional and cognitive bonds individuals establish with their environments, is crucial for understanding how such events impact cultural identity and connection to the land. The study underscores the significance of addressing both tangible and intangible traumas for holistic community recovery. As communities renegotiate their affiliations with altered environments, the cultural landscape emerges as instrumental in shaping place-based identities. This renewed understanding is pivotal for reshaping adaptation planning. The research advocates for adaptation strategies rooted in the lived experiences and testimonies of the affected populations. By incorporating both the tangible and intangible facets of trauma, planning efforts are suggested to be more culturally attuned and emotionally insightful, fostering true resonance with the affected communities. Through such a comprehensive lens, this study contributes enriching the climate change discourse, emphasizing the intertwined nature of tangible recovery and the imperative of emotional and cultural healing after environmental disasters. Following the pronounced aftermath of the Lytton Creek Fire in 2021, research aims to deeply understand its impact on place attachment (PA), encompassing the emotional and cognitive bonds individuals form with their environments. The interpretive phenomenological approach, enriched by a hermeneutic framework, is adopted, emphasizing the experiences of the Lytton community and co-researchers. Phenomenology informed the understanding of 'place' as the focal point of attachment, providing insights into its formation and evolution after traumatic events. Data collection departs from conventional methods. Instead of traditional interviews, walking audio sessions and photo elicitation methods are utilized. These allow co-researchers to immerse themselves in the environment, re-experience, and articulate memories and feelings in real-time. Walking audio facilitates reflections on spatial narratives post-trauma, while photo voices captured intangible emotions, enabling the visualization of place-based experiences. The analysis is collaborative, ensuring the co-researchers' experiences and interpretations are central. Emphasizing their agency in knowledge production, the process is rigorous, facilitated by the harmonious blend of interpretive phenomenology and hermeneutic insights. The findings underscore the need for adaptation and recovery efforts to address emotional traumas alongside tangible damages. By exploring PA post-disaster, the research not only fills a significant gap but advocates for an inclusive approach to community recovery. Furthermore, the participatory methodologies employed challenge traditional research paradigms, heralding potential shifts in qualitative research norms.

Keywords: wildfire recovery, place attachment, trauma recovery, cultural landscape, visual methodologies

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