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Different Scripts, Different Casts: A Crime Script Analysis Indicating Intimate Partner Violence is Not All the Same

DOI: 10.31038/AWHC.2024731

 

The endemic nature of intimate partner violence continues to pose a significant challenge to government policy makers and those on the frontline charged with responding to calls for help. Whilst not a panacea, innovative approaches may help reduce the burden of intimate partner violence. The study by Christine Carney, Mark Kebbell, Li Eriksson and Regan Carr, titled “Different Scripts, Different Casts: A Crime Script Analysis Indicating Intimate Partner Violence is not all the Same,” used a novel approach to understanding intimate partner violence reported to police [1].

Theoretical Framework

Crime script analysis tells the story of how a crime is committed from the initial decision of the offender to act through to exiting the scene of the crime and disposing of the evidence [2] Differing levels of analysis can be used ranging from the generic to the specific (Table 1).

Crime script analysis has been used to understand violent crimes such as sex crimes but the utility of this approach has rarely been used to explore intimate partner violence [3,4].

Table 1: Crime Script Levels of Analysis

tab 1

Methodology and Key Findings

Qualitative thematic analysis of police administrative data was used to develop a Protoscript of intimate partner violence. This Protoscript identified commonality across offender criminal histories and recent situational factors identified in the extant literature as precursors to high risk and/or lethality . These factors included a history of violence, recent substance use, recent or pending separation and ongoing relationship issues. The location of contact between offender–victim, precursors to escalation (such as an escalating argument and accusations of infidelity immediately prior to violence), followed by the actions of the offender and victim were also captured (Figure 1) [5,6].

fig 1

Figure 1: Intimate Partner Violence Protoscript

Cluster analysis was then used to identify distinct script tracks from the data, with Bonferroni’s Post-Hoc Test to determine statistically significant differences between the clusters. The analysis identified four distinct script tracks of intimate partner violence, ‘Escalating Jealousy’, ‘Persistently Possessive’, ‘Controlling Victim Agency’, and ‘Enduring Argument’ (Table 2).

Table 2: Cluster Analysis – Script Tracks

tab 2(1)

tab 2(2)

Note. Each superscript letter (e.g., a) indicates a subset of group categories (i.e., clusters) whose proportions do not differ from one another at the .05 significance level. Percentages that are not statistically different share superscript letters, while percentages that are statistically different do not share superscript letters.

Conclusion and Policy Implications

The clusters identified in this study found that half of all intimate partner violence incidents were associated with ongoing or escalating arguments as opposed to jealous or controlling behaviors – an important distinction given prior research has shown that jealousy and controlling behaviors are high risk factors for future harm and lethality. This suggests that of all incidents attended by police, it is likely that 50% of incidents involve potentially high risk factors that must be identified and effectively addressed. For incidents such as those within the persistently possessive cluster, where several high risk factors including history of control, jealousy, separation, and ongoing jealous, controlling, and stalking behaviors are evident, more punitive responses may be required. The remainder of incidents that do not display controlling behaviors may require a different response, such as support to referral services, anger management, financial support or other more generalist support options [7].

Understanding diversity within intimate partner violence may support policy and procedural changes designed to better identify specific behaviors evident within incidents that police attend. It could also provide guidance on the most appropriate action to take at the scene and following an intimate partner violence incident.

References

  1. Carney, CT, Kebbell, MR, Eriksson, L, Carr RM (2023) Different Scripts, Different Casts: A Crime Script Analysis Indicating Intimate Partner Violence Is Not All the Same. Violence Against Women, 30(9).
  2. Cornish D (1994a) Crimes as scripts. proceedings of the International Seminar on Environmental Criminology and crime analysis, University of Miami Coral Gables, Florida.
  3. Beauregard, E, Rossmo, DK, Proulx J (2007) A Descriptive Model of the Hunting Process of Serial Sex Offenders: A Rational Choice Perspective. Journal of Family Violence, Benoit Leclerc, S. a. R. W (2014) Interpersonal scripts and victim reaction in child sexual abuse.
  4. A quantitative analysis of the offender–victim In R. Wortley, B. Leclerc (Eds.), Cognition and Crime: Offender decision making and script analyses. Routledge.
  5. Boxall, H, Boyd, C, Dowling, C, Morgan A (2018) Understanding domestic violence incidents using crime script analysis. Trends and Issues in Crime and Criminal Justice, Available from: https://www.aic.gov.au/sites/default/files/2020-05/ pdf
  6. Stark E (2007) Coercive control: How men entrap women in personal life. Oxford University Press.
  7. Johnson, H, Eriksson, L, Mazerolle, P, Wortley R (2019) Intimate Femicide: The Role of Coercive Feminist Criminology, 14(1),Availabel From: https://doi. org/10.1177/1557085117701574
  8. Ibid, Myhill, A, Hohl K (2019) The “Golden Thread”: Coercive Control and Risk Assessment for Domestic Violence. Journal of interpersonal violence, 34(21-22) Available From: https://doi.org/10.1177/0886260516675464

Earth Birthing Geoscapes: Southern Paiute Ceremonies and Grand Canyon Volcanos

DOI: 10.31038/GEMS.2024644

Abstract

The Grand Canyon of the Colorado River is the traditional homeland of many Native American peoples, including the Southern Paiutes, Hualapai, Havasupai, Zuni Pueblo, Hopi Pueblo, and Navajo. Many massive volcanoes with widespread lava flows have been witnessed by these Native Americans over the past 40,000 years, so their various cultural understandings and ceremonial responses to volcanism are grounded in experience. Pilgrimage is one example of a persistent ceremonial response to volcanic areas by Native American peoples. This analysis is based on 902 ethnographic interviews with Paiute elders conducted over decades by the authors. The Paiute response to volcanism is typical of Native Americans in the Southwestern United States but manifests itself uniquely in the geology of the Grand Canyon and the Colorado River. The analysis argues that these are heritage places and landscapes to be protected by the IUCN World Conservation Congress (IUCN 2024) which is where the world comes together to set priorities and drive conservation and sustainable development action. More than 9,000 people participated in the 2021 Congress in Marseille. Experts shared the latest science and best practice, and IUCN Members voted on 39 motions to guide humanity’s relationship with our planet for the decades ahead.

Keywords

Volcanic cultural heritages, Geosites, Geoscapes, Geoheritage, Native Americans, Southern Paiutes aboriginal lands, Grand Canyon, Colorado river

Introduction

Piapaxa ‘uipi: The river there is like our veins. Some are like the small streams and tributaries that run into the river there. So the same things; it’s like blood- -it’s the veins of the world… This story has been carried down from generation to generation. It’s been given to them by the old people… it would be given to the new generation, too… (San Juan Southern Paiute elder, (interviewed about the Colorado River at Willow Springs, September 27, 1993).

The analysis contributes to the burgeoning academic literature that has responded to the United Nations’ call for the identification of geological places and landscapes as cultural heritage deserving preservation [1]. The ICUN and the WCPA have a Geoheritage Specialist Group that has documented the need for such new heritage preservation approaches [2]. That literature is illustrated by the 20 published peer reviewed papers in the Special Issue of the journal Land entitled Geoparks, Geotrails, and Geotourism – Linking Geology, Geoheritages, and Geoeducation edited by Brocx and Semenluk (2022) [3]. This Special Issue included studies from Europe, Australia, USA, Latin America, and Asia. Subsequently, published articles on this topic are illustrated by Geoheritage and Cultural Heritage Overview of the Toba Caldera Geosites, North Sumatr, Indonesia [4]. These studies [5] document a range of complexities involved in preserving, interpreting, and managing complex geoheritage. The Geology profession through the International Commission on Geoheritage [6] has responded by identifying significant geosites around the world using both their importance to science and to humans as criteria [6]. This analysis describes a long Native American pilgrimage trail that has been used for tens of thousands of years and located north of the Grand Canyon in Arizona. The analysis is based on 902 ethnographic interviews of which 149 interviews were conducted specifically in the study area. Interviews on this topic were conducted with Southern Paiute elders over decades with the authors. Especially important are two points (1) the pilgrimage trail is responsive to massive volcanic activities that have produced major lava flows, lava dams, and lakes in the Grand Canyon Colorado River Corridor (Figure 1 and 2) the analysis illustrates the need for holistic geoheritage understandings of Native American pilgrimage routes including the spaces between places, the presence of functionally integrated geosites along the routes, and multipurpose ceremonial destinations.

fig 1

Figure 1: The Colorado River’s flow through the Grand Canyon

fig 2

Figure 2: The Uinkaret Volcanic Field, the Grand Canyon, and the Colorado River

A Paiute described the Colorado River as a living cultural resource as follows:

Piapaxa ‘uipi: The river there is like our veins. Some are like the small streams and tributaries that run into the river there. So the same things; it’s like blood- -it’s the veins of the world… This story has been carried down from generation to generation. It’s been given to them by the old people… it would be given to the new generation, too (Stoffie et al. 1994) [7-8]. The focus of the analysis is the Uinkaret volcano field (the dark areas centered in Figure 2), which is a central component of USA federal lands managed by the following agencies: (1) the Grand Canyon National Park, North Rim Unit (NPS); (2) Grand Canyon – Parashant National Monument, (NPS and Bureau of Land Management); (3) Arizona Strip Bureau of Land Management (BLM); and (4) the Grand Canyon Colorado River Corridor, Bureau of Reclamation (BOR) (Figure 3). The analysis documents challenges associated with accurately knowing about, interpretating, and conducting culturally sensitive management of this and similar spatially long and temporarily deep Native American heritage areas. Management issues are dominated by problems of Environmental Communication especially when this involves Epistemological Divides [9].

fig 3

Figure 3: USA Federal Land Jurisdiction Map

This analysis is situated within the greater Uinkaret volcanic field and its related geosites and geoscopes (Figure 4). Using this geographic focus, this analysis aims to understand and elaborate upon the cultural understandings of the greater Uinkaret geoscape by Southern Paiute people, as well as their deep heritage connections to this aboriginal land. These heritage connections are further situated in time with new, scientifically backed occupation dates for Native People in the Southwestern United States of about 40,000 years Before Present (BP). The temporal frame for this heritage analysis is operationally defined as the late Pleistocene, which occurred between 128,000 BP and 11,700 BP, as well as the Holocene, which has occurred from 11,700 BP through modern times. Scientific studies have placed Native Americans in the region at least by 37,000 BP with the geoarchaeology dates of 23,000 to 21,000 BP at White Sands National Park in New Mexico [10-11] and 38,900 to 36,250 BP at the Harley Rock Shelter on the Rio Puerco, New Mexico [12]. These new geoscience dates indicate that Indigenous Peoples experienced this area as both a massive wetland filled with lakes, rivers, and swamps and then as an arid desert with intermittent streams, sand dunes, small artesian springs, and heritage playas.

fig 4

Figure 4: Geoscape and Southern Paiute Aboriginal Lands North of the Grand Canyon

The data used in this analysis argue that the Uinkaret volcanic study area contains a Native American heritage landscape that is best understood as being composed of geosites and geoscapes, also known as geoheritage [1, 13] as defined by the International Union for the Conservation of Nature [14]. The concept of heritage landscape implies that both natural and cultural components combined over time to produce a phenomenon that is clearly located somewhere and can be considered for identification and protection by contemporary nations and the guidelines of the International Union for the Conservation of Nature [14]. Native people argue that their traditional volcanos, lava flows, hot springs, charismatic viewscapes, the Grand Canyon, and the Colorado River all have been alive since Creation, and they remain so today. Native Americans argue that these geosites and geoscapes are key to their contemporary heritage because these contain the songs, prayers, ceremonies, and memories of ancestors who lived in this area since Creation.

Geoscapes of the Uinkaret Volcanic Field

The geology of the western Grand Canyon (Figure 5) represents what is perhaps the most spectacular three-dimensional display of volcanological processes in the world [15]. The dramatic sight of frozen basaltic lava falls cascading over the Canyon’s inner gorge was first documented during John W. Powell’s initial expedition into the region in 1869 [16]. The Uinkaret volcanic field is a tectonically controlled lava field whose southern reaches meet with both the Colorado River and Grand Canyon. Over the past two million years, lavas have erupted from both fissures and central vents, forming the volcanic field [15]. Mount Trumbull and its associated lava flows and volcanoes are located within the northern portion of the large Uinkaret volcanic field [17-18]. The Uinkaret lava field lies 120 km south of St. George, Utah, and is tectonically defined by two major normal faults — the Hurricane to the west and the Toroweap to the east. At its southern reaches where the Uinkaret volcanic fields borders the northern rim of the Grand Canyon, there are cinder cones that have produced lava flows that have repeatedly cascaded into the canyon, creating temporary lava dams [19]. While most of the volcanic activity in the Uinkaret volcanic field dates to the Pleistocene, some of the volcanic activity has been dated later to the Holocene including about 1000 AD [20].

fig 5

Figure 5: Uinkaret volcanic field where it meets the Grand Canyon and the Colorado River, with pilgrimage trail marked in red.

The latest lava flows that erupted close to the northern edge of the Grand Canyon’s rim flowed down and formed cascades over 900 meters high [15, 21]. In addition to this activity, multiple vents erupted within the canyon itself. The products of this activity effectively dammed the Colorado River a total of 13 times – the remnants of which are still visible along the canyon walls today. The largest of the dams formed a 700-meter-deep lake which extended upriver into present day Utah [21-22, 23].

Paiute Epistemology

The ways in which societies relate to their environments are grounded in their epistemologies. In Southern Paiute society, relationships and deep connections with the environment were formed during Creation. Southern Paiutes maintain that the Creator gave them the responsibility and the rights to manage their environment to promote environmental growth and sustainability. To fulfill these responsibilities endowed upon them since Creation, over tens of thousands of years, they have developed numerous strategies and activities that increase biodiversity and biocomplexity throughout their homeland. The basic tenets of Southern Paiute epistemology have helped forge the relationship they have with their environment. To Southern Paiutes, the universe is alive and everything is interconnected through all types of relations, what anthropologist Roy Rappaport (1999: 263-271; 446) [24] calls “the ultimate sacred postulate.” The universe is alive in the same way that humans are alive, and the universe possesses most of the same anthropomorphic characteristics as well. The universe has discrete physical components such as power and elements. It is a living system. This concept of the living universe is so fundamental that any discussion of Southern Paiute culture cannot occur without it.

As explained by Liljeblad (1986: 643-644) [25], to the Southern Paiutes, power is everywhere and is “a source of individual competence, mental and physical ability, health, and success.” Power is referred to as Puha. This concept is similar to that of many different tribes living throughout the western United States. Other Numic language speaking people, such as the Ute, Western Shoshone, Owens Valley Paiutes, and Northern Paiutes have similar words. In his article, “Basin Religion and Theology: A Comparative Study of Power (Puha),” Miller (1983: 79-89) [26] noted that: Ute- Puwavi, Western Shoshone- Puha and Poha, Northern Paiute- Puha, the Chemehuevi and Southern Paiute- Puhaare the same people with a common language. The term for Puha is the same among all of these cultural groups. Alternate spellings aside, Puha is a fundamental principle of each of their epistemologies as well. The concept of spiritual power is not limited to the Great Basin and Colorado Plateau peoples, however; it is also a core epistemological principle in the cultures of nearby Upland and Colorado River Yuman-speaking peoples such as the Mojave, Hualapai, and Havasupai. According to Numic beliefs, Puha is derived from Creation and permeates the universe, which resembles a spider web. Sometimes it is like a thin scattering, and at other times it occurs where there are clusters of life in definite concentrations with currents. Puha exists throughout the universe, but varies in intensity from person to person, place to place, element to element, and object to object. This is similar to how strength differs among humans. Puha can also vary in what it can be used for, and it determines the tasks certain elements (air, water, rocks, plants, animals) can perform or accomplish. Puha is networked; it connects, disconnects, and reconnects elements in different ways. This occurs because of the will of the elements that have the power. Puha is present in and can move between the three levels of the universe: the upper level— where powerful anthropomorphic beings live, the middle level—where people live now, and the lower level—where extraordinary beings with reptilian or distorted humanoid appearances live [27].

Power is diffused everywhere in continuous flux and flow, which, however, is not haphazard because, as an aspect of memory, power is rational. From all available evidence, the routes of concentrated power within generalized dispersion are web-like, moving both in radial patterns and in recursive concentric ones, out from the center and back again… The web image is reflected in the stories where Coyote assumes the form of a water spider to carry humans to land and Sun takes the form of a spider who is webbing the firmament of the universe… The web of power, however, is not static like that of a spider because the webbing actually consists of the flow of power rather than filaments per se. Rather, the web is pulsating and multidimensional, even having aspects of a spiral, sometimes regular and sometimes erratic, intersection with the radials from the center. This spiral movement is represented most graphically by an in-dwelling soul of a person that can be seen escaping the body at death as a whirlwind. While operating in a dynamic equilibrium within the universe, Puha is also entropic [27-29]. This means that over time, Puha has gradually diminished since Creation in quality, quantity, and availability. The reason for this is that human beings at various times treated it improperly, and failed to uphold their responsibilities in the relationship they have with the interdependent system. Indigenous people believe that a very rapid loss of Puha occurred after the European encroachment. Knowledge concerning how to regulate relationships with powerful elements was lost through the processes of colonization. Despite this, Puha is always retrievable in some form, as long as new guidelines are established for obtaining, maintaining, and respecting it. In Southern Paiute culture, there are rules for handling Puha and powerful objects. These rules function to control the person with the Puha and prevent him or her from misusing it in one of two ways. First, power can only be used at proper times and places and must be used in accordance with standardized procedures, such as preparation and pilgrimage to ceremonial areas. Secondly, people who have obtained and controlled Puha and its knowledge may withhold information on procedures for acquiring and maintaining power from uninitiated persons or persons who are deemed unworthy candidates.

As Stoffie, Zedeño, and Halmo (2001: 65) [27] wrote, “the diversity and unpredictability of power was consistent with an ecosystem that was equally diverse and unpredictable, although often kind and bountiful in the resources provided.” In her ethnography of the Northern Paiute – a tribe that is culturally and linguistically similar to Southern Paiutes – Catherine Fowler (1992: 170-172) [30] described how the people of Fox Peak believe Puha is present in all elements of the Earth:

One of the most basic beliefs that guided the interactions of people with the land and its resources was the concept that the Earth was a living being, just as were the Sun and Moon, the Stars and natural forces such as Water, Wind, and Fire. The life force within all of these, as well as particular geographic features and classes of spirit beings, was power (Puha)… Although power potentially resides anywhere, its association with mountains caves, spirits or other water sources, and the results of past activities by Immortals or humans was particularly apparent.

This discussion of Puha in her ethnography emphasizes that power concentrates in all aspects of the universe and serves as the life force in these elements as well. Fowler also notes that power is attracted to special people who can channel it and use it during prayer and ceremony. For Numic-speaking peoples of the Great Basin and Colorado Plateau, this concept and understanding of Puha frames how they relate to, understand, interact with, and use the lands around them.

Puha and Ceremony

People use Puha in a number of different ceremonies, each of which occurs in a unique place and thus requires people to seek those places out for ceremony. One type of place that people visited for ceremonies was one where they could perform activities that brought individuals, communities, and the world in balance, also known as Round Dances. A suitable place for a ceremonial Round Dance required a large, flat space that had associations with Creation. Round Dance sites are found throughout the Great Basin and the Southwestern United States, and they can be sites that involve human participants or animal participants. The ceremony involved a large number of people, all of whom have traveled some distance away from their home community. One Round Dance site is the Rabbit Circle Dance site in the Spring Mountains [31]. Its name reflects the Southern Paiute belief that the site was used by Rabbit, a Creator being, in the mythic times to balance the world.

Other significant Round Dance places in southern Nevada are Corn Creek, Indian Springs, and Wellington Canyon. Another well documented Round Dance site is found near Kanab, Utah. On January 6, 1872, John Wesley Powell and Fredrick Dellenbaugh saw a Round Dance at this site. Dellenbaugh stated that the entire Kaibab Paiute band was camped together, which at the time would have been approximately 200 people. At the center of the dance circle was a cedar tree with most of its branches removed. All that remained was a tuff at its top. The entire group formed a large circle around the tree and danced and sang. A man who was in charge led the group in song and stood at the center of the dance circle [32]. Round Dances were performed seasonally in order to keep the world in balance. Some Round Dances took place following the harvest of planted crops or the gathering of wild plant resources like pine nuts or agave. There were other types of Round Dances performed on an irregular basis such as the Ghost Dance, when extraordinary forces seemed to place the world more out of balance than normal [33-34]. Some ceremonies, like pilgrimages, were performed by a small number of specialized shamans. These activities required physical and spiritual preparation to handle being isolated from normal daily lives, and for making the long difficult journey to high mountain peaks. Shamans also needed to be prepared to acquire large amounts of power during their ceremonial trek. Southern Paiute shamans went on pilgrimage for two predominant reasons—rites of passage activities for young males, and for obtaining knowledge and power to be used in doctoring and balancing ceremonies. The knowledge and power they gained during these ceremonies aided their communities, districts, and the entire Southern Paiute nation. Puha’gants, or the shamans who journeyed for themselves and their communities, gained the knowledge to conduct rain making ceremonies, heal the sick, and put the world in balance.

Puha and Volcanism

Volcanos have a special place in Southern Paiute epistemology, and Southern Paiute people are strongly culturally attached to volcanic places and events. Volcanic episodes are distinctive moments when Puha moves from lower to higher levels of existence, causing the power to accumulate in these areas [35-41]. Puha moves from the lower portions of the Earth to form hot springs, mountains, volcanic cones, basalt mesas, lava tubes, basalt bombs, and obsidian deposits. Volcanic places and materials play important roles in the formation of special minerals and biotic communities found here. Some resources can be found only where volcanic activity has created power landscapes. Southern Paiute people respect and interact with places of volcanic activity; because these places contain powerful forces and spiritual beings who can help balance human society at local, regional, and world levels. As one Southern Paiute elder said, “Volcanoes are sacred mountains. The old people knew it was alive, like the mother earth is alive. We have a song about the rocks shooting out of a volcano near home,” [42]. Places that contain volcanic activity are considered sacred and powerful. Numic peoples believe that volcanic events are moments when Puha deep inside the Earth is brought to the surface as a way for the land to renew itself or be reborn. Volcanism is also a way for Puha to be distributed across a landscape. Above ground, Puha follows the flow of water and distributes itself across a landscape. This distribution occurs similarly below the surface, where Puha follows the flow of magma rather than that of water. As Puha moves through underground channels, it distributes itself and connects volcanic places over vast distances.

Methods

BARA ethnographers collected cultural interpretations about natural resources, places, and landscapes by using both formal and informal interviewing techniques. These data gathering instruments have been drafted, approved by tribal governments, and applied in nine ethnographic studies of volcanic landscapes. This report is primarily based on such interviews conducted at field sites chosen as part of the six ethnographic research studies that are listed in Table 1, which presents the number of formal and informal interviews. Interviews are defined as a conversation between an ethnographer and a cultural representative during which information specific to the project is shared and recorded. Most interviews were guided by a set of prewritten, culturally sensitive questions, but informal interviews occurred when these types of formal interviews were not possible or appropriate. Informal interviews and discussions can occur for various reasons, with one of the most common reasons being that the ethnographer and the cultural representative are walking to or from a geosite that is being studied. Either the place or the conversation may elicit a response that is relevant to some cultural dimension of the study. In most cases, the information is offered at a time when it is difficult to record, and the ethnographer instead records a personal account of the conversation. Informal interviews are a common and important source of cultural information and have occurred throughout these studies. A number of formal interviews were conducted with survey instruments during six ethnographic studies. The spatial extent of these studies exceeded the narrower focus of this Uinkaret analysis, so of the 902 total interviews, only 149 interviews were conducted in areas specifically considered in this analysis. It is important to note, however, that cultural interpretations from places in the vicinity of the Uinkaret volcanic field were conducted with Southern Paiute tribal representatives, and therefore these other interviews helped to situate the Uinkaret data. Issues such as the purpose of pilgrimage and the cultural reasons for visiting kinds of geosistes were components of all 902 Grand Canyon Colorado River Corridor and Arizona Strip interviews (Table 1).

Table 1: Ethnographic Studies Used in This Analysis from the Grand Canyon Colorado River Corridor and Arizona Strip Studies.

tab 1

Confidence in interview findings, and thus this analysis, increases with the number of interviews that occur at a given place. In general, four interviews with the same form are required at each geosite for a minimal confidence level to be achieved. Four to 11 interviews were conducted at all sites. It is important to note that a few quotes were used in this analysis to represent both the primary and alternative interpretations of geosites. In any ethnographic study, participating tribal governments may request that some other interpretations remain confidential and not be used in technical reports. Such was the case on several occurrences with the studies that make up this report, so the requests of the tribal governments have been respected and these confidential interpretations have not been presented here, nor in past reports pertaining to the same studies. To further preserve the integrity of culturally significant places, the data of geosites is deliberately vague unless they are already marked on public maps. The vague locations are used to protect less well known culturally sensitive resources. Tourism is a critical threat to all geosites involved in the studies. The public copies of the study reports were reviewed by the participating elders and their tribal governments.

The Uinkaret Volcanic Case Study

There are spatially large geoscapes that involve hundreds of geosites that are connected by an extensive network of spiritual and physical trails. The following section is a reconstruction of two ceremonial geoscapes found near Mount Trumbull in the southcentral portion of the Arizona Strip. This analysis is based on geosite and geoscape interpretations made by Southern Paiute elders who participated in ethnographic studies and the interpretations of many others over the last forty years. Some of the geosites have cultural meaning and ceremonial roles in other geoscapes creating what can be best be described as an overlapping mosaic of nested geoscapes. Therefore, it is always important to think of Native American geoscapes and geosites in terms of having multiple cultural meanings for Native Americans with meanings that are both established at the same and different time periods. Mount Trumbull is connected to two local geoscapes. The first focuses on a pilgrimage to Toroweap Overlook (and Vulcan’s Throne) at the North Rim of the Grand Canyon. The second geoscape is a pilgrimage to a ceremonial landscape at Vulcan’s Anvil at the bottom of the Grand Canyon. Both geoscapes involve trails along the pilgrimage which lead to Mount Trumbull, followed by a visitation at Coyote Spring. One landscape, and perhaps both given the spiritual needs of the pilgrims, involves purification, acquiring Puha, and Puha’pah (power water) at Little Spring. These places have been interactive since they fundamentally conclude where past lava flows from the North Rim have filled the Colorado River— from top to bottom forming a massive upstream lake. Evidence of former lava flows exist in abundance at the Vulcan’s Anvil, Vulcan’s Throne, and Lava Falls.

Northern Pilgrimage Trail

This northern portion of the Uinkaret geoscape (also called the Arizona Strip) contains five geosites: (1) Coyote Springs, (2) Paiute Cave, (3) Little Springs Lava Flow and Hot Spring, (4) Nampaweap, and (5) Vulcan Volcano and Toroweap Overlook which are looks on the edge of the North Rim of the Grand Canyon, above Lava Falls (Figure 6). For Southern Paiute people seeking visions, spirit helpers, or medical cures, each of these places has a unique function. In addition, each place is sequentially linked, thus creating a ceremonial pilgrimage landscape that is integrated in terms of time, function, and space. For this geoscape, we consider the hypothesis that Southern Paiutes might not have been the only people using this area. Other Indigenous groups, such as the Hopi, Havasupai, and Hualapai may have also used the Mount Trumbull area for ceremony. As an example, it is well documented that the Hualapai frequently traveled across the Grand Canyon to participate in joint ceremonies with Southern Paiute people [45]. There are a total of twenty-three traditionally used trails across the Colorado River where it passes through the Grand Canyon making access possible [46]. Based in part on his work with Dan Bulletts, Stoffie (1982: 124) [47], wrote that “Trails tied Indian people together affording a regular exchange of goods, services, innovations, news, marriage partners, and occasionally warring parties. It is no wonder, then, that trails and often the people who used them became culturally significant.”

fig 6

Figure 6: Northern Mount Trumbull Geoscape

Paiute Cave

Southern Paiute representatives and UofA ethnographers visited a place located 15 miles north of the Little Springs Lava Flow and Mount Trumbull [42]. This site, known as Paiute Cave (Figure 7), is part of the northern portion of the Uinkaret Lava Field. The cave is found at the base of a large volcanic deposit which is bordered by the eastern edge of the Uinkaret Plateau. Given its geological composition and cultural resources, this cave is linked to ceremonial activity at the Little Spring Lava Flow and to geosites in the Grand Canyon.

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Figure 7: Entryway to the Paiute Cave

Paiute Cave is a collapsed volcanic lava tube. The area around and on top of the cave is part of a large pyroclastic deposit. These types of deposits are characterized as being cinder, bomb deposits, and reddish-gray, black, red, and gray tuff. These deposits are found near a pyroclastic cone. This cone is located near one or more vents that overlap the coalescing basalt flows [19]. Paiute Cave is one of these volcanic vents. Volcanic vents allow air to flow from deep inside the air outward which from a Southern Paiute perspective is a testament to the Earth breathing and being an active living entity. Caves in Southern Paiute culture are understood as powerful sacred places. Caves in general are deemed important because they provide shelter and collect water—both vital for all life. Caves also tend to be dark and moist like what Miller (1983) [26] refers to as the initial world. Caves have been described by Southern Paiute religious leaders as being the mouths of mountains [27]. Additionally, Liljeblad (1986) [25] noted that caves were often used during power acquisition ceremonies and that caves served as entrances to underground pathways. Each cave has its own purpose, and thus, no two caves can be considered the same. Caves were used by Puha’gants (medicine men) to gain spirit helpers or knowledge such as songs or prayers. Paiute Cave is unique in that it contains red, yellow, and white painted figures at various locations inside the cave which indicates that the cave was used for ceremonial activity (Figure 8). Tribal representatives maintain that the ceremonial activities conducted at Paiute Cave were linked to the Little Spring Lava Flow and Puha acquisition.

fig 8

Figure 8: Red and Yellow Figure on the Left side of the Cave (L) and Painted Cave Figure on the Back Wall (R).

As one travels south from Paiute Cave towards Mount Trumbull, the valley becomes bounded by high volcanic mountains and lava flows. These types of constrictions are important physical attributes to Southern Paiute pilgrimage trails, because culturally narrow and constricted spaces influence cultural meaning and affect the movement of natural elements like wind and water. Pilgrimage trails pass through these narrow spaces because these are areas where Puha converges and collects in a manner similar to how water will pool in constricted places. As a trail passes through these types of locations, a pilgrim can experience and draw upon the power of the area as he or she progresses on the journey.

Coyote Spring

Ceremonies are conducted at places with high concentrations of puha, too dangerous for non-religious specialists to stay for long periods at ceremonial places. Therefore, people who use a ceremonial area must have had to travel to it from safe home bases. Southern Paiutes would have come from oasis-based agricultural villages located away from ceremonial places elsewhere, like those located north of Mount Trumbull in the Kanab River area, the Virgin River area near present-day Zion National Park, and the Santa Clara River area [48- 50]. People traveling to the Mount Trumbull area traveled major trails, many of which have since been given Anglo names as a result of the frequency with which Euro-Americans traveled these trails during the exploration and expansion periods. These old Indian trails cut across large portions of Arizona, Utah, Colorado, and Nevada. The Mormon Temple Trail, the Honeymoon Trail, and the trail used by Escalante and Dominguez were originally Indian trails. These were the kinds of trails that would have been taken by people en route to the Trumbull area for ceremony in the Coyote Spring located on the southwestern flank of Mount Trumbull. The nearby Uinkaret Pueblo was formed in part from volcanic stones. When people traveled to the Mount Trumbull area for ceremonies, it was not uncommon for their families to come too. The families would have stayed in the Coyote Spring area while the others went on their pilgrimage. It would have been too dangerous for family members to accompany the pilgrims to the ceremonial places. These puha places were only visited by types of people who have certain amounts of puha and had begun a long series of preparations prior to arriving in the Mount Trumbull area. The people who remained at Coyote Spring carried on with daily activities while the pilgrims were away. Depending on the time of year, the families would have gathered different kinds of plants, like three- leaf sumac, cedar, or pine nuts. Family members could also take this opportunity to hunt animals like deer, rabbits, elk, or antelope.

Little Springs Flow and Hot Spring

The pilgrims traveled south to Little Springs Lava Flow and hot spring, which were produced by a recent basaltic lava flow. This analysis is shorted because information regarding this geosite has been published elsewhere [40-42, 51]. Pilgrims would have interacted with the lava flow spring to cleanse and purify themselves for their journey. The hornitos located throughout the lava flow would have been places for sweat lodges and the lava rocks are well suited for holding heat. Indian people have formed miles of trails on top of the lava flow connection places near the Hornitos. Pilgrims prepared for ceremony and travel by singing songs and saying prayers to the lava flow, the surrounding volcanic mountains, the water, the plants, and the animals. They asked for a safe journey to the North Rim of the Grand Canyon where some ceremonies were conducted. Water was taken from the spring and brought with them to Nampaweap where it would have been used in ceremony and left as an offering.

The Lighting Site

The Lighting Site is an enclosed and one roofed structure whose walls are formed of volcanic boulders carried from the Little Spring volcanic flow. Some of the boulders were made by puha’gants at hornitos (Figure 9) on the active lava flow at the time of the eruption [42]. The process of going on to active lava flows and making artifact boulders from splashes of lava at hornitos is documented for Sunset Crater [52]. There the boulders were imprinted with corn whereas at Little Spring the puha’gants placed ceramic pots on the edge of the hornito. These are generally called sherd rocks whereas at Sunset Crater they are called corn rocks. At both locations the artifact rocks were subsequently taken away and made into a structure used for ceremonies. Many Native American cultures had religious specialists who gathered, used, and prayed with volcanic rocks. Round volcanic rocks are often used in the Sweat Lodge fires where they are called Grandfather Rocks. These boulders and the places where they were taken are extremely sacred because they contain pottery sherds deriving from that ceremonial connection of a volcanic source and a human artifact. This site is not further discussed here due to its cultural sensitivity. The site continued to be used for ceremonies long after the eruption and is visited by tribal members today.

fig 9

Figure 9: Hornito at Kilauea Volcano, Hawai’i for a Visual Example (Elson et al. 2002)

Nampaweap

From Little Springs, the pilgrims would travel roughly three miles to Nampaweap; a small basaltic canyon that constricts the trail to the North Rim. The upper portion of the canyon has a series of peckings, a rock shelter, and a spring, and thus it has high concentrations of puha. The pecking were interpreted as associated with Origin Stories given some pecking were only used where such stories were recounted. The Ocean Woman’s Net is in the upper left of the image below (Figure 10). When people came to Nampaweap, they would have first offered the place water brought from Little Springs, and then explained the purpose of their visit and asked for the puha they need to continue to the North Rim.

fig 10

Figure 10: Peckings found at Nampaweap, Ocean Women’s Net Upper Left

According to representatives the small canyon provided a song to be sent to the big canyon and used during the ceremony at that place. Additionally, more water was collected from the spring found above the rock art panels. It would have served both as an offering and for members of the vision quest, support camp at the North Rim.

Toroweep Overlook and Vulcan’s Throne

Following prayers at Nampaweap, people traveled east towards Toroweap Valley and then south towards the North Rim of the Grand Canyon, covering a distance of twelve miles. While traveling, the pilgrims continued to pray and announce to the canyon and the mountains why they were there, and they would ask for permission to enter the area. The people would have been given a sign, like an eagle flying by that would have signaled they had permission to enter the area. Upon reaching the north rim of the Grand Canyon and receiving permission to enter, the vision seekers could go to either one of two locations to obtain their vision — Vulcan’s Throne or Toroweap Overlook. From these locations, there are impressive views of the Grand Canyon and the Colorado River (Figure 11).

fig 11

Figure 11: The Toroweap Overlook View Down into the Colorado River

Vulcan’s Throne is a pure cinder cone volcano located on the North Rim. This volcano erupted on five separate occasions and is recognized as a port of the volcanic system that was responsible for filling the Grand Canyon with lava twelve times during the last 1.2 million years. The lava flows created a series of dams in the Grand Canyon which were responsible for creating a series of lakes in the canyon that extended to the head of today’s Lake Powell. The Vulcan’s Throne flow was approximately eight to ten miles long. The flows from Vulcan’s Throne are some of the oldest and largest in terms of volume in the Grand Canyon (Hamblin 1989: 190-192) [53]. Pilgrims stopping at this volcano would have prayed to explain their purpose. They would bring puha’pah, plants, and stones to this place to leave as an offering. At Toroweap Overlook, people have a clear view of Vulcan’s Anvil and Lava Falls, two important powerful ceremonial features located within the Grand Canyon (see next local landscape description). It is important to note that Toroweap Overlook is the only place where a person can look from the upper rim of the Grand Canyon directly down at the Colorado River. This allows the pilgrim to have a clear view of the powerful places below. The person would be able to talk directly to the Colorado River and draw from its puha. The pilgrim would seek some type of puha from the place, such as a vision, song, or spirit helper. The person could seek more puha to confront new problems facing him or his people. Perhaps the pilgrim would be preparing to go into the canyon for ceremony at Lava Falls.

A small camp would be set up to serve as support for the vision seeker. This location would be near to where the vision seeking would occur but would be sufficiently removed from the location to give the vision seeker privacy. Little is known about vision quest support people except they had two roles: (1) to advise the seeker and help interpret what was happening and (2) to ensure that the vision seeker did not become comatose. The vision was sought over a period of two to three days. When the vision was achieved or at such time that the support person suggested the time to leave had come, they would leave the North Rim area and make their way back to their villages. On the return they would stop at Nampaweap, Little Springs, and Paiute Cave to say exit prayers thanking the spirits for protecting them during their pilgrimage and providing enough puha to withstand the intensity of the vision quest. It was very likely that the returning pilgrims collected puha’pah from Little Springs to bring back to their communities. The puhapah would have been used in curing and blessing ceremonies.

South Pilgrimage Trail: The Grand Canyon Geotrail

The second portion of the pilgrimage trail is the Grand Canyon Geoscape (Figure 12), which connects geosites on the North Rim with a functionally integrated ceremonial area that is centered on Lava Falls and nearby geosites along the Colorado River downriver from Vulcan’s Anvil. Considered in this analysis are (1) Vulcan’s Anvil, (2) Hot Mineral Spring, (3) Yellow Paint Source Wall, (4) Preparation Rock Shelter, and (5) Lava Falls and Water Babies Peckings Cave. This geoscape is especially critical given it is the location of several volcanic flows deriving from the north, south, and from the walls of the Grand Canyon. These often (apparently 13 times) created dams that filled the Grand Canyon, thus causing the Colorado River to become a massive lake. The remains of some lava flows are visible, and Vulcan’s Anvil is a flat-topped volcanic plug in the middle of the Colorado River. Lava Falls was produced by these lava flows, which formed a truly spectacular volcanic geoscape.

fig 12

Figure 12: South Pilgrimage Geoscape with Geosites and Geotrail in the Grand Canyon

Vulcan’s Anvil

The Colorado River, as it passes through the Grand Canyon, is a culturally special landscape comprised of many culturally important and interconnected places. The Grand Canyon has always (since Creation) played a critical role in the lives of Southern Paiutes. The canyon and the Colorado River define the boundary of four Southern Paiute sociopolitical districts – Shivwits/Santa Clara, Uinkaret, Kaibab, and the San Juan. Elders identified a network of more than twenty-three trails that permitted free movement across the Grand Canyon and the Colorado River. These allowed Paiutes to have access to many things within the canyon, such as farming, hunting, trade, and ceremony with the Hopis, Havasupai, and Hualapai. This section focuses on a particular local landscape involving places on the North Rim and a series of locations found within the Grand Canyon. This landscape is associated with Paiute doctoring, ceremony, and acquisition of spirit helpers. This landscape is linked to ceremonies discussed in the previous local landscape. This landscape involves steps in preparation for ceremonies at Vulcan’s Anvil near Lava Falls. Vulcan’s Anvil is a powerful doctoring area, which would require long periods of preparation and ceremony before a person or persons could enter this area. The Vulcan’s Anvil-Lava Falls complex was also known as a powerful doctoring site. A well-known Southern Paiute religious leader was associated with this area. Eventually, he moved across the Colorado River and married two Hualapai women, and because of this, he became one of their primary medicine persons. As such, he became an important figure in Hualapai history and a lesson in the meaning of cultural differences in the Grand Canyon region.

Hot Mineral Spring

Pilgrims swam or floated directly across the river to the southern bank of the river where there was and is a hot mineral spring (Figure 13). The spring water is heavily mineralized and was used for prayers and purification. Water was collected at the spring and brought to a nearby ceremonial rock shelter where the pilgrims would have used it as an offering. The spring was cleaned of natural fibers that were either blown out or produced when the Colorado River flooded. Plants, such as willows, were cut back from the spring so pilgrims could use them without interference.

fig 13

Figure 13: Mineral Springs

Yellow Paint Source Wall

From the spring, pilgrims traveled to a deposit of yellow ochre nodules (Figure 14), which occurs in a vertical gravel wall which is part of the boundary of Prospect Canyon. The yellow ochre deposits in this wall were formed as lava flowed past the wall, which was made of nonvolcanic materials some of which became ochre due to the intense heat and pressure. The Yellow ochre nodules deposit are pure power about the size of a large potato and situated in the wall composed of gravels. The Yellow ochre nodules can be removed easily as a single nodule. When the nodule is broken open it contains almost pure yellow ochre. Yellow ochre, like red ochre, is a powerful element associated with ceremony. The yellow ochre wall is covered in red ochre blessing smudges, which are produced when red paint is dipped with fingers and drawn as lines on the wall.

fig 14

Figure 14: Yellow Paint Ochre

The yellow ochre was used in medicine and ceremony conducted at Vulcan’s Anvil. To be used in ceremony, the pigment had to be mixed with water to make the yellow paint. To collect the pigment, the pilgrims would have left water from the Hot Mineral Spring as an offering as they collected the pigment. Once the pigment was gathered, the pilgrims ventured to a nearby ceremonial rock shelter where both yellow and red paint figures were painted on the rock walls.

Preparation Rock Shelter

At a ceremonial rock shelter (Figure 15), which is located directly above the yellow paint wall, is where the people continued their preparations for ceremonies at Vulcan’s Anvil and elsewhere like the Water Baby Peckings Cave across the river. The rock shelter contains paint figures made in part from the yellow paint nodules found in the nearby Prospect Canyon wall paint deposits. Inside the rock shelter, the pilgrims would have prayed and prepared themselves. They used the water brought in from the mineral spring. After prayers, the pilgrims would have waited for a spiritual signal to proceed with their journey.

fig 15

Figure 15: Yellow Paint Rock Shelter

Some Quotes:

  • It was a place they went to prepare for something to keep spirits away – that is what we do Images are not a ghost, which would be dots – a drowned person, flat and bloated.
  • It is a place where people with supernatural powers came. Women would come here if they needed to be healed by the shaman.
  • It may have been a female site – a woman’s isolated site for the moon.

More than half the representatives specifically discussed a connection between the panels and Vulcan’s Anvil. A majority of the representatives perceived the rock art site to be connected to other sites in the area.

People could have received songs during this period to take with them to Vulcan’s Anvil. According to Southern Paiute epistemology, rock shelters are powerful places that people visit to acquire puha and songs that are remembered from earlier times. Once the pilgrims received puha from the rock shelter, and after the appropriate signal, they could continue to visit and climb atop Vulcan’s Anvil. The pilgrim’s support persons would remain at the river’s bank –perhaps in the rock shelter during the pilgrim’s time on Vulcan’s Anvil.

Lava Falls and Water Baby Peckings and Cave

At a place immediately next to Lava Falls the pilgrims would stop to interact with Water Baby peckings located on large lava boulders at the entrance to a small cave. Water babies arespirit helpers for shamans who bring the rain and they are dangerous and powerful. These peckings were on a large boulder in a small cave splashed by water from the churning rapids. The peckings, boulders, and cave occur where the trail crosses the river. The peckings were interpreted as indicating the presence of water babies (Figure 16 and 17).

fig 16

Figure 16: Lava Falls

fig 17

Figure 17: Lava Falls Rock Shelter With Water Baby Peckings Inside

Some Quotes

  • It was a place where a medicine man or other people came to conduct ceremonies and get their spiritual healing before crossing the river to get the red paint or to visit Vulcan’s Anvil.
  • This is where they came to get their spiritual healing and their being able to go across the river and get the paint that they need to protect themselves from the spirits that are bad.
  • The majority of people interviewed said that Southern Paiutes visited or used the panel in the One said his family had traditionally visited or used the panel and two said that Southern Paiutes currently visit or use the panel.
  • A majority of the representatives said there would be stories or legends associated with the One individual interpreted the panel as reflecting a story or legend about Paiute philosophy.
  • A majority of the representatives said the panels would have been used by other Indian people. The Indian people named include the Havasupai, Hopi, Hualapai, and Navajo.

Pilgrims came to this location to say prayers of introduction and to request protection while crossing the river. It is possible that some spiritual leaders came to this spot to receive a water baby as a spirit helper for making rain [54]. The pilgrims drew upon the Puha from the peckings to continue their journey and in return they left offerings of tobacco and Puha’pah for the water babies represented by the peckings.

Vulcan’s Anvil

In order to reach Vulcan’s Anvil, the pilgrims (including medical patients if doctoring was the purpose of the pilgrimage) would have to swim to the center of the Colorado River where Vulcan’s Anvil occurs as a large volcanic plug or throat. Here Vulcan’s Anvil is surrounded by a calm and very deep portion of the Colorado River created in part with the backwater of materials that constitute Lava Falls. Vulcan’s Anvil is the only rock of its kind along the entire Grand Canyon Corridor. Vulcan’s Anvil can best be described as a power rock in a power place thus making it a very special destination for Puha’gants (medicine men) (Figure 18).

fig 18

Figure 18: Vulcan’s Anvil

When the pilgrim(s) reached Vulcan’s Anvil, they swim from the river’s edge and climb from the water up its vertical slick sides to the wide flat top. On top, a person had a view of the Grand Canyon and the Colorado River up and downstream. Looking up, the pilgrim would view the vertical canyon face containing evidence of a dozen previous volcanic dams and many separate lava flows. Here people could draw from the power of the volcanic rocks, the river, the canyon, and the presence of volcanic plug sitting in the bottom of the river. After a period (up to three days could be needed if medicine healing or if vision quest was involved), the pilgrims would leave the top of Vulcan’s Anvil, swim to the south shore, spend time in the ceremony rock shelter, cleanse themselves in the hot mineral spring, and begin to reverse their journey back to Mount Trumbull. Pilgrims return to the geosites they visited on the path to Vulcan’s Anvil in order to conduct exit prayers and offer expressions of gratitude for safety. Puha’pah was collected by the pilgrims at the base of Lava Falls and the mineral spring to bring back to their villages to be used in curing or other ceremonies. The yellow pigment was carried to be used again in Paiute Cave. There is evidence of the use of this yellow paint at ceremonial sites in Kanab Creek.

Discussion

This is a holistic ethnographic analysis of a long and ancient Native American pilgrimage trail that is situated in a volcanic field composed of cinder cones, lava flows, collapsed lava tubes, and mineral deposits made by lava flows. The area of analysis includes a large volcanic mountain to the north and the Colorado River as it passed through the Grand Canyon. The trail crosses an area of volcanic events where the Grand Canyon was filled with lava thus disrupting the flow of the Colorado River. When these massive dams were formed lakes then extended upriver and along canyons for hundreds of miles. Eventually the dams were eroded away, only to occur again a dozen times. Native people have lived in this area for 40,000 years or more and are documented as actually interacting with lava flows during the past thousand years [51]. In this volcanic landscape or geoscape are unique places or geosites that have special cultural importance to Native American people. Some of these places are culturally organized into the pilgrimage trail or geotrail described and explained in this analysis. The technical prefix – geo – is utilized to describe the trail, places along it, and the broader landscape withing which it occurs. Places along the geotrail are organized and utilized as central component of Native American heritage. The volcanic geology of the area is a primary foundation for Native ceremony. Thus, volcanic events are places critical to Native American heritage [55]. According to Native American Creation accounts volcanos are alive and intended for the benefit of all other (emphasis added) living beings including the wind, rain, animals, plants, and humans. Pilgrims traveled along this trail to perform ceremonies at these locations since Time Immemorial according to Native beliefs. The oldest types of artifacts are regularly found in the area [56,57]. The performance of these ceremonies increases balance between the involved beings, the communities and habitats where they reside, and the Earth itself. For Native Americans, the act of pilgrimage along the geotrail is essential because here they can draw on the most powerful Earth forces and thus can better form relationships between other beings and increase balance in the World [40]. The analysis is intended to explain Native American relationships with what in Western culture and science is call Nature [41]. The reason for participating in the ethnographic studies by tribal governments and their cultural representatives has been and continues to provide an alternative cultural interpretation of the volcanic landscape by which to better inform those people and agencies who manage and use this geoscape. Currently the geoscape is threated by spiritual and physical disruptions deriving from uranium mining, livestock grazing, offroad travel, river raft adventures, and millions of tourist visitors. Native participants in these studies believe (trust) that these actions and their impacts potentially can be mitigated through environmental education using Native American perspectives of the Living Earth. Also essential is Native American ceremonial use of the geotrail, geosites, and geoscape.

Acknowledgment

The authors would like to acknowledge the representatives of the USA federal agencies who are both land managers and funders of these ethnographic studies. For the Arizona Strip we thank the Bureau of Land Management Staff especially Gloria Bulletts-Benson. Tribal government support was provided by the Paiute Indian Tribe of Utah, the Kaibab Band of Paiute Indians, and the San Juan Southern Paiute Tribe. There were six Grand Canyon Colorado River Corridor ethnographic river trips, all of which were supported by the David E. Ruppert for the National Park Service and David Wegner for the Glen Canyon Environmental Studies, the Bureau of Reclamation. Special professional experts included Henry F. Dobyns, Helen C. Fairley, Arthur M Phillips, III, Gilford Harper, Angelita Bulletts and Vivienne C. Jake. Betty Cornelius, Director, Colorado River Indian Tribes supported the participation of the tribal video team. Special thanks to the dozens of tribally appointed cultural representatives who participated. This is their story.

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Interferon Activating Effect of Staphylococcal Enterotoxins

DOI: 10.31038/MIP.2024513

Abstract

The cellular target for staphylococcal enterotoxins is human spleen cells. The effect of enterotoxins is to induce the production of endogenous IF. St. aureus enteropathogenic proteins (enterotoxins) possess an antitumour effect. After intraperitoneal inoculation they decrease the size and, in some cases, prevent the development of the human hypernephroma in the cheek pouch of golden hamsters. The effect of enteropathgenic proteins may possibly consist in inducing the production of endogenous immune interferon which activates the host immune system and enhances the rejection of heterologous tumour cells.

Keywords

Gamma-interferon, Enterotoxins, Antitumour activity

Introduction

Staphylococcal enterotoxins (SE) were first described and designated serotypes A,B,C by Bergdoll [1]. Unlike enterotoxins, which have a subunit structure, the protein of staphylococcal enterotoxins is a single-chain consisting of 22-24 amino acids. The sequence connected by a disulfide bond. Molecular weight of SE proteins no more than 20-25 kD.

Being the main factor of enteropathogenicity, staphylococcal thermostable enteropathogenic proteins also have superantigenic activity and the ability to confuse antibiotic resistance [2]. The St.aureus enteretoxins function is both as potent gastrointestinal toxins as well as superantigens that stimulate non-specific T-cell proliferation. In the enterotoxin molecule, the sites that control the secretion of the main factor of enteropathogenicity and superantigenic activity have different domain localization [2]. The impact of enterotoxins on the immune system is carried out through superantigenic activity, determined by the corresponding domain structure of the molecule.

Staphylococcal enterotoxins possess low antigenic activity and low toxicity in animalexperiments.The exception is type B (SEB), which has high lethal activity [3]. This article presents the results of the immunomodulatory effect of SEA on human splenocytes, the secretion of interferon gamma and the antitumor effect in animals.

Experimental Part

In the experiments, preparations of staphylococcal enterotoxins were used, previously obtained by the ion exchange cellulose method [4].

I. Binding of Staphylococcal Enterotoxin A (SEA) with Human Splenic Lymphocytes, 1983

Summery

  1. In experiments studying binding to human splenocytes, staphylococcal enterotoxin thia A, labeled I125] SEA, was used. A high degree of specific binding of [I I25] SEA to human splenocytes has been established [5].
  2. It has been established that the binding of SEA to the surface of splenocytes at 4 C is characterized by saturation, reversibility and high affinity for the receptor Kd = 4.0 x 10-7 M)
  3. The number of binding sites on a splenocyte cell is 6000,0.
  4. The effect of temperature on the binding of SEA to the surface of the splenocte was studied. It was shown that at 23°C, the binding of the labeled toxin to the cell is described by a two-phase curve.
  5. The conditions under which there is an increase in the connection of SEA with splenocytes and, accordingly, an increase in the level of interferon gamma production, have been determined.

Printing increases the association of SEA with the splenocytes and correspondently increases the production level of gamma-interferon.

II. Nonspecific Antitumour Activity of Staphylococcal enterotoxins, 1987 [6].

It is known that the components of the interferon (IF) antitumour activity include the direct effect on tumour cells and the indirect effect on various body systems [7,8]. It is not entirely clear what is the contribution of each IF effect to the tumour process inhibition. Thus, in thymus-deprived mice, a slowdown in the growth of transplanted human tumours was noted when they were injected with both human and mouse IF [1]. In addition, there are reports of the inhibitory effect of IF on tumour development in vivo with the resistance of tumour cells to IF in vitro [9].

Inductors of IF are also used in the experiment for the tumour treatment [10]. Staphylococcus aureus proteins deserve special attention in this regard – staphylococcal enterotoxins, which are also active immunomodulators [11,12]. Immune IF produced by T-lymphocytes induced by these proteins has a pronounced antiproliferative effect [13]. We studied the effect of St. aureus enterotoxins on the development of human hypernephroma in the cheek pouch of golden hamsters.

Methods

The passaged culture of human hypernephroma was obtained from cells of a similar tumour. The culture has passed more than 200 times; it contains specific markers and has properties inherent to the primary tumour [14]. The culture was passaged on the Eagle medium with lactalbumin hydrolysate (1: 1) and 10% bovine serum. The culture formed a monolayer with growth, the passage index was 1: 3. As an experimental model, 50 golden hamsters weighing 250 g were used supplied by the kennel Stolbovaia of the USSR Academy of Medical Sciences, to which, 4 x 106 cells of human hypernephroma were injected into the cheek pouch under Nembutal anaesthesia.

Human leukocyte IF (HLI) was obtained by the method described by V. D. Soloviov, T. A. Bektemirov [15], human immune IF (HII) – according to the method proposed by L. M. Mentkevich et al. [16]. The potency of HLI and HII was 1,000 U/mL. Enterotoxins A and B of St. aureus were obtained by the method of Ezepchuk et al. [4]. IF and enterotoxins were injected into golden hamsters intramuscularly or into the abdominal cavity in a volume of 1 mL daily, starting from the next day after human hypernephroma cells administration. The size of the tumours was considered 2 weeks after the experiment start. The level of IF in the blood serum of golden hamsters was determined by titration on human embryo fibroblast cultures and the transplanted culture of BHK-21 golden hamster. Titration was carried out by micro method on a monolayer of cells inoculated into 96-well plates. The IF titre was considered as its last dilution protecting cells from the cytopathic effect of 100 doses of the vesicular stomatitis virus. The titre of antibodies to staphylococcal enterotoxin in the blood serum of golden hamsters was determined 3 weeks after the start of experiments by immunoprecipitation.

Results and discussion. A preliminary study of HLI showed that it had absolute species specificity: it showed antiviral effect in the culture of human embryo fibroblasts and had no effect on the culture of BHK-21 golden hamster. The culture of human hypernephroma cells turned out to be weakly sensitive to the antiviral effect of HLI, as well as other transplanted human cultures, and sensitive to its anti-proliferative effect. On this basis, it was concluded that human hypernephroma cells injected into the cheek pouch of golden hamsters should be sensitive to the virus injected into hamsters, and due to its species specificity, it should not affect the host organism.

Human hypernephroma cells were injected into the cheek pouch of 30 golden hamsters. Then, the animals were divided into five groups. Animals of group I, which were not injected with IF, were the control; HLI was injected into the abdominal cavity of group II animals; intramuscularly into group III animals; HII was injected into the abdominal cavity of group IV animals; intramuscularly into group V animals.

In animals of groups II and III, compared with animals of group I, neither the incidence of tumours nor their size decreased (Table 1). The introduction of HII to golden hamsters had a therapeutic effect. So, tumours occurred in 50% of group IV animals compared to 83.3% in the control. The average diameter of tumours in group IV animals was significantly lower than in control animals: 1.0 ± 0.57 and 4.0 ± 0.93 mm, respectively, the difference is significant. In golden hamsters of group V, the incidence of tumours was the same as in the control, and the tumour size was lower (2.0 ± 0.57 mm). However, due to the large spread of figures, these differences turned out to be not significant. So, the HII injected into the abdominal cavity prevented the occurrence, and in case of occurrence, inhibited the development of human hypernephroma in the cheek pouch of golden hamsters.

Table 1: The development of tumours in golden hamsters after the introduction of human hypernephroma cells exposed by HLI and HII.

Introduced IF

Administration method Tumour incidence, %

Tumour diameter, mm(M ± m)

HLI Abdominally

83.3

3.4 ± 1.16

HLI Intramuscularly

83.3

4.6 ± 1.54

HII Abdominally

50.0

1.0 ± 0.57*

HII Intramuscularly

83.3

2.0 ± 0.57

Control

83.3

4.0 ± 0.93

*The difference is significant (Р < 0.05).

One of the differences between the used drugs of IF was that HLI did not contain an active inducer of IF, whereas HII contained staphylococcal enterotoxin A (SEA). We suggested that the therapeutic effect of HII could be associated not only with the administered IF, but also with SEA, which could induce the production of endogenous immune IF in the body of golden hamsters. To test this assumption, intact hamsters were injected with native HII into the abdominal cavity and then blood was sampled over time. The presence of IF in the blood serum of golden hamsters was determined in the monolayer of human fibroblast cells and hamster cells.

HII in the blood was not detected throughout the experiment. Apparently, it was quickly adsorbed by tissues and excreted from the body. IF of hamsters was detected in the blood of animals 15 minutes after administration of the IF drug reaching a maximum after 1 h (64 U/mL) and disappearing after 6 hours from the bloodstream. Therefore, SEA contained in native HII induced the production of endogenous homologous IF in the body of golden hamsters.

Several types of enterotoxins were isolated from St. aureus. Enterotoxins A and B have the same interferon-inducing, but different immunomodulatory property [17].

The objective of this series of experiments was to study the antitumour effect of enterotoxin B (SEB), since it is less toxic than SEA. Otherwise, the experiments were planned similarly to those already described. From the next day after the introduction of human hypernephroma cells, golden hamsters were injected daily into the abdominal cavity with 1 or 0.1 µg of SEB. 2 weeks after the administration of a higher dose of SEB, tumours in the cheek pouch appeared in 16.6% of golden hamsters compared to 85.7% o in the control. The mean diameter of tumours in experimental animals was 0.66 ± 0.67 mm, and in control animals – 3.6 ± 0.61 mm (P< 0.01). When a lower dose of SEB was administered, the number of experimental animals with developed tumours was the same (83.3%) as in the control (85.7%), the average diameter of tumours in experimental animals was slightly lower than in control animals (2.65 ± 0.62 mm), but the difference was not significant (Table 2).

Table 2: The development of tumours in golden hamsters after the introduction of human hypernephroma cells exposed by SEB.

Experiment settings

Drug concentration, µg Tumour incidence, %

Tumour diameter, (M ± m)

Test

0.1

83.3

2.65 ± 0.62

1.0

16.6

0.66 ± 0.67*

Control

85.7

3.6 ± 0.61

*The difference is significant (P < 0.01).

Thus, SEA and SEB slow down and in some cases prevent the development of human hypernephroma in the cheek pouch of golden hamsters. The effect of enterotoxins is to induce the production of endogenous immune IF, which activates the body’s immune system and enhances the effect of heterologous tumour cells rejection noted in the model system used. We cannot exclude the direct stimulating effect of enterotoxins on the immune system of golden hamsters.

St. aureus enterotoxins are proteins with weak antigenic properties. In our experiments, after repeated administration of these proteins, antistaphnococcal antibodies in titres 1: 2-1: 4 were detected in the blood of golden hamsters with implanted human hypernephroma cells. With the same scheme of enterotoxins administration to intact hamsters, the level of antibodies was significantly higher (1: 16). It has been established that even a small amount of anti-staphylococcal antibodies in the blood can serve as an obstacle to the enterotoxin action. In this regard, for further work, it is necessary to obtain fragments of proteins that do not cause the production of antibodies, but have an antitumour effect.

III. Effect of spleen cells sensitized with staphylococcal enterotoxin type A on metastasis of Lewis lung carcinoma in mice [18].

The effect of intact murine splenocyte cells sensitized in vitro with staphylocoeic enterotoxin (SEA) on spria – ding of mouse Levis carcinoma was studied. A significant reduction in the number of lung metastases and lung weight was found after multiple intrapulmonary inoculation of plant cells treated with SEA for 6 hours. The effect was less noticeable after inoculation of sensitized cells intraperitoneally or sensitized intraperitonialy or into the femoral muscle of the leg affected with the tumour.

Discussion and Conclusion

Staphylococcal superantigennenic enteropathogenic proteins, which have weak antigenic activity, exhibit high immunomodulatory properties in animal experiments. It has been shown that the intensity of gamma interferon secretion correlates with the presence of SEA binding compounds on the surface of splenocytes. The antitumor effect is apparently due to the effect of immune interferon on oncogenic cells.

The fact of different domain localization in the enterotoxic protein molecule indicates that only the superantigenic activity of the toxin is related to the secretion of immune interferon. Of great interest is the spatial structure of the domain that controls superantigenic activity. Deciphering the molecular structure of the domains holds the key to the use of enteropathogenic proteins for medical purposes.

References

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  9. Gresser I (1983) Possible mechanisms responsible for the antitumor effect of interferon (IFN) in mice//Intern. Symp. of Interferons, Abstracts (October 3-6, 1983). Kyoto, Japan 22.
  10. AS Sadykov, FI Ershov, AS Novokhatsky, et al. (1978) Interferon inductors Tashkent: FAN 303.
  11. Jonson HМ, Torres ВA (1983) Recombinant mouse interferon regulation of antibody production. Infec Immunity 2: 546-548. [crossref]
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  16. Mentkevich LM, Zhdanova LV, Meshkova EI, Ezepchuk IuV (1983) Formation of immune interferon induced by staphylococcal enterotoxin and phytohaemagglutinin. Virology Concerns 1: 58-62. [crossref]
  17. NP Kunevich, SA Anatolii, Yu V Ezepchuk (1982) The effect of staphylococcal enterotoxins A and B on the proliferative activity of lymphocytes and the primary immune response. Immunology 6: 60-62.
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Knowledge and Practices Regarding Antenatal Care and Care After Elective Caesarean Section Among Pregnant Mothers

DOI: 10.31038/IJNM.2024531

Abstract

Introduction: Pregnancy gives joy and new feelings to the mothers but along with that, there are different issues and problems faced by the mothers in the antenatal period and postnatal period. These problems can put the mother in danger. Worldwide, approximately 830 women died every single day due to complications during pregnancy or childbirth (2015) [1]. It is very important for the mothers to have knowledge regarding antenatal and postnatal care after caesarean section. So, the present study was conducted to find the knowledge and practices regarding antenatal care and care of self and newborn after caesarean section.

Objective: The study was conducted with the objectives of “to assess the effectiveness of ‘Health Promotion Interventions’ for women undergoing elective caesarean in PGIMER, Chandigarh on knowledge and practices related to antenatal care.

Method: A quasi experimental study was done in OBG unit of Nehru hospital PGIMER, Chandigarh during the month of July-Aug 2019. Total 80 pregnant mothers admitted for elective caesarean section were enrolled as per inclusion criteria by using purposive sampling technique. Pregnant mothers were interviewed by using interview schedule to assess knowledge and practices. The tool was validated by experts of National Institute of Nursing College, Obstetrics and Gynecology Department and department of Physiotherapy PGIMER, Chandigarh. Each interview took 25-30 minutes to complete.

Results: The mean age of the subjects was 29.32 ± 4.4 years. Majority of subjects (37%) had placenta previa as the indication of elective caesarean. More than half of the mothers were aware about diet (53%) and importance of personal hygiene (100%) in antenatal period. Less than half of the mothers were had knowledge regarding other aspects of antenatal care like rest and sleep (45.8%), body mechanics (44.6%), less than half of the mothers were practicing antenatal exercises i.e. deep breathing exercises (12%), foot and ankle exercises (2.4%) and maintaining daily fetal movement count (25.3%). Majority of the mothers were knew about breastfeeding (initiation, duration, position) (65.1%), condom and oral pills as contraceptive methods (78.3% and 61.4% respectively) but less than half of the mothers were had knowledge about breastfeeding complications and their management (38.6%), warning signs of postpartum complications (19.3%), about lochia (38.6%), postnatal exercises (4.8%), benefits of early ambulation (13.3%), about another contraceptive methods and newborn care after caesarean section.

Conclusion: Hence, has been concluded that there was a need to plan a health intervention program or protocol aiming to improve the maternal health knowledge and practices which eventually improve the health status of the mothers as well as baby.

Keywords

Antenatal care, Self-care after caesarean section, Newborn care

Introduction

Pregnancy is the period of transition which would nearly disturbed the every aspect of a woman’s life. The postoperative course of a mother having a caesarean section is different for each mother. The issues related to the postpartum period can be managed by providing efficient, effective, quality nursing care to postnatal mothers and their neonates. Mothers have to face different problems during pregnancy, immediately after childbirth and in the postnatal period. During pregnancy the problems faced by the mothers are lower back pain, swelling of the lower legs, heartburn, breathing difficulties which are most common complaints amongst women during the antenatal period, have a great impact on their quality of life. Certain interventions like education on body mechanics for back pain, range of motion exercises for leg swelling, deep breathing exercises, and advising mother to lie in left lateral position and diet modifications including small and frequent meal can reduce these problems to some extent. If the mothers have knowledge regarding these problems and their interventions she will be able to deal with the problems early and can prevent arising of complications. Health knowledge is an important element to enable mothers to be aware about their health status and any abnormal signs which required further investigations. Only on the basis of knowledge assessment we are able to finds the gaps and interventions to fulfill these gaps in improving maternal and newborn health. So, this study was conducted to determine the level of knowledge and practices regarding antenatal care and knowledge regarding postnatal care and newborn care after caesarean section. This will be used as baseline data and will help the future planning of Health Intervention Program. Various literatures had proved that the knowledge gaps, cultural beliefs and behavioral pattern of which mothers had an impact on neonatal skin-care. Health education needs to change wrong practices [2]. The studies were also suggested that educations provided in antenatal period will results in better maternal and neonatal outcomes. The quality of the health care for mothers and newborns is supported with education; their health status will be affected positively in future [3] Education can be provided by using different methods like self-instructional module and information booklet. Similar findings were found in the another study that self- instructional module was effective in improving the knowledge of mothers on postoperative self-care after caesarean section [4].

Objective

To assess the eff ectiveness of ‘Health Promotion Interventions’ for women undergoing elective caesarean in PGIMER, Chandigarh on knowledge and practices related to antenatal care.

Material and Method

A quasi experimental study study was done in OBG unit including clean labor room, maternity ward, Gynae ward and CLR extension of Nehru hospital PGIMER, Chandigarh during the month of July-Aug 2019. Total 80 pregnant mothers were enrolled as per inclusion criteria i.e. pregnant mothers admitted for elective caesarean section with ≥ 32 weeks of gestation period and who were willing to participate. The women with known mental illness were excluded. Purposive sampling technique was used for data collection. Ethical clearance was obtained from the Institute Ethics Committee PGIMER, Chandigarh with reference number (NK/5167/MSc/10). Written permission was taken from the Head of the Department of Obstetrics and Gynaecology, PGIMER Chandigarh. Patient information sheet was given the pregnant mothers which contains all the information regarding the study. Informed Written Consent was obtained from the pregnant mothers enrolled in the study. Anonymity and confidentiality of the study subjects were maintained. The investigator was introduced her to the pregnant mothers and gradually moved to the interview by asking questions, data was also taken from hospital records. Pregnant mothers were interviewed by using interview schedule which included a) Socio-demographic profile b) Obstetrical profile c) Self-developed questionnaire included questions regarding knowledge and practices of pregnant mothers on antenatal care and care after caesarean section. The tool was validated by experts of National Institute of Nursing College, Obstetrics and Gynecology Department and department of Physiotherapy PGIMER, Each interview took 25-30 minutes to complete.

Results

Socio-Demographic Profile of the Subjects

As shown in Table 1 the mean age of the subjects was 29.32 ± 4.4 years. More than half of the mothers (60.2%) of the subjects were Hindu. Majority of the pregnant mothers and their spouse (54.2% and 62.7%) had education up to senior secondary and above level respectively. More than half of the pregnant mothers (85.5%) were homemaker and more than half of the spouse were doing private job. Most of the subjects (75.9%) were having joint family. The mean monthly per capita income of the subjects was 4795 ± 4913.2rupee symbol.

Table 1: Socio-demographic profile of the subjects (n=80)

Variables

f (%)

Age* (years)
20-25

13 (15.7)

26-30

40 (48.2)

>30

27 (32.5)

Religion

Hindu

50 (60.2)

Sikh

25 (30.1)

Others

5 (6.0)

Educational qualification of mother
Primary

13 (15.7)

Secondary

22 (26.5)

Senior secondary and above

45 (54.2)

Occupation status of mother
Homemaker

71 (85.5)

Working

10 (12.0)

Educational qualification of spouse
Primary

7 (8.4)

Secondary

21 (25.3)

Senior secondary and above

52 (62.7)

Occupation status of spouse
Private job

69 (83.1)

Govt. job

11 (13.3)

Family type
Nuclear

17 (20.5)

Joint

63 (75.9)

Monthly per capita income (rupee symbol)#
7008 and above

20 (24.1)

3504-7007

21 (25.30)

2102-3503

13 (15.7)

1051-2101

14 (16.90)

Below 1050

12 (14.5)

*Mean ± SD=29.32 ± 4.4
#Mean ± SD=4795 ± 7012.1

Obstetrical Profile of the Subjects

As shown in Table 2 that more than half of the subjects (67.5%) were multigravida and 28.9% and of subjects were primigravida. Majority of the subjects (79.5%) were having a period of gestation between 33 weeks to 37 weeks.

Table 2: Obstetrical Profile of the subjects admitted for elective caesarean (n =80)

Variables

f (%)

Gravida
Primi

24 (28.9)

Multi

56 (67.5)

Period of gestation (in weeks)
33-37

66 (79.5)

>38

14 (16.9)

Pre-interventional comparison of knowledge regarding antenatal self-care among subjects shown in Table 3a, mean baseline knowledge about nutrition among subjects was 14.8 ± 1.39 and 3.7 ± 0.72) in the subjects of control and experimental group respectively (p=<0.01). Mean baseline knowledge about the rest and sleep of the mother in control and experimental groupwas 2.95 ± 1.71 and 3 ± 0.81 respectively (p=0.77). Mean baseline knowledge about body mechanics was 1.62 ± 0.49 and 1.45 ± 0.50 respectively (p=0.11). Mean baseline knowledge about preparation for elective caesarean was 1.80 ± 0.4 and 1.75 ± 0.43 respectively (p=<0.01). The total Mean baseline knowledge amongst subjects about antenatal self- care in control and experimental group was 15.6 ± 1.28 and 14.8 ± 1.39 respectively (p=0.06).

Table 3a: Pre-interventional comparison of knowledge regarding antenatal self care among subjects of Control group and Experimental group in antenatal period (n=80)

Knowledge domain (maximum attainable score)

Control group (n1=40) Mean ± SD Experimental group (n 2=40) Mean ± SD

χ2/Fisher*/t value (df) p value

Nutrition (6)

14.8 ± 1.39

3.7 ± 0.72

-3.59

(78) 0.001*

Rest and sleep (4)

2.95 ± 1.71

3 ± 0.81

0.29

(78) 0.77

Hygiene (10)

5 ± 0

5 ± 0

Body mechanics (2)

1.62 ± 0.49

1.45 ± 0.50

-1.57

(78) 0.11

Pre-preparation for elective caesarean (2)

1.80 ± 0.4

1.75 ± 0.43

-0.53

(78) 0.59

Total (24)

15.6 ± 1.28

14.8 ± 1.39

-2.8

(78) 0.06

*p value significant at <0.05

Pre-interventional comparison of antenatal care practices among subjects shown in Table 3b that deep breathing exercises were performed by only 20% and 5% subjects in the control and experimental group respectively. Majority of the subjects in the experimental group (55%) and in the control group (22.5%) performed walking after each meal. In the control group (32.5%) and in the experimental group (20%) of subjects were keeping a record of daily fetal movements count.

Table 3b: Pre-interventional comparison of antenatal care practices among subjects of Control group and Experimental group (n=80).

Variables

Control group (n 1=40) f (%) Experimental group (n2=40) f (%)

χ2/Fisher$/value (df) p value

Antenatal Exercises
Deep breathing exercises Foot and ankle exercises. Kegel exercises
Walking 10-15 min after each meal

8 (20)
1 (2.5)
0 (0)
18 (22.5)

2 (5)
1 (2.5)
1 (2.5)
22 (55)

1.11  (1) 0.09#
1.0 (1) 1.0
1.01$
0.80 (1) 0.37

Daily fatal movements count chart

13 (32.5)

8 (20)

1.61 (1) 0.20

#Yates correction

Post-interventions comparison of knowledge regarding antenatal self-care among subjects as shown in Table 4, Mean knowledge about rest and sleep of the mother in control and experimental group was 2.9 ± 1.01 and 2.2 ± 0.40 respectively (p=<0.01). Mean knowledge about body mechanics was 1.62 ± 0.45 and 1 ± 0 respectively (p=<0.05). Mean knowledge about preparation for elective caesarean was 1.72 ± 0.45 and 1 ± 0 respectively (p=<0.01). The total Mean knowledge amongst subjects about self-care in the antenatal period was 15.6 ± 1.43 and 12.1 ± 0.36 respectively (p=<0.001). Hence, post- interventional knowledge score of subjects regarding antenatal self- care in the experimental group was significantly higher as compared to the control group.

Table 4: Post-interventions comparison of knowledge regarding antenatal self care among subjects of Control group and Experimental group in antenatal period (n=80).

 

Variables

Control group (n 1=40)

Means/

f (%)

Experimental group (n 2=40) Mean ± SD/f (%)

χ2/t value (df) p value

Nutrition (6)

4.3 ± 0.82

3 ± 0

-10.11

(78) <0.001*

Rest and sleep (4)

2.9 ± 1.01

2.2 ± 0.40

-4.35

(78) <0.001*

Hygiene (10)

40 (100)

40 (100)

Body mechanics (2)

1.62 ± 0.45

1 ± 0

-9.0

(78) <0.001*

Pre-preparation for elective caesarean(2)

1.72 ± 0.45

1 ± 0

-10.14

(78) <0.001*

Total (24)

15.67 ± 1.43

12.1 ± 0.36

-15.02

(78) <0.001*

*p value significant at <0.05.

Post-interventional comparison of antenatal care practices among subjects as shown in Table 5, that a significantly higher percentage of subjects in the experimental group was adherent to antenatal exercises, deep breathing exercises (100%), foot and ankle exercises (100%), walking after each meal (100%), Kegel exercises (97.5%) and daily fetal movement count (100%) whereas in the control group lower percentage of subjects were doing deep breathing (15%), foot and ankle exercises (2.5%), walking (42.5%), daily fetal movement count (32.5%) and no one had performed kegel exercises. Findings revealed that post-intervention almost 100% of the subjects in the experimental group performed antenatal exercises and maintained a daily fetal movement count chart as compared to the control group.

Table 5: Post-interventional comparison of antenatal care practices among subjects of Control group and Experimental group (n=80).

Variables

Control group (n1=40) Mean ± SD/f (%) Experimental group (n2=40) Mean ± SD/f (%)

χ2/t value (df) p value

Antenatal Exercises
Deep breathing exercises Foot and ankle exercises. Kegel exercises
Walking 10-15 min after each meal.

6 (15)
1 (2.5)
0
17 (42.5)

40 (100)
40 (100)
39 (97.5)
40 (100)

59.13 (1) 0.001*
76.09 (1)<0.001*
76.09 (1) 0.001*
32.28 (1)<0.001*

Daily fatal movements count chart

13 (32.5)

40 (100)

45.49
(1) <0.001*

*p value significant at <0.05.

Discussion

Pregnancy is the one of the most important event in the life for all mothers. From the conception until postpartum it may be a critical time for the mother and baby. The postnatal period becomes much difficult when it is after caesarean section. At this time consistent care is required by the mother. Previous knowledge about post caesarean period plays an important role in the recovery and the mother is also motivated for breastfeeding and newborn care. The health care personals are obliged to educate the mothers in antenatal period. It is said that by educating a mother we educate a family, a community and whole nation. So, knowledge plays an important role in lowering the maternal and infant mortality and morbidity. The present study was conducted with the objective of assessment of assess knowledge and practices regarding antenatal care and knowledge regarding self-care and newborn care after caesarean section. The mean age of the subjects was 29.32 ± 4.4 years. In the present study pregnant mothers with ≥32 weeks of gestation admitted for elective caesarean section were selected. In the current study more than half of the subjects (67.5%) were multigravida and 28.9% and of subjects in were primigravida. Majority of the subjects (79.5%) were having a period of gestation between 33 weeks to 37 weeks. In the present study is has found that the majority of subjects (37%) had placenta previa as the indication of elective caesarean. In the present study it has been found that more than half of the pregnant mothers (53%) were had knowledge about nutrition to be taken in antenatal period. 45.8% of the pregnant were know about rest and sleep as an important aspect in antenatal period. 44.6% of the pregnant mothers had knowledge regarding body mechanics and only 21.7% of the pregnant mothers were aware of preparation for elective caesarean section. The present study was supported by study done by V Yashodha (2014). Study results showed that majority of mothers (82%) were had inadequate knowledge and 18% had moderately adequate knowledge, 54% had moderate and only 10 had adequate knowledge regarding antenatal care. The study concluded that by providing information guide sheet, knowledge can be improved [5]. The present study concluded that lower percentages of the mothers were practicing antenatal exercises i.e. only 12% of the mothers were performed deep breathing exercises. Majority of the subjects (48.2%) were performed walking after each meal. Only 2.4% of the pregnant mothers were performed foot and ankle exercises. These findings were consistent with the findings of Elamurugan Sujindra et al. who reported that knowledge and practices of antenatal exercises was less than average and a very few mothers were practicing exercises in pregnancy [6].

Current study found that more than half of the pregnant mothers (65.1%) had knowledge regarding breastfeeding (initiation of breastfeeding, correct positioning and burping and exclusive breastfeeding upto 6 months) but they don’t know the correct duration, position and attachment. A similar study done by Dr. Deepanjan Ray et al. concluded that benefits of breastfeeding was known to majority but correct duration, intervals, initiation were lacking [7]. Less than half of the pregnant mothers were having knowledge about breastfeeding complications and their management (breast engorgement, cracked and sore nipples) (38.6%), hunger signs of the newborn (32.5%) and about spoon and katori feed (28.9%) respectively. Majority of the pregnant mothers (49.4%) were known about incisional site care. Only 4.8% of the pregnant mothers were known about postnatal exercises and its benefits. The present study resulted that more than half of the mothers (81.9%) were had knowledge about maintenance of temperature of the newborn. Less than half of the mothers were have knowledge regarding normal weight of newborn (41%), changes in weight of the newborn with days of life (3.6%), umbilical cord care (27.7%), not to apply kajal (21.7%), sponge bath after 24 hours of the birth (27.55%), eye care ( inner canthus to outer canthus) (16.9%), skin care (32.5%), warning signs of newborn (33.7%) and immunization respectively (12%) . The present study was supported by similar study done by Ali BCT et.al. which was resulted that the awareness about postnatal care and breastfeeding was good among participants while lacking in a few aspects like vaccination. Hence, the study concluded that there is a need to educate the antenatal mothers about various aspects of vaccination and postnatal care [8]. More than half of the pregnant mothers were known about condom (78.3%,) and oral pills (61.4%) as contraceptive methods respectively. Less than half of the mothers were known about permanent methods (43.4%) and PPIUCD (33.7%). The study was supported by the similar study done by Radha Sangavi et. al. which was concluded that 78% of the subjects were aware about barrier method of contraception [9]. Hence, the study was concluded that pregnant mothers were having adequate knowledge about diet and importance of personal hygiene in antenatal period, about breastfeeding, about temperature maintenance in newborn. More than half of the mothers were known about condom and oral pills as methods of contraception. But less than half of the mothers had knowledge about antenatal exercises, about DFMC, post caesarean care, about alternative methods of contraception and about newborn care.

References

  1. International Journal of Community Medicine and Public Health Kaur A et al. Int J Community Med Public Health. 2018 Oct; 5.
  2. Srinivasa S, Bhavya G, Patel S, Harish S, Anjum SK (2018) Knowledge, attitude and practice of mothers in infantile skin care. Int J Contemp Pediatr 5: 536-541.
  3. Esin Çeber, Neriman Sogukpinar, Birsen Karaca Saydam, Rabia Ekti Genç Hafize Öztürk Can, et al. (2013) Mother and Newborn Home Care Education Program The Effects of “Mother and Newborn Home Care Education Program (MNHCEP)” on Mother and Persons Providing Care of Mother/Newborn.
  4. Rajan E, Nayak S (2014) Effectiveness of self instructional module on knowledge of post operative self care for mothers undergoing elective caesarean section in selected hospitals, Nitte Univ J Heal Sci 4: 39-41.
  5. YashodhaV, Hemavathy V (2020) The knowledge of primigravida mother regarding antenatal care in selected rural and urban areas. International Journal of Innovative Research in Science, Engineering and Technology 3.
  6. Sujindra E, Bupathy A, Suganya A, Praveena R (2015) Knowledge, attitude and practice of exercise during pregnancy among antenatal mothers. Int J Educ Psychol Res 1: 234-237. [crossref]
  7. Deepanjan Ray, Abdur Rahman, Aprajita Dasgupta (2015) A cross-sectional study to assess breastfeeding knowledge among antenatal mothers. IOSR journal of Dental and Medical Science 14.
  8. Ali BCT, Fysal N, Asha Saleema CV, et al. (2019) Study about the knowledge and attitude of anatnatal women on postnatal care and immunization. Int J Contemp Pediatr 6: 1003-1007.
  9. Sangavi R, Hantoor S (2018) Knowledge, attitude and practice of contraception among antenatal care Int. J Repord Contracept Obstet Gynecol 7: 3065- 3068.

Monocrystalline lonsdaleite in REE-Rich Fluorite from Sadisdorf and Zinnwald/E-Erzgebirge, Germany

DOI: 10.31038/GEMS.2024643

Abstract

We present the results of our Raman studies on natural lonsdaleite crystals in fluorite of the two tin deposits Sadisdorf and Zinnwald in the E-Erzgebirge/Germany. The Raman spectra,  specially from Zinnwald, can deconvoluted into three Raman-active vibrational modes: E2g, A1g, and E1g. For the origin, transport via supercritical fluid or melting from the mantle region into the crust is necessary.

Keywords

Lonsdaleite, REE-rich fluorite, Raman spectroscopy, Sadisdorf and Zinnwald tin-tungsten deposits, Supercritical fluid

Introduction

The Variscan Erzgebirge (German side) and Krušné hory (Czech side) contain many tin-tungsten deposits of vein and greisen type. Famous deposits are that from Zinnwald, Cinnovec, Krupka, Sadisdorf, Ehrenfriedersdorf, and Geyer. For the regional geology and description of single deposits, extensive literature is present [1-5] and references in these). From a repetition of that, we will abstain because our described observations are new and do not fit into the old genetic view, forcing us to adopt a new approach for the whole region. In the abandoned Sadisdorf Sn-W-(Cu) deposits, there are vein and greisen- type mineralizations (Figures 1a and 1b).

The frequently present breccia pipes here are analogous to the famous Schneckenstein breccia in the W-Erzgebirge, which is very characteristic of this mineralization type [6]. During the study of thin sections from the Sadisdorf deposit, peculiar violet fluorite aggregates attract attention. These aggregates contain many black, sometimes bent needles, as well as also spherical to elliptical carbon solids. A similarity to the other described new findings of spheric high-pressure minerals is very obvious (see, for example, Thomas et al., 2023) [7]. This publication also contains a schematic geological map of the Erzgebirge-Vogland Zone with the Variscan granites, etc.

fig 1a

Figure 1a: Location and simplified geological map of the Sadisdorf and Zinnwald deposit/ E-Erzgebirge.

fig 1b

Figure 1b: Schematic cross-section through the Sadisdorf deposit with the approximate origin place of the studied sample. The green color marks the origin of the Sadisdof sample.

Sample Material

Sadisdorf

The rock material is from the endocontact of the tin-tungsten- copper deposit Sadisdorf in eastern Erzgebirge/Germany [1,8]. The sample thin section (SD-H01B) is from a fine-granular white quartz-topaz rock with violet fluorite, taken during the exploration campaign Sc-ore 2012/2013 – the violet fluorite is, according to Raman spectroscopy, very REE-rich. Besides the primary mineral quartz and rarer topaz, there are many small, mostly opaque mineral grains of wolframite, cassiterite, columbite, and others. The large fluorite aggregates are not isomorphic but more in tube or irregular form. Smaller fluorite crystals are isometrically. These large tubular fluorite aggregates contain many black and transparent needles, grains, and curved crystals (Figure 2) and are generally fluid inclusion-free. If present, then they are secondary late formations.

The curved black crystal (Figure 2) contains many nano-diamonds. The straight black needles are prevailing graphite-like material. Graphite is very often present in the Variscan tin mineralization, and it is also often present in cassiterite. Graphite has mostly not been paid attention to in the past.

fig 2

Figure 2: Curved graphite aggregate with nano-diamonds in REE-rich fluorite. All black points are graphite-like stuff and contain nano-diamonds.

Zinnwald

For comparison, we used fluorite grains included in tabular zinnwaldite crystals from the Zinnwald deposit (deep Bünau gallery) in the E-Erzgebirge/Germany, which is not far from the Sadisdorf deposit (taken by the first author in 1984). This violet fluorite sample contains numerous sharp black disk-like bodies of lonsdaleite-diamond-graphite (Figure 3). Some of these form half- moon-like bodies (Figure 4) where the sharp edges lie parallel to the crystallographic{100} planes.

It follows from Figures 3 and 4 that the black bodies obviously form hemispheres on the fluorite surfaces. The general impression is that this fluorite is an early formation and has a more plastic behavior at the formation time. That spoke for a high-temperature and high- pressure formation from a fluorine-rich melt containing such C-aggregates.

fig 3

Figure 3: Small disk-like bodies of lonsdaleite in fluorite from Zinnwald/E-Erzgebirge (top view).

fig 4

Figure 4: Side view of such bodies, as shown in Figure 3, arranged to the growth zones of the fluorite host.

Methodology: Microscopy and Raman Spectroscopy

For the study of the lonsdaleite-diamond-graphite-bearing samples and their paragenetic main minerals, we use the Zeiss JENALAB pol as well as the Raman spectrometer EnSpectr R532 combined with the Olympus BX43 microscope both for transmitted and reflected light and equipped with a rotating stage. Note here that the incident laser light is always polarized – in our case, N – S (see Tuschel, 2012) [9]. Generally, we used an Olympus long-distance LMPLFL100x objective lens. For the identification of different minerals, we used the RRUFF and the Hurai et al. Raman mineral databases [10,11]. As references, we applied a water-clear diamond crystal from Brazil (1331.63 ± 0.60 cm-1 and a semiconductor-grade silicon single-crystal (520.70 ± 0.15 cm-1). For this study, we used laser energies from 0.9 to 50 mW on the sample. Because the minerals lonsdaleite, diamond, and nano- diamond contain black graphite particles and are metastable in the new upper crust surrounding, heating by the laser energy can partially destroy these minerals in the extreme case or shift the characteristic peak position of Raman bands [12,13] to lower values.

Results

Sadisdorf

The sizeable bent carbon crystal (Figure 2) contains many small nano-diamonds. The diamond main band lies at 1331.8 ± cm-1 (11 different crystals). The FWHM (Full Width at Half Maximum) is 83.1 ± 13.9 cm-1. Needle-formed diamonds, generally black, give the prominent diamond peak a value of 1333.6 ± 5 cm-1 (5 needles). In violet REE-rich fluorite of the rock, there are a lot of black needles and sphäric or elliptic crystals. Some needles are twisted or bent. Most of them contain graphite or carbonaceous material (see Beyssac et al., 2002) as well as nano-diamonds. There are also whisker-like transparent and some thick, short, transparent prismatic crystals. As a total surprise, the rare whiskers and these short prismatic crystals are, according to Raman spectroscopy, lonsdaleite (Lon). Such crystals are present exclusively only in fluorite. Figure 5 shows two such prismatic lonsdaleite crystals, and Figure 6 depicts a lonsdaleite whisker. The lonsdaleite crystal (Lon) in the center of Figure 5 is 14 x 2 µm large.

fig 5

Figure 5: Lonsdaleite (Lon) crystals in REE-rich fluorite

By the Raman spectrum (band at 1325 cm-1), these transparent crystals are monocrystalline lonsdaleite (see Shumilova et al., 2011) [14] and, according to Bhargava et al. (1995) [15], hexagonal diamond. By the form (long-prismatic), the hexagonal diamond has a high probability of being lonsdaleite (Figure 6).

With Raman spectroscopy, we obtained the following data for the five lonsdaleite crystals: 1318 ± 3.8 cm-1. Opposite to fluorite, the black points (mainly carbon) in quartz are ore minerals like wolframite, columbite, and different sulfides. Obviously, bulk rocks (quartz and topaz) are the result of varying evolutions. Fluorite looks like remnants of a high-temperature melt. According to Seiranian et al. (1974), the eutectic points in the CaF2– YF3 system occur at 60 and 91 % (mol/mol) and 1120 and 1106 °C. Similar systems (CaF2-BaF2) have analog high temperatures (Figure 8) [16].

Zinnwald

In the violet fluorite from Zinnwald, there are a lot of black bodies (Figures 3 and 4). Some are large enough to perform systematic Raman studies. In the beginning, we used 20 mW on the sample. The corresponding Raman spectrum (Figure 9) resembles the monophase lonsdaleite (Figure 3 in Shumilova et al., 2011) [14]. To prevent heating of the lonsdaleite sample by always presenting black carbon, we used low laser energy on the sample (0.9 mW of the 532 nm laser). The authors Goryainov et al., 2018 [17] used the excitation of a UV laser with a wavelength of 325 nm and low intensity of 1 mW on the sample.

Interpretation

The synthesis of hexagonal lonsdaleite succeeded in 1966 by Bundy and Kasper (1967) – [18] at 1000°C and 130 kbar. In nature, lonsdaleite was found first (1967) in the Canyon Diablo meteorite by Frondel and Marvin (cited in Shumilova et al., 2011) [14] and in the Kumdykol diamond deposit (North Kazakhstan) by Shumilova et al., 2011) [14]. The Raman bands at 1318 to 1324 cm-1 are evident and characteristic of the hexagonal diamond phase in the Sadisdorf material (see also Misra et al., 2006) [19]. Lonsdaleite in the fluorite shows a certain metastability due to laser irradiation, perceptible by the increase of the G bands at about 1580 to 1600 cm-1 (Figures 6 and 8) and the black coloring of the nearly colorless lonsdaleite crystals during the Raman measuring. The metastability of high-pressure minerals coming from mantle deeps and staying at high temperatures for a long time in low- pressure regions (upper crust) is very characteristically [13,20-22]. One exception is moissanite here, which is very stable. Because lonsdaleite is a high-pressure and high-temperature mineral, its formation in the deposit level (≤ 3km; see Thomas and Klemm, 1997) [23] is usually not possible. Therefore, the formation of the lonsdaleite-bearing fluorite occurred at significantly greater depths and came from mantle depths via supercritical fluids or melts into the crustal level. However, the formation of lonsdaleite whisker is, at the moment, a mystery.

fig 6

Figure 6: Raman spectrum of both lonsdaleite crystals in Figure 5. The broad Raman band at about 1325 cm-1 results from a small component of diamond (a two-phase crystal of lonsdaleite-diamond [14].

fig 7

Figure 7: Lonsdaleite (Lon) whisker in fluorite. The whisker has a length of 45 µm and a thick of 0.9 µm.

fig 8

Figure 8: Raman spectrum of the whisker-like (Figure 7) monophase lonsdaleite crystal (characteristic band at 1319 cm-1). The bands at 321 cm-1 and lower values come from the matrix fluorite.

fig 9

Figure 9: Raman spectrum of lonsdaleite in fluorite from Zinnwald/E-Erzgebirge taken at 20 mW on the sample.

Discussion

According to Németh et al., 2014 [24] lonsdaleite does not exist as a discrete material. That is in contradiction to our observations. Figures 5 and 7 clearly show prismatic crystals with a Raman spectrum corresponding, according to Shumilova et al. (2011) [14], to natural lonsdaleite. Of course, the formation of lonsdaleite is unclear. However, this material is existent as prismatic crystals. The lonsdaleite whisker (Figure 7) shows the same Raman spectrum. Although it is well-known that cubic crystals can also form whiskers (for example, GaP-whiskers grown from a non-stochiometric Sn-melt produced by the first author in 1970 (unpublished results). Shiell et al. (2016) [25] report the synthesis of almost pure nanocrystalline lonsdaleite in a diamond anvil cell at 100 GPa and 400°C from glassy carbon. That means lonsdaleite is, in contrast to Németh et al. (2014) [24], a discrete material. Our findings of macroscopic lonsdaleite in fluorite from Sadisdorf underline this statement. That means at least that at the formation of lonsdaleite, an enormous pressure has worked. Conceivable is the transport from mantle regions via supercritical fluids or melts or a tremendous pressure impact during the breccia formation. The lonsdaleite crystals in violet fluorite from Zinnwald/E- Erzgebirge are more frequent and more stable than the lonsdaleite from Sadisdorf. Therefore, we could perform more Raman measurements under different conditions. At the high intensity of the laser (about 20 mW on the sample), a very strong graphite line at 1581 cm-1 appears. The clear differentiation between diamond and lonsdaleite is uncertain (line at 1328 cm-1). To avoid heating the lonsdaleite sample using the laser, we used a low-intensity laser excitation (0.9 mW on the sample) in analogy to Goryainov et al., 2018) [17], which used a 325 nm UV laser with 1 mW on the sample. Figure 10 shows the results of our measurements. We see clearly three Gaussian components at (1251.3 ± 9.4 cm-1), (1310.6 ± 3.9), and (1350.4 ± 9.9 cm-1), with the FWHMs of 57.4, 58,8, and 67.0 cm-1, respectively – 10 measurements each. These three experimental lines, according to Goryainov et al., 2018 [17], can be assigned to the theoretical Raman lines E2g, A1g, and E1g obtained through ab initio calculations [17]. Independent of the interpretation of our described carbon phases as lonsdaleite or hexagonal diamonds as inclusions in upper crustal minerals, transport via supercritical phases from the mantle region to the crust is necessary. Our here-presented results increase the number of high- pressure and high-temperature minerals (diamond, nano-diamonds, moissanite, stishovite, coesite, kumdykolite, beryl-II, cristobalite-II, cristobalite X-I, and CaCl2-type cassiterite) in the Variscan granites and tin mineralizations in the crustal Erzgebirge region [26].

fig 10

Figure 10: Raman spectrum of a lonsdaleite crystal (diameter ~ 24 µm, thickness ~14 µm) in fluorite from Zinnwald/E-Erzgebirge, taken with 0.9 mW on the sample and a measuring time of 1000 s.

Acknowledgment

For the longstanding and often controversial discussions of the interaction between mantle and crust, the first author thanks Otto Leeder (1933-2014) from the Mining Academy Freiberg.

References

  1. Baumann L, Kuschka E, Seifert T (2000) Lagerstätten des Enke. Pg: 300.
  2. Hösel G (1994) DasZinnerz-Lagerstättengebiet Ehrenfriedersdorf/Erzgebirge. Bergbau in Sachsen. Bd.1, Pg: 195.
  3. Leopardi D, Gutzmer J, Lehmann B, Burisch M (2024) The spatial and temporal evolution of the Sadisdorf Li-Sn-(W,Cu) magmatic-hydrothermal greisen and vein system, Eastern Erzgebirge, Germany Economic Geology 110: 771-803.
  4. Seltmann R, Kampf H, Möller P (eds) (1994) Metallogeny of Collisional Orogens focused on the Erzgebirge and comparable metallogenetic settings. Czech Geological Survey, Prague 1994, Pg: 448.
  5. Weinhold G (2002) die Zinnerz-Lagerstätte Altenberg/Osterzgebirge. Bergbau in Bd. 9, 283 p.
  6. Rösler HJ, Baumann L, Jung W (1968) Postmagmatic mineral deposits of the northern edge of the Bohemian Massif (Erzgebirge-Harz). International Geological Congress, XXIII Session, guide to Excursion 22 AC, ZGI: 57 p.
  7. Thomas R, Davidson P, Rericha A, Recknagel U (2023) Ultrahigh-pressure mineral inclusions in a crustal granite: Evidence for a novel transcrustal transport mechanism. Geosciences 13: 1-13.
  8. Schröcke H (1954) Zur Paragenese erzgebirgischer Zinnlagerstätten. Neues Jb Mineral Abh 87: 33-109.
  9. Tuschel D (2012) Raman crystallography, in theory and in Spectroscopy 27: 2-6.
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  11. Hurai V, Huraiova M, Slobodnik M, Thomas R (2015) Geofluids – Developments in Microthermometry, Spectroscopy, Thermodynamics, and Stable Isotopes. Elsevier, Pg:489.
  12. Tuschel D (2016) Raman Spectroscopy 31: 8-13.
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  17. Goryainov SV, Likhacheva Y, Ovsyuk NN (2018) Raman scattering in Journal of Experimental and Theoretical Physics 127: 20-24.
  18. Bundy FP, Kasper JS (1967) Hexagonal diamond – a new form of carbon. The J of Chemical Physics 46: 3437-3446.
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Commentary on “The Clinical Syndromes Produced by the Offensive Biological Agents”

DOI: 10.31038/IDT.2024515

Commentary

This presentation was due to cover a wide range of clinical syndromes, induced by microorganisms that could be used as biological threats. This was issued for the European Training in Infectious Disease Emergencies (ETIDE), held at the Lazzaro Spallanzani Institute of Infectious Diseases in Rome, Italy, where I participated as lecturer during 2008-2009.

The presentation has a general part that was reviewing the main European Programs concerning the highly infectious diseases, then defining the clinical microorganisms which to be concerned off, and reviewing the main clinical syndromes produced by such microorganisms, then the main syndromic presentations: respiratory, influenza-like, digestive, neurologic, cutaneous, sepsis.

The isolation precautions basics were discussed, then I focused on the general means of laboratory diagnosis (sample collection for isolate, immunological testing, toxin detection, molecular biology).

On the special part of presentation I focused on each syndrome and the microrganisms that induced it, discussing the etiology, modes of transmission, clinical presentation, the definite diagnosis, the treatment and the preventive measures.

Thus as respiratory syndromes I discussed the: anthrax, plague, tularemia, melioidosis, glanders, SARS, for the influenza like syndromes (influenza), for the neurological syndromes (botulism, anthrax), cutaneous syndromes ( anthrax, plague, tularemia, melioidosis, glanders, smallpox), for sepsis (plague, melioidosis, glanders, hemorrhagic fevers), as for the digestive syndromes (gastrointestinal anthrax, tularemia, the hemolytic uremic syndrome).

Towards the end of my presentation I discussed the coordinated response against those biological threats (e.g for paramedics, triage nurses, nurses), and the conclusions: that bioweapon proliferation is a contemporary reality, the potentially use of the genetically modified microorganisms.

The reality was that the syndromic approach represents a ready and efficient answer to bioweapon threats, and a practical and efficacious way to biodefense. The proper strategically approach includes: the coordinated response (medical and social) where co-operation is necessary.

Thus, my presentation represents a synthesis of the syndromes produced by the offensive microbiological agents, and the proper preparing for those conditions is a realistic way to protect the population for the eventuality of these unwanted events.

“A Spirit Encroachment”: Hysterical Possession, Case Study from Kerala

DOI: 10.31038/AWHC.2024724

Abstract

The Present case of a 45-year-old female with a 10th-grade education who presented with a history of episodes where she would display extraordinary strength while becoming aggressive towards her family members and displaying bizarre behavior. The period was short. She was diagnosed with hysterical based on possession. She would always claim amnesia for the event. She claimed a hidden treasure that was in her dream in her backyard and seemed to be also possessed with spirit as she said. The family tried black magic to cure it. But the black magician tries to physically assault her. Later she starts showing physical symptoms of hysterical possession. She always tries to avoid her family husband and children. The suggestions of a close family member brought the patient for consultation in the hypnotherapy and counseling clinic. The present case illustrates how sexual harassment can lead to possession. Visualization hypnotherapy and counseling were the treatments given to the client. Finally, the client completely cured.

Keywords

Hysterical possession, Hypnotherapy, Counseling, spirit

Introduction

The word “hysteria” is frequently used to define highly charged, seemingly uncontrollably emotional behavior. During the Victorian era, the term hysteria was a common medical diagnosis, especially for women. Hysteria was viewed as a psychological disorder as far back as 1900 BCE. The word hysteria comes from the Greek “hystera”, which means “uterus”. This is when ancient Egyptians first described the condition, adding that it was caused by “spontaneous uterus movement.” This was also sometimes referred to as having a wandering uterus. In the early 1600s, the focus switched, such as when anatomist Thomas Willis concluded that hysteria did not originate in the uterus, but in the brain. This understanding opened the possibility that hysteria could affect men as well. In the 1800s, for instance, French neurologist Jean-Martin Charcot utilized hypnosis to treat women suffering from hysteria. It was Freud’s work with colleague Josef Breuer on the case of Anna O, a young woman experiencing symptoms of hysteria. that helped lead to the development of psychoanalytic therapy.Carl Jung, a colleague of Freud’s, treated a young woman named Sabina Spielrein who was also thought to suffer from hysteria. The term “hysterical neurosis” was first mentioned in the second edition of the DSM (DSM-II), published in 1968, but has since been abandoned in favor of a diagnosis of somatic symptom disorder, dissociative disorder, or conversion disorder [1-8].

Sensory Disturbances

These disturbances include paresthesia, hypersensitivity, and complete or partial loss of sensation. In severe cases, hysteria may also cause damage to other sensory organs and cause blindness, hearing loss, and loss of taste or smell.

Motor Symptoms

Motor symptoms include complete paralysis, tremors, or convulsions. When the disease progresses, it may even cause loss of speech, vomiting, hiccuping, etc. However, when undergoing a neurological examination of the affected site, these individuals present intact neuromuscular apparatus with normal electrical activity, response, and stimulation.

Psychic Symptoms

These symptoms are generally called dissociative reactions, where a person presents with attacks of amnesia and sleepwalking and can also present with multiple personalities. For example, a person with a dissociative reaction sometimes forgets his name or house address or has a split personality. Females with hysterical behaviors can behave emotionally charged, and out of control [9].

Discussion

Case Presentation

The case on the current study was took place in March 2016. The client was a 45-year-old woman and had a 10th-grade education. She had a husband and two daughters in the family. The beginning was that she showed some special unusual symptoms like strange behavior, extreme unrest, change of voice, seizures and acquiring tremendous strength shown to the children and the husband, especially to the husband. In Kerala, associated with the Hindu belief system, a spirit (called “Yakshi -A female spirit”) enters the body in myths and old texts. That belief is still being followed to some extent in Kerala, the majority of the parts. The client grew up amide such beliefs. Once one night she dreamed that a treasure was hidden in her backyard. Even then and before that, she was experiencing symptoms like unusual psychomotor agitation. Her husband brought the information to a black magician. He summoned everyone at night two 2 am and cast a spell. Finally, the black magician was relieved to let the woman sit in the room and asked the other relatives to go out. Then he closed the door and tried to rape her. She screamed. Everyone ran to her. After that incident, she has unusual psychomotor agitation when she sees her husband. She assumes that the spirit has entered her body. Sometimes swearing at someone who resembles her husband also causes symptoms.

Patient History in Their Words

As soon as the client came, unusual behavior was visible to therapist. They asked to stop the red light coming from the computer monitor on the table.

“That red light should be turned off,” she strictly said

When asked if she believed she was infected, she gave the therapist strange wordings with expression.

“I will kill you and drink your blood”

When asked to her, she did not remember anything that happened at that time of possession, she spoke in such a way that she had the knowledge that others had told to her.

The information given by the client confirmed what the bystanders. They also believed that there was treasure in the back yard and she is possessed by the spirit.

Medical History

Her whole family members believed in superstitious things. After the appearance of the black magician they again visited many other several faith healers and swamis with no improvement in her condition. They had no idea that she was mentally ill and this mental illness should need to be treated. They visit the therapist for consultation only after when one of their educated close family members suggests. The client was not at all interested in that particular decision. She never visits a doctor or psychologist or takes any other medication for this illness.

Treatment History

Visualization hypnotherapy and Counseling were the treatments given to the client.

Visualization Hypnotherapy

Visualization is just about the most powerful form of suggestion imaginable. The more senses that are stimulated, the more realistic the image to the brain, and the easier it is to establish that all-important process of selective thought within the hypnotic state. Just about any sort of hypnotic suggestion we might wish to give somebody can be enhanced by the use of the “four-sense” method of creative visualization. It means we include sounds, feelings, and even smells — in addition to any visual imagery [10].

Counseling

Counseling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues. Sometimes the term “counseling” is used to refer to talking therapies in general, but counseling is also a type of therapy in its own right [11].

Clinical Findings General Examination

She was not properly tied his hair. She had an average mode of dressing. Other than that on examination, all general parameters were normal.

Differential Diagnosis

  1. Possession syndrome (most likely diagnosis for discussion).
  2. Schizo-Hysteria (not in the diagnostic classification system).
  3. Schizophrenia (not meeting the criteria).
  4. Organic brain syndrome (ruled out).

Diagnostic Findings

  • Cannot control themself: She didn’t know what she was doing. She was unable controlhimself. She used to be violent towards family members especially, her husband and children.
  • New personality: New personality, introduced to her- the victim becomes a different person and acts and speaks as one who is controlled by another personality
  • Different voice: A slight change and tone in her voice identifies
  • Supernatural knowledge: She repeatedly says that a treasure in the backyard
  • New abilities: She, those possessed by can demonstrate superhuman strength, the family reported

Her family was a lower class one. Finances have overwhelmed them to spend their days constantly. Being a family that strongly followed the superstitious belief, she believed that they would get a way out of that one day. That may be the reason she believes there is treasure in their backyard, her family must have believed it too. It is also a reason to introduce the black magician. There is a common belief in Kerala that only a person with supernatural powers can take the treasure.

What made this client the most difficult was the insecure feeling that came to her. The fact that the black magician tried to physically harm the client after letting her husband, children and relatives out and closing the door while they were outside, caused a great impact on them. The reason for their anger towards her husband is that, it was her husband who brought the man there. She hated everyone who had left her alone in front of the man and guarded her. It was that hatred that later came out as possession symptoms.

Therapeutic Intervention

Hypnotherapy and counseling methods were used for the client.

Hypnotherapy

In getting the true basic information about the client, the therapist talked to the client, the bystanders that arer her husband, children, and the two elder brothers of the client. The therapist did not have to use any form of hypnotic techniques for information gathering, because it was clearly understood that the information given by them was accurate and the necessary information was already available. But here hypnotherapy was used as a treatment modality later. The visualization technique was used. Being a hysteric patient, the suggestibility of the client was high. So that it was also possible to bring the client into deep hypnosis very quickly. Through suggestions, she went to “Aluva Manappuram” (the place where the Aluva Manappuram temple is located, Ernakulam), which is a very important sacred place according to the Hindu faith and “Periyar” (the largest river in Kerala) flows nearby it. Curative suggestions are that when you immerse yourself in the river, the spirit goes away with the very strong flow of the river and the spirit is unable to swim back to her. The client was following the suggestion exactly. The situation was explained in detail. So it was easy for her to follow it. After the procedure, let her sleep and when awakened visible difference started to be seen. It was with just one trial. She was that much cooperative. As a follow-up, she was subjected to hypnotherapy for three consecutive days to make counseling in her subconscious mind. Both of those times they were subjected to light hypnosis and after that time she seems to be almost completely free.

Counseling

The suggestions given in light hypnosis convinced her even when she was awake. She understood what her problem was and said that she would never have that problem again. Therapist gave satisfactory answers to her questions. Client gave counseling three times more every each week.

Conclusion

Possession syndrome is important diagnostic category that should be considered especially in cross culture contexts. Because most of the times it’s deeply connected with culture. If it is in India or especially in Kerala is has another dimension too. The religion Psychotic illnesses can manifest in various forms. We can’t predict it anyway. It depends on so many psycho -socio- cultural factors. Cultural consultation is important in treatment.

Foot note

Informed consent: Yes

Competing interests: None

Patient consent: Obtained

References

  1. Baloh RW (2021) Early Ideas on Hysteria. In: Medically Unexplained Symptoms. Copernicus,
  2. Britannica (2020) Conversion disorder.
  3. C, Rapetti M, Carta MG, Fadda B (2012) Women and hysteria in the history of mental health. Clin Pract Epidemiol Ment Health 8: 110-119. [crossref]
  4. Arraez-Aybar L, Navia-Alvarez P, Fuentes-Redondo T, Bueno-Lopez J (2015) Thomas Willis, a pioneer in translational research in anatomy (on the 350th anniversary of Cerebri anatome) J Anat 226(3). [crossref]
  5. Carota A, Calabrese P (2014) Hysteria around the world. Front Neurol Neurosci 35. [crossref]
  6. Tsuman L Anna O. (2020) Encycloped Personal Indiv Diff.
  7. Balbuena F (2020) Sabina Spielrein: From being a psychiatric patient to becoming an analyst Am J Psychoanal 80(3). [crossref]
  8. North C (2015) The classification of hysteria and related disorders: Historical and phenomenological considerations. Behav Sci 5(4). [crossref]
  9. Gandhi VA (2022) Hysteria – Types, Causes, Diagnosis, and The virtual  hospital.
  10. com (2022) Creative Visualization and Self Hypnosis Available from: https://www.selfhypnosis.com/creative-visualization/
  11. NHS (2021) Counselling.

The CaCl2-to-Rutile Phase Transition in SnO2 from High to Low Pressure in Nature

DOI: 10.31038/GEMS.2024642

Abstract

Raman studies on cassiterite from the Sauberg mine near Ehrenfriedersdorf showed that besides the tetragonal rutile-type phase in the root zone of a cassiterite vein, there is also present orthorhombic cassiterite with the CaCl2 structure. According to Raman measurements, a maximal pressure of 18.9 GPa results. Such pressure implies the origin of that cassiterite from great depths, brought with supercritical fluids into the lower crustal level. The results show a reverse transition from high-pressure to low-pressure polymorphs of SnO2 in nature.

Keywords

Raman spectroscopy, Tetragonal and orthorhombic Cassiterite, CaCl2-to-rutile transition, Supercritical fluids

Introduction

The naturally occurring form of cassiterite is usually tetragonal, with the point group 4/m 2/m 2/m (point group number 128), and crystallizes as a rutile type phase. The paper by Thomas [1] described unusual cassiterite crystals from the tin deposit Ehrenfriedersdorf, Erzgebirge/Germany, as orthorhombic ones.

However, in the Balakrishnan et al. [2], only the bands at 446 (444 and 448 cm-1) are present for the stable SnO2 polymorphs. The data for the metastable phases are not given. All in all, the authors mentioned 20 relatively stable polymorphs. Seven stable polymorphs are tabulated. The band at 832 cm-1 is missing for all stable newly identified orthorhombic cassiterites. However, in the case of Ehrenfriedersdorf, at azimuthal rotation under the Raman microscope, some crystals show two unusual Raman bands at about 446 and 832 cm-1, which are very strong at specific azimuthal positions and room temperature and room pressure. These authors (Balakrishnan et al., [2] have also stated that one polymorph can easily transformed into another by varying temperature or pressure. That must be true also for a combination of both variables. However, the transformation is sluggish enough to conserve precede phase states. In the case of the specific cassiterite from Ehrenfriedersdorf, we assume that the cassiterite came very fast from mantle deeps via supercritical fluids indicated by minerals like diamond, graphite, moissanite, OH-rich topaz, and the high-temperature feldspar kumdykolite [NaAlSi3O8] in the closer paragenesis [1]. Therefore, it is quite possible that at room temperature and pressure, “abnormal” cassiterite contains quenched remnants of high-temperature and high-pressure indications in the form of unusual Raman bands. This paper serves as a starting point for more systematic studies of cassiterite as a natural pressure sensor.

Sample Material

All sample material for this study came from a specimen, about 10 x 7 x 3 cm large, taken from the Prinzler counter vein in the Sauberg mine near Ehrenfriedersdorf by Puffe in 1936. The main minerals are quartz (~6 cm long), cassiterite (2 cm in diameter), and violet to green, sometimes pink fluorite (up to 1 cm in diameter). In the root zone, there are inclusions in different minerals (topaz, quartz, muscovite), which are generally tiny crystals of albite, kumdykolite, plagioclase, trilithionite, calcite, colorless high-temperature fluorite, OH-rich topaz, rynersonite, cassiterite, mangancolumbite, uraninite, monazite, xenotime, graphite, diamond, moissanite, and Ti-carbides [1]. Figures 1-3 show the studied cassiterite crystals, which are very different in appearance. In muscovite, there are smaller crystals beside the crystal shown in Figure 1, which are spherical or elliptical. The cassiterite crystal in Figure 2 is 500 µm thick as the tick section is. Figure 3 is a sizeable orthorhombic cassiterite crystal in spherical muscovite inclusion surrounded by dark tetragonal cassiterites. All cassiterites with the untypical Raman bands at 445 and 832 cm-1 are inclusion- free, and the trace element concentration is low (about at the detection limit of the microprobe). Tiny crystals are colorless.

FIG 1

Figure 1: Cassiterite crystal I with rhombohedral cross-section in muscovite. The Raman bands of muscovite are entirely suppressed.

FIG 2

Figure 2: Cassiterite (Cst) crystall (crystal-II), about 250 x 390 µm large, beside tetragonal cassiterite (black), OH-rich topaz (OH-Toz) and calcite (Cal).

FIG 3

Figure 3: Large orthorhombic cassiterite crystal (o-Cst) in a muscovite inclusion (white) between normal tetragonal cassiterite (Cst). That is the sample cassiterite III.

The differentiation between tetragonal and orthorhombic cassiterite is under the Raman microscope with a rotating stage simple. Rutile-type cassiterite shows at room temperature only one strong Raman band at about 633 cm-1 during azimuthal rotation under the polarized Raman light. Strong Raman bands at about 76, 448, 635, and 834 cm-1 are characteristically for orthorhombic cassiterite. The symmetry of the CaCl2-type structure is orthorhombic and has the space group P42/mnm.

Microscopy and Raman Spectroscopy: Methodology

For the study of the cassiterite sample and the paragenetic minerals, we use the Zeiss JENALAB pol as well as the Raman spectrometer EnSpectr R532 combined with the Olympus BX43 microscope both for transmitted and reflected light and equipped with a rotating stage. For the identification of minerals and slight mineral inclusions, we used an Olympus long-distance LMPLFL100x objective lens. For the identification of different minerals, we used the RRUFF and the Hurai et al. [3] Raman mineral databases [3-4]. As references, we applied a water-clear diamond crystal from Brazil and a semiconductor-grade silicon single-crystal.

Results

In contrast to the typical tetragonal cassiterite of the Erzgebirge with the usual bands at 474, 633, and 775 cm-1 (both bands at 474 and 775 cm-1 are generally weak), the here-discussed cassiterite shows additional azimuthal-depending strong bands at 446, 832 cm-11, beside the 633 cm-1 band [1]. In the compilation [2] of the Raman modes of stable SnO2 polymorphs, only the orthorhombic cassiterite Pbcn (point group 2/m 2/m 2/m (number 60 in the room group list) contains a Raman active band at about 446 cm-1. The 832 cm-1 band is completely missing in the list of polymorphs. Figure 4 shows a typical Raman spectrum of cassiterite crystal III. Conspicuous are the strong bands at 76, 448, 635, and 834 cm-1.

FIG 4

Figure 4: Raman spectrum (a choice of 46 spectra) of SnO2 (sample III).

According to the measurements of the Raman intensity of both bands (446 and 832 cm-1), there is a good correlation shown in Figure 5. That means that both Raman bands belong together.

FIG 5

Figure 5: Correlation between the Raman intensity of the 446 and 832 cm-1 bands; I832cm-1=-89.829 + 0.609 * I446 cm-1, r2=0.989.

Because mineral inclusions in all the studied cassiterite crystals here are missing, the Raman bands are clearly components of the orthorhombic cassiterite, and both are strongly correlated. Also, the other crystals show a correlation between the two bands with near the same incline. That also will be clear from the following diagram (Figure 6). This figure shows the intensity ratio between the 633 and 832 cm-1 bands in dependence on the azimuth position. The figure (Figure 6) shows, in principle, the results for all three studied cassiterite crystals (I to III), which only show a peaks’ position dependence on the crystal orientation (a synchronous shift of the maxima to right or left).

FIG 6

Figure 6: Intensity ratio between the 633 and the 832 cm-1 bands versus the azimuth position for crystal I. Similar figures resulted for the cassiterite crystals II and III.

Figure 7 shows the azimuthal Raman intensity distribution for the orthorhombic cassiterite main band at 633 cm-1. The position of the points depends on the orientation of the studied sample. The points for the 446 and 832 Raman bands lie almost perpendicular to the 150° – 330° line. In the case of tetragonal cassiterite, the open red points would form a circle.

FIG 7

Figure 7: Cassiterite, crystal-III: Raman intensity distribution for the 633 cm-1 band in dependence on the azimuth position of the crystal. The numbers on the left are intensities.

Interpretation

The Raman bands at 446, 633, and 832 cm-1 are strongly polarized, and the bands at 446 and 832 have a different symmetry – they are almost perpendicular to the 633 cm-1 band. The explanation is not simple. Have we, in this case, a different polymorph phase of SnO2 not described in Balakrishnan et al., [2]? Or are the unusual Raman bands of SnO2 frozen high-temperature and high-pressure remnants of the rutile-type, orthorhombic, or the CaCl2 phase of cassiterite?. Note that in Figure 8, the points for the 832 cm-1 Raman band show a twisted form. From 38 measurements of the 832 cm-1 band on the cassiterite crystal-III, we obtain a mean of 833.9 ± 0.4 cm-1. This value corresponds to Hellwig et al. [5] for the B2g mode to a pressure of 10.5 GPa and falls into the rutile-type cassiterite. According to Girao [6], we can assume that the high-temperature and high-pressure cassiterite are well-crystallized (indicated by the intense and sharp Raman bands), are nano-particles in high concentrations, or contain larger domains. According to Girao [6] [Table 4, p.105], it results from the mean of 833.9 cm-1, a pressure of about 15 GPa. This pressure marks the rutile- to CaCl2-type transition. The rutile polymorph of SnO2 underwent a phase transition to a CaCl2 polymorph at 11.8 GPa under hydrostatic conditions [2]. Sometimes, we observe on the 833.9 band a shoulder at 849.7 ± 1.1 cm-1 (n = 10). Using Table 4 in Girao [6], it results in a pressure of 18.9 GPa and is, obviously, a high-pressure remnant of the CaCl2-type cassiterite.

FIG 8

Figure 8: Cassiterite, crystal-III: Raman intensity distribution for the 633 cm-1 (red) and the 832 cm-1 (green) bands in dependence on the azimuth position of the crystal. The other orientation of the 832 cm-1 band is good to see. The measured intensities are the numbers on the right side of the diagram.

Generally, besides the 633 cm-1 prominent bands, small bands at 695.9 ± 2.1 cm-1 are present. After Figure 7 and Table 4 in Hellwig et al. [5], results for this A1g mode band a pressure of 12.2 GPa and, according to Girao [6] [Figure 54 and Table 4], a pressure of 13.7 GPa. For the cassiterite crystal-III, we could also determine for the B1g mode a mean of 76.1 ± 0.5 cm-1 (n = 46). The intensity of this Raman band is very high. Using Figure 8 in Hellwig et al. [5] results in a pressure of 10.8 GPa. By some uncertainties (strong asymmetry of this band) of the soft mode in the CaCl2 phase [5], the 76.1 cm-1 band can also represent the CaCl2-type phase. The symmetry is similar to the 446 and 832 cm-1 bands.

The band at 448.2 ± 0.4 cm-1 strongly correlated with the 833 cm-1 band (n = 38) (see Figure 5), resulting after Girao [6] only a pressure of 5.7 GPa. That means the freezing behavior for the different Raman bands of different SnO2 polytypes is not regular.

Discussion

The exceptional Raman band at 832 cm-1, shown at first by Thomas [1], can explained, according to Hellwig et al. [5] and Girao [6], as frozen remnants of high-pressure phases of rutile- and CaCl2-type cassiterite structures.

Because together with the orthorhombic cassiterite at room temperature, there are also present high-pressure and high-temperature indicator minerals, like diamond, moissanite, Ti-carbides, and kumdykolite [1], the interpretation of the extreme Raman bands finds his explanation. That means that a part of the cassiterite of the Ehrenfriedersdorf Sauberg mine comes directly from the mantle regions. Schütze et al., [7] came after careful studies to the result that the Ehrenfriedersdorf granite presents the differentiation products of subducted altered ocean crust. The proof of high-pressure cassiterite (with signs up to 18.9 GPa) underlines this interpretation. After a couple of studies (for example, Thomas and Rericha, 2023) [8], the transport of high-pressure cassiterite (suspended as solid phases) happens via supercritical fluids from mantle regions to the crust. We have not considered the influence of the temperature on the band shift [9].

We found many deposits in the Erzgebirge (Germany) and the Slavkovsky les (Czech Republic), which prove the presence of orthorhombic cassiterites. More sophisticated studies on the natural cassiterite samples are necessary.

Acknowledgments

For the sample, we are grateful to Professor Ludwig Baumann (1929-2008) from the Mining Academy Freiberg. We thank Pierre Bouvier, Grenoble, France, and Jörg Acker, Cottbus, Germany, for the courtesy of critical references and for starting the discussion on the unusual cassiterite from Ehrenfriedersdorf.

References

  1. Thomas R (2023) Unusual cassiterite mineralization, related to the Variscan tin- mineralization of the Ehrenfriedersdorf deposit, Germany. Aspects in Mining & Mineral Science 11 : 1233-1236.
  2. Balakrishnan K, Veerapandy V, Fjellvåg H, Vajeeston P (2022) First-principles exploration into the physical and chemical properties of certain newly identified SnO2 ACS Omega 7 : 10382-10393. [crossref]
  3. Hurai V, Huraiova M, Slobodnik M, Thomas R (2015) Geofluids – Developments in Microthermometry, Spectroscopy, Thermodynamics, and Stable Isotopes. Elsevier, 489 pp.
  4. Lafuente B, Downs RT, Yang H, Stone N (2015) The power of database: s RRUFF In: Armbruster T, Danisi RM (eds.). Highlights in mineralogical crystallography. Berlin 1-30.
  5. Hellwig H, Goncharov AF, Gregoryanz E, Mao H, Hemley RJ (2003) Brillouin and Raman spectroscopy of the ferroelastic rutile-to CaCl2 transition in SnO2 at high Physical Review 67 : 174110-1174110-7
  6. Girao HT (2018) Pressure-induced disorder in bulk and nanometric SnO2. Material Chemistry, Theses, Université de Lyon, 139 pp.
  7. Schütze H, Stiehl G, Wetzel K, Beuge P, Haberland R, et al. (1983) Isotopen-und elementgeochemische sowie radiogeochronologische Aussagen zur Herkunft des Ehrenfriedersdorfer Granits-Ableitung erster Modellvorstellungen. ZFI-Mitteilungen 76 : 232-254.
  8. Thomas R, Rericha A (2023) The function of supercritical fluids for the solvus formation and enrichment of critical elements. Geology, Earth and Marine Science 5 : 1-4.
  9. Diéguez A, Romano-Rodríguez A, Vilà A, Morante JR (2001) The complete Raman spectrum of nanometric SnO2 Journal of Applied Physics 90 s: 1550-1557.

Applications of Ezrin Peptide Therapy to Long COVID, Drug Resistant Infections, Chronic Inflammation and in the Support of Healthy Aging

DOI: 10.31038/MIP.2024512

Introduction

Ezrin peptides amplify adaptive immunity through the RANTES/CCL5 pathways that lead to cures of drug resistant infections due to bacteria, viruses, fungi and protozoans. Ezrin peptides simultaneously suppress chronic pro-inflammatory cytokine and chemokine signalling, leading to cures for chronic inflammatory disease of the muscular-skeletal system (for example; Ankylosing Spondylitis): inflammatory gut diseases (for example; ulcerative colitis): inflammatory liver diseases (for example; HCV induced hepatitis) and inflammatory heart disease (for example; myocarditis).

Ezrin peptide pharmaceutical technology evolved from a prototype HIV peptide vaccine program in London UK and San Antonio TX, USA, established by Dr Rupert Holms in the mid-1980s. In the early 1990s, Dr Holms discovered that the amino-acid sequence at the C-terminus of HIV gp120 mimics part of the Alpha domain of human ezrin, a protein that builds multi-protein cell signalling complexes of adhesion molecules and receptors on the cell surface; with adaptor proteins, kinases and cytoskeletal components attached to the sub-surface of the cell-membrane. Aqueous solutions of Ezrin peptides are active on mucosal membrane surfaces and seem to behave as a ligand for a surface-exposed “receptor” transition conformation of human ezrin, which causes allosteric changes in the submembrane multi-protein complex that triggers intra-cellular signaling [1].

Dr Holms organised development of Human Ezrin Peptide One (HEP1) which was a synthetic peptide copy of the protein sequence between amino-acids 324 and 337 of human ezrin, at The Gamaleya Institute and Institute of Immunology in Moscow. Safety and efficacy of HEP1 was first demonstrated in HIV and AIDS opportunistic infections, and later in drug resistant sex infections. The first ezrin peptide product (HEP1) was launched on the Russian market in 2001 (brand name “Gepon”) as an adaptive immune amplifier that simultaneously down-regulated inflammation for treatment of AIDS and other defective immune responses to infection.

A normal course of treatment is 2mg ezrin peptide per day for 5 days. Ezrin peptides have been clinically demonstrated as safe: no adverse reactions, nor adverse drug interactions, nor allergic responses, have been reported. Human Ezrin Peptide One (HEP1) and Regulatory Ezrin Peptide Glycine 3 (RepG3) are closely related fourteen amino acid synthetic peptides, which are highly charged, highly soluble, 4-turn alpha helical peptides, mimicking the Alpha domain of human ezrin. Ezrin peptides are cheap and simple to manufacture and the active substance costs less than one pound per milligram (mg). Ezrin peptides are stable at room temperature in solid form for at least 2 years. In aqueous solution, ezrin peptides degrade at about 1% per month.

Treatment of Drug Resistant Infections

After the registration of HEP1 in the Russian Federation, a large number of clinical trials were performed with ezrin peptide HEP1 in the treatment of drug resistant chronic sex infections. Generally the clinical trials of HEP1 treatment of chronic viral, bacterial, fungal or protozoan infection, demonstrated approximately ninety per cent success rates, either in combination with existing therapy or as monotherapy, and there were no reports of any adverse reactions. Clinical use of ezrin peptide therapy in Russia to treat and prevent Candida, Chlamydia, Trichomonas vaginalis, Syphilis, HPV and Herpes (HSV-1 & 2) revealed a broad clinical potential for this adaptive immunity amplification technology. HEP1 was also used to successfully treat HCV hepatitis in HIV patients and as an adjuvant to increase antibody titres during hepatitis B vaccination of children [2,3].

Treatment of Acute COVID

Between 2020 and 2022, experimental ezrin peptide therapy using generation one ezrin peptide HEP1 or generation three ezrin peptide RepG3, was used to successfully treat acute COVID, based on earlier clinical successes using ezrin peptides to treat acute viral respiratory infections with inflammatory complications [4]. Investigation of the pro-inflammatory cell-signalling problem triggered by spike protein of SARS-CoV-2, identified RAGE, PKC, p38, NFkB & IL-6 hyper-expression as important components of the problem. The understanding of a possible disease mechanism, suggested both ezrin peptide therapy and also vaso active intestinal peptide (VIP) therapy as potential solutions in which suppression of NFkB mediated chronic expression of pro-inflammatory cytokine expression could be achieved by the induction of PKA>CREB signaling [5].

Treatment of Long COVID and mRNA Vaccine Injury

Long COVID, also referred to as Post-Acute Sequelae of COVID (PASC), is probably triggered during acute SARS-CoV-2 infection by Spike protein binding and hyper-activating the cell-membrane expressed Receptor for Advance Glycation End-products (mRAGE) and Toll-Like Receptor 4 (TLR4). SARS-CoV-2 infects lung monocytes by Spike binding to mRAGE (not ACE2). During acute COVID-19, high levels of IL-6 hyper-stimulate S100A8/A9 expression and secretion. Although no viral protein nor mRNA can be detected in half of long COVID (PASC) patients, there is a significant elevation of serum levels of IL-1b, IL-6, TNFa, and S100A8/A9. It appears that a pathological pro-inflammatory feedback loop (the TLR4/RAGE-loop) is established during acute COVID-19, which is maintained by S100A8/A9 > RAGE/TLR4 chronic inflammatory signalling, even after SARS-CoV-2 has been cleared from the body [6].

However, more evidence has emerged of chronic spike expression over long periods of time, both as a result of SARS-CoV-2 infection and the use of mRNA COVID vaccines. NewalR&D established a volunteer experimental ezrin peptide treatment program for Long COVID and COVID vaccine injury in which more than sixty volunteers have been treated on an individual unmet medical need basis (this data is anecdotal and is not a clinical trial). However the general observation is that ezrin peptide therapy is safe in Long COVID and COVID vaccine injury patients, about half report symptom improvement and about ten per cent report a significant benefit. The most common symptomatic improvements suggest reduction of inflammation in the gut, brain and heart. Ezrin peptides have already been shown to be clinically effective as anti-inflammatory therapy for any ulceration or inflammation in the gut, including the treatment and prevention of stomach & duodenal ulcers, and ulcerative colitis [7-9].

During the treatment of a vaccine injury patient, blood results provided new information that ezrin peptide RepG3 was inducing enhanced RANTES/CCL5 expression, providing an explanation for the amplification of adaptive immunity which has been observed with ezrin peptide treatment over the previous thirty years. In addition a second control pathway was identified that had a dominant suppressive effect on pro-inflammatory cytokine expression [10]. Results from individual Long COVID patients with other co-morbidities, also revealed a potent ezrin peptide cure for the inflammatory spine disease Ankylosing Spondylitis, and relief from myocarditis chest pains experienced by COVID vaccine injury patients, in addition to the reduction of symptoms of gut inflammation and “brain fog” due to CNS inflammation.

Current Developments

Research and clinical use of ezrin peptides over three decades has revealed the unusually broad beneficial biological activities of ezrin peptides, in the absence of adverse reactions. The scientific endeavour is to develop an integrated theory to explain these diverse results.

Ezrin peptides induce RANTES/CCL5 amplification of adaptive immunity while simultaneously suppressing pro-inflammatory cytokines and chemokines. Ezrin peptides are effective therapy for drug resistant infection whether viral, bacterial, fungal or protozoan, and are effective as monotherapy or in combination with existing therapy, to over-come Anti-Microbial Resistance (AMR). 17 clinical trials have been performed that showed clinical efficacy in a variety of sexually transmitted infections that failed to respond to existing therapy.

Ezrin peptides amplify adaptive B-cell and T-cell programmed immune responses, mediated via RANTES/CCL5 secondary signalling. Ezrin peptides also suppress pro-inflammatory cytokines (IL1b, IL6, IL8, IL13 & TNFa) and chemokines (MIP1a & MIP1b). Ezrin peptides amplify programmed B-cell responses, increase antibody titres and have vaccine adjuvant effects. Ezrin peptides also induce leukocyte migration and fibroblast activation. They stimulate tissue repair, wound healing, ionization radiation recovery and ulcer healing. Ezrin peptides stimulate NK-cell responses and have anti-solid tumour activity in animal models.

Ezrin peptides activate various cell signalling pathways: such as the Ras>Raf>MEK>ERK growth signalling and PI3K>AKT anti-apoptotic signalling, and possibly the JNK stress response pathway, and “Hippo” cell proliferation control pathway. Observations of anti-solid tumour activity, recovery from ionizing radiation damage and tissue regeneration suggest “Hippo” signalling and JNK signalling may be modulated by ezrin peptides.

Over the thirty years ezrin peptide technology has evolved, the evidence has grown that these peptides are operating at a deep level of living systems. For example, in chronic toxicity-safety studies mice displayed features of a slow-down of the rate of aging (healthier hair and higher fecundity). Ezrin peptides may enhance activity of transcription factor FOXO3: it is already known that some FOXO3 SNPs that enhance its activity are associated with extreme human longevity. Ezrin peptides have potential applications in the treatment of radiation sickness and in the enhancement of healthy aging but much more research needs to be done.

References

  1. Holms RD, Ataullakhanov RI (2021) Ezrin Peptide Therapy from HIV to COVID: Inhibition of Inflammation and Amplification of Adaptive Anti-Viral Immunity. Int J Mol Sci 22: 11688. [crossref]
  2. Holms RD (2023) Pandemics of Sexually Transmitted Infections (STIs): Clinical Use of Ezrin Peptide Therapy in Russia to Treat and Prevent Candida, Chlamydia, Trichomonas vaginalis, Syphilis, HPV and Herpes (HSV-1 & 2) Microbiology & Infectious Diseases. Microbiol Infect Dis 7.
  3. Salamov G, Rupert Holms RD, Wolfgang G, Bessler WG, Ataullakhanov RI (2007) Treatment of Hepatitis C Virus Infection with Human Ezrin Peptide One (HEP1) in HIV Infected Patients. Arzneimittel-Forschung (Drug Research) 57: 497-504. [crossref]
  4. Holms RD, Ataullakhanov RI (2021) Ezrin Peptide Therapy: A Potential Treatment for COVID. J Bioprocess Biotech 12: 3. [crossref]
  5. Holms RD (2022) The COVID-19 Cell Signalling Problem: Spike, RAGE, PKC, p38, NFkB & IL-6 Hyper-Expression and the Human Ezrin Peptide, VIP, PKA-CREB Solution. Immuno 2: 260-282.
  6. Holms RD (2022) Long COVID (PASC) Is Maintained by a Self-Sustaining Pro-Inflammatory TLR4/RAGE-Loop of S100A8/A9 >TLR4/RAGE Signalling, Inducing Chronic Expression of IL-1b, IL-6 and TNFa: Anti-Inflammatory Ezrin Peptides as Potential Therapy Immuno 2: 512-533.
  7. Chulkina M, Negmadjanov U, Lebedeva E, Pichugin A, Mazurova D, et al. (2017) Synthetic peptide TEKKRRETVEREKE derived from ezrin induces differentiation of NIH/3T3 fibroblasts. European Journal of Pharmacology 811: 249-259. [crossref]
  8. Malakhova NS, Pichugin AV, Khaliph IL, Ataullakhanov RI (2005) Use of Immuno-Enhancer Gepon For The Treatment Of Ulcerative Colitis. [crossref]
  9. Chulkina MM, Pichugin AV, Ataullakhanov RI (2020) Pharmaceutical grade synthetic peptide Thr-Glu-Lys-Lys-Arg-Arg-Glu-Thr-Val-Glu-Arg-Glu-Lys-Glu ameliorates DSS-induced murine colitis by reducing the number and pro-inflammatory activity of colon tissue-infiltrating Ly6G+ granulocytes and Ly6C+ monocytes Peptides 132. [crossref]
  10. Holms R (2024) The therapeutic potential of RANTES/CCL5 across diverse infections and its synergistic enhancement by ezrin peptide RepG3 for long COVID. Microbes & Immunity 1: 2474.

Pattern of Presentation of Newly Diagnosed Diabetes Mellitus Among Sudanese Patients

DOI: 10.31038/EDMJ.2024824

Abstract

The objectives of this study is to know the pattern of presentation of newly diagnosed diabetic patients among Sudanese, and how late they present, after developing micro and macro vascular complications. Among 620 diabetic patients attending a medical clinic for ten month duration, 44 patient were newly diagnosed diabetes mellitus patients. 54.5% were male and 45.5% female, with the mean age of 49.6 year, hemoglobin A1c% (Hb A1c) ranging from 7.1 to 15.9 mean of (11.02%). Most of them have positive family history of diabetes 75%, other risk factors include obesity 47.7, and hypertension31.8%. 7 patients out of 44 patients (15%). presented with micro and macro vascular complications which was not related to the level of HbA1c at presentation. These results make the need for screening for diabetes mellitus in those with risk factors is important for early diagnosis to prevent or delay the development of these complications.

Main Objective

To study the pattern of presentation of newly diagnosed diabetic patients among Sudanese population.

Specific Objective

  1. To study the risk factors for diabetes
  2. To know how late is the presentation, after the development of the acute and chronic diabetic complication.
  3. To study the relation between the complication at presentation and the risk

Keywords

Type2 diabetes mellitus (T2DM), Hemoglobin A1c (Hb A1c), Hypertension (HTN)

Introduction

Diabetes mellitus is a growing health problem, leading to morbidity and mortality. Type 2 diabetes mellitus (T2DM) is increasing and the prevalence and number of adults affected, have risen faster in lower income than in high-income countries. Sudan is one of the lower income country, with poor income and resources. Diabetes Mellitus is common in Sudan, with some studies showing the prevalence is 19% of the adult population. Type 2 diabetes mellitus is sometimes diagnosed when chronic complications have already developed and one third of all people with type 2 diabetes mellitus may be undiagnosed until late. this make the screening for diabetes mellitus for those at high risk of developing diabetes is crucial [1]. Early diagnosis and control of blood sugar will delay if not prevent the development of micro and macro vascular complications.

Methodology

This is a retrospective study for the patients attending a medical clinic in the period from April 2022 to February 2023 (about 10 months duration), from 620 diabetic patients attending the clinic, 44 patients were newly diagnosed diabetes mellitus. 24 male patients (54.5%) and 20 female (45.5%) out of them 7 patients (15%) presented with micro and macro vascular complication.

The risk factor for most of them was the family history of diabetes 75.0%, followed by obesity 47.7%, hypertension 31.8%, and a single case with past history of gestational diabetes.

The study showed that males have significantly more obese than females (62.5% compared to 30.0%) p value <.032.

The mean age at presentation was 49.6 year. Hemoglobin A1c (HbA1c) at presentation was varying from 7.1 to 15.9 mean of (11.02%) (Table 1).

Table 1: Mean age

Mean

Std. Deviation

N

AGE

49.68

13.194

44

A1c%

11.018

2.2152

44

7 out of 44 patients (15%) have obvious diabetic complication at presentation including peripheral neuropathy 4.6%, diabetic septic foot, chronic kidney injury, ischemic heart disease, diabetic ketoacidosis and diabetic retinopathy 2.3% for each (Table 2).

Table 2: Diabetic complication

Frequency

Percent

Valid Percent

Valid CHRONIC KID INJ

1

2.3

2.3

DIAB KETO ACIDOS

1

2.3

2.3

DIAB SEP FOOT

1

2.3

2.3

IHD CHF

1

2.3

2.3

NO

37

84.1

84.1

PERIPH NEUROPATH

2

4.5

4.5

RETINOPATHY

1 2.3

2.3

Total

44

100.0

100.0

There was no relation between the presentation with diabetic complication and A1c% at presentation (Table 3).

Table 3: Relation between the presentation with diabetic complication and A1c% at presentation

A1c% COMPL

Mean

N

Std. Deviation

CHRONIC KID INJ

8.300

1 .

DIAB KETO ACIDOS

7.800 1

.

DIAB SEP FOOT

7.100

1 .

IHD CHF

10.500 1

.

NO

11.508

37 1.9916

PERIPH NEUROPATH

8.150 2

2.3335

RETINOPATHY

9.000

1 .

Total

11.018 44

2.2152

Discussion

This study describes the pattern of newly diagnosed diabetes mellitus in Sudan, and the risk factors and how late they present, after the appearance of micro and vascular complication. Similar to other studies in Africa, the age of presentation of newly diagnosed diabetes in our study was in younger age group (the mean is 49.6 year), in contrast to with that from higher income countries where diabetes incidence peak is between 60 and 70 years [2] The risk factor for developing diabetes in our study was mainly the non- modifiable risk factor, the familial predisposition, and family history of DM similar to that in Saudi Arabia, in addition to the other modifiable risk factors like obesity, hypertension and sedentary lifestyle [3]. The risk factors for developing type 2 diabetes mellitus in Sudan is high, according to the study done in North of Sudan, using Finnish score as a risk assessment for predicting type 2 diabetes mellitus, more than half of the population of the study group were at risk of developing type 2 diabetes mellitus, and if not discovered early are prone of developing diabetic complications [4]. The development of complications was not related to the level of HbA1c at presentation, diabetic complications may be related to the chronicity of the disease, rather than the blood sugar at the time of diagnosis Peripheral neuropathy was the most common diabetic complication at presentation, 28.5% of cases with micro and macro vascular complication at initial presentation similar to study done in Pakistan [5]. Peripheral neuropathy patients present with symptoms of numbness and paraethesia, with impaired sensation [6]. Patients with diabetic nephropathy present with proteinuria, renal impairment or chronic kidney injury. Diabetic retinopathy patients present with symptoms of blurring of vision, headache, pain in the eyes and impairment of vision. Final examination will show background diabetic retinopathy, new vascularization and intra retinal hemorrhage leading to loss of vision and blindness [6].

Notice: Formal visual examination wasn’t done in all patients.

Recommendation

We recommend screening for those who are at risk of developing diabetes mellitus, specifically those with family history of DM and other modifiable risk factors like obesity or sedentary lifestyle, so we can avoid the late presentation after developing micro and macro vascular complications.

References

  1. Clinical Practice Guidelines and Standards of Care of Diabetes Mellitus in Sudan 2020.
  2. Roy William Mayega et (2018) Clinical presentation of newly diagnosed diabetes patients in a rural district hospital in Eastern Uganda. Afr Health Sci. 18(3): 707-719 [crossref]
  3. Saudi Diabetes Clinical Practice Guidelines (SDCPG) 2021.
  4. Sufian et al. (2024) benefit of Finnish Score as a Risk Assessment Tool for predicting type 2 DM among Sudanese population in North Sudan, Sudan Journal of Medical Science.
  5. Nalia Naeem et al. (2014) Frequency of peripheral neuropathy in newly diagnosed patients of diabetes mellitus 2 on clinical and electrophysiological Pakistan Journal of Neurological Science vol 9 issue 4.
  6. A P Nambuya et The presentation of newly diagnosed diabetic patients in Uganda, Q J Med. [crossref]