bluuebunny/crossref_metadata_2025 huggingface dataset:
596 Homeless Tent Fires: A Descriptive Analysis of Tent Fires in the Homeless Population
Authors: Huang Samantha , Choi Katherine J , Pham Christopher H , Collier Zachary J , Dang Justin , Kiwanuka Harriet , Sheckter Clifford C , Yenikomshian Haig A , Gillenwater Justin
Published: April 2021

Introduction

Homelessness is a rising concern as insufficient housing and significant barriers to shelter has led to more individuals seeking shelter in tents. Within this demographic there has been an increased trend of burn injuries from tent fires in regions with large homeless populations. This represents a public health crisis given the long-term psychosocial and functional sequela of burn injuries and existing data that suggest worse outcomes in the homeless population. To our knowledge, homeless related tent fire burns have not previously been studied in the literature. The aim of this study is to describe the characteristics and outcomes of tent fire burn injuries in the homeless population.

Methods

A retrospective cohort study was conducted involving two verified regional burn centers with patients admitted for tent fire burns between January 1, 2019 to July 31, 2020. Patients were identified as either domiciled or homeless based on medical records at the time of injury. Variables recorded include demographics, injury characteristics, hospital course, and patient outcomes.

Results

A total of 45 patients were identified. The most common mechanisms of injury were by portable stove accident (29%), assault (27%), bonfire (22%), and tobacco or methamphetamine paraphernalia-related (16%). Median percent total body surface area (%TBSA) burned was 5.5 (IQR 5.5). Maximum depth of injury was second degree in 62% (n=28) of patients and third degree in 38% (n=17) of patients. Burns to the upper extremities were present in 84% of patients and burns to the lower extremities were present in 53% of patients. Median hospital LOS was 9.5 days (IQR=10) and median ICU LOS was 2 days (IQR=4.8), with inhalation injury present in 16% (n=7) of patients. Surgical intervention was required in 40% (n=18) of patients, which included debridement, skin grafting, and escharotomy. In-hospital mortality occurred in 5% (n=2) of patients.

Conclusions

Burn injuries from tent fires incur significant injury burden to an already vulnerable population, with risk factors that predispose them to poor burn outcomes. Injuries in our cohort were severe enough to require inpatient and ICU level of care. We saw a high proportion of injuries to the extremities, which pose functional and psychosocial challenges to the wellbeing of these patients. Further resources are needed to better prevent tent fires and care for this population.
605 Representation Matters: An Assessment of Diversity in Current Major Textbooks on Burn Care
Authors: McLawhorn Melissa M , Travis Taryn E , Tejiram Shawn , Shupp Jeffrey W , Johnson Laura S
Published: April 2021

Introduction

Racial and gender disparities in health care have been well described. The Association of American Medical Colleges states they are committed to diversity, equity, and inclusion in preparing medical trainees. Increasing attention is paid to representative diversity in the images and educational resources utilized during medical training. One recent example of this is the Instagram account, “Brown Skin Matters,” that focuses on the representation of dermatologic diseases in the skin of people of color. Nearly 40% of the population of the United States identifies as a person of color, and patients of color reflect 41% of the total burn population seen in the United States. In comparison, national data on providers suggests about 5% of the Burn Team would be people of color. As representation matters, a better understanding of the diversity represented by burn related medical literature could affect management of patients with diverse backgrounds and recruitment into this field. The goal of this study is to investigate the representation of diverse skin tones in the leading medical textbook of burn care.

Methods

The 5th edition of “Total Burn Care (TBC)”, 5th ed, DN Herndon editor, was reviewed from cover to cover. All photographs that contained people were evaluated for the number of people present and the depicted role of person present (i.e.: provider, patient or other). Each picture was considered as an isolated image, regardless of whether it was part of a series. Diversity count was assessed in a binary fashion - was the individual represented a person of color or not? Additional information was collected on the gender of providers present.

Results

690 total individuals were identified in images in TBC. There were 3 providers of color identified in TBC images out of a total of 63(5%); 24 providers were women (38%), of whom none were women providers of color. People of color were represented in 107 of 627 non-providers shown in TBC (17%). There were 29 patients whose skin color was unable to be evaluated due to the nature of the injury, the quality of the image or the surface area of dressings visualized in the image (5%).

Conclusions

Both patients and providers of color are underrepresented in the leading textbook of burn care. Proper representation must be included in modern educational materials to better prepare providers for a diverse population of burn injured patients and appropriately address injury identification, wound healing properties, and scar outcomes. Diverse and proportional representation of potential outcomes needs to be a component of educational materials. to ensure effective and thoughtful care.
616 Young Adults Burn Survivors - Key Challenges They Faced While Growing Up
Authors: Brubaker Ruth B , Bay Curt , Rutter Cindy , Chacon Daniel W , Wise Dustin K , Duke Desiree , Milem Mik , Foster Kevin N
Published: April 2021

Introduction

There is a paucity of research regarding the challenges faced by young adults (YA) who matured with burns. It is well documented that acute burn care is laden with painful surgeries/dressing changes, gruesome physical/occupational therapies, anxiety and time away from family & friends. However, the specific issues young adults burned as children find most challenging remain largely unknown. This study sought to provide YA survivors with an opportunity to describe the difficult issues they endured.

Methods

Burn surviving youth responded to the open-ended statement “The hardest thing about being burned is…” Seven themes were derived from their responses: People Staring at Me, Being Bullied, Remembering When I was Burned, Having Additional Surgeries, My Scars, Getting Questions About My Burns,& the Pain & Itching, Young adult survivors were asked to rate each item on a 4-point scale from (1) Not at all to (4) Really a lot.

Results

Participants were YA survivors (n=64) mean age 19.1 years, female (62%) male (38%), average age at burn of 6.4 yrs. Sixty-eight percent reported both visible & hidden scars; 25% had a TBSA > 50%., Sixty-six percent were minority race/ethnicity. More than half of respondents reported issues with My Scars (65%), Remembering the Burn (52%) and Pain & Itching (50%). People Staring and Bullying has been bothersome for over 70%, 72% reported Being Bullied and 71% noted People Staring. The highest 5 means among YA subgroups included: Participants with hand scars- Being Bullied (2.6), those with visible scars - My Scars (2.6). Those reporting both facial & hand scars endorsed People Staring (2.4), youth with a TBSA ≥ 50% - Being Bullied (2.4) and with visible scars - Remembering the Burn – (2.4). Girls were bothered significantly more by My Scars (p=.02). Youth with both facial & hand scars had greater issues with Pain/Itch (p=.03).

Conclusions

This study provides insight into problems encountered by maturing burn survivors and discloses the more challenging issues they endured. These data can assist burn centers, camps, and psychotherapists in discussing potential survivor issues and suggest interventions to help burn-injured youth respond to challenges. Special consideration should be given to girls, those with facial/hand scars, large TBSAs and visible scarring.
623 Procedural Pain Management in Burn Patients – A Quality Improvement Project
Authors: Fleishhacker Zachary , Galet Colette , Wibbenmeyer Lucy
Published: April 2021

Introduction

Achieving adequate burn pain control in patients is paramount as inadequate control can lead to PTSD, suicidal ideation, and depression. The pain accompanying hydrotherapy can be extreme and challenging to manage. The purpose of this quality improvement project was to assess our burn center’s current nurse-driven procedural pain control protocol during hydrotherapy.

Methods

Burn patients admitted from June to August 2020 who underwent hydrotherapy were observed during the procedure. Demographics, comorbidities, injury related data, and pain and sedation medication data were collected. Pain scores (1–10), patient and nurse satisfaction scores (1–10) were collected before, during, and after hydrotherapy. A single patient could be surveyed for up to three times. Paired t-tests and one-way ANOVA were performed to assess significant differences between pre- and post-procedure patient pain scores and satisfaction ratings across encounters, respectively. P < 0.05 was considered significant.

Results

Twenty-eight patients and 48 hydrotherapy events were surveyed. Patients were predominately male (23, 82.1%), middle aged (44.8 ± 19.6), and had a TBSA of 11.9 ± 10.5%. Analyzing only the first hydrotherapy sessions, time from initial opioid dose to hydrotherapy varied greatly as did the opioid morphine equivalent dose (OME) provided prior to hydrotherapy (Table 1). Only 13 (46.4%) subjects received versed during hydrotherapy. Pain scores post-procedure significantly increased compared to pre-procedure scores (5.39 vs. 6.32; p = 0.035). There was no significant difference in patients’ or nurse’s satisfaction scores regarding pain control nor with nurse’s rating of ease of procedure when comparing scores across the three encounters (Table 1). No adverse events (SaO2 < 92% or deep sedation RAS < 2) were observed across all encounters.

Conclusions

Our results suggest that procedural pain control during hydrotherapy, while safe, has opportunities for improvement. Pre-procedural medication timing remains imprecise and widely divergent. Satisfaction scores, while high, also have room for improvement. Finally, pre-procedural pain control is unacceptable (mean 5.39) and requires attention.
629 Acute Kidney Injury, Burn Resuscitation, and a Novel, Visualization Approach to Resuscitation Review
Authors: Luttrell Charles J
Published: April 2021

Introduction

A review of patients who sustained 20% or greater TBSA burns (n = 33) found 58% of the sample to have a stage 1 (n = 5), 2 (n = 4), or 3 (n = 10) acute kidney injury (AKI). Of those who sustained an AKI, 63% did not survive their injuries. An inquiry into the current, resuscitation protocols used at this facility was subsequently conducted. Protocol dictated the Parkland Formula/method as the standard of care for resuscitation needs of the sample. While information for net-totals of inputs and outputs (I&O) and hourly I&O values was easily obtainable, presenting these numbers in table-form was both cumbersome to create and difficult to quickly convey to both clinical and non-clinical staff. Thus, a visual approach was chosen to better understand how each patient was resuscitated in the first 24-hours of burn injury.

Methods

The software package R (R Core Team, 2020) was used to clean/analyze data, as well as create a graphical illustration of the data via an interactive dashboard using these variables: urine output (UOP); nurse charting of I&Os; fluid orders by provider; pre-hospital fluids; lab values; and vital signs. Using this software an interactive dashboard was created to allow users to interact with the graphs and visualize not only the numerical values associated with resuscitation, but to also see how each of these numbers relate to one another in an hourly timeline (e.g., reducing fluids by half is followed by a decrease in UOP).

Results

A trend of over-resuscitation in the first 24-hours of burn injury, as compared to the calculated requirements based on the Parkland Formula was observed. Also, irregularities of hourly administration of fluids (e.g., frequent/over blousing) and inadequate hourly charting were observed.

Conclusions

While this method for assessing resuscitation is a new approach at this facility, the ability to visually recount the resuscitation efforts of each patient has opened the conversation about best practices. Also, more disciplines can participate in the resuscitation efforts due to the ease with which the presented information can be disseminated and explained to both seasoned and novice staff. This has allowed for more stakeholders to participate in the burn program. Finally, further uses and applications of interactive dashboards are being explored for other aspects of burn care management.
630 A Multidisciplinary Approach to Decrease Infection using Visual Management
Authors: Grubbs Alicia
Published: April 2021

Introduction

Burn patients are at high risk for infection secondary to skin loss from their wounds. These infections come at great risk for patient safety and are known to increase length of stay, morbidity, and mortality. Due to these factors, we used a multidisciplinary approach to maintain the environment in our Regional Burn Center using visual management. The purpose of this project is to improve communication and follow-through between the Environmental Services Team (EVS), Facilities Management department and the Burn Center Team to initiate and complete repair work and improve cleanliness in patient rooms. The goal is to decrease risk for infection from environmental factors through collaboration with multiple departments and improve patient experience and care.

Methods

Each room in the Burn Center is mapped out on the Visual Management Board (VMB). Anytime a staff member notices that EVS and/or Facilities Management repair work is needed, they can take the appropriate magnet from the board (see legend) and place it on that room square. Unit leadership will round each morning to see what needs are indicated on the board and initiate work orders or communication with designated unit EVS to meet that need. The issues indicated by the magnets will be logged into a printed spreadsheet (placed on VMB). Each day unit leadership will round to facilitate completion of needed work and will place a date of completion on the spreadsheet when that work is finished as well as remove the magnet from the rooms space. Every Monday, Unit leadership will round at the VMB with EVS and Facilities Management Leadership to address any further needs that were unable to be completed at the unit level that need escalated. EVS/Facilities Management will round back with unit leadership when these items are completed.

Key Stakeholders

4. Environmental Services Staff (housekeeping) and Leadership

5. Facilities Management (carpentry) Staff and Leadership

6. Burn Unit Staff and Leadership

Additional Resources

• Legend for needed work

• Communication Tracking Tool

• Picture of VMB workspace for this project

Results

Maintenance and daily cleaning improved. Increased staff engagement in facilities issues in each patient room and the autonomy to notify someone and get escalation of issues when needed. Improved communication and collaboration with multidisciplinary teams for increased awareness of unit-based needs and improved patient safety.

Conclusions

Upon completion of this presentation, learners will be prepared to discuss multidisciplinary ways to collaborate with the partners that support your Burn Center to enforce patient care and safety.
642 Orthotic Fabrication of the Upper Extremity Survey
Authors: Warthman Renee , Martinez Andria , Murray Derek , Richey Karen J , Yelvington Miranda L , Foster Kevin N
Published: April 2021

Introduction

Designing and fitting orthoses is an essential component of burn care. Burn therapists fabricate and fit orthoses at a high rate due to continuous changes in patient presentation. The purpose of this survey was to assess the current level of comfort with orthosis fabrication of burn therapists, identify trends about management and quality assurance regarding orthoses, and determine areas that may be improved through a directed educational initiative.

Methods

An anonymous, internet-based, 31-item survey was developed to evaluate training and comfort level of practicing therapists. The survey was distributed to burn therapists at North American burn centers. Descriptive statistics were performed.

Results

There were 44 respondents to the survey. Most were occupational therapists (75%), followed by physical therapists (25%). The majority of respondents had more than 15 years of burn experience (61%). Most respondents reported education at a master’s degree level or higher (59%), 18% reported being a certified hand therapist, and 13% a burn certified therapist. A large majority of respondents indicated they received orthotic instruction as part of their academic curriculum (91%), and 80% indicate instruction lasted a semester or less. Since graduation, 89% respond that they have had further orthotic instruction, with most training occurring on the job (92%). One hundred percent of respondents indicated therapists were involved in fitting orthoses. Most indicated they were very comfortable with fabricating both static (90%) and static progressive (69%) upper extremity orthoses. Elbow extension orthotics received the highest very comfortable rating at 92%, while shoulder abduction splints received the lowest relative rating at 56% reporting very comfortable. Despite these confident scores, 51% of respondents reported complications due to orthoses at least sometimes or more often, and these are seldom or never (55%) reviewed through a formal process.

Conclusions

Unanimously, therapists are involved with fitting orthoses. The majority of respondents do not have advanced certifications and receive limited post-graduate orthotic training. Complications occur at least sometimes according to most respondents and appear only modestly integrated into peer review. Given the potential consequences of orthotic induced complications and the high reported comfort levels fabricating orthotics by primarily veteran burn therapists, there is concern that these issues are under-examined through formal processes.
649 The Quality of Survey Research in Burn Care: A Systematic Review
Authors: Anderson Dana , Fordyce Erin , Vrouwe Sebastian Q
Published: April 2021

Introduction

Burn care is a relatively small field with contributions from many healthcare disciplines. Further, the practice of burn care varies considerably from center to center and between regions. Given these factors, survey studies are frequently used to better understand practice variations, establish guidelines, and direct future research questions. If survey research is poorly designed or reported, it limits the ability to form meaningful conclusions. Given the prevalence of clinician surveys published in burn care, this study aims to evaluate its quality and to determine which approaches lead to a more successful survey.

Methods

A systematic review was performed by two independent reviewers using PubMed, Scopus, and Web of Science databases for the dates January 1, 2000 to March 19, 2020. Articles were included if they were published in English and surveyed providers on a topic related to burn care. Surveys of patients, those that evaluated an intervention or included other research designs were excluded. Data related to survey content, methodology, and quality was extracted independently by two reviewers.

Results

The search identified 7351 non-duplicate citations, of which 247 underwent full text review, and 144 met inclusion criteria. The number of published surveys increased by an average of 21% annually over the study period (P< 0.001). The majority of surveys originated in the United States (40%), United Kingdom (19%) and Canada (7%) and were either national (47%) or international (37%) in scope. The most common themes were education/training/workforce (21%), resuscitation/critical care (17%) and wound care (14%). Burn surgeons/physicians (45%) were the most frequently surveyed population, but all disciplines were represented. The majority of surveys were electronic (51%) and sampled all members of a defined group (72%). Few studies reported the use of reminders (29%) or incentives (2%) to improve survey completion. In terms of quality, the majority did not report any survey development steps (71%) or survey validity/reliability (92%), and half did not include the questionnaire in the manuscript or appendix. A response rate was calculated in 82% of studies. The median (IQR) response rate of all studies was 54% (32–83). A subgroup analysis of national and international studies sent electronically to burn surgeons/physicians (N=28) had a response rate of 40% (26–50).

Conclusions

Survey research is increasingly published in the burn care literature and covers a range of themes and populations. Despite the limited use of reminders and incentives, survey participation is relatively high. The quality of survey reporting is generally poor, limiting the ability to apply this research into practice.
667 Necrotizing Soft Tissue Infection Within 48 Hours Post-Scald Burn: A Rare Presentation
Authors: Meza Luis E , Rehou Sarah , Grotski Courtney H , Shahrohki Shahriar
Published: April 2021

Introduction

We report a case of a patient with a burn injury who developed a devastating necrotizing soft tissue infection (NSTI) early in the post-burn period.

Methods

An elderly male was admitted to an ABA verified burn centre after sustaining a 20% scald burn to his back and right upper extremity. He was found in the bathtub; a fall was suspected based on his history of Parkinson’s disease and a finding of bruising to his bilateral knees. Initially, his hospital course was uneventful apart from an elevated creatine kinase, which decreased with adequate resuscitation without signs or symptoms of compartment syndrome. Thirty-six hours following his admission, he developed rapid onset of progressively worsening renal function, respiratory requiring intubation, mechanical ventilation, and circulatory failure requiring vasopressor support. After ruling out other causes of shock and upon re-examination of his burns there were clinical signs of a rapidly advancing necrotizing soft tissue infection. He was taken urgently to the operating room for aggressive debridement of nonviable tissue. He underwent a right shoulder disarticulation and extensive debridement of the right chest, abdomen, and back. Intra-operative tissue samples and preoperative blood cultures were positive for Group A Streptococcus. The patient was predicted to require multiple operations and a prolonged hospital stay. Despite these interventions, his prognosis was poor. The family and the treatment team, in the context of the patient’s previous independent functioning, revised his goals of care on his first post-operative day. Life-sustaining treatment was withdrawn, and comfort care measures were implemented. The patient passed away two days later.

Results

We report a case of a patient with a burn injury who developed a devastating NSTI early in the post-burn period within 36–48 hours of presentation to a burn center. Soft-tissue infections in the immediate post-burn period are rare unless there is subsequent contamination. Burned tissue contains a large amount of necrotic tissue and protein-rich wound exudate, which provides a rich growth medium for bacteria. This, in addition to the immunosuppression secondary to the burn insult, favors the development of infection. NSTI in the context of thermal injury is a rare phenomenon and in the few reported cases in burn patients, necrotizing infections occurred closer to two weeks following the initial injury.

Conclusions

Necrotizing soft tissue infections are entities with a rapid and devastating course. The diagnosis is challenging, and occlusive dressings may contribute to a delay in diagnosis in burns. Acute hemodynamic compromise without any obvious cause should raise the suspicion for a necrotizing soft tissue infection and lead to early exposure of wounds in burn patients.
673 Effect of Subcutaneous Topical Ozone Therapy on Second Degree Burn Wounds in Rats: An Experimental Study
Authors: Karakaya Emre , Akdur Aydincan , Ebru H , Soy Ayvazoglu , Atilgan Alev Ok , Ozer Eda Ozturan , Haberal Mehmet
Published: April 2021

Introduction

Burn is one of the most severe traumas that causes coagulative destruction of the skin. The use of various products that accelerate wound healing in patients with burn may affect the patient’s survival and reduce the complications that may be seen. In the present study we aimed effects of subcutaneous ozone injection on second degree burn wound.

Methods

A total of 72 Sprague-Dawley male rats included in the study were divided randomly into three groups (control group (CG), silver sulfadiazine group (SG), ozone group (OG)) and each group was divided randomly two subgroups (as sacrificed on d7 and on d14).A deep second degree scald burns were created on the lower back. In CG subcutaneous 0.9% serum saline was injected daily into the burn area. In SG, burns were dressed with silver sulfadiazine daily and in OG subcutaneous ozone was injected daily into the burn area. Tissue hydroxyproline level measurement and histopathological evaluation were done.

Results

When the groups were compared in terms of weight change, no significant difference was found on the 7th and 14th days. In the evaluation made in terms of tissue hydroxyproline, tissue hydroxyproline level in OG was found to be significantly higher on both the 7th and 14th days (p < 0.001). In histopathological evaluations, it was determined that wound healing in OG was significantly higher than in the other groups.

Conclusions

According to the results, subcutaneous ozone therapy is more effective than silver sulphadiazine in the healing process of second-degree burn wounds and it can be safely used in the treatment of burn wounds.
Dark energy survey year 3 results: weak lensing shape catalogue
Authors: Gatti M , Sheldon E , Amon A , Becker M , Troxel M , Choi A , Doux C , MacCrann N , Navarro-Alsina A , Harrison I , Gruen D , Bernstein G , Jarvis M , Secco L F , Ferté A , Shin T , McCullough J , Rollins R P , Chen R , Chang C , Pandey S , Tutusaus I , Prat J , Elvin-Poole J , Sanchez C , Plazas A A , Roodman A , Zuntz J , Abbott T M C , Aguena M , Allam S , Annis J , Avila S , Bacon D , Bertin E , Bhargava S , Brooks D , Burke D L , Carnero Rosell A , Carrasco Kind M , Carretero J , Castander F J , Conselice C , Costanzi M , Crocce M , da Costa L N , Davis T M , De Vicente J , Desai S , Diehl H T , Dietrich J P , Doel P , Drlica-Wagner A , Eckert K , Everett S , Ferrero I , Frieman J , García-Bellido J , Gerdes D W , Giannantonio T , Gruendl R A , Gschwend J , Gutierrez G , Hartley W G , Hinton S R , Hollowood D L , Honscheid K , Hoyle B , Huff E M , Huterer D , Jain B , James D J , Jeltema T , Krause E , Kron R , Kuropatkin N , Lima M , Maia M A G , Marshall J L , Miquel R , Morgan R , Myles J , Palmese A , Paz-Chinchón F , Rykoff E S , Samuroff S , Sanchez E , Scarpine V , Schubnell M , Serrano S , Sevilla-Noarbe I , Smith M , Soares-Santos M , Suchyta E , Swanson M E C , Tarle G , Thomas D , To C , Tucker D L , Varga T N , Wechsler R H , Weller J , Wester W , Wilkinson R D
Published: April 2021

We present and characterize the galaxy shape catalogue from the first 3 yr of Dark Energy Survey (DES) observations, over an effective area of  4143 deg2 of the southern sky. We describe our data analysis process and our self-calibrating shear measurement pipeline metacalibration, which builds and improves upon the pipeline used in the DES Year 1 analysis in several aspects. The DES Year 3 weak-lensing shape catalogue consists of 100 204 026 galaxies, measured in the riz bands, resulting in a weighted source number density of neff = 5.59 gal arcmin−2 and corresponding shape noise σe = 0.261. We perform a battery of internal null tests on the catalogue, including tests on systematics related to the point spread function (PSF) modelling, spurious catalogue B-mode signals, catalogue contamination, and galaxy properties.
The dust mass in Cassiopeia A from infrared and optical line flux differences
Authors: Niculescu-Duvaz Maria , Barlow M J , Bevan A , Milisavljevic D , De Looze I
Published: April 2021

The large quantities of dust that have been found in a number of high-redshift galaxies have led to suggestions that core-collapse supernovae (CCSNe) are the main sources of their dust and have motivated the measurement of the dust masses formed by local CCSNe. For Cassiopeia A (Cas A), an oxygen-rich remnant of a Type IIb CCSN, a dust mass of 0.6–1.1 M⊙ has already been determined by two different methods, namely (a) from its far-infrared spectral energy distribution and (b) from analysis of the red–blue emission line asymmetries in its integrated optical spectrum. We present a third, independent, method for determining the mass of dust contained within Cas A. This compares the relative fluxes measured in similar apertures from [O iii] far-infrared and visual-region emission lines, taking into account foreground dust extinction, in order to determine internal dust optical depths, from which corresponding dust masses can be obtained. Using this method, we determine a dust mass within Cas A of at least 0.99$^{+0.10}_{-0.09}$ M⊙.
Thermal formaldehyde emission in NGC 7538 IRS 1
Authors: Shuvo Onic I , Araya E D , Tan W S , Hofner P , Kurtz S , Pihlström Y M , Hoffman I M
Published: April 2021

Spectral lines from formaldehyde (H2CO) molecules at cm wavelengths are typically detected in absorption and trace a broad range of environments, from diffuse gas to giant molecular clouds. In contrast, thermal emission of formaldehyde lines at cm wavelengths is rare. In previous observations with the 100 m Robert C. Byrd Green Bank Telescope (GBT), we detected 2 cm formaldehyde emission towards NGC 7538 IRS1 – a high-mass protostellar object in a prominent star-forming region of our Galaxy. We present further GBT observations of the 2 and 1 cm H2CO lines to investigate the nature of the 2 cm H2CO emission. We conducted observations to constrain the angular size of the 2 cm emission region based on a East–West and North–South cross-scan map. Gaussian fits of the spatial distribution in the East–West direction show a deconvolved size (at half maximum) of the 2 cm emission of 50 arcsec ± 8 arcsec. The 1 cm H2CO observations revealed emission superimposed on a weak absorption feature. A non-LTE radiative transfer analysis shows that the H2CO emission is consistent with quasi-thermal radiation from dense gas (${\sim}10^5$–$10^6$ cm−3). We also report detection of four transitions of CH3OH (12.2, 26.8, 28.3, 28.9 GHz), the (8,8) transition of NH3 (26.5 GHz), and a cross-scan map of the 13 GHz SO line that shows extended emission (>50 arcsec).
Low resistance but high resilience to drought of flushing Norway spruce seedlings
Authors: Hájíčková Martina , Plichta Roman , Urban Josef , Volařík Daniel , Gebauer Roman
Published: April 2021

Spring drought episodes are becoming more frequent and intensive in European temperate forests. To study tree resilience to spring drought, Norway spruce seedlings were exposed to three levels of drought stress (well-watered (W), moderately stressed (M) and severely stressed (S)) for 42 days and then fully irrigated for 14 days. Drought strongly reduced gas exchange parameters for both M and S seedlings. After 42 days, stomatal conductance was lower by 83 and 97% in M and S, respectively, than in W seedlings. Respiration prevailed over photosynthesis in S seedlings at the end of the drought period. Drought mostly reduced longitudinal growth, especially in shoots and needles. Xylem growth reduction was caused mainly by a lower number of newly produced tracheids, not by changes in their size. Norway spruce seedlings showed good resilience to spring drought, as the observed physiological parameters started to recover after rewatering and seedlings started to sprout and form new tracheids. In M seedlings, all physiological traits recovered to the level of W seedlings during the 14-day irrigation period but the recovery took longer in S seedlings. Shoots and needles did not regrow in length but leaf mass per area increased during the recovery phase. To conclude, Norway spruce seedlings showed good resilience to spring single-drought event, but time necessary to full recovery from stress could make seedlings more vulnerable to recurrent drought events.
Transgender surgery – Knowledge gap among physicians impacting patient care
Authors: Mani Vishnu R. , Valdivieso Sebastian C. , Hanandeh Adel , Kalabin Aleksandr , Ramcharan Alexius , Donaldson Brian
Published: April 2021

Transgender surgeries are increasingly performed across the globe and in the United States. Although comprehensive centers exist, which are well equipped to cater and tailor to the needs of this population subset, quite often their resultant complications are handled at a different institution owing to the acuity of the condition. However, interestingly the psychosocial needs, medical pathophysiology, available surgical procedures, and their resultant complications are still not a part of the regular medical curriculum. This translates into inadequate care when physicians from vast majority of institutions that do not routinely perform transgender surgery encounter these patients with complications from gender-affirming surgeries. We present a case of a patient who underwent complex multiple gender-affirming surgeries, presenting to our emergency department with an acute abdomen; this resulted in a diagnostic and management dilemma and review of brief pertinent literature. We recommend that transgender medicine and its basics needs should be exposed to currently practicing physicians by continuing medical education, trainees and medical students alike via incorporation into their curriculum, to decrease health disparities among the lesbian, gay, bisexual, transgender, and queer community.
In vivo photobleaching kinetics and epithelial biodistribution of hexylaminolevulinate-induced protoporphyrin IX in rat bladder cancer
Authors: El Khatib Sami
Published: April 2021

In a previous paper, we showed that rat bladder instillations with 8 or 16 mM of hexyl aminolevulinate (hALA) result in diametrically opposed photodynamic therapy efficiency. Although the same fluorescent intensities were detected spectroscopically and by fluorescent microscopy in both conditions, while a given light dose resulted in tumor necrosis with an intact bladder wall after 8 mM hALA, bladders instilled with 16 mM showed total wall necrosis without impact on the tumor. The current study investigated the photobleaching and localization pattern of protoporphyrin IX (PpIX) after both hALA intravesical instillations in tumor-bearing rat bladders. The total PpIX content was evaluated by the extraction of postmortem whole bladders. Photobleaching was evaluated in vivo by fluorescent spectroscopy. Cryosections of bladders were subjected to fluorescent microscopy for cellular localization of the photosensitizer. PpIX extraction showed identical amounts of photosensitizer in tumor-bearing bladders at both concentrations. Photobleaching experiments revealed mono-exponential decay curves in both situations but with a two times faster decay constant in 16 mM bladders. Fluorescent microscopy showed an identical fluorescent pattern for normal bladders at both concentrations and tumor bladders at 8 mM with bright spots. Tumor bladders at 16 mM exhibited a more diffuse cytoplasmatic fluorescent distribution. The different response to photodynamic therapy with regard to the initial pro-drug concentration can thus be attributed to the different cellular localizations.
Childhood Maltreatment and Subclinical Atherosclerosis: Findings From the General Population
Authors: Spitzer Carsten , Lübke Laura , Klinger-König Johanna , Frenzel Stefan , Schminke Ulf , Völzke Henry , Grabe Hans Jörgen
Published: April 2021

Objective

Evidence suggests that childhood maltreatment (CM) is cross-sectionally and prospectively associated with cardiovascular disease. However, its association with proxy markers of atherosclerosis has hardly been investigated. Thus, in this general population study, we examined the association of CM with carotid plaque and intima-media thickness.

Methods

Adults from the general population free of any cardiovascular disease (n = 1909; mean [SD] age = 50.4 (13.6) years, 53.9% women) completed the self-report Childhood Trauma Questionnaire for the assessment of emotional, physical, and sexual abuse as well as emotional and physical neglect; in addition, an ultrasound of the carotid arteries was performed in each participant.

Results

At least one type of CM was reported by 25% of the participants. Carotid plaque was significantly more frequent in those with CM compared with those without (odds ratio = 1.47, 95% confidence interval = 1.19–1.81). Accounting for age and sex rendered it nonsignificant (odds ratio = 1.07, 95% confidence interval = 0.81–1.42). Emotional abuse and physical neglect were significantly associated with both carotid intima-media thickness and plaque occurrence, but these associations were fully explained by risk factors. Neither sexual nor physical abuse was related to proxy markers of atherosclerosis.

Conclusions

Our findings suggest that the relationship between CM types and subclinical atherosclerosis as well as its clinical end points is complex and remains inconclusive, suggesting the need for further research.
Short-term antibody response and tolerability after one dose of BNT162b2 vaccine in patients receiving hemodialysis: A report from the Quebec Renal Network COVID-19 study
Authors: Goupil Rémi , Benlarbi Mehdi , Beaubien-Souligny William , Nadeau-Fredette Annie-Claire , Chatterjee Debashree , Goyette Guillaume , Lamarche Caroline , Tom Alexander , Finzi Andrés , Suri Rita S.
Published: April 2021

Background

Patients receiving in-center hemodialysis (HD) are at high risk of exposure to SARS-CoV-2 with high mortality, and response to vaccination is uncertain.

Methods

We obtained serial plasma from 58 HD patients and 32 health-care workers (HCW) before and after vaccination with one dose of the BNT162b2 mRNA vaccine; as well as convalescent plasma from 11 HD patients who survived COVID-19. Anti-RBD (region binding domain of the SARS-CoV-2 Spike protein) IgG and IgM levels were measured by ELISA. Groups were stratified by evidence of prior SARS-CoV-2 infection.

Results

In HD patients without prior SARS-CoV-2, antiRBD levels were significantly lower at 4 and 8 weeks after vaccination, compared to in HCWs after 3 weeks (p<0.001), and to convalescent plasma (p=0.002). Anti-RBD IgG was non-detectable in 29/46 (63%) of HD, compared to 1/16 (6%) of HCWs (p<0.0001). No patient with non-detectable levels at 4 weeks developed antiRBD by 8 weeks. In HD patients with prior SARS-CoV-2, mean 8-week anti-RBD IgG levels were similar to controls at 3 weeks (p=0.16), and to convalescent plasma (p=0.45). No patients reported symptoms 7 days after vaccination on a standardized questionnaire.

Interpretation

While the BNT162b2 vaccine was well-tolerated in hemodialysis patients, a single dose failed to elicit a humoral immune response in the majority of SARS-CoV-2 naïve patients even after prolonged observation. In those with prior SARS-CoV-2 infection, the humoral response after vaccination was delayed. Whether HD patients develop T-cell responses requires further study. Until then, we advise the second dose be administered to all HD patients at the recommended 3-week time interval, and that rigorous SARS-CoV-2 infection prevention and control measures be continued in dialysis units until vaccine efficacy is proven.
Novel insights into joint estimations of demography, mutation rate, and selection using UV sex chromosomes
Authors: Carey Sarah B. , Peniston James H. , Payton Adam C. , Kim Min , Lipzen Anna , Bauer Diane , Lail Kathleen , Daum Chris , Barry Kerrie , Jenkins Jerry , Grimwood Jane , Schmutz Jeremy , McDaniel Stuart F.
Published: April 2021

A central goal in evolutionary genomics is to understand the processes that shape genetic variation in natural populations. In anisogamous species, these processes may generate asymmetries between genes transmitted through sperm or eggs. The unique inheritance of sex chromosomes facilitates studying such asymmetries, but in many systems sex-biased mutation, demography, and selection are confounded with suppressed recombination in only one sex (the W in females, or the Y in males). However, in a UV sex-determination system, both sex chromosomes are sex-specific and experience suppressed recombination. Here we built a spatially-structured simulation to examine the effects of population density and sex-ratio on female and male effective population size in haploids and compare the results to polymorphism data from whole-genome resequencing of the mossCeratodon purpureus. In the parameter space we simulated, males nearly always had a lower effective population size than females. Using theC. purpureusresequencing data, we found the U and V have lower nucleotide diversity than the autosomal mean, and the V is much lower than the U, however, we found no parameter set in the model that explained both the U/V and U/autosome ratios we observed. We next used standard molecular evolutionary analyses to test for sex-biased mutation and selection. We found that males had a higher mutation rate but that natural selection shapes variation on the UV sex chromosomes. All together the moss system highlights how anisogamy alone can exert a profound influence on genome-wide patterns of molecular evolution.
Chromatin accessibility changes induced by the microbial metabolite butyrate reveal possible mechanisms of anti-cancer effects
Authors: Durrant Matthew G. , Fremin Brayon J. , Rao Abhiram , Cribas Emily , Montgomery Stephen , Bhatt Ami S.
Published: April 2021

Butyrate is a four-carbon fatty acid produced in large quantities by bacteria found in the human gut. It is the major source of colonic epithelial cell energy, can bind to and agonize short-chain fatty acid G-protein coupled receptors and functions as a histone deacetylase (HDAC) inhibitor. Anti-cancer effects of butyrate are attributed to a global increase in histone acetylation in colon cancer cells; however, the role that corresponding chromatin remodeling plays in this effect is not fully understood. We used longitudinal paired ATAC-seq and RNA-seq on HCT-116 colon cancer cells to determine how butyrate-related chromatin changes functionally associate with cancer. We detected distinct temporal changes in chromatin accessibility in response to butyrate with less accessible regions enriched in transcription factor binding motifs and distal enhancers. These regions significantly overlapped with regions maintained by the SWI/SNF chromatin remodeler, and were further enriched amongst chromatin regions that are associated with ARID1A/B synthetic lethality. Finally, we found that butyrate-induced chromatin regions were enriched for both colorectal cancer GWAS loci and somatic mutations in cancer. These results demonstrate the convergence of both somatic mutations and GWAS risk variants for colon cancer within butyrate-responsive chromatin regions, providing a molecular map of the mechanisms by which this microbial metabolite might confer anti-cancer properties.

Highlights

Chromatin accessibility changes longitudinally upon butyrate exposure in colon cancer cells.

Chromatin regions that close in response to butyrate are enriched among distal enhancers.

There is strong overlap between butyrate-induced peaks and peaks associated with SWI/SNF synthetic lethality.

Butyrate-induced peaks are enriched for colorectal cancer GWAS loci and somatic variation in colorectal cancer.
Tunable human myocardium derived decellularized extracellular matrix for 3D bioprinting and cardiac tissue engineering
Authors: Basara Gozde , Ozcebe S. Gulberk , Ellis Bradley W. , Zorlutuna Pinar
Published: April 2021

The generation of 3D tissue constructs with multiple cell types and matching mechanical properties remains a challenge in cardiac tissue engineering. Recently, 3D bioprinting has become a powerful tool to achieve these goals. Decellularized extracellular matrix (dECM) is a common scaffold material due to providing a native biochemical environment. Unfortunately, dECM’s low mechanical stability prevents usage for bioprinting applications alone. In this study, we developed bioinks composed of decellularized human heart ECM (dhECM) with either gelatin methacryloyl (GelMA) or GelMA- methacrylated hyaluronic acid (MeHA) hydrogels dual crosslinked with UV light and microbial Transglutaminase (mTGase). We characterized the bioinks’ mechanical, rheological, swelling, printability and biocompatibility properties. Composite GelMA-MeHA-dhECM (GME) hydrogels demonstrated improved mechanical properties by an order of magnitude, compared to GelMA-dhECM (GE) hydrogels. All hydrogels were extrudable and compatible with human induced pluripotent stem cells derived cardiomyocytes (iCMs) and human cardiac fibroblasts (hCFs). Tissue-like beating of the printed constructs with striated sarcomeric alpha-actinin and Connexin 43 expression was observed. The order of magnitude difference between the elastic modulus of these hydrogel composites offers applications inin vitromodelling of the myocardial infarct boundary. Here, as a proof of concept, we created an infarct boundary region with control over mechanical properties along with cellular and macromolecular content through printing iCMs with GE bioink and hCFs with GME bioink.
HuConTest: Testing human contamination in great ape samples
Authors: Kuhlwilm Martin , Fontsere Claudia , Han Sojung , Alvarez-Estape Marina , Marques-Bonet Tomas
Published: April 2021

Modern human contamination is a common problem in ancient DNA studies. We provide evidence that this issue is also present in studies in great apes, which are our closest living relatives, for example in non-invasive samples. Here, we present a simple method to detect human contamination in short read sequencing data from different species. We demonstrate its feasibility using blood and tissue samples from these species. This test is particularly useful for more complex samples (such as museum and non-invasive samples) which have smaller amounts of endogenous DNA, as we show here.

Significance statement

Human contamination can be a confounding factor in genomic studies, especially in the case of fecal, museum or ancient DNA from great apes. It is important for quality assessment, screening purposes and prioritization to identify and quantify such contamination. The tool presented here is a simple and versatile method for this purpose, and can be applied to a wide range of sample types.