bluuebunny/crossref_metadata_2025 huggingface dataset:
Quasi-monoenergetic carbon ions generation from a double-layer target driven by extreme laser pulses
Authors: Wei Yuqing , Wang Weiquan , Hu Yanting , Zou Debin , Yu Tongpu , Shao Fuqiu
Published: May 2023

High quality energetic carbon ions produced via laser-plasma have many applications in tumor therapy, fast ignition and warm dense matter generation. However, the beam achieved in current experiments is still limited by either a large energy spread or a low peak energy. In this paper, a hybrid scheme for the generation of quasi-monoenergetic carbon ions is proposed by an ultra-intense laser pulse irradiating a double-layer target. Multi-dimensional particle-in-cell (PIC) simulations show that the carbon ions are first accelerated via laser piston mechanism in the former carbon layer and then further accelerated by Coulomb repulsion force in the attached neon target. Since electrons are bunched synchronously in longitudinal and transverse direction by radiation reaction during the whole acceleration process, a quasi-monoenergetic carbon ion beam is eventually produced. In the following stage, the neon target provides the Coulomb field required for the continuous acceleration of the carbon ions which helps to prevent the carbon ion layer from diffusion. It is demonstrated that quasi-monoenergetic carbon ions with peak energy of 465 MeV u−1, energy spread of ∼13%, a divergence of ∼15∘, and laser-to-ion energy conversion of 20% can be achieved by using a laser pulse with intensity of 1.23 × 1023 W cm−2. An analytical model is also proposed to interpret the carbon ion acceleration, which is fairly consistent with the PIC simulations.
Scientific CMOS Sensors in Astronomy: IMX455 and IMX411
Authors: Alarcon Miguel R. , Licandro Javier , Serra-Ricart Miquel , Joven Enrique , Gaitan Vicens , de Sousa Rebeca
Published: May 2023

Scientific complementary metal-oxide-semiconductor (CMOS) detectors have developed quickly in recent years thanks to their low cost and high availability. They also have some advantages over charge-coupled devices (CCDs), such as high frame rate or typically lower readout noise. These sensors started to be used in astronomy following the development of the first back-illuminated models. Therefore, it is worth studying their characteristics, advantages, and weaknesses. One of the most widespread CMOS sensors are those from the Sony IMX series, which are included in large astronomical survey projects based on small and fast telescopes because of their low cost, and capability for wide-field and high-cadence surveys. In this paper, we aim to characterize the IMX455M and IMX411M sensors, which are integrated into the QHY600 and QHY411 cameras, respectively, for use in astronomical observations. These are large (36 × 24 and 54 × 40 mm) native 16 bit sensors with 3.76 μm pixels and are sensitive in the optical range. We present the results of the laboratory characterization of both cameras. They showed a very low dark current of 0.011 and 0.007 e− px−1 s−1 @–10°C for the QHY600 and QHY411 cameras, respectively. They also show the presence of warm pixels, ∼0.024% in the QHY600 and 0.005% in the QHY411. Warm pixels proved to be stable and linear with exposure time, and are therefore easily corrected using dark frames. Pixels affected by the Salt & Pepper noise are ∼2% of the total and a method to correct for this effect is presented. Both cameras were attached to night telescopes and several on-sky tests were performed to prove their capabilities. On-sky tests demonstrate that these CMOS behave as well as CCDs of similar characteristics and (for example) they can attain photometric accuracies of a few mili-magnitudes.
Star-image Centering with Deep Learning: HST/WFPC2 Images
Authors: Casetti-Dinescu Dana I. , Girard Terrence M. , Baena-Gallé Roberto , Martone Max , Schwendemann Kate
Published: May 2023

A deep learning (DL) algorithm is built and tested for its ability to determine centers of star images in HST/WFPC2 exposures, in filters F555W and F814W. These archival observations hold great potential for proper-motion studies, but the undersampling in the camera’s detectors presents challenges for conventional centering algorithms. Two exquisite data sets of over 600 exposures of the cluster NGC 104 in these filters are used as a testbed for training and evaluating the DL code. Results indicate a single-measurement standard error from 8.5 to 11 mpix, depending on the detector and filter. This compares favorably to the ∼20 mpix achieved with the customary “effective point spread function (PSF)” centering procedure for WFPC2 images. Importantly, the pixel-phase error is largely eliminated when using the DL method. The current tests are limited to the central portion of each detector; in future studies, the DL code will be modified to allow for the known variation of the PSF across the detectors.
MHD stability of negative triangularity DIII-D plasmas
Authors: Boyes W. , Turco F. , Hanson J. , Marinoni A. , Turnbull A. , Austin M. , Navratil G.
Published: May 2023

Negative triangularity (NT) experiments in DIII-D point to an emergent reactor scenario free of sawteeth, endowed with benign, nondisruptive n = 2 tearing modes, which experience q
min

⩾

1 similar to the positive triangularity hybrid scenario. Plasmas exhibiting this behavior attain

β

N

>
3

, high enough to reconsider long held views of NT stability. Ideal MHD and tearing stability analysis of well-diagnosed equilibrium reconstructions of experimental hybrid-like plasmas predict that among shape parameters, MHD stability limits are only sensitive to average triangularity. Operation is predicted to be possible at

β

N

relevant to upcoming tokamaks and commercial NT reactors.
Application of sensor structures based on a photoelectric transducer to determine the activity of aspartate and alanine aminotransferases in blood plasma
Authors: Kozinetz Aleksey , Tsymbalyuk Olga , Litvinenko Sergii
Published: May 2023

The successful application of a recombination sensor for the real-time detection of transaminasethe detection of transaminase activities (ALT/AST) in the blood plasma of rats has been demonstrated. The parameter directly measured in real time is the photocurrent through the structure with buried silicon barrier when light with high absorption coefficient is used. Detection is realized as a result of specific chemical reactions catalyzed by ALT and AST enzymes (α-ketoglutarate + aspartate and α-ketoglutarate + alanine). The change of the effective charge of the reagents allows recording the activity of enzymes from photocurrent measurements. The main factor in this approach is the influence on the parameters of the recombination centers at the interface. The physical mechanism of the sensor structure can be explained within the framework of the Stevenson theory, taking into account the changes in the pre surface band bending, the capture cross sections and the energy position of the recombination levels during adsorption. The paper also offers theoretical analyze allowing optimization of analytical signals of recombination sensor. A promising approach to develop a simple and sensitive method for real time detection of transaminases activity has been discussed in detail.
Do quantum circuit Born machines generalize?
Authors: Gili Kaitlin , Hibat-Allah Mohamed , Mauri Marta , Ballance Chris , Perdomo-Ortiz Alejandro
Published: May 2023

In recent proposals of quantum circuit models for generative tasks, the discussion about their performance has been limited to their ability to reproduce a known target distribution. For example, expressive model families such as quantum circuit Born machines (QCBMs) have been almost entirely evaluated on their capability to learn a given target distribution with high accuracy. While this aspect may be ideal for some tasks, it limits the scope of a generative model’s assessment to its ability to memorize data rather than generalize. As a result, there has been little understanding of a model’s generalization performance and the relation between such capability and the resource requirements, e.g. the circuit depth and the amount of training data. In this work, we leverage upon a recently proposed generalization evaluation framework to begin addressing this knowledge gap. We first investigate the QCBM’s learning process of a cardinality-constrained distribution and see an increase in generalization performance while increasing the circuit depth. In the 12-qubit example presented here, we observe that with as few as

30
%

of the valid data in the training set, the QCBM exhibits the best generalization performance toward generating unseen and valid data. Lastly, we assess the QCBM’s ability to generalize not only to valid samples, but to high-quality bitstrings distributed according to an adequately re-weighted distribution. We see that the QCBM is able to effectively learn the reweighted dataset and generate unseen samples with higher quality than those in the training set. To the best of our knowledge, this is the first work in the literature that presents the QCBM’s generalization performance as an integral evaluation metric for quantum generative models, and demonstrates the QCBM’s ability to generalize to high-quality, desired novel samples.
Importance nested sampling with normalising flows
Authors: Williams Michael J , Veitch John , Messenger Chris
Published: May 2023

We present an improved version of the nested sampling algorithm nessai in which the core algorithm is modified to use importance weights. In the modified algorithm, samples are drawn from a mixture of normalising flows and the requirement for samples to be independently and identically distributed (i.i.d.) according to the prior is relaxed. Furthermore, it allows for samples to be added in any order, independently of a likelihood constraint, and for the evidence to be updated with batches of samples. We call the modified algorithm i-nessai. We first validate i-nessai using analytic likelihoods with known Bayesian evidences and show that the evidence estimates are unbiased in up to 32 dimensions. We compare i-nessai to standard nessai for the analytic likelihoods and the Rosenbrock likelihood, the results show that i-nessai is consistent with nessai whilst producing more precise evidence estimates. We then test i-nessai on 64 simulated gravitational-wave signals from binary black hole coalescence and show that it produces unbiased estimates of the parameters. We compare our results to those obtained using standard nessai and dynesty and find that i-nessai requires 2.68 and 13.3 times fewer likelihood evaluations to converge, respectively. We also test i-nessai of an 80 s simulated binary neutron star signal using a reduced-order-quadrature basis and find that, on average, it converges in 24 min, whilst only requiring

1.01
×

10

6

likelihood evaluations compared to

1.42
×

10

6

for nessai and

4.30
×

10

7

for dynesty. These results demonstrate that i-nessai is consistent with nessai and dynesty whilst also being more efficient.
The stability of inorganic perovskite solar cells: from materials to devices
Authors: Yu Bingcheng , Tan Shan , Li Dongmei , Meng Qingbo
Published: May 2023

Inorganic halide perovskite solar cells (IHPSCs) have become one of the most promising research hotspots due to to the excellent light and thermal stabilities of inorganic halide perovskites (IHPs). Despite rapid progress in cell performance in very recent years, the phase instability of IHPs easily occurs, which will remarkably influence the cell efficiency and stability. Much effort has been devoted to solving this issue. In this review, we focus on representative progress in the stability from IHPs to IHPSCs, including (i) a brief introduction of inorganic perovskite materials and devices, (ii) some new additives and fabrication methods, (iii) thermal and light stabilities, (iv) tailoring phase stability, (v) optimization of the stability of inorganic perovskite solar cells and (vi) interfacial engineering for stability enhancement. Finally, perspectives will be given regarding future work on highly efficient and stable IHPSCs. This review aims to provide a thorough understanding of the key influential factors on the stability of materials to highly efficient and stable IHPSCs.
Our fragile space
Authors: Alexander Max
Published: May 2023

Max Alexander has designed an exhibition and science communication project aimed at protecting the near-space environment
LENS: Landscape of Effective Neoantigens Software
Authors: Vensko Steven P , Olsen Kelly , Bortone Dante , Smith Christof C , Chai Shengjie , Beckabir Wolfgang , Fini Misha , Jadi Othmane , Rubinsteyn Alex , Vincent Benjamin G
Published: May 2023

Motivation

Elimination of cancer cells by T cells is a critical mechanism of anti-tumor immunity and cancer immunotherapy response. T cells recognize cancer cells by engagement of T cell receptors with peptide epitopes presented by major histocompatibility complex molecules on the cancer cell surface. Peptide epitopes can be derived from antigen proteins coded for by multiple genomic sources. Bioinformatics tools used to identify tumor-specific epitopes via analysis of DNA and RNA-sequencing data have largely focused on epitopes derived from somatic variants, though a smaller number have evaluated potential antigens from other genomic sources.

Results

We report here an open-source workflow utilizing the Nextflow DSL2 workflow manager, Landscape of Effective Neoantigens Software (LENS), which predicts tumor-specific and tumor-associated antigens from single nucleotide variants, insertions and deletions, fusion events, splice variants, cancer-testis antigens, overexpressed self-antigens, viruses, and endogenous retroviruses. The primary advantage of LENS is that it expands the breadth of genomic sources of discoverable tumor antigens using genomics data. Other advantages include modularity, extensibility, ease of use, and harmonization of relative expression level and immunogenicity prediction across multiple genomic sources. We present an analysis of 115 acute myeloid leukemia samples to demonstrate the utility of LENS. We expect LENS will be a valuable platform and resource for T cell epitope discovery bioinformatics, especially in cancers with few somatic variants where tumor-specific epitopes from alternative genomic sources are an elevated priority.

Availability and implementation

More information about LENS, including code, workflow documentation, and instructions, can be found at (https://gitlab.com/landscape-of-effective-neoantigens-software).
Advances in understanding the function of alpha-synuclein: implications for Parkinson’s disease
Authors: Calabresi Paolo , Di Lazzaro Giulia , Marino Gioia , Campanelli Federica , Ghiglieri Veronica
Published: May 2023

The critical role of alpha-synuclein in Parkinson’s disease represents a pivotal discovery. Some progress has been made over recent years in identifying disease-modifying therapies for Parkinson’s disease that target alpha-synuclein. However, these treatments have not yet shown clear efficacy in slowing the progression of this disease. Several explanations exist for this issue. The pathogenesis of Parkinson’s disease is complex and not yet fully clarified and the heterogeneity of the disease, with diverse genetic susceptibility and risk factors and different clinical courses, adds further complexity. Thus, a deep understanding of alpha-synuclein physiological and pathophysiological functions is crucial.

In this review, we first describe the cellular and animal models developed over recent years to study the physiological and pathological roles of this protein, including transgenic techniques, use of viral vectors and intracerebral injections of alpha-synuclein fibrils. We then provide evidence that these tools are crucial for modelling Parkinson’s disease pathogenesis, causing protein misfolding and aggregation, synaptic dysfunction, brain plasticity impairment and cell-to-cell spreading of alpha-synuclein species. In particular, we focus on the possibility of dissecting the pre- and postsynaptic effects of alpha-synuclein in both physiological and pathological conditions. Finally, we show how vulnerability of specific neuronal cell types may facilitate systemic dysfunctions leading to multiple network alterations.

These functional alterations underlie diverse motor and non-motor manifestations of Parkinson’s disease that occur before overt neurodegeneration. However, we now understand that therapeutic targeting of alpha-synuclein in Parkinson’s disease patients requires caution, since this protein exerts important physiological synaptic functions. Moreover, the interactions of alpha-synuclein with other molecules may induce synergistic detrimental effects. Thus, targeting only alpha-synuclein might not be enough. Combined therapies should be considered in the future.
P2X7 receptor-mediated depression-like reactions arising in the mouse medial prefrontal cortex
Authors: Ren Wen-Jing , Zhao Ya-Fei , Li Jie , Rubini Patrizia , Yuan Zeng-Qiang , Tang Yong , Illes Peter
Published: May 2023

Major depressive disorder is a frequent and debilitating psychiatric disease. We have shown in some of the acute animal models of major depressive disorder (tail suspension test and forced swim test) that depression-like behavior can be aggravated in mice by the microinjection into the medial prefrontal cortex of the P2X7R agonistic adenosine 5′-triphosphate or its structural analog dibenzoyl-ATP, and these effects can be reversed by the P2X7R antagonistic JNJ-47965567. When measuring tail suspension test, the prolongation of immobility time by the P2YR agonist adenosine 5′-[β-thio]diphosphate and the reduction of the adenosine 5′-(γ-thio)triphosphate effect by P2Y1R (MRS 2179) or P2Y12R (PSB 0739) antagonists, but not by JNJ-47965567, all suggest the involvement of P2YRs. In order to elucidate the localization of the modulatory P2X7Rs in the brain, we recorded current responses to dibenzoyl-ATP in layer V astrocytes and pyramidal neurons of medial prefrontal cortex brain slices by the whole-cell patch-clamp procedure; the current amplitudes were not altered in preparations taken from tail suspension test or foot shock-treated mice. The release of adenosine 5′-triphosphate was decreased by foot shock, although not by tail suspension test both in the hippocampus and PFC. In conclusion, we suggest, that in the medial prefrontal cortex, acute stressful stimuli cause supersensitivity of P2X7Rs facilitating the learned helplessness reaction.
Takotsubo syndrome: getting closer to its causes
Authors: Akhtar Mohammed Majid , Cammann Victoria L , Templin Christian , Ghadri Jelena R , Lüscher Thomas F
Published: May 2023

Takotsubo syndrome (TTS) accounts for between 1 and 4% of cases presenting clinically as an acute coronary syndrome. It typically presents as a transient cardiac phenotype of left ventricular dysfunction with spontaneous recovery. More dramatic presentations may include cardiogenic shock or cardiac arrest. Despite progress in the understanding of the condition since its first description in 1990, considerable questions remain into understanding underlying pathomechanisms. In this review article, we describe the current published data on potential underlying mechanisms associated with the onset of TTS including sympathetic nervous system over-stimulation, structural and functional alterations in the central nervous system, catecholamine secretion, alterations in the balance and distribution of adrenergic receptors, the additive impact of hormones including oestrogen, epicardial coronary or microvascular spasm, endothelial dysfunction, and genetics as potentially contributing to the cascade of events leading to the onset. These pathomechanisms provide suggestions for novel potential therapeutic strategies in patients with TTS including the role of cognitive behavioural therapy, beta-blockers, and endothelin-A antagonists. The underlying mechanism of TTS remains elusive. In reality, physical or emotional stressors likely trigger through the amygdala and hippocampus a central neurohumoral activation with the local and systemic secretion of excess catecholamine and other neurohormones, which exert its effect on the myocardium through a metabolic switch, altered cellular signalling, and endothelial dysfunction. These complex pathways exert a regional activation in the myocardium through the altered distribution of adrenoceptors and density of autonomic innervation as a protective mechanism from myocardial apoptosis. More research is needed to understand how these different complex mechanisms interact with each other to bring on the TTS phenotype.
Human antigen R regulates autophagic flux by stabilizing autophagy-associated mRNA in calcific aortic valve disease
Authors: Fang Juan , Qian Yi , Chen Jinyong , Xu Dilin , Cao Naifang , Zhu Gangjie , Hu Wangxing , Hu Haochang , Qian Ningjing , Yang Shuangshuang , Wang Jian’an , Liu Xianbao
Published: May 2023

Aims

The incidence of calcific aortic valve disease (CAVD) has risen over the last decade and is expected to continue rising; however, pharmacological approaches have proven ineffective. In this study, we evaluated the role and underlying mechanisms of human antigen R (HuR)–mediated post-transcriptional regulation in CAVD.

Methods and results

We found that HuR was significantly upregulated in human calcified aortic valves and primary aortic valvular interstitial cells (VICs) following osteogenic stimulation. Subsequent functional studies revealed that HuR silencing ameliorated calcification both in vitro and in vivo. For the first time, we demonstrated that HuR directly interacted with the transcript of phosphatidylinositol-5-phosphate 4-kinase, type II, alpha (PIP4K2A), which mediates phosphatidylinositol signalling, facilitates autophagy, and acts as an mRNA stabilizer. HuR positively modulated PIP4K2A expression at the post-transcriptional level and consequently influenced the AKT/mTOR/ATG13 pathway to regulate autophagy and CAVD progression.

Conclusion

Our study provides new insights into the post-transcriptional regulatory role of HuR in modulating autophagy-positive factors to regulate the pathogenesis of CAVD. Our findings highlight the potential of HuR as an innovative therapeutic target in CAVD treatment.
Method Comparison and Workflow Differences Using the Same Free Light Chain Assay on 2 Analyzer Platforms
Authors: Omosule Catherine L , Hock Karl G , Dalton Claire , Scalpati Anthony , Gronowski Ann M , Brants Aigars , Farnsworth Christopher W
Published: May 2023

Background

The Freelite assay (The Binding Site) is utilized to quantify serum immunoglobulin free light chains (sFLC), which is crucial for diagnosing and monitoring plasma cell dyscrasias (PCDs). Using the Freelite test, we compared methods and evaluated workflow differences across two analyzer platforms.

Methods

sFLC concentrations were measured in 306 fresh serum specimens (cohort A) and 48 frozen specimens with documented sFLC >20 mg/dL (cohort B). Specimens were analyzed on the Roche cobas 8000 and Optilite analyzers using the Freelite κ and λ assays. Performance was compared using Deming regression. Workflow was compared by assessing turnaround time (TAT) and reagent usage.

Results

For cohort A specimens, Deming regression revealed a slope of 1.04 (95% CI, 0.88–1.02) and an intercept of −0.77 (95% CI, −0.57 to 1.85) for sFLCκ and a slope of 0.90 (95% CI, −0.04 to 1.83) and intercept of 1.59 (95% CI, −3.12 to 6.25) for sFLCλ. Regression of the κ/λ ratio revealed a slope of 2.44 (95% CI, 1.47–3.41) and intercept of −8.13 (95% CI, −16.82 to 0.58) with a concordance kappa of 0.80 (95% CI, 0.69–0.92). The proportion of specimens with TAT >60 min was 0.33% and 8% for the Optilite and cobas, respectively (P < 0.001). The Optilite required 49 (P < 0.001) and 12 (P = 0.016) fewer tests for sFLCκ and sFLCλ relative to the cobas. Cohort B specimens showed similar but more dramatic results.

Conclusions

Analytical performance of the Freelite assays was comparable on the Optilite and cobas 8000 analyzers. In our study, the Optilite required less reagent, had a slightly reduced TAT, and eliminated manual dilutions for samples with sFLC concentrations >20 mg/dL.
Prioritizing nutrition interventions for low-income clients receiving public health nurses’ home visiting services: a latent class analysis study of Omaha System data
Authors: Lee Jiwoo , Austin Robin R , Mathiason Michelle A , Monsen Karen A
Published: May 2023

Objective

This study aimed to identify phenotypes of nutritional needs of home-visited clients with low income, and compare overall changes in knowledge, behavior, and status of nutritional needs before and after home visits by identified phenotypes.

Materials and methods

Omaha System data collected by public health nurses from 2013 to 2018 were used in this secondary data analysis study. A total of 900 low-income clients were included in the analysis. Latent class analysis (LCA) was used to identify phenotypes of nutrition symptoms or signs. Score changes in knowledge, behavior, and status were compared by phenotype.

Results

The five subgroups included Unbalanced Diet, Overweight, Underweight, Hyperglycemia with Adherence, and Hyperglycemia without Adherence. Only the Unbalanced Diet and Underweight groups showed an increase in knowledge. No other changes in behavior and status were observed in any of the phenotypes.

Discussion and conclusions

This LCA using standardized Omaha System Public Health Nursing data allowed us to identify phenotypes of nutritional needs among home-visited clients with low income and prioritize nutrition areas that public health nurses may focus on as part of public health nursing interventions. The sub-optimal changes in knowledge, behavior, and status suggest a need to re-examine the intervention details by phenotype and develop strategies to tailor public health nursing interventions to effectively meet the diverse nutritional needs of home-visited clients.
Bottom-up and top-down paradigms of artificial intelligence research approaches to healthcare data science using growing real-world big data
Authors: Wang Michelle , Sushil Madhumita , Miao Brenda Y , Butte Atul J
Published: May 2023

Objectives

As the real-world electronic health record (EHR) data continue to grow exponentially, novel methodologies involving artificial intelligence (AI) are becoming increasingly applied to enable efficient data-driven learning and, ultimately, to advance healthcare. Our objective is to provide readers with an understanding of evolving computational methods and help in deciding on methods to pursue.

Target Audience

The sheer diversity of existing methods presents a challenge for health scientists who are beginning to apply computational methods to their research. Therefore, this tutorial is aimed at scientists working with EHR data who are early entrants into the field of applying AI methodologies.

Scope

This manuscript describes the diverse and growing AI research approaches in healthcare data science and categorizes them into 2 distinct paradigms, the bottom-up and top-down paradigms to provide health scientists venturing into artificial intelligent research with an understanding of the evolving computational methods and help in deciding on methods to pursue through the lens of real-world healthcare data.
T3 Sexual Satisfaction and Association with Psychosocial Outcomes Among Burn Survivors
Authors: Cato Liam D , Shepler Lauren J , McMullen Kara , Roaten Kimberly , Kazis Lewis E , Ryan Colleen M , Schneider Jeffrey C
Published: May 2023

Introduction

Sexual satisfaction is often unaddressed in clinical care despite it being an important aspect of healing and quality of life for burn survivors. Previous literature has focused predominantly on physical function rather than perceived satisfaction. This study aimed to determine the associations of sexual satisfaction with psychosocial outcomes and assess sexual satisfaction recovery over time after burn injury.

Methods

Patients consenting to provide data to the Burn Model System (BMS) National Database injured after 2015, aged greater than 18 years at the time of burn injury, and alive at discharge were included in the analysis. Sexual satisfaction was collected at six months and then every year for five years post-injury using two PROMIS sexual satisfaction items, a composite T-score was derived, where a higher score indicated higher sexual satisfaction. Analyses included sexual satisfaction scores as outcomes with mixed models that included repeated measures controlling for correlated error of the outcomes and covariates that included demographics. Psychosocial measures analyzed included: PROMIS-29 Anxiety, Depression, Fatigue and Sleep scores; VR-12 mental component score (MCS) and physical component score (PCS); and the Post-Traumatic Growth Inventory (PTGI) total score.

Results

The analysis identified 561 individuals with sexual satisfaction data for at least one time point. The population demographics included a median age of 46 years (IQR 34, 59), reported sex (female = 171 (30.5%)), and median TBSA burned 10% (IQR 3, 26). Increasing age (p < 0.0001) and marital status with those ‘Divorced’ (p=0.004) or ‘Single’ (p=0.0003) were associated with lower sexual satisfaction. There was no association with TBSA burn size. Within psychosocial metrics, we found that the CIQ Social Integration score (p < 0.0001), VR-12 MCS (p=0.008), PTGI Total Score (p=0.01), and PROMIS 29 Sleep Disturbance score (p=0.0004) were also significantly associated. Change in scores were associated with the VR-12 MSC (p=0.03), where an increased MCS score predicted improved sexual satisfaction by final follow-up.

Conclusions

A significant association was found between sexual satisfaction and social integration, mental health, and post-traumatic growth.

Applicability of Research to Practice

These findings suggest that interventions to improve the sexual satisfaction of burn survivors should focus on the importance of social integration, mental health, and sleep quality.
T4 Integration of PT/OT in Burn Wound Care Increases Therapist Productivity
Authors: Schwartzman Amy , Balstad Blaire , Wiktor Arek J , Mueller Scott W
Published: May 2023

Introduction

Inpatient physical (PT) and occupational (OT) burn therapists must balance complex patient factors such as daily wound care when attempting skilled therapy sessions, while also attaining specific productivity standards. These factors often lead to inefficient work flow and loss of productivity. The purpose of this study was to assess the productivity and feasibility of therapist integration into daily burn wound care.

Methods

A quality improvement project was initiated by the burn therapy team at our ABA verified burn center. One full time equivalent (FTE) PT or OT was assigned to the burn wound care team five days a week, involving 6 therapists (3 PTs and 3 OTs). General duties included wound assessment, functional wound dressings, and skilled therapeutic interventions. The primary outcome measure was individual therapist productivity tracked 3 months pre and 3 months post project implementation. Productivity was calculated by taking total billable patient time divided by total workday time, with a goal of 50% productivity. Billed time units were also compared to goal units. The results were analyzed using a paired t-test to measure significance and averaged. The secondary outcome measure was program feasibility, assessed by a qualitative questionnaire taken by burn staff pre and post.

Results

Overall therapist productivity increased, 49% pre implementation vs 54% post (p=0.0041). The difference of billed vs goal units increased, 5 pre vs 15.9 post (p= 0.00142). Proportion of therapists meeting target productivity increased, 57.1% pre vs 90.5% post (p=0.0052). Prior to program implementation, survey results found that 77% of burn staff (n=23 respondents) were favorable of project implementation, whereas 23% were either hesitant or indifferent. After 3 months post implementation, 95% of burn staff were favorable of therapist participation, 95% indicated ease of staffing burden, and 100% reported improved multidisciplinary communication. Furthermore, 100% of burn staff felt that the unit’s workflow had improved.

Conclusions

Full time therapy participation in wound care increases therapist productivity and increases the likelihood of meeting target productivity in the future. The majority of burn staff actively supported this pilot program and felt that it eased staffing demands, improved unit workflow, and improved multidisciplinary communication. Future efforts should focus on measuring specific patient outcomes and cost as a result of therapist participation in daily wound care practice.

Applicability of Research to Practice

All burn units should consider implementing a skilled burn therapist in wound care practice.
40 Home-Based Virtual Rehabilitation Does Not Improve Daily Walking in the First Twelve Weeks After Discharge
Authors: Sibbett Stephen , Orton Caitlin , Carrougher Gretchen , Stewart Barclay , Bunnell Aaron , Gibran Nicole , Pham Tam
Published: May 2023

Introduction

Restoring cardiovascular fitness can be challenging during the first months after hospital discharge for adult burn patients. Furthermore, adherence to prescribed home therapy among people with burn injury has traditionally been low. We conducted a 5-year randomized controlled trial of 12-weeks of gamified virtual home therapy compared to prescribed home exercise (usual care). We hypothesized that those assigned to the virtual therapy would log more total daily walking during the intervention period.

Methods

All English-speaking adult patients hospitalized with burn injury were screened for participation. Eligibility criteria required discharge to home, personal smartphone, and access to a television with HDMI connectivity. Participants randomized to the virtual therapy group received access to a customized exercise software program with motion sensing hardware to use for twelve weeks in addition to usual home therapy instructions. All participants were instructed to continuously wear a provided actigraphy device during the 12-week period. Wilcoxon rank sum tests were used to compare median miles walked per day between groups. Adherence to the actigraphy device was defined a priori as having wear-data for 5 days in a calendar week.

Results

Actigraphy data from 44 participants (22 control, 22 experimental) were compared. Median miles walked per day increased from 1.5 miles/day (IQR 1.0-2.7) in Week 1 to 2.85 miles/day (IQR 1.8-4.5) in Week 12. Wilcoxon rank sum testing revealed no significant difference in median miles/day between groups during any week (Figure 1). Adherence to wearing the actigraphy device was equal or higher in control participants for all weeks.

Conclusions

Home-based virtual rehabilitation did not increase total daily walking during the first twelve weeks after discharge. At Week 12, daily walking is nearly twice that of Week 1 in both groups.

Applicability of Research to Practice

Post-discharge actigraphy data from people with burn injury can inform both patients and providers about activity after hospital discharge.
57 Effect of High-Dose Ascorbic Acid in Major Burn Patients: A Systematic Review and Meta-Analysis
Authors: Pleehachinda Punthiti , Muangman Pornprom , Chinaroonchai Kusuma
Published: May 2023

Introduction

High-dose ascorbic acid (HDAA) plays an important role in oxygen radical elimination which is a major cause of pathophysiological derangement in burn patients. However, there was limited explicit data on the clinical effect of HDAA in major burn patients. The purpose of this study was to identify the benefit and risks of HDAA in major burn patients.

Methods

MEDLINE, EMBASE, and Cochrane database searches were conducted. An additional search of relevant primary literature and review articles was performed. All the studies related to HDAA and burn were included in the analysis. HDAA group was defined by receiving ascorbic acid 66 mg/kg/day in the first 24 hours. The primary outcome was the 24-hour fluid requirement. The secondary outcomes were in-hospital mortality, 24-hour urine output, ventilator day, hospital length of stay, and in-hospital complications. Pooled incidences and 95% confidence interval (CI) were calculated and summarized using a random effect model on Stata/MP 16.1.

Results

Of 875 studies, 7 articles (293 patients) were included in this meta-analysis. HDAA significantly reduced 24-hour fluid requirement compared with usual care (no HDAA) (SMD -0.75 ml/kg per TBSA, 95% CI [-1.38 to -0.12]). HDAA group showed a decrease in 24-hour urine output (SMD, 0.65; 95% CI, 0.41 to 0.89). However, it did not demonstrate significant increase in acute kidney injury (RR 1.37, 95% CI [0.60 to 3.13]) and the need for renal replacement therapy (RR 1.31, 95% CI [0.50 to 3.44]). In terms of in-hospital complications, there was no significant difference in abdominal compartment syndrome (RR 0.22, 95% CI [0.08 to 0.89]) and pneumonia or acute respiratory distress syndrome (RR 1.03, 95% CI [0.70 to 1.51]). Though there was a trend to decrease mortality in the HDAA group, there was no statistical difference in mortality (RR 1.27, 95% CI [0.85 to 1.91]). HDAA group had a comparable hospital length of stay (SMD 0.1, 95% CI [-0.44 to 0.63]) and ventilator day (SMD 0.03, 95% CI [-0.64 to 0.70]).

Conclusions

High-dose ascorbic acid had a clinical benefit in the significant reduction of 24-hour fluid requirement without increasing the risk for acute kidney injury or the need for renal replacement therapy. Though it did not demonstrate a significant improvement in mortality or length of stay, there were no significant reported complications from high-dose ascorbic acid. A multicenter randomized controlled trial is warranted.

Applicability of Research to Practice

The potential benefit of HDAA in major burn
60 A Retrospective Review of High-Frequency Percussive Ventilation in Inhalation Injury
Authors: Miller Emily , Zhang Xu , Huzar Todd , Harvin John
Published: May 2023

Introduction

Inhalation injury (II) is a major contributor to mortality in burn patients. These patients often require mechanical ventilation, but there is no clear consensus on optimal ventilatory strategy for this population. Previous studies in patients with acute respiratory distress syndrome (ARDS) demonstrated that high frequency percussive ventilation (HFPV) improved oxygenation and mobilization of airway secretions. However, HFPV in the context of II remains poorly studied. We hypothesized that for these patients, use of HFPV in addition to conventional mechanical ventilation (CMV) would reduce complications and decrease mortality compared to patients treated with CMV only.

Methods

We conducted a retrospective chart review of 200 patients admitted to a burn center from February 2008 - January 2019 with burns and/or II and ventilated either with CMV alone or with CMV + HFPV. Patients who were under the age of 18 or who received mechanical ventilation for less one day were excluded. Information including patient demographics and comorbidities, percent total body surface area burned, ventilation method, length of stay, complications, and outcomes were collected. Two-sample comparisons were performed by using score test for proportions and Wilcoxon rank sum test for continuous variables with significance defined as p< 0.05.

Results

Of 200 patients studied, 84 received CMV + HFPV and 116 received CMV alone. There was no difference in mortality between groups (CMV+HFPV 39.3% vs CMV 31.0%; p=0.23). There was also similar incidence of pneumonia (CMV+HFPV 53.6% vs CMV alone 63.8%; p=0.15), pneumothorax, ARDS, and sepsis. Patients on CMV + HFPV had a greater incidence of acute kidney injury (CMV+HFPV 60.7% versus CMV alone 43.1%; p=0.014) and reduced development of wound complications (CMV+HFPV 7.1% versus CMV alone 16.4%; p=0.05). In surviving patients (n=131), length of hospital stay was not significantly different between groups.

Conclusions

These single-center results do not support the use of CMV + HFPV rather than CMV alone in patients with II. Further research in this area, including larger multi-center studies, is warranted.

Applicability of Research to Practice

This is a hypothesis-generating study that adds to the currently limited understanding of best practice for managing patients with II.
64 Worse Itch and Fatigue in Racial and Ethnic Minorities: A Burn Model System Cross-sectional Study
Authors: Won Paul , Stoycos Sarah , Ding Li , McMullen Kara , Kowalske Karen , Stewart Barclay , Yenikomshian Haig
Published: May 2023

Introduction

Racial and ethnic minority patients may experience worse hypertrophic scar after burn injury than Non-Hispanic, White patients. Consequently, they may encounter differences in scar-related recovery domains including itch and fatigue. We examined disparities in post-burn injury itch and fatigue in minority patients to better inform counseling and treatment considerations.

Methods

From the multicenter National Institute of Disability, Independent Living and Rehabilitation Research Burn Model System Database (2015-2019), we analyzed outcomes at three time-points (discharge from index hospitalization, 6- and 12-months post-injury) using the 5-D Itch and PROMIS-29 Fatigue measures. Multi-level linear mixed effects regression modeling analyzed associations between race/ethnicities and outcomes over time.

Results

Of 893 total patients, 149 (17%) patients were Hispanic/Latino, 603 (68%) Non-Hispanic, White, and 86 (10%) Black. Minority patients reported higher/worse itch scores at all time points compared to Non-Hispanic, White patients. Itch scores were significantly higher for Black patients at 6 months (β=1.42, p=0.03) and 12 months (β=3.36, p< 0.0001) when compared to Non-Hispanic, White patients. Black patients reported higher fatigue scores than Non-Hispanic, White patients at all time points. Fatigue scores were significantly higher for Hispanic/Latino patients at discharge (β=6.17, p< 0.0001), 6 months (β=4.49, p=0.0003), and 12 months (β=6.27, p< 0.0001) than Non-Hispanic, White patients.

Conclusions

This study supports investigation of potential factors leading to increased itch and fatigue such as genomic scar differences, relative treatment effects (e.g., medications, cognitive processing therapy), and psychosocial impacts of these symptoms.

Applicability of Research to Practice

In the short-term, minority patients may benefit from additional counseling and focused treatments addressing itch and fatigue after burn injury.
65 Differences in Pain Experience by Race, Ethnicity, and Socioeconomic Status Among People with Burn Injury
Authors: Pacleb Maiya , Stewart Barclay , Carrougher Gretchen , Kowalske Karen , Mandell Samuel , Schneider Jeffrey , Silver Julie , McMullen Kara , Orton Caitlin , Sibbett Stephen , Ashford Nathaniel
Published: May 2023

Introduction

Disparities in pain experience and treatment amongst people of different races and ethnicities have been described for several conditions. However, the relationship between race, ethnicity, socioeconomic status (SES) and pain reported by people with burn injury is not well understood. This study compares pain intensity and interference with daily activities among burn-injured adults of various sociodemographic backgrounds. We hypothesized that minority and low-income populations will report greater pain intensity and interference, necessitating additional strategies to address pain disparity.

Methods

Adult multicenter national database participants with complete PROMIS® pain intensity and pain interference measures at 6 and 12 months after injury were analyzed. Linear regression models examined associations between sex, race, ethnicity, education, income, burn size and pain interference and intensity scores. Regression model diagnostics were tested, and final models used robust standard errors to account for heteroskedasticity.

Results

Data from 656 participants were analyzed, with a mean age of 47.1 ± 16.2. Racial representation was 84.0% White, 8.8% African American/Black, 2.5% Asian/Native Hawaiian/Pacific Islander, 1.9% American India laskan Native, and 2.8% other/more than one race; 80.4% were non-Hispanic and 19.6% Hispanic. Weighted regression models revealed that pain intensity at 6 mo (Ⓡ=1.25, p=0.029) and interference at 12 mo (β=6.71, p=0.013) among Black participants were markedly higher than White participants. Hispanic participants reported lower pain intensity (β=-0.86, p=0.036) and interference (β=-4.06, p=0.007) compared to non-Hispanic participants at 6 mo. Average pain intensity at 6 mo varied significantly by income (p=0.01), with the highest pain intensity (mean 3.8, SD 3.0) reported by those making < $25,000/year. Females reported greater pain intensity at 6 mo than males (β=0.63, p=0.029).

Conclusions

Greater pain intensity and interference were reported by Black participants compared to White participants, while Hispanic participants reported lower pain outcomes. Lower income was also associated with worse pain outcomes. Targeted study of pre-injury pain experiences, pain management, psychosocial health, and financial toxicity are required to identify opportunities for intervention on the many dimensions and causal factors of unsatisfactory pain experiences.

Applicability of Research to Practice

Systematic screening for pain intensity and interference after burn injury may find sociodemographic groups with high pain levels and a need for interdisciplinary pain and psychosocial health management. Comprehensive pain treatment following burn injury should account for social determinants of health and impact of bias to further improve quality care for all people.