bluuebunny/crossref_metadata_2025 huggingface dataset:
761 Transforming Fluid Resuscitation Documentation to Improve Quality Outcomes
Authors: Thomas Shawna A , Roggy David , Fitzgerald Natalie , Tosino Kim , Magbanua Dennis , Grooms Cortni , Boyd Allison N
Published: April 2024

Introduction

Accurate and readily available documentation of burn fluid resuscitation is essential for decision-making by the multidisciplinary team during the first 24 to 48 hours of care. Fluid resuscitation documentation in the electronic medical record (EMR) is ideal. However, due to the limitations of the EMR, bedside nurses must navigate to various tabs to document fluids, view orders, document events, review labs, and notify providers. To decrease burden of care and improve the accessibility of accurate fluid resuscitation information, our multidisciplinary team embarked on a journey to create a new format in the EMR for fluid resuscitation with our information technology (IT) department.

Methods

In April 2022, the burn team initiated discussions to build a new and streamlined process for documentation of fluid resuscitation. The goal was to decrease the amount of navigation in the EMR during fluid resuscitation by the bedside nurse and improve the accessibility of meaningful hourly documentation for the multidisciplinary team.

During monthly meetings, a multidisciplinary team of nurses, a pharmacist, educators, and IT professionals collaborated on each component needed to capture the desired detailed documentation of each fluid resuscitation.

Results

The new format for fluid resuscitation documentation in the EMR is constructed as a navigator flowsheet and initiated in September 2023. The bedside nurse performs all documentation on this one flowsheet. Information from the Lund-Browder calculates initial fluid resuscitation rates and goal hourly urine output. Once the bedside nurse initiates the fluid resuscitation, navigating to any additional flowsheets or tabs in the EMR is unnecessary. Certain information also pulls in automatically from devices, such as vitals, bladder pressure, and urine output.

Documentation of hourly fluids infused, vital signs, urinary output, fluids changes, bedside procedures performed, provider notification, nursing notes, and consulting team interventions are all performed in the narrator. The bedside nurse can also access all orders, labs, and notes without navigating elsewhere in the EMR. Real-time documentation using the narrator allows multidisciplinary team access without disrupting the patient’s nursing care. The post-resuscitation report provides hour-by-hour documentation for debriefing and reviewing each fluid resuscitation.

Conclusions

The development of this new tool has afforded bedside nurses more time spent caring for the patient rather than navigating the EMR. Providers no longer go to the patient room to retrieve information to help guide fluid resuscitation and disrupt patient care. The post-resuscitation report provides an accurate account of the fluid resuscitation period for debriefing and review.

Applicability of Research to Practice

Our process can be shared with other burn centers hoping to replicate this process.
763 Is Central Venous Catheter the Main Culprit for Clinically Significant Venous Thromboembolism in Burn Patients
Authors: Caesar-Peterson Shannon , Libraro Kaitlyn M , Houng Abraham
Published: April 2024

Introduction

Venous thromboembolism (VTE) is a significant clinical problem for burn patients. The incidence of VTE has been reported as 0.25% to 47.1%. Known risk factors include large burn size, increasing age, male gender, active smoker or alcohol use, blood transfusion and surgeries. Central venous line (CVL) use is also a known risk factor for VTE. With all the known factors, we retrospectively analyzed our patients with VTE.

Methods

Retrospective chart review was performed on a single institution burn center in the calendar year of 2022. Pediatric patients were excluded. Following data were collected: age, burn size, mechanism, length of hospital stays, VTE diagnosis, VTE chemoprophylaxis, and central venous line days. VTE diagnosis was made using CT venogram or ultrasound. This project was a quality improvement initiative.

Results

There were 420 patients in the study period. Of all the admitted patients, there were 6 patients diagnosed with 7 VTE. One patient had 2 separate diagnoses of VTE at 2 distinct period and anatomical site. The incidence of VTE is 1.7%. Upon further chart review, all the VTE were at the site of central venous catheters. All the patients were on VTE chemoprophylaxis. The correlation between burn size, age, length of hospital stay and VTE was not significant.

Conclusions

Risk of VTE is high in burn patients due to the correlation with the Virchow’s Triad. All the patients admitted to the burn unit are placed on chemoprophylaxis unless contraindicated. The 7 patients diagnosed with VTE were on chemoprophylaxis. All the VTE were at the site of central venous catheter insertion sites, which is a known complication of catheters. The incident of 1.7% is on par with VTE incidents of burn patients, but much less than VTE caused by central venous catheters in non-burn patients. Large multicenter data collection is needed to validate this finding.

Applicability of Research to Practice

Directly appliable
775 A Unique Semirigid Silicone Neck Collar for Management of Hypertrophic Scars
Authors: Dwertman Michelle N , Freeman Catherine
Published: April 2024

Introduction

In the realm of burn injuries, the use of rigid hard neck collars, or soft collars, is indispensable for optimizing neck positioning and scar management. However, when injuries encompass the head and neck, a critical challenge arises only one rigid orthosis can typically be worn one at a time. We are introducing a novel solution: a semirigid neck collar crafted from flexible silicone. This collar combines the benefits of semirigid support with the freedom of natural neck and allows jaw movement and may be worn with a rigid facemask. Furthermore, it can be customized to effectively manage hypertrophic scarring, making it a promising advancement in burn injury care.

Methods

Our semirigid neck collar is crafted with High Consistency Rubber (HCR) silicone. The HCR can be fabricated as a solid sheet or perforated. This HCR applies a gentle, consistent minimum pressure of 20mmHg as displayed by the Kikuhime pressure monitoring device while remaining pliable enough to accommodate natural neck movements and TMJ mobility. The material is mixed, pigment tinted, and rolled to achieve the desired thickness. Following this, the HCR silicone is heated and molded based on a 3D scan of the patient's neck and fit to the patient.

A successful trial was conducted in a patient with severe facial and neck burns, resulting in improved neck ROM and hypertrophic scar progression. The resulting scar displayed improvement on the Vancouver Scar Scale yielded as reported on the Likert scale and the patient reporting increased compliance of the semirigid collar.

Results

In the trial involving a patient with severe neck and facial burns:

1. Improved Neck ROM, Eating, and Mandibular Movement: While using the semirigid silicone neck collar, the patient experienced improvements in neck ROM, eating comfort, and mandibular movement. The average Likert scale rating for these improvements was five out of five.

2. Decreased Scarring upon Vancouver Scar Scale displaying the difference between the initial and final VSS scores, indicating how much the scar improved.

3. Patient Preference: A preference for the semirigid silicone neck collar, upon rating it a perfect five on the Likert scale. The patient was able to wear it in combination with a hard TFO facial orthotic.

Conclusions

The semirigid silicone neck collar represents a move forward in the field of neck orthosis design, particularly concerning scar management. Its innovative blend of design elements, including flexibility, adaptability, and customizable features, holds great promise for individuals dealing with burn-related neck scarring.

Applicability of Research to Practice

This semirigid appliance offers increased comfort compared to traditional rigid collars and an option in the management of neck positioning and scar hypertrophy. Its flexible nature, including color-tinting, and cost-effective modification options make it a valuable tool for improving scar management outcomes neck for patients with neck and combined facial/neck scarring.
782 Process for Estimating Burn Clinical Research Staffing Needs and Measuring Work Output and Productivity
Authors: Wilson Joan , Price Austin , Hassan Zaheed , Homsombath Bounthavy F , Fagan Shawn P , Hardy Kade , Sood Rajiv
Published: April 2024

Introduction

In the setting of burn clinical research, no widely adopted tool exists that helps predict staffing needs. Additionally, there is very little reported on burn quality metrics at all. This results in a gap in practice when one considers that there is always a mix of funded versus non-funded projects, all of which require varying levels of workload and input. Adequate staffing is required, regardless of the work mix. While a few sources are available in the oncology research setting, none offer a valid tool for determining staffing for clinical research coordinators (CRCs). A comprehensive search for such a tool identified the TOPS tool (Tool for Operational Protocol Scoring). Because the tool considers protocol complexity, it gives the user a valid means of assigning needs for any project. This tool has allowed us to justify the number of protocols we can feasibly take on considering the number of CRCs on staff and remain fiscally and administratively efficient.

Methods

The TOPS tool was implemented to determine the overall complexity score for the work at hand and to verify that the number of coordinators on staff was adequate. Additionally, a complete list of tasks was developed to account for non-research-related work (i.e., admin, meeting attendances, daily rounds, training, etc.). Each employee estimated the time spent on every task they performed. To validate this, all staff were then asked to document their time. The Director and lead coordinator documented time spent on all other tasks not assigned to CRCs. At the end of 3 months, the time documented was very similar to the time estimated initially, so this time was then used to calculate workload distribution by percent effort. The total number of work hours in a year was used to calculate the portion of work time spent on each task to obtain percentage effort.

Results

According to the TOPS tool, protocol complexity indicated that staff was adequate to cover staffing needs at that time. All staff members worked at over 100% effort.

Conclusions

The TOPS tool is a very close predictor for staffing implementation for research work of varying complexity. Validating percent effort by role further validates staffing and work assignments. These activities are also helpful in planning future research activities and timelines.

Applicability of Research to Practice

There currently is a gap in practice to identify proper tools to predict the need for staffing of a burn research office. Specifically, how many coordinators does it take to run the number of studies and projects at any given time? This tool addresses that gap.
784 Burn Injuries During Pregnancy
Authors: Jacobs Jordan , Carter Elisabeth A , Williams Felicia , Chrisco Lori , King booker
Published: April 2024

Introduction

Burn injury during pregnancy is uncommonly studied, but represents a potentially devastating public health crisis. There is the potential for multiple people injured and lives lost. The aim of this study was to review our institution’s experience with this rare subgroup and to isolate specific trends.

Methods

A retrospective study of burn injuries in pregnant women, admitted from 2013-2023 to a single burn center, was conducted to determine outcomes of pregnant patients. Data on these patients were collected utilizing the burn registry and a manual chart review.

Results

Forty patients were identified and stratified by age, weeks of gestation, mechanism of burn injury, TBSA, length of stay, ICU status, surgical intervention, maternal and fetal mortality, and substance use. The mean average age was 27.6 years, and patients were, on average, 20.8 weeks pregnant. The majority of the injuries being sustained were from scald burns (22), followed by flame (12), chemical (3), contact (2), and electrical (1), with one reported inhalation injury. TBSA ranged from 0-40%, with an average TBSA of 4.5%. Length of stay averaged 5.3 days, and 12 patients were admitted to the ICU, with a mean ICU length of stay of 4.3 days. The majority of patients did not receive any surgical intervention, but for those who did, they received either skin replacement (11), or skin substitute (4). During this time, there was one live birth, and no maternal or fetal deaths. Of those admitted, 12 (30%) tested positive for illegal substance use (22.5% marijuana, 7.5% cocaine), and 5 (12.5%) identified as a smoker.

Conclusions

The high incidence of substance use in this population was a surprising finding and warrants further investigation. There is a need for a multi-center, retrospective study to better understand trends in this unique population, with a focus on substance use.

Applicability of Research to Practice

Investigating substance use in this population will help us understand how to better treat these patients.
786 Decreased Coagulation Activity in Burn Shock Patients Administered Albumin Supplementation
Authors: Hassan Taha F , Mathew Merry , Bingi Sai Pranathi , Yeater Thomas B , Shepherd Colton , Pang Alan , Griswold John A
Published: April 2024

Introduction

Burn shock is a systemic inflammatory response and potentially fatal complication of severe burns. Traditional management of burn shock utilizes fluid resuscitation, which involves the administration of crystalloid or colloid solutions. Commonly used colloid solutions include albumin and plasma. Albumin has recently gained traction as a component of this fluid resuscitation; however, it has demonstrated anti-coagulant activity. It is imperative that we study potential coagulation changes as burn patients are already at risk for various other complications.

Methods

This study aims to determine the effect of albumin administration in resuscitation therapy on coagulation in burn patients. To accomplish this goal, we used electronic medical records to compare the indicators of coagulation change in individuals receiving albumin as a part of resuscitation therapy versus those who are not. We posited that the coagulation activity of burn patients decreased in individuals receiving albumin as a component of fluid resuscitation compared to other solution types. A regression analysis was conducted using data from 245 observations for partial thromboplastin time (PTT) and 253 observations for prothrombin time (PT).

Results

The results indicated that total albumin levels showed a significant positive association with both PTT (β = 0.051, p < 0.01) and PT (β = 0.008, p < 0.01), suggesting an anti-coagulant effect. These findings highlight the potential role of albumin in influencing coagulation parameters. Total albumin was found to be correlated positively to the differences in partial thromboplastin time and prothrombin time, showing that albumin exhibits anti-coagulant activity.

Conclusions

The observed anti-coagulant effect of albumin highlights the importance of careful consideration and monitoring when using colloid solutions in burn management

Applicability of Research to Practice

These results build on existing evidence of albumin exhibiting an anticoagulant effect by binding to antithrombin, inhibiting clotting factors and platelet aggregation. Other studies have also found albumin to decrease coagulation in major surgery and oligemic shock patients. This study confirms the anti-coagulant effect of albumin in severe burn patients. The observed anti-coagulant effect of albumin highlights the importance of careful consideration and monitoring when using colloid solutions in burn management. The results of this study, as well as other studies with similar conclusions, will impact evidence-based guidelines for fluid resuscitation in burn patients.
609 The State of Burn Care Training During General Surgery Residency
Authors: Vrouwe Sebastian Q , Davis Brittany , Lacey Alexandra M
Published: April 2024

Introduction

There is an ongoing and looming shortage of burn surgeons. Workforce reports suggest possible hurdles attracting general surgeons into burn care include the removal of the general surgery training requirement of a formal burn rotation over a decade ago. The purpose of this study was to (1) determine the current state of burn care in general surgery residency and (2) identify what barriers might exist for general surgeons pursuing a practice that involves burn care.

Methods

Surveys were electronically distributed to General surgery program directors and residents, respectively, during the 2022–2023 academic year.

Results

A total of 82 programs (response, 13%) and 62 program directors (17%) agreed to send the surveys on to their residents. Of the participating programs, 48 had one or more residents complete a survey (59%), with a total of 250 general surgery residents (10%) participating. Burn care was felt to be an important component of training by most program directors (82%) and residents (81%). The majority of responding program directors included a burn unit rotation (61%), and the majority of responding residents had or would complete a burn rotation in their residency (59%). Of those residents who had completed a burn rotation, 33% felt it increased their interest, 44% felt it had no impact on their interest, and 24% felt it decreased their interest. Of the residents that did not have a formal burn rotation, 61% were interested in participating in one. Regardless of whether the residents had exposure to burn care, 50% of surveyed resident participants expressed interest in a career that involved some degree of burn care. The top factors that would discourage a trainee from practicing burn care in the future included the narrow scope of practice (44%), nature of burn operations (43%), nature of burn care (39%), and insufficient exposure during their training (32%).

Conclusions

This study indicates that burn rotations in general surgery training are important in establishing interest in burn care. Insufficient exposure to burn care may be one of the top factors discouraging trainees from a career in burn surgery.

Applicability of Research to Practice

In light of the projected workforce shortage, these findings may encourage programs to incorporate a regular burn rotation and increase exposure to a career in burn care for general surgery residents who would otherwise not pursue the field.
789 Six Year Experience with Autologous Skin Cell Suspension for Burn Wounds
Authors: West William , Moffitt Sarah , Nehila Timothy , Jupudi Rithvic , Buller Kristina , Le Nicole K , Whalen Kristen , Troy Jared , Laun Jake
Published: April 2024

Introduction

Autologous skin cell suspensions (ASCS) minimize the donor site required for addressing partial and full thickness burns. ASCS is currently FDA approved for use in combination with meshed split thickness skin grafts (STSGs) for full-thickness thermal burns in pediatric and adult patients. Besides the initial clinical trials of ASCS and STSG use for burn wounds, there are minimal studies reporting outcomes of their use. Here, we present our experience using ASCS in the past six years. We hypothesized that ASCS and STSG would result in a low reoperation and infection rate.

Methods

Retrospective review of patients seen at an American Burn Association verified burn center between 2017 and 2023 identified 15 patients treated with ASCS overlying STSG. Data collected included patient demographics, burn characteristics, surface area of ASCS usage, and patient outcomes. The primary outcome of interest was the requirement for reoperation following ASCS use. Secondary outcomes included hospital length of stay (LOS), ICU LOS, infection, and the necessity for scar revision via surgery or laser treatment. Data was analyzed using descriptive statistics with categorical variables presented as frequencies and percentages and continuous variables reported as medians and ranges.

Results

The median age of patients treated with ASCS was 36 years (13-67 years). The median BMI was 27.4 (17.7-35.4) and median total body surface area (TBSA) affected by burn was 18% (5.75-69.5%). Six patients (40%) had full thickness in addition to partial thickness burns. Most burns, 11 (73%) were the result of flames, although there were three grease burns and one friction burn. The median time to ASCS application was 10 days (1-39 days) and the median number of ASCS application sites was 2 (1-6). Most ASCS sites were on the upper or lower extremities or the torso; however, two patients had ASCS applied to their feet while another patient had it applied to their genitalia. Median ASCS surface area was 2,464 cm2 (289-20,000 cm2). Median LOS was 23 days (8-125 days) and median ICU LOS was 3 days (0-94 days). Four patients (26.7%) required reoperation on sites of ASCS application with the median time to reoperation being 40.5 days (28-66 days). Three patients (20%) required scar contracture surgery and three (20%) received laser treatments. There were no cutaneous infections in our cohort.

Conclusions

ASCS was effectively used to treat both partial thickness and full thickness burns and burns due to flame, grease, and friction. There did not seem to be any relationship between the necessity for reoperation after ASCS and the burn depth, etiology, surface area, or location.

Applicability of Research to Practice

Clinicians can look to our study for potential outcomes when using ASCS with STSG in a variety of situations.
802 Increase in Surgical Burn Management During the COVID-19 Pandemic
Authors: Chaker Sara C , Saad Mariam , James Andrew , Torres-Guzman Ricardo , Slater Elizabeth L , Lineaweaver William
Published: April 2024

Introduction

The COVID-19 pandemic has had a profound impact on healthcare systems worldwide. This study explores the consequences of the pandemic on pediatric burn management, specifically focusing on whether the pandemic contributed to a surge in the volume of pediatric burns requiring surgical interventions.

Methods

All surgical cases that had a post-operative ICD-10 diagnosis of a burn was collected from the National Surgical Quality Improvement Program Pediatric database. Patient demographics, procedure codes, and postoperative complications was collected.

Results

From 2018 to 2021, there was a total of 872 pediatric burns that required surgical intervention. The median age of the patients was 5.4 years. There was an 8.7% increase in volume of these cases from 2019 to 2020. The overall rate of complications was 8.4%. The predominant surgical approach employed in the majority of cases was the utilization of split-thickness autograft.

Conclusions

There was an increase in pediatric surgical burn treatment volume during the COVID-19 pandemic. Further investigation into the underlying causes and implications of this surge is warranted.

Applicability of Research to Practice

This analysis provides more information on the incidence of pediatric burns managed by surgical treatment and how it was affected by the COVID-19 pandemic.
Assessing the mental health and psychosocial well-being of Ukrainian pediatric trauma and burn patients and their caregivers amidst the war: insights from a surgical medical mission in Poland
Authors: Bean Christopher , Yevchenko Natalia , Yakovleva Olga , Dabek Robert J , Fuzaylov Gennadiy
Published: April 2024

On a recent surgical medical mission caring for Ukrainian pediatric burn and trauma patients in Poland, an assessment of the mental health and well-being of children and their caregivers was completed. Children living in war zones frequently experience significant distress and mental health problems, but little is known about the impact of coexisting related or unrelated burn injuries or physical disabilities. Nineteen Ukrainian children and their caregivers were interviewed utilizing validated questionnaires Child Behavioral Checklist (CBCL) and Youth Self-Report (YSR) to assess their risk for developing or for the presence of clinically significant mental health problems. We found a high percentage of children at risk for developing mental health disorders and an unexpectedly high number of children meeting the criteria for mental health disorders. As a result of interviewing the caregivers, agreement was seen between the self-assessment in children and the perception of parents about their children’s well-being. Further study is needed to better understand the complex interactions between pre-existing burn and traumatic injuries and their impact on the psychosocial well-being of children living in war-torn environments.
High prevalence of former elite ice hockey players requiring early hip arthroplasty surgery
Authors: Abrahamson Josefin , Lindman Ida , Jónasson Pall , Tegner Yelverton
Published: April 2024

The high-impact nature of ice hockey puts the players at a higher risk of developing early hip osteoarthritis (OA). This study aims to evaluate the presence of cam morphology, early radiological findings of OA and total hip arthroplasty (THA) in former Swedish elite ice hockey players. Male elite ice hockey players in the highest league in Sweden seeking orthopedic consultation for hip and groin pain with restricted hip joint range of motion and subsequent radiographs (Antero/posterior view, Lauenstein view and/or Hip frontal view) were included. The radiographs were performed between 1988 and 2009 and retrospectively examined for the presence of cam morphology (evaluated by α-angle ≥ 60°) and hip OA (evaluated by Tönnis classification). All players were contacted between 11 and 33 years after baseline radiograph examination for follow-up investigation of the presence of subsequent THA. A total of 44 male ice hockey players were included, of which 31 had available radiographs and 39 answered the follow-up questions. Cam morphology (α-angle ≥60°) was present in 81% of the players. Seven players (18%) had received a THA with a mean age of 55.7 (SD 6.1) years at time of THA-surgery. Tönnis score at baseline radiographs were associated with THA later in life (P < 0.001). This study conclude that former elite Swedish ice hockey players underwent THA at a younger age than the general population. Despite confirming previous research of high prevalence of cam morphology in elite ice hockey players, no association could be established between cam morphology and the need for THA.
A data-driven estimation of the ribosome drop-off rate in S. cerevisiae reveals a correlation with the genes length
Authors: Awad Sherine , Valleriani Angelo , Chiarugi Davide
Published: April 2024

Ribosomes are the molecular machinery that catalyse all the fundamental steps involved in the translation of mRNAs into proteins. Given the complexity of this process, the efficiency of protein synthesis depends on a large number of factors among which ribosome drop-off (i.e. the premature detachment of the ribosome from the mRNA template) plays an important role. However, an in vitro quantification of the extent to which ribosome drop-off occurs is not trivial due to difficulties in obtaining the needed experimental evidence. In this work we focus on the study of ribosome drop-off in Saccharomyces cerevisiae by using ‘Ribofilio‘, a novel software tool that relies on a high sensitive strategy to estimate the ribosome drop-off rate from ribosome profiling data. Our results show that ribosome drop-off events occur at a significant rate also when S. cerevisiae is cultured in standard conditions. In this context, we also identified a correlation between the ribosome drop-off rate and the genes length: the longer the gene, the lower the drop-off rate.
Bible and Film
Authors: Burnette-Bletsch Rhonda
Published: April 2024

Bible and Film is an interdisciplinary field concerned with the complex interplay and multiple intersections between moving images and biblical texts. While “film” continues to be used as a shorthand, the constant evolution of technology and storytelling forms means that Bible and Film research might engage with any media that involves moving images (e.g., television, streamed content, video shorts, commercial advertising). Researchers in this field employ diverse methodologies in pursuit of equally diverse goals (reception history, film history, cultural studies, genre analysis, intertextual conversations, political/ideological criticism, semiotics, adaptation/translation theory, hermeneutics, theology/homiletics, innovative pedagogy). One direction of research examines media that overtly adapt biblical texts by retelling an identifiable story using identifiable characters (Bible “on” film). Other researchers are interested in films that appropriate the Bible in different ways, such as quotation, allusion, or the use of biblical imagery or paradigms (Bible “in” film). Still other work in the field indicates that certain films or film genres function similarly to given biblical texts or genres by exorcising cultural fears, expressing lament, exploring theodicy, or upending social givens through subversive narratives (film “as” Bible). A fourth direction of fruitful research is the analysis of films that bear no tangible relationship to a biblical text but nonetheless generate mutually enriching insights when placed in critical conversation with the Bible (Bible “and” film). In all these endeavors, good research moves beyond the identification of biblical elements in film or the compare-and-contrast approach. As semiotic analysis recognizes, a profound act of translation occurs when appropriating aspects of a written text into the radically different system of signs constituted by the moving image. This recognition demands attention to non-narrative aspects of media and a deeper engagement with film theory. Cultural studies and reception studies move beyond the identification of biblical elements in media to the analysis of how such films reflect and respond to their cultural contexts of production and consumption. Why appropriate aspects of the Bible in this historical-cultural moment? For what purpose? What relationships of power and privilege are legitimated or challenged by these films/texts? Such questions are posed of Bible and Film by ideological criticism. Finally, scholars employing genre theory and intertextuality studies move beyond compare-and-contrast approaches by allowing the analysis of Bible and/in/on/as film to create a mutually illuminating dialogue. A critical encounter between Bible and Film, when neither is privileged over the other, generates fresh understandings of each.
Swaminarayan
Authors: Chag Avni , Mamtora Bhakti
Published: April 2024

Swaminarayan (International Alphabet of Sanskrit Transliteration, IAST: Svāminārāyaṇa, b. 1781–d. 1830), or Sahajānand Svāmī, was the founder and is the principal deity of the eponymous tradition, the Swaminarayan Sampradaya. Born in 1781 in Chhapaiya, a village near Ayodhya, northern India, Swaminarayan lived a short life of forty-nine years. As a child, he was known as Ghanaśyam until he left home at the age of eleven to undertake a journey across the subcontinent as the child-yogi Nilakaṇṭh. Eventually settling in western India, he accepted initiation from Rāmānand Swami (b. 1738–d. 1801) (not to be confused with Rāmānanda of the well-known Rāmānandi Sampradaya) under the name Sahajānand Svāmī. Soon after, Rāmānand Swami bestowed leadership of his sampradāya onto this young and newly initiated ascetic, before passing away. As early as the turn of the 19th century, his followers had begun writing about Swaminarayan as the manifestation of God. They understood him as Parabrahman, their chosen (iṣṭa) deity and paid their reverence to him as Bhagavān Swaminarayan. The tradition saw rapid growth under his leadership across the western Indian regions of Gujarat, Kathiawar, and Kutch, with much of the final decade of his life engaged in activities aiding the tradition’s formal institutionalization, with the establishment of temples, scriptures, and administrative and spiritual leadership. Swaminarayan’s following is estimated to have been 1.8 million by the time of his death. Today the Swaminarayan tradition is one of the largest and most visible expressions of Hinduism across the world, representing a distinct and dynamic form of Hinduism in India and in the Indian diaspora. The last decade has witnessed considerable interest in the tradition, with literature produced under a wide range of topics and disciplinary lenses, and with a particular focus on the BAPS (Bochasanwasi Akshar Purushottam Sanstha) denomination. This article provides an introduction to the literature on Swaminarayan and his eponymous tradition, comprising primary sources written by Swaminarayan and his disciples, translations, and studies of these works, and various secondary studies of the tradition written in English, French, German, and Gujarati. One hopes that this bibliography will spark interest in the developing, nascent field of what might be called “Swaminarayan Studies,” a field dedicated to scholarship on this dynamic form of Hinduism, with important contributions to various discourses and frameworks, from colonial history, media, art, and architecture to digital religion, philosophy, modern religion, globalization, and more.
Phillis Wheatley
Authors: Smith Cassander L.
Published: April 2024

The Atlantic, as a route and a region, was fundamental in the shaping of the person we know as Phillis Wheatley (Peters). Wheatley was an enslaved Black woman living in 18th-century Massachusetts who rose to fame as a poet when she published her one and only volume of poetry, Poems on Various Subjects, Religious and Moral, in 1773. Hers is the earliest known book published by a person of African descent living in British North America. Wheatley was born in the Senegambia region of West Africa, somewhere between the Senegal and Gambia Rivers. Her encounter with the Atlantic began in 1761, when she was about seven or eight years old. She was kidnapped, taken across the Middle Passage, and sold into slavery in colonial Massachusetts. Compelled by what her enslavers deemed a natural curiosity, Wheatley quickly learned how to read and write in English. She began publishing poems as a young teen. One of her most famous poems, published in 1770, when she was about sixteen, is an elegy occasioned by the death of the Reverend George Whitefield, a famous English Methodist evangelist. Three years later, with the help of an English philanthropist named Selina Hastings, Countess of Huntingdon, Wheatley published Poems on Various Subjects. Importantly, she published the book in London when efforts to secure publication in colonial Massachusetts failed. In 1773 she traveled with the son of her enslavers to England to oversee publication and promote the book. The Atlantic was a prominent aspect in the process by which Wheatley published her book and in the themes of the poems in the book. The poems meditate on her capture from West Africa and transatlantic travel. She penned verses in honor of prominent figures in England and Massachusetts and even offered occasional oblique references to her parents in Senegambia. Shortly after the book was published, the Wheatleys manumitted Phillis Wheatley, succumbing perhaps to the pressures of a transatlantic community that advocated for her freedom. As a newly emancipated woman, Wheatley continued to pen verses with the intention of publishing a second book. The book never materialized in print, however, perhaps owing in part to the outbreak of war. In 1778 she married a man named John Peters, who also was formerly enslaved. Peters owned a small grocery store. They moved to the countryside outside of Massachusetts, until just before Wheatley’s death on 5 December 1784, at the approximate age of thirty-one.
Teaching Pragmatics
Authors: Taguchi Naoko
Published: April 2024

Pragmatics involves a complex interplay among language, language users, and context of use. We use language to achieve a variety of communicative goals—to introduce yourself on the first day of school, to present a new product at a company meeting, to negotiate household choirs with your spouse, or to decline telemarketers’ solicitations. For all these goals, our success depends on how we use language effectively and appropriately in the given social context. For example, an indirect refusal like “This isn’t a good time” might work to refuse a telemarketer for the first time, but on repeated occasions, we might be more direct, saying “I’m not interested. Put me on the do-not-call list.” Our choice of linguistic forms is bound to context—settings, occasions, roles, and topics of conversation. Pragmatic knowledge involves knowing which forms to use in what context, and understanding how our linguistic choice affects others’ perceptions and reactions. Given the complexity involved in pragmatics, one can easily imagine that acquiring pragmatic knowledge in a second (or any additional) language is a challenging task. The form-context connections are unique to individual languages and cultures. Second language learners (hereafter L2 learners) need to learn cultural norms that shape how people communicate in the L2 community, as well as L2-specific means of communication. While the challenge of pragmatic acquisition is clear, one element that can assist the process is direct instruction. Focused instruction on pragmatics can be effective, as research findings generally show that instructed L2 learners tend to outperform their non-instructed counterparts in the amount and quality of pragmatic knowledge acquired. A number of studies have supported this trend across different theoretical frameworks, instruction and assessment methods, and contexts of instruction. This article presents selective references of those studies. The article is organized according to three broad topics: (1) Theories and Methods of Instruction, (2) Measures of Instructional Outcomes, and (3) Contexts of Instruction. Under each topic, several subtopics are presented, along with their representative references.
Caribbean/West Indies
Authors: Berman Carolyn Vellenga
Published: April 2024

The West Indian islands circling the Caribbean Sea—and other nearby colonies—were a key locus of the British Empire. They were also a major source of wealth for Great Britain from the 17th century until the early 19th century. As historians have shown, the Atlantic trade furnishing slave labor for plantations was a generator of capital, enabling the British transition to an industrial economy. But the dependence of Caribbean colonies and the British government on slavery and the African slave trade was also a source of anxiety and national shame. A series of colonial rebellions, revolution in Haiti, and the rise of an antislavery movement in the United Kingdom culminated in the parliamentary prohibition of the trade in 1807 and the subsequent emancipation of all those enslaved in British colonies (passed in 1833, but not effective until 1838). By this law, reparative payments were made not to the enslaved but to their former “owners,” including many in the highest ranks of government. In subsequent decades, the British navy’s rebranding as an antislavery force ironically offered an alibi for colonization in Africa. Even as sugar production migrated elsewhere, rivalries with other imperial powers and the replacement of emancipated laborers by the transportation of South Asian workers kept the Caribbean closely entwined with the expanding British Empire. Complex struggles between local and imperial rule arose in the violent suppression of an 1865 uprising in Jamaica; the restriction of local self-governance; and the establishment of “free” trade networks bypassing the colonies. Long neglected in both histories of 19th-century British literature (as a distant outpost) and in Caribbean literature (as colonial, often expressing pro-slavery views), early anglophone Caribbean literature is now coming into the forefront, recognized as containing the seeds of a future Caribbean literature as well as major features of a globalizing Victorian literature. British writers of the 19th century repeatedly turned to “Creole” characters (those raised in the Caribbean) and West Indian settings to canvas not only geopolitics, but also sex, gender, race, class, labor, national governance, and ideas of freedom. Meanwhile, writers in the region developed distinctive perspectives. This entry focuses on anglophone writing in and about the Caribbean, although literary production in French and Spanish was more widespread in the region. This body of literature allows scholars and students to reckon with the legacies of slavery, the blurring of national and linguistic borders, and voices previously excluded or marginalized in the isolationist view of Victorian literature—including authors of African, South Asian, East Asian, Irish, Scottish, English, Jewish, and Indigenous descent in the anglophone Caribbean.
Mapping Proximity to Infectious Disease Physicians Across the United States
Authors: Maamari Julian , Chen Zhuo , Motairek Issam , Al-Kindi Sadeer , Fleisher Jorge
Published: April 2024

Enduring shortages of infectious disease physicians across the United States continue despite efforts to mitigate the problem. The recent fellowship match results underscore the difficulty in rectifying that shortage. Our report sheds light on the current geographic distribution of US infectious disease physicians and highlights the challenges faced by rural communities.
Counting the Cost of Daptomycin Versus Vancomycin in Hospitalized Patients: A Cost Minimization Analysis
Authors: Wagner Jamie L , Jones Bruce M , Stover Kayla R , Cleary John D , Bland Christopher M , Schipper Katie E , Chastain Daniel B , Barber Katie E
Published: April 2024

Daptomycin use for gram-positive infections has increased. This cost minimization analysis aimed to determine cost and/or time savings of daptomycin over vancomycin. The estimated hospital cost savings was US$166.41 per patient, and pharmacist time saved of almost 20 minutes per patient. Daptomycin has the potential to save both time and money.
Casimir Energy through Transfer Operators for Sine-Gordon Backgrounds
Authors: Santamaría-Sanz Lucía
Published: April 2024

The quantum vacuum interaction energy between a pair of semitransparent two-dimensional plates represented by Dirac delta potentials and its first derivative, embedded in the topological background of a sine-Gordon kink, is studied through an extension of the TGTG-formula (developped by O. Kenneth and I. Klich in the scattering approach). Quantum vacuum oscillations around the sine-Gordon kink solutions are interpreted as a quantum scalar field theory in the spacetime of a domain wall. Moreover, the relation between the phase shift and the density of states (the well-known Dashen–Hasslacher–Neveu or DHN formula) is also exploited to characterize the quantum vacuum energy.
A domain-oriented approach to characterizing movement-evoked pain
Authors: Crow Joshua A. , Joseph Verlin , Miao Guanhong , Goodin Burel R. , Sibille Kimberly T. , Cardoso Josue , Bartley Emily J. , Staud Roland , Fillingim Roger B. , Booker Staja Q.
Published: April 2024

Introduction:

Movement-evoked pain (MEP) impacts a substantial proportion of US adults living with chronic pain. Evidence suggests that MEP is influenced by numerous biopsychosocial factors and mediated by mechanisms differing from those of spontaneous pain. However, both characteristic and mechanistic knowledge of MEP remain limited, hindering effective diagnosis and treatment.

Objectives:

We asked (1) can chronic pain, functional, psychosocial, and behavioral measures be grouped into descriptive domains that characterize MEP? and (2) what relationships exist between biopsychosocial factors across multiple domains of MEP?

Methods:

We formed 6 characteristic domains from 46 MEP-related variables in a secondary analysis of data from 178 individuals (aged 45–85 years) with knee pain. Ratings of pain during 3 functional activities (ie, Balance, Walking, Chair Stand) were used as primary MEP variables. Pearson correlations were calculated to show linear relationships between all individual domain variables. Relationships between variables were further investigated through weighted correlation network analysis.

Results:

We observed a unique combination of pain characteristics associated with MEP apart from general pain. Notably, minutes doing physical activity were inversely associated with multiple variables within 4 of the 6 domains. Weighted correlation network analysis largely supported our classification of MEP domains. Additional interdomain relationships were observed, with the strongest existing between MEP, Mechanical Pain, and Multiple Pain Characteristics and Symptoms. Additional relationships were observed both within and between other domains of the network.

Conclusion:

Our analyses bolster fundamental understanding of MEP by identifying relevant mechanistic domains and elucidating biopsychosocial and interdomain relationships.
Phytochemical Screening, Investigation of the toxic and hepatoprotective effect of leaves ofPrunus africana-using mice model
Authors: Dabe Nikodimos Eshetu , Kefale Adane Teshome , Addo Habtamu Acho , Dido Teshale Worku , Kedir Muktar Sano , Afework Hana Tadesse , Kebede Molla Asnake
Published: April 2024

Purpose

Liver disease is a growing public health problem both in developing and developed countries. Allopathic medicines available for liver disease are not accessible and affordable for 3rdworld countries, like Ethiopia. There is a need to search for alternative therapy, in which herbals are widely used in traditional medicine and promising for the development of effective and less costly treatment. As a result, this study aimed to screen phytochemicals and investigate the toxic and hepatoprotective effects ofPrunus africanawhich is traditionally used in Benchi sheko and Sheka Zones, Southwest Ethiopia.

Methods

Methanolic extracts ofPrunus africana, were used to evaluate the toxicity and hepatoprotective activity in both male and female swiss Albino Mice. Liver injury was induced by carbon tetrachloride (CCl4). The toxicity and hepatoprotective activity were examined biochemically, histologically, and through the analysis of the general features of the study animals. The phytochemical composition was screened qualitatively using standard chemical tests for secondary metabolites. The results were expressed as Mean ± SD, and differences at P < 0.05 were considered significant. Differences between the experimental and control groups were analyzed using one-way analysis of variance (ANOVA) followed by Dunnett’s T-test to determine their level of significance.

Results

The extract ofPrunus africanarevealed positive for the presence of flavonoids and Saponins but negative for Anthraquinone glycoside. The current study showed that the median oral lethal dose of the plant was greater than 5000mg/kg. The general behavior of the animal and organ weight, gross morphology, and the biochemical and histological parameters confirmed that the Methanolic leaves extract of this plant is safe during the sub-acute toxicity tests with a dose of 600 and 1800mg/kg. Methanolic extract before and after the CCl4 administration caused a significant reduction in the values of Alanine transaminase, Aspartate transaminase, Alkaline phosphatase, and bilirubin (P<0.05) almost comparable to the standard drug Silymarine. The hepatoprotective activity was supported by histopathological examination of the liver tissue of control and treated animals.

Conclusion

The methanolic extract ofPrunus africanaat the test doses did not show significant toxicity. The results of this study also demonstrate that the extract was effective for the prevention of CCl4-induced hepatic damage in Mice. This study thus justifies that, the use ofPrunus africanain the treatment of liver diseases and points out that this plant warrants further detailed investigation as a promising hepatoprotective agent.