bluuebunny/crossref_metadata_2025 huggingface dataset:
Mimosa ceratonia (climbing mimosa).
Authors: Rojas-Sandoval Julissa , Acevedo-Rodríguez Pedro
Published: April 2021

M. ceratonia is a fast-growing perennial multi-stemmed vine that is considered a weed in Puerto Rico (Vélez and Overbeek, 1950). The species is able to grow in a great range of habitats including fencelines, roadsides, pastures, brushy pastures, wooded drains, forest edges and openings in secondary forests. Consequently, it has the potential to spread much further than it has to date, both inside and outside its native range. Seeds are easily dispersed by the pods clinging to clothing or to the fur of animals, and they can remain viable for several years (Francis, 2000).
Alternanthera philoxeroides (alligator weed).
Authors: Rojas-Sandoval Julissa
Published: April 2021

A. philoxeroides is one of the worst weeds in the world because it invades both terrestrial and aquatic habitats. The aquatic form of the plant has the potential to become a serious threat to rivers, waterways, wetlands and irrigation systems. The terrestrial form grows forming dense mats with a massive underground rhizomatous root system (ISSG, 2016). This weed is extremely difficult to control, is able to reproduce from plant fragments and grows in a wide range of climates and habitats, including terrestrial areas. In aquatic habitats it has deleterious effects on other plants and animals, water quality, aesthetics, vector populations, water flow, flooding and sedimentation. In terrestrial situations, it degrades riverbanks, pastures, and agricultural lands producing massive underground lignified root systems penetrating up to 50-60 cm deep. Currently, A. philoxeroides is listed as invasive in the United States, Puerto Rico, France, Italy, India, Sri Lanka, China, Taiwan, Indonesia, Myanmar, Singapore, Australia and New Zealand (Weber et al., 2008; Chandra, 2012; Rojas-Sandoval and Acevedo-Rodriguez, 2015; DAISIE, 2016; USDA-ARS, 2016; USDA-NRCS, 2016; Weeds of Australia, 2016). Once established, it behaves as an aggressive invader with the capability to totally disrupt natural aquatic ecosystems, shoreline vegetation and terrestrial and semi-aquatic environments (ISSG, 2016; USDA-NRCS, 2016).
Rhopalosiphum rufiabdominalis (rice root aphid).
Authors: Whittaker Angela
Published: April 2021

R. rufiabdominalis is an economic pest of upland rice, particularly in Japan, but is not a pest of irrigated rice anywhere in the world (Grist and Lever, 1969). Injury to upland rice can be severe in Japan, with losses of up to 50-70% (Yano et al., 1983). Occurrence was related to the cultivars of upland rice in China, where aphids caused light damage at the seedling stage and heavy damage at the tillering stage (Ding, 1985). Generally, aphids cause more serious damage during the early growth stages (Yano et al., 1983).
Setaria verticillata (bristly foxtail).
Authors: Parker Chris
Published: April 2021

S. verticillata is listed by Holm et al. (1979) as a 'serious' or 'principal' weed in 11 countries in Europe, Asia, Africa, South America and the Pacific. From its origins in Europe and perhaps Africa, it has been accidentally introduced to many other countries across the world. It is often listed as one of the two or three most important weeds in a wide range of crops, within and outside its native range, and it can also become dominant in grassland. The combination of ready dispersal by its 'sticky' seed and seed-heads, and its C4 physiology and rapid growth make it an extremely successful invader. It adapts to local conditions rapidly and has developed resistance to atrazine and other herbicides.
Quelea quelea (weaver bird).
Authors: Cheke Robert
Published: April 2021

The red-billed quelea is a small weaver bird native to sub-Saharan Africa and renowned for its attacks on small-grain crops within Africa. It is the most numerous bird species in the world, with peak post-breeding population estimated at 1,500,000,000. The red-billed quelea is mainly granivorous, except when feeding its chicks insects or when eating insects prior to migration or breeding, and it relies on a supply of grass seeds to survive. When unable to find grass seeds or when opportunities arise, quelea will attack crops. It is a major pest throughout much of sub-Saharan Africa and can cause significant economical losses.
Senna spectabilis (whitebark senna).
Authors: Datiles Marianne Jennifer , Acevedo-Rodríguez Pedro
Published: April 2021

Senna spectabilis is an attractive small- to medium-sized (to about 10 m tall) multi-stemmed tree, native to Central and South America and naturalized in many other parts of the humid tropics, particularly the Philippines and East and southern Africa. It is a fast-growing species, particularly on deep soils, and is fire- and termite-resistant and tolerant of strongly acid soils. It is reported to be easier to raise, less susceptible to pests and diseases, and more drought-resistant than Senna siamea. It is often planted for fuelwood, as an ornamental and as a shade tree in agroforestry situations. Although a legume, it is not a nitrogen-fixing species but is nevertheless useful for fodder, mulches, and as a honey source. Its rapid regeneration and growth make it a potential weed. The wood is of small dimensions, commonly used as fuelwood; posts; building poles; and general utility. Further research is needed on the cultural management of S. spectabilis.
Cedrela odorata (Spanish cedar).
Authors: Pasiecznik Nick
Published: April 2021

C. odorata is a large tree up to 40 m tall and 2 m in diameter which produces a light-weight timber. Its natural distribution range is confined to the New World, extending from northern Mexico to Argentina, including the Caribbean. It is widely planted throughout the tropics and its timber is well known for its use in cigar boxes and a broad range of other products, including musical instruments. It is also occasionally planted for shade and used as an ornamental tree on roadsides and in parks. C. odorata has great potential as a plantation species, due to its fast growing and timber producing characteristics. It is also used as an agroforestry species in cocoa and coffee plantations (Lemmens et al., 1995). C. odorata is highly vulnerable to attack by shoot borers (Hypsipyla spp.), whose larvae damage seedlings and saplings. There is some evidence that infestation can be controlled by planting C.odorata with other species, such as Leucaena leucocephala, Neolamarckia cadamba or (under light shade) with Eucalyptus deglupta (Lemmens et al., 1995).
Cupressus sempervirens (Mediterranean cypress).
Authors: Rojas-Sandova Julissa
Published: April 2021

C. sempervirens is a multipurpose tree species, which may reach up to 30 m in height with a d.b.h. of 50-60 cm. This species produces high-quality and very durable wood at low yields and is utilized more frequently as windbreaks, soil conservation, protection forest, and as an ornamental in many European landscapes. This species is suitable for plantation programmes in unfavourable conditions in many countries, including for afforestation on dry, shallow, clay soils. Since the beginning of the 1950s, Seiridium cardinale (cypress canker) has decimated common cypress plantations in Italy, Greece and France.
Lagerstroemia speciosa (pride of India).
Authors: Rojas-Sandoval Julissa
Published: April 2021

L. speciosa is a medium-size to large deciduous tree distributed throughout India, Myanmar, Sri Lanka and Bangladesh, except for dry areas. The rate of growth is moderate and the trees grow best on deep, rich, well-drained alluvial loam, with sufficient moisture. The timber is used for buildings, ships, boats, dug-out canoes, bridges, water tanks, railway wagons, bus bodies, turnery, cooperage and many other purposes. L. speciosa is suitable for afforestation of sites prone to dampness and waterlogging, and can be grown successfully from seed, seedlings and stump plants. It is used in farming systems, as it is particularly suited to paddy rice agroforestry. L. speciosa is one of the most beautiful ornamental trees when in flower and is widely planted in India in gardens, parks, homesteads and avenues.
Bauhinia variegata (mountain ebony).
Authors: Rojas-Sandoval Julissa , Acevedo-Rodríguez Pedro
Published: April 2021

B. variegata is of great importance as a multipurpose tree, particularly as a source of fodder in rural economies. Its wood is used for agricultural implements and the bark for tanning. The tree is very handsome when in flower and is widely planted as an ornamental (Watt, 1972).
Deubiquitinases USP20/33 promote the biogenesis of tail-anchored membrane proteins
Authors: Culver Jacob A. , Mariappan Malaiyalam
Published: April 2021

Numerous proteins that have hydrophobic transmembrane domains (TMDs) traverse the cytosol and posttranslationally insert into cellular membranes. It is unclear how these hydrophobic membrane proteins evade recognition by the cytosolic protein quality control (PQC), which typically recognizes exposed hydrophobicity in misfolded proteins and marks them for proteasomal degradation by adding ubiquitin chains. Here, we find that tail-anchored (TA) proteins, a vital class of membrane proteins, are recognized by cytosolic PQC and are ubiquitinated as soon as they are synthesized in cells. Surprisingly, the ubiquitinated TA proteins are not routed for proteasomal degradation but instead are handed over to the targeting factor, TRC40, and delivered to the ER for insertion. The ER-associated deubiquitinases, USP20 and USP33, remove ubiquitin chains from TA proteins after their insertion into the ER. Thus, our data suggest that deubiquitinases rescue posttranslationally targeted membrane proteins that are inappropriately ubiquitinated by PQC in the cytosol.
Quality Parameter Index Estimation for Compressive Sensing Based Sparse Audio Signal Reconstruction
Authors: Upadhyaya Vivek , Sharma Girraj , Kumar Ashish , Vyas Sandeep , Salim Mohammad
Published: April 2021

As we, all know that the size of data is increasing tremendously day by day. In a recent project, several petabytes were used to save an image of the Black Hole. Therefore, it is very crucial to develop a method that can reduce the size of data for transmission & storage purposes. The Traditional method for data compression & reconstruction requires so much data space, due to this problem another technique is proposed for the compression and recovery purpose. This method is termed Compressive Sensing (CS). As per the Nyquist sampling theorem, for proper reconstruction of the signal, we have to do sampling at the double rate of maximum data rate available in the signal. As a result, the storage requirement increased as well as the cost of the system was also enhanced. While on the other hand in Compressive Sensing, little samples are required for the reconstruction of the signal. So here in this paper, we have considered three music signals which are single tone, instrumental and vocal song. Values of Mean Square Error, Root Mean Square Error and Signal to Noise Ratio for different compression ratios mentioned in the tables and plots. By analyzing these values we can easily investigate the effectiveness of compressive sensing.
Application of SNORT and Wireshark in Network Traffic Analysis
Authors: Jain G , Anubha
Published: April 2021

Now a days, our life is totally dependent on internet which in turn leads to different kind of intrusion. In order to detect intrusion, detection tool is needed so as to detect any kind of intrusion without user involvement. Intrusion detection system is a process of analyzing intrusion so as to provide secured data transmission in networking. One of the most used tools in analyzing packets is Wireshark. Nevertheless, Wireshark is less effective in detecting the intrusion still it can be used to intercept and detect network encrypted traffic which will analyze the captured traffic. Wireshark helps in identifying number of attacks like DoS, DDOS etc. SNORT take all live packets from internet and captured the live packets with predefined rules and if matches didn’t find then directs alert messages to the user. In this method, router is used to access internet so as to get precise flow of data packets. It generates a log file which entails all the live captured packets. The log file “Wi-Fi” generated by SNORT tool is then exported to Wireshark to examine the captured network packets. The Wireshark tool creates each detail about the packets of the recorded log file. In this paper, the I/O graph outlined the flow of the packet which demonstrations the total traffic which is further measured in either bytes or packets per second. TCP errors and delta time graph are shown.
Performance Improvement of Circular Micro-Strip Patch Antenna for WCS
Authors: Kannadhasan S. , Nagarajan R.
Published: April 2021

The proposed a circular micro-strip antenna (CMSA) with a circular slot in this paper, that solves the current narrow bandwidth dilemma. The parametric analysis reveals that only with the right choice of parameters would wideband features be achieved with a smaller antenna. The proposed antenna is built at 27.5GHz with wider bandwidth and tremendous return failure. This antenna can also be used extensively for embedded applications with a large data rate. This antenna can be physically implemented with embedded devices that enable it to function in a broader variety of applications.
A Novel and Efficient Approach for Content- Based Image Retrieval
Authors: Saxena Akash , Rajpoot Vikram , Chaturvedi Ankur
Published: April 2021

In content-based image retrieval (CBIR) means the quest of an image continues at the real content material of picture to a positive volume to its metadata. The CBIR System has utilized for the remove the features, indexing individual’s features by inappropriate formation and capably given a response to user’s uncertainty. To provide the significant response to client question, CBIR gave some run of work. A novel scheme is proposed in this research work for color picture indexing by introducing the ease of the SVM system. A novel method is introduced for color picture indexing by exploit for it easy of the SVM system. This feature Extraction was seen as the binary classification problem and SVM was used for the problem’s solution. It is concluded that to attain the extraction at the high speed as well as for making it so flexible that it can also adjust with the images of large size. The objective of this paper is to stand for the importance of maintaining vector machine in the well-organized retrieval of an image in SVM is utilizes as classifier that performing task of classification the image and this process of classification are providing to all picture that are mined later by feature extraction process
PLC Operated Colour Based Product Sorting machine
Authors: Vandana S , Shamukha Sri Sai K , Rohila P , Manideep V
Published: April 2021

Manual sorting requires excessive effort and takes time, while automated sorting makes it possible to sort items quickly and efficiently. Production and packaging systems widely use the sorting method of product lines as a bridge. Industries have been sorting processes to arrange the materials of their items according to the requirements to decrease labour and increase overall accuracy. We have developed a S71200 PLC-based sorting system to demonstrate this sorting system, where we use electro-magnetic actuators with TCS2300 colour sensor to automate the whole system. The system consists of a conveyor belt to carry items and a colour sensor to sense the product’s colour form, and the system will then use 2 electromagnetic actuators to actuate and drive the product at its respective collection station. To identify the colour of the object moving on the conveyor belt, a colour sensor was used. The colour sensor transmits a particular signal to the PLC as soon as the appropriate colour is detected, which, in turn, operates the corresponding electromagnetic actuator to force the product out of the respective station. We can completely automate the sorting system in this way. In parallel processing industries, the sorting of these goods is very difficult. A consistency issue is created by continuous manual sorting. For controlling the overall operation, PLC is used as a master controller and Arduino as a slave controller. The colour identification method is based on the frequency analysis of the colour sensor’s output. This will fulfil the requirements of higher output and accurate performance in the field of automation.
A Study on Movie Recommendations using Collaborative Filtering
Authors: Pradhan Rahul , Swami Ashish Chandra , Saxena Akash , Rajpoot Vikram
Published: April 2021

The Recommendation system plays a major role nowadays, which is used for many applications. We know that the online content and service providers have a huge amount of content so the problem which arises is which data is required for whom so the problem of providing apposite content frequently. This paper represents the overview and approaches of techniques generated in a recommendation system. One of them is Collaborative Filtering which we will discuss about.
Mid-infrared supercontinuum generation using low peak pump power in As38Se62 based chalcogenide photonic crystal fiber
Authors: Vyas S , Shiong N S , Kumar A , Sharma G , Jaiverdhan  , Chandna V K , Singh G
Published: April 2021

A supercontinuum (SC) based chalcogenide As38Se62 PCF for broadband mid-infrared light source is numerically reported. For the computational studies, the design of the proposed structure is made up of three rings of air holes with circular and elliptical shapes. The proposed structure provides excellent nonlinear coefficient and dispersion optimization. For the analysis, the finite difference frequency domain (FDFD) method is employed. Due to the high nonlinear refractive index and optimizing design of As38Se62 chalcogenide glass, an effective mode area of 40.5972 μm2 is obtained. The dispersion characteristic of the proposed structure has a zero-dispersion wavelength at 3.89 μm. The nonlinear coefficient is 761 W-1km-1 at the wavelength of 4 μm. Dispersion is almost flat from 2 μm up to 10 μm. The supercontinuum spectrum calculated ranges from 2 μm to 9 μm. The presented structure is appropriate for medical imaging, optical coherence tomography and optical communications.
We need to address ableism in science
Authors: Peterson Raven J.
Published: April 2021

In science, technology, engineering, and mathematics (STEM) fields, disabled people remain a significantly underrepresented part of the workforce. Recent data suggests that about 20% of undergraduates in the United States have disabilities, but representation in STEM fields is consistently lower than in the general population. Of those earning STEM degrees, only about 10% of undergraduates, 6% of graduate students, and 2% of doctoral students identify as disabled. This suggests that STEM fields have difficulty recruiting and retaining disabled students, which ultimately hurts the field, because disabled scientists bring unique problem-solving perspectives and input. This essay briefly explores the ways in which ableism—prejudice against disabled people based on the assumption that they are “less than” their nondisabled peers—in research contributes to the exclusion of disabled scientists and suggests ways in which the scientific community can improve accessibility and promote the inclusion of disabled scientists in academic science.
Functional and Structural Properties of Highly Responsive Somatosensory Neurons in Mouse Barrel Cortex
Authors: Barz C S , Garderes P M , Ganea D A , Reischauer S , Feldmeyer D , Haiss F
Published: April 2021

Sparse population activity is a well-known feature of supragranular sensory neurons in neocortex. The mechanisms underlying sparseness are not well understood because a direct link between the neurons activated in vivo, and their cellular properties investigated in vitro has been missing. We used two-photon calcium imaging to identify a subset of neurons in layer L2/3 (L2/3) of mouse primary somatosensory cortex that are highly active following principal whisker vibrotactile stimulation. These high responders (HRs) were then tagged using photoconvertible green fluorescent protein for subsequent targeting in the brain slice using intracellular patch-clamp recordings and biocytin staining. This approach allowed us to investigate the structural and functional properties of HRs that distinguish them from less active control cells. Compared to less responsive L2/3 neurons, HRs displayed increased levels of stimulus-evoked and spontaneous activity, elevated noise and spontaneous pairwise correlations, and stronger coupling to the population response. Intrinsic excitability was reduced in HRs, while we found no evidence for differences in other electrophysiological and morphological parameters. Thus, the choice of which neurons participate in stimulus encoding may be determined largely by network connectivity rather than by cellular structure and function.
A Sensitive LC–MS/MS Method for the Determination of Afatinib in Human Plasma and Its Application to a Bioequivalence Study
Authors: Luo Xi , Zhang Xiu Jin , Zhu Wen Ling , Yi Jin Ling , Xiong Wen Gang , Ye Feng , Zheng Chao , Fan Ming Xia
Published: April 2021

A high performance liquid chromatography–tandem mass spectrometry assay for the determination of afatinib (AFT) in human plasma was established. A simple sample preparation of protein precipitation was used and separation was achieved on a C18 column by the gradient mixture of mobile Phase A of water (containing 0.1% ammonia) and the mobile Phase B of acetonitrile and water (V:V = 95:5, containing 0.2% ammonia). The multiple reaction monitoring mode was used to monitor the precursor-to-production transitions of m/z 486.2 → m/z 371.4 for AFT and m/z 492.2 → m/z 371.3 for AFT-d6 (internal standard) at positive ionization mode. The calibration curve ranged from 0.100 to 25.0 ng·mL−1 and the correlation coefficient was greater than 0.99. The intra- and inter-batch precision was less than or equal to 10.0%. Accuracy determined at four concentrations was in the range of 92.3–103.3%. In summary, our method was sensitive, simple and reliable for the quantification of AFT and was successfully applied to a bioequivalence study.
Limited transgenerational effects of environmental temperatures on thermal performance of a cold-adapted salmonid
Authors: Penney Chantelle M , Burness Gary , Tabh Joshua K R , Wilson Chris C
Published: April 2021

The capacity of ectotherms to cope with rising temperatures associated with climate change is a significant conservation concern as the rate of warming is likely too rapid to allow for adaptative responses in many populations. Transgenerational plasticity (TGP), if present, could potentially buffer some of the negative impacts of warming on future generations. We examined TGP in lake trout to assess their inter-generational potential to cope with anticipated warming. We acclimated adult lake trout to cold (10°C) or warm (17°C) temperatures for several months, then bred them to produce offspring from parents within a temperature treatment (cold-acclimated and warm-acclimated parents) and between temperature treatments (i.e. reciprocal crosses). At the fry stage, offspring were also acclimated to cold (11°C) or warm (15°C) temperatures. Thermal performance was assessed by measuring their critical thermal maximum (CTM) and the change in metabolic rate during an acute temperature challenge. From this dataset, we also determined their resting and peak (highest achieved, thermally induced) metabolic rates. There was little variation in offspring CTM or peak metabolic rate, although cold-acclimated offspring from warm-acclimated parents exhibited elevated resting metabolic rates without a corresponding increase in mass or condition factor, suggesting that transgenerational effects can be detrimental when parent and offspring environments mismatch. These results suggest that the limited TGP in thermal performance of lake trout is unlikely to significantly influence population responses to projected increases in environmental temperatures.
Barriers to the utilization of community-based child and newborn health services in Ethiopia: a scoping review
Authors: Miller Nathan P , Bagheri Ardestani Farid , Wong Hayes , Stokes Sonya , Mengistu Birkety , Paulos Meron , Agonafir Nesibu , Sylla Mariame , Ameha Agazi , Birhanu Bizuhan Gelaw , Khan Sadaf , Lemango Ephrem Tekle
Published: April 2021

The Ethiopian Federal Ministry of Health and partners have scaled up integrated community case management (iCCM) and community-based newborn care (CBNC), allowing health extension workers (HEWs) to manage the major causes of child and newborn death at the community level. However, low service uptake remains a key challenge. We conducted a scoping review of peer-reviewed and grey literature to assess barriers to the utilization of HEW services and to explore potential solutions. The review, which was conducted to inform the Optimizing the Health Extension Program project, which aimed to increase the utilization of iCCM and CBNC services, included 24 peer-reviewed articles and 18 grey literature documents. Demand-side barriers to utilization included lack of knowledge about the signs and symptoms of childhood illnesses and danger signs; low awareness of curative services offered by HEWs; preference for home-based care, traditional care, or religious intervention; distance, lack of transportation and cost of care seeking; the need to obtain husband’s permission to seek care and opposition of traditional or religious leaders. Supply-side barriers included health post closures, drug stockouts, disrespectful care and limited skill and confidence of HEWs, particularly with regard to the management of newborn illnesses. Potential solutions included community education and demand generation activities, finding ways to facilitate and subsidize transportation to health facilities, engaging family members and traditional and religious leaders, ensuring consistent availability of services at health posts and strengthening supervision and supply chain management. Both demand generation and improvement of service delivery are necessary to achieve the expected impact of iCCM and CBNC. Key steps for improving utilization would be carrying out multifaceted demand generation activities, ensuring availability of HEWs in health posts and ensuring consistent supplies of essential commodities. The Women’s Development Army has the potential to improving linkages between HEWs and communities, but this strategy needs to be strengthened to be effective.
Fast classification rates without standard margin assumptions
Authors: Bousquet Olivier , Zhivotovskiy Nikita
Published: April 2021

We consider the classical problem of learning rates for classes with finite Vapnik–Chervonenkis (VC) dimension. It is well known that fast learning rates up to $O\left (\frac{d}{n}\right )$ are achievable by the empirical risk minimization (ERM) algorithm if low noise or margin assumptions are satisfied. These usually require the optimal Bayes classifier to be in the class, and it has been shown that when this is not the case, the fast rates cannot be achieved even in the noise free case. In this paper, we further investigate the question of the fast rates in the agnostic setting, when the Bayes classifier is not in the class and the noise in the labeling is allowed. First, we consider classification with a reject option, namely Chow’s reject option model, and show that by slightly lowering the impact of hard instances, a learning rate of order $O\left (\frac{d}{n}\log \frac{n}{d}\right )$ is always achievable in the agnostic setting by a specific learning algorithm. Similar results were only known under special versions of margin assumptions. As an auxiliary result, we show that under the Bernstein assumption the performance of the proposed algorithm is never worse than the performance of ERM even if some of the labels are predicted at random. Based on those results, we derive the necessary and sufficient conditions for classification (without a reject option) with fast rates in the agnostic setting achievable by improper learners. This simultaneously extends the work by Massart & Nédélec (2006, Ann. Stat., 34, 2326–2366), which studied this question in the case where the Bayesian optimal rule belongs to the class, and the work by Ben-David and Urner (2014, COLT, pp. 527–542 ), which allows the misspecification but is limited to the no noise setting. Our result also provides the first general setup in statistical learning theory in which an improper learning algorithm may significantly improve the learning rate for non-convex losses.
Geographic Pattern of Typhoid Fever in India: A Model-Based Estimate of Cohort and Surveillance Data
Authors: Cao Yanjia , Karthikeyan Arun S , Ramanujam Karthikeyan , Raju Reshma , Krishna Swathi , Kumar Dilesh , Ryckman Theresa , Mohan Venkata Raghava , Kang Gagandeep , John Jacob , Andrews Jason R , Lo Nathan C
Published: April 2021

Background

Typhoid fever remains a major public health problem in India. Recently, the Surveillance for Enteric Fever in India program completed a multisite surveillance study. However, data on subnational variation in typhoid fever are needed to guide the introduction of the new typhoid conjugate vaccine in India.

Methods

We applied a geospatial statistical model to estimate typhoid fever incidence across India, using data from 4 cohort studies and 6 hybrid surveillance sites from October 2017 to March 2020. We collected geocoded data from the Demographic and Health Survey in India as predictors of typhoid fever incidence. We used a log linear regression model to predict a primary outcome of typhoid incidence.

Results

We estimated a national incidence of typhoid fever in India of 360 cases (95% confidence interval [CI], 297–494) per 100 000 person-years, with an annual estimate of 4.5 million cases (95% CI, 3.7–6.1 million) and 8930 deaths (95% CI, 7360–12 260), assuming a 0.2% case-fatality rate. We found substantial geographic variation of typhoid incidence across the country, with higher incidence in southwestern states and urban centers in the north.

Conclusions

There is a large burden of typhoid fever in India with substantial heterogeneity across the country, with higher burden in urban centers.
T2 One Year Follow up Results of the DETECT Enzymatic Debridement Multicenter RCT
Authors: Hickerson William L , Goverman Jeremy , Blome-Eberwein Sigrid A , Singer Adam , Wibbenmeyer Lucy , Meyer Nicholas , Carson Joshua S , Gallagher James , Kahn Steven , Bhavsar Dhaval , Mozingo David , Pham Tam N , Gibran Nicole S , Shupp Jeffrey W , Foster Kevin N , Lewis Giavonni M , Caffrey Julie , Shoham Yaron
Published: April 2021

Introduction

Bromelain Based Debridement (BBD) of deep thermal burns has been approved for use in Europe, Argentina, Russia, South Korea, Peru, and Israel, and is an investigational product in the United States. Topline results of acute stage endpoints of the DETECT Phase 3 multicenter RCT have been reported previously. The aim of this abstract is to present the 12-month follow-up of predefined endpoints of scar quality, function and quality of life (QoL).

Methods

One-hundred and seventy-five adult patients with deep burns were randomized in a Phase 3 clinical trial to one of 3 treatment arms – BBD, Standard of Care (SOC), or Gel vehicle (placebo control) in a 3:3:1 ratio (75 BBD, 75 SOC, and 25 Gel). Scar quality (cosmesis) and function data were analyzed for longer-term data collected at 3, 6, 12 (and 24 - data not yet final) months. Cosmesis and function were measured using Modified Vancouver Scar Scale (MVSS) and Patient and Observer Scar Assessment Scale (POSAS) to demonstrate that BBD treatment was non-inferior to SOC treatment, as measured at 12 months from wound closure date, evaluated by assessors blinded to the treatment arm. QoL was measured by the EQ-5D (EuroQol 5 Dimensions), VAS (Visual Analog Scale) and BSHS-B (Burn Specific Health Scale – Brief) scales. Missing values were imputed in the analysis using multiple imputation, with best case-worst case imputations as sensitivity analyses.

Results

The 12-month follow-up mean MVSS scores were lower (better) for the BBD group (3.70±2.10) than for the SOC (5.08±3.11) and Gel groups (5.63±2.99). A regression analysis showed that BBD has a 1.36 MVSS point advantage over SOC after adjustment for all other variables in the model (p-value = 0.0027). The 95% CI for this treatment effect was -2.24 to -0.48, excluding the pre-defined non-inferiority margin of +1.9 points, thus establishing non-inferiority of BBD treatment compared with SOC. Note that the interval also excludes 0, indicating superiority of BBD over SOC. The 3- and 6-month follow-up MVSS scores are also lower for the BBD group (5.51±3.09, 4.43±2.59) than for the SOC (6.63±3.44, 5.43±3.75) and Gel (7.56±2.67, 8.89±3.37) groups. POSAS total scores followed similar trends to MVSS scores but did not reach statistical significance at 12 months. QOL was generally similar among the treatment arms.

Conclusions

In addition to the significant acute stage results presented previously, the long-term results of this RCT further demonstrate the safety of BBD treatment, including significantly better 12-month follow-up MVSS scores.
T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury
Authors: Abouzeid Callie , Wolfe Audrey E , Carrougher Gretchen J , Gibran Nicole S , Holavanahalli Radha K , Ni Pengsheng , Roaten Kimberly , Ryan Colleen M , Suman Oscar E , Wolf Steven E , Kazis Lewis E , Schneider Jeffrey C
Published: April 2021

Introduction

Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury.

Methods

Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates.

Results

The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure.

Conclusions

Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.
T6 Burn Survivors Can Perform Mild/moderate-intensity Exercise in Thermoneutral Conditions Without a Risk of Excessive Elevations in Core Body Temperature
Authors: Crandall Craig G , Belval Luke N , Cramer Matthew N , Huang Mu , Moralez Gilbert , Watso Joseph C , Kowalske Karen J
Published: April 2021

Introduction

Burned skin excision and subsequent grafting removes sweat glands, which impairs thermoregulation. Consequently, exercise prescribed for rehabilitation may expose individuals with burn injuries to a greater risk of hyperthermia, depending on exercise duration, intensity, and environmental temperature. Little is known regarding the risk of hyperthermia in adult burn survivors performing mild/moderate-intensity exercise under thermoneutral environmental conditions, i.e. conditions similar to the rehabilitation clinic and/or the gym. This project tested the hypothesis that burn survivors, across a wide range of percent total body surface area (%TBSA) burned, can participate in mild/moderate-intensity exercise in a thermoneutral environment without excessive elevations in core body temperature.

Methods

Twenty-eight well-healed burn survivors with low (23±5%TBSA; N=10), moderate (42±7%TBSA; N=9), and high (60±8%TBSA; N=9) sized burn injuries performed 60 minutes of cycle ergometry exercise (72±15 Watts, oxygen uptake rate of 1.25±0.21 L/min equivalent to 4.5±0.2 METs) in a 25°C and 23% relative humidity environment. Absolute gastrointestinal temperatures (Tcore) and changes in gastrointestinal temperatures (ΔTcore) were obtained at 15-minute increments throughout the exercise bout. A participant with an absolute Tcore of greater than 38.5°C, and/or a ΔTcore of >1.5°C, at any time point during the trial was categorized as being at risk for hyperthermia.

Results

Sixty minutes of exercise increased Tcore in all groups (Low: 0.72±0.21°C; Moderate: 0.42±0.22°C; High: 0.77±0.25°C, all P< 0.01 from pre-exercise baseline), resulting in similar absolute Tcore values of upon exercise termination (Low: 37.87±0.24°C; Moderate: 37.56±0.34°C; High: 37.76±0.47°C, P=0.19). Importantly, no participant was categorized as being at risk for hyperthermia, based upon the aforementioned criteria.

Conclusions

These data indicate that individuals with substantial %TBSA burned can exercise at a mild/moderate intensity for 60 minutes in thermoneutral environmental conditions without a risk of excessive elevations in body core temperature.
3 Development of School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE 5–12) Profile: Item Pool
Authors: Rodríguez-Mercedes Silvanys L , Rencken Camerin A , Patel Khushbu F , Grant Gabrielle G , Kinney Erin M , Stoddard Frederick J , Kazis Lewis E , Schneider Jeffrey C , Ryan Colleen M
Published: April 2021

Introduction

The transition from early childhood to teen years (5–12) is a critical time of development, which can be made particularly challenging by a burn injury. Currently, few validated standardized measures exist for this age group. This study aimed to generate item pools to create a computer adaptive test (CAT) assessing post-burn recovery in school-aged children.

Methods

Item pool development was based on the School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) Conceptual Model and the World Health Organization’s International Classification of Functioning, Disability, and Health for Children and Youth. Additional elements included a literature review, expert consensus meetings, and parent cognitive interviews. Candidate items assessing health outcomes were extracted from existing legacy measures during the literature review. Details of expert consensus meetings and parent cognitive interviews are in Table 1.

Results

Items assessing health outcomes (n=3,732) were extracted during the literature review. Experts binned items across three domains: 1) Physical Functioning (55 items), 2) Psychological Functioning (80 items), and 3) Family and Social Functioning (57 items). Six cognitive interviews were conducted. Qualitative data resulted in further review of 86 items. The results of the cognitive interviews indicated that item stems and response choices were interpretable by respondents.

Conclusions

This study developed an item pool (n=192) to assess post-burn recovery of school-aged children. The next step in the SA-LIBRE5-12 CAT Profile development will be field-testing for the calibration and item response theory-based validation of the assessment.
8 Variations in COMT Gene Are Not Associated with Patient-Reported Outcomes: A Multicenter Collaborative Proof of Concept Study
Authors: Sibbett Stephen H , Oh Jamie , Wolfe Audrey E , Schneider Jeffrey C , Kowalske Karen J , Stewart Barclay T , Gibran Nicole S
Published: April 2021

Introduction

Variant single nucleotide polymorphisms (SNPs) in the catechol-O-methyl transferase (COMT) gene have previously been associated with pain thresholds, resiliency, and cognitive functioning. Known colloquially as the “warrior/worrier” gene, the GG variant is associated with higher resilience whereas the AA variant is associated with lower resilience. The aim of this study is to demonstrate the feasibility of correlating a genomic data repository with multicenter national longitudinal burn data.

Methods

From August 2018 to July 2020, participant cheek swabs were collected in-person or by mail at three burn centers and sent to the lead center for DNA isolation and storage. COMT SNPs were determined by polymerase chain reaction (PCR). SNP data were merged with a multicenter burn database. Outcomes of interest included the Patient-Reported Outcomes Measurement Information System (PROMIS-29), Community Integration Questionnaire (CIQ), Veterans RAND 12 (VR-12) physical (PCS) and mental component summary (MCS) scores, posttraumatic stress disorder (PTSD) measure, and Posttraumatic Growth Inventory (PTGI). Follow-up data were obtained at 6 months post-discharge. We used a Kruskal-Wallis test to determine associations between COMT SNPs and outcomes.

Results

Of the 126 cheek swabs obtained, DNA was successfully isolated from 124 swabs, and PCR SNP analysis was successful for 111 swabs. The distribution of COMT SNPs in our study population was consistent with the general population. Kruskal-Wallis analysis revealed no association between COMT SNPs and patient outcomes. Median PTGI scores trended toward significance, but in the opposite direction than predicted for COMT genotypes.

Conclusions

A national longitudinal database can be feasibly supplemented by a genomic data repository. Variation in the COMT gene did not correlate with health-related quality of life measures examined in a small cohort of burn survivors. Lack of statistical significance can be attributed to small sample size.
20 Chronic Cardiovascular Dysfunction Following Lower Extremity Amputation in Burn Patients
Authors: Hallman Taylor , El Ayadi Amina , Ozhathil Deepak K , Golovko George , Song Juquan , Wolf Steven E
Published: April 2021

Introduction

Long-term chronic cardiovascular dysfunction is a well-reported outcome in patients who have suffered severe burns associated with diminished muscle mass and hypermetabolism. Devastating burn injuries sometimes warrant extremity amputation to preserve life over limb. A lower extremity amputation can exacerbate the risk of burn-related sequelae due to prolonged recovery and reduced mobility. We queried a large multi-institutional national database to investigate whether lower extremity amputations in those with severe burns were associated with increased incidence of chronic myocardial dysfunction syndromes.

Methods

We accessed the TriNetX Global Health Research Network and queried ICD-10 codes for burn injuries (T20-25, T30-32) across 41 participating health care organizations. Comparative cohorts of patients who underwent lower extremity amputations and those who did not were identified. A matched case-control analysis of these cohorts accounting for age and gender matching was compared for the subsequent diagnosis of chronic cardiac dysfunction syndromes (I50.22, I50.32, I50.42, I50.812).

Results

A total of 347,156 patients did not undergo lower extremity amputation, and their demographics showed a mean age of 38 years, 54% males, 60% white and 18% African American. In contrast, 1,535 patients underwent lower extremity amputation with a mean age was 59 years, 73% were male, 60% white and 24% African American. Burn patients who underwent amputations showed a comparative increased risk of 5.77% (p < 0.0001) for developing of chronic cardiac dysfunction compared to those who did not undergo amputations (RR 3.512, 95% CI: 2.39–5.16). One year following injury this comparative risk diminished to 3.45% (p < 0.0001; RR 3.14, 95% CI: 1.96–5.04). The difference in risk was not significant 3 years after burn injury (0.538%, p = 0.2163, RR 1.54, 95% CI: 0.77–3.09).

Conclusions

Patients who underwent amputations after severe burn are at increased risk of developing chronic cardiac dysfunction compared to those that did not undergo amputation; the significance appears to diminish with time. Further research is indicated to elucidate the mechanism for this relationship.
21 Navigating Controversial Therapies for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Syndrome Using Large Database Analysis
Authors: Ozhathil Deepak K , Gore Nicholas A , Nguyen Kayla Y , Golovko George , Pham Judy , Gutierrez Garret , Song Juquan , El Ayadi Amina , Wolf Steven E
Published: April 2021

Introduction

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis Syndrome (TENS) are part of a spectrum of autoimmune conditions, which cause epidermal detachment and keratinocyte necrosis. Due to the rare incidence, a dramatic heterogeneity in treatment algorithms and prolonged discussion of controversial therapies has ensued. We queried a large national data network to better understand how these therapies are actually implemented and the relative impact on survival.

Methods

The TriNetX Global Health Research Network (41 healthcare organizations) was queried using ICD-10 codes (L51.1 - 51.3) to identify patients diagnosed with SJS or TENS from 2000 to 2020. A treatment frequency map was constructed to determine the most common treatment groupings, and cohorts were indexed based on the most frequent isolated and combined therapy algorithms: systemic steroids (SS), diphenhydramine (DH), cyclosporine (CS), intravenous immunoglobulin (IVIG) and tumor necrosis factor alpha inhibitors (TNFαi). Cohorts were case matched for demographics against a restricted control group (RC; patients who did not receive any of the above-mentioned therapies) and an unrestricted control group (UC, all patients diagnosed with SJS or TENS) to evaluate mortality risk, survival probability, and to uncover Type II error.

Results

Cohorts were UC (6,196), RC (2,248), SS+DH (3,459), SS (1,269), SS+CS (1,554), DH (479), CS (52), IVIG (10) and TNFi (10). The treatment map showed 36.3% of patients did not receive any of the listed therapies. Of those that did 48.2% initially got SS, 24.3% got DH, 15.4% got SS+DH and 3% got SS+CS. Patients who received SS had a 8.51% mortality risk and 2.84% risk reduction compared to UC (p = 0.017). However, the Hazard Ratio (HR) was 0.80 (95% CI: 0.57, 1.23) showing no survival advantage. Compared to RC risk reduction decreased to 0.47% (p = 0.667). SS+DH showed a risk reduction of 1.13% compared to UC (p = 0.113; HR 0.89, 95% CI: 0.69, 1.16), but this advantage resolved when compared to RC. Similarly, SS+CS had a risk reduction of 2.12% compared to UC (p = 0.039; HR 0.80, 95% CI: 0.58, 1.09), which decreased to 0.07% (p = 0.947) when compared to RC. DH and CS had no significant risk reduction (p = 0.25 - 1.00) or survival advantage. IVIG and TNFαi were underpowered for analysis.

Conclusions

The most common treatments for patients diagnosed with SJS or TENS are systemic steroids, diphenhydramine, or a combination of the two. Unfortunately, none of the above therapies confer a significant survival advantage. Furthermore, some therapies raised concern for Type II errors when the control group is not adjusted for alternative therapies.