bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carbon metabolism snapshot by ddPCR during the early step of Candida albicans phagocytosis by macrophages
Authors: Laurian Romain , Jacot-des-Combes Cécile , Bastian Fabiola , Dementhon Karine , Cotton Pascale 
Published: March 2020

ABSTRACT
During Candida macrophage interactions, phagocytosed yeast cells feed in order to grow, develop hyphae and escape. Through numerous proteomic and transcriptomic studies, two metabolic phases have been described. A shift to a starvation mode is generally identified as early as one-hour post phagocytosis, followed by a glycolytic growth mode after C. albicans escaped from the macrophage. Healthy macrophages contain low amounts of glucose. To determine if this carbon source was sensed and metabolized by the pathogen, we explored the transcription level of a delimited set of key genes expressed in C. albicans cells during phagocytosis by macrophages, at an early stage of the interaction. This analysis was performed using a technical digital droplet PCR approach to quantify reliably the expression of carbon metabolic genes after 30 min of phagocytosis. Our data confirm the technique of digital droplet PCR for the detection of C. albicans transcripts using cells recovered after a short period of phagocytosis. At this stage, carbon metabolism is clearly oriented towards the use of alternative sources. However, the activation of high-affinity glucose transport system suggests that the low amount of glucose initially present in the macrophages is detected by the pathogen.
Low Neuroactive Steroids Identifies a Biological Subtype of Depression in Adults with Human Immunodeficiency Virus on Suppressive Antiretroviral Therapy
Authors: Mukerji Shibani S , Misra Vikas , Lorenz David R , Chettimada Sukrutha , Keller Kiana , Letendre Scott , Ellis Ronald J , Morgello Susan , Parker Robert A , Gabuzda Dana 
Published: March 2020

AbstractBackgroundThe prevalence and mortality risk of depression in people with human immunodeficiency virus (HIV) infection receiving antiretroviral therapy (ART) is higher than in the general population, yet biomarkers for therapeutic targeting are unknown. In the current study, we aimed to identify plasma metabolites associated with depressive symptoms in people with HIV receiving ART.MethodsThis is a prospective study of ART-treated HIV-infected adults with or without depressive symptoms assessed using longitudinal Beck Depression Inventory scores. Plasma metabolite profiling was performed in 2 independent cohorts (total n = 99) using liquid and gas chromatography and tandem mass spectrometry.ResultsParticipants with depressive symptoms had lower neuroactive steroids (dehydroepiandrosterone sulfate [DHEA-S], androstenediols, and pregnenolone sulfate) compared with those without depressive symptoms. The cortisol/DHEA-S ratio, an indicator of hypothalamic-pituitary-adrenal axis imbalance, was associated with depressive symptoms (P &lt; .01) because of low DHEA-S levels, whereas cortisol was similar between groups. The odds of having depressive symptoms increased with higher cortisol/DHEA-S ratios (adjusted odds ratio, 2.5 per 1-unit increase in z score; 95% confidence interval, 1.3–4.7), independent of age and sex. The kynurenine-to-tryptophan ratio showed no significant associations.ConclusionsThese findings suggest that altered neuroactive steroid metabolism may contribute to the pathophysiological mechanisms of depression in ART-treated HIV-infected adults, representing a potential biological pathway for therapeutic targeting.
26 Brief Psychological Intervention for Distress Reduction in Inpatient Burn Survivors: A Pilot Study
Authors: Stoycos Sarah A , Semple Randye J , Garner Warren L , Tankersley Amelia P , Yenikomshian Haig A , Briere John 
Published: March 2020

Abstract

Introduction
It is estimated that 19–45% of hospitalized burns patients exhibit symptoms of posttraumatic stress (PTS) during hospitalization, and inpatient distress is linked with poorer functional, psychosocial, and medical prognosis. Despite this, research on psychological intervention for PTS during inpatient treatment for burns remains nascent. The current study developed and pilot-tested a six-session cognitive-behavioral therapy (CBT) for adult inpatients with acute burns.

Methods
After IRB approval, patients were enrolled in a single verified ABA burn center. Interventions consisted of 6, 50-minute CBT sessions over two weeks. Therapeutic techniques included mindfulness-focused relaxation training, titrated exposure, psychoeducation, and cognitive restructuring. Depression (Beck Depression Inventory II; [BDI]), anxiety (Beck Anxiety Inventory [BAI]), and PTS (Detailed Assessment of Posttraumatic Stress- PTS-T subscale) were assessed at baseline, 2 weeks, and 6 weeks post-intervention. All data were analyzed in SPSS using Student’s univariate t-tests and Last Observation Carried Forward analysis for missing data at T1. No missing data were imputed for T2 given the high drop-out rate.

Results
Seventeen adult participants were enrolled (13 female; Mage = 31.7 years, SD = 8.7, range 21–53 years; 35% Hispanic/Latinx; MTBSA = 21.6%, SD = 20.2). Analyses indicated no relation between demographic or study variables and drop-out. Average number of sessions was 4.8 (SD = 1.4). At baseline, participants reported moderate anxiety (M = 23, SD = 12.32), mild depression (M = 14.18, SD = 8.46), and clinically significant posttraumatic stress (M = 72.18, T score = 75, 99th percentile).
Comparing baseline to post-intervention, BAI scores decreased, t(16) = 3.76, p = .002, Cohen’s d = .61, whereas BDI scores, t(16) = 1.06, ns, Cohen’s d = .19, and PTS scores, t(16) = 1.03, ns, Cohen’s d = .12, did not change. There were no changes from post-intervention to follow-up in BAI, t(5) = 1.48, ns, Cohen’s d = .43, BDI, t(5) = 1.06, ns, Cohen’s d = .54, or PTS scores (t(5) = .55, ns, Cohen’s d = .12) for the six participants who completed follow-up assessment. TBSA burn was not associated with anxiety, depression, or PTS symptoms at any timepoint.

Conclusions
Participants reported significant reductions in anxiety, but not PTS or depression symptoms, following a CBT distress-reduction intervention. More generally, the findings of this study point to the potential utility of implementing an early intervention of empirically-based treatment components to help burn survivors manage emotional symptoms following trauma.

Applicability of Research to Practice
Patients experiencing anxiety may benefit from short-term mindfulness or exposure interventions and more research is needed to understand the trajectory and heterogeneity of PTS symptom relief following acute burns.
58 The Homelessness Crisis and Burn Injuries: A Cohort Study
Authors: Vrouwe Sebastian Q , Johnson Maxwell B , Pham Christopher H , Lane Christianne J , Garner Warren L , Gillenwater Justin , Yenikomshian Haig A 
Published: March 2020

Abstract

Introduction
Many metropolitan areas face a growing homelessness crisis. Lower socioeconomic status has been shown to be a consistent risk factor for burn injury; however, only a limited number of studies have specifically examined homeless burn patients. The purpose of this study is to characterize the demographics and outcomes of homeless patients who sustain burn injuries and compare them to a cohort of domiciled patients in a large, metropolitan city.

Methods
A retrospective cohort study was performed at an ABA-verified center located in a major metropolitan area. Consecutive acute burn admissions in adults from June 1, 2015 to December 31, 2018 were included. Prevalence was estimated using data from the regional homeless count. Comparisons of demographics, burn characteristics, clinical outcomes, and disposition were made between patients categorized homeless or domiciled at the time of their injury.

Results
Of 881 admissions, 751 (85%) had stable housing, and 130 (15%) were homeless. The mean prevalence rate of burn injury requiring hospitalization for homeless adults was estimated at 88 per 100,000 persons. Homeless patients had a significantly larger median burn size (7% vs 5%, p&lt; 0.05), characterized by a greater rate of flame burns (68% vs 42%, p&lt; 0.001). For the homeless, rates of assault and self-inflicted injury were four- (18% vs 4%, p&lt; 0.001) and two-fold higher (9% vs 4%, p&lt; 0.001), respectively. Homeless patients had higher rates of mental illness (32% vs 12%, p&lt; 0.001) and substance abuse (88% vs 22%, p&lt; 0.001), and were less likely to follow-up as outpatients (54% vs 87%, p&lt; 0.001). There were no significant differences in mortality. Homeless patients had a longer median length of stay (LOS, 11 days vs 7 days, p&lt; 0.001), but there were no significant differences in LOS per %TBSA. Homeless patients had more complex discharge dispositions and were more frequently discharged to a recuperative care facility than domiciled patients (27% vs. 1%, p&lt; 0.001).

Conclusions
Homeless patients comprised a significant subset of our adult inpatient population, with an estimated five-fold greater rate of burn injury requiring hospitalization compared to the national average. These patients sustained larger burn injuries with greater rates of assault or self-inflicted injury.

Applicability of Research to Practice
Homeless individuals should be considered a high-risk population for burn injury. This distinction serves as a call to action for the development of burn prevention strategies.
509 Fungal Infections After Blast and Thermal Injury
Authors: Pruskowski Kaitlin A , Rizzo Julie A , Cancio Leopoldo C 
Published: March 2020

Abstract

Introduction
Invasive fungal wound infections have been reported after combat-related blast injury sustained in recent conflicts. Systemic antifungal agents are commonly used as an adjunct to urgent surgical debridement. There is currently controversy in defining the depth of fungal invasion, which is the most critical factor that determines the treatment strategy. The objective of this study was to describe fungal infections in blast injury patients admitted to our burn center.

Methods
This was a retrospective chart review. Subjects who were admitted between January 2004 and February 2019, received a systemic antifungal agent, and experienced a blast injury were included. Culture and histopathology results were recorded.

Results
Eighty one patients were included. Seventy five subjects (92.6%) were active-duty service members at the time of injury and 79 (97.5%) subjects were male. On average, subjects were 27.4±7.8 years old with a burn size of 51.4±25.3% TBSA. Twenty seven subjects (33.3%) died during their hospital stay.
The 75 subjects had 157 cultures positive for fungi, including 130 tissue cultures. The most common genera isolated was Aspergillus (n=148), Candida (n=106), Fusarium (n=16), and Mucor (n=12). Fifty seven percent of subjects who grew Mucor died, as compared to 52% who grew Aspergillus, 50% who grew Fusarium, and 32.3% who grew Candida.
For histopathology, 33 subjects (40.7%) had results with fungus in non-viable tissue, 27 subjects (25.9%) had results with fungus in viable tissue, and 14 (17.3%) had results with angioinvasion. Subjects who had fungus in viable tissue had the highest mortality rate (71.4%), followed by angioinvasion (64.3%), and fungus in non-viable tissue (33.3%).
The 75 subjects received 121 courses of systemic antifungals. The average duration of therapy was 12.3±13.6 days. The most common antifungals ordered were voriconazole (n=58), fluconazole (n=53), and liposomal amphotericin B (n=42).

Conclusions
Invasive fungal infection after blast injury had a high mortality rate. Early recognition and management of fungal infections is paramount to patient survival. A consensus is needed on how to best define the depth and level of invasion of fungal wound infections, and to determine the optimal treatment duration of systemic antifungal agents for these patients.

Applicability of Research to Practice
Invasive fungal wound infections carry a high mortality rate. A consensus is needed on the optimal systemic therapy.
532 Early Debridement and Cultured Allogenic Keratinocyte Dressing Prevent Hypertrophic Scarring in Infants with Deep Dermal Burns
Authors: Lee SeungJe 
Published: March 2020

Abstract

Introduction
Deep dermal burns are frequently treated with excision and skin grafting. Otherwise, wound healing may take up to 4 to 6 weeks, with serious scarring. Especially in pediatric patients, post-burn scarring could result in psychologic trauma and functional disability. We aimed to investigate the efficacy of early debridement and dressing using cultured allogenic keratinocytes in infants with deep dermal burns to prevent hypertrophic scarring.

Methods
From April 2016 to April 2018, 18 infants were treated for deep dermal burns. Except for 5 infants who underwent skin grafting or excision, 13 infants were included in this study. We performed early debridement in these patients using Hydrosurgery device and serial dressings using cultured allogenic keratinocytes.

Results
The average operative date was 8.3 days after the accident. The mean healing time was 18.3 days after the accident. The patients did not experience any contraction, but 3 patients had hyperpigmentation, 2 patients had mild hypertrophic scarring, and 1 patient had mixed pigmentation (hyperpigmentation and hypopigmentation).

Conclusions
Our prophylactic scar therapy, using early debridement with VersajetTM and dressings with Kaloderm®, may be beneficial for infants with dermal burns. This method was able to shorten the healing time, resulting in better scar outcomes. Our follow-up findings revealed that the scars had an aesthetically pleasing appearance and patients were able to perform normal activities without restrictions.

Applicability of Research to Practice
Burn scars are painful regardless of their seriousness. They restrict the function of the body, are aesthetically unappealing, and may feel unpleasant. Patients with a post-burn scar may have aesthetic, functional, and psychological problems. In particular, infant patients experience difficulties due to scarring as they grow up.
534 Management of Burn Scar with Dermabrasion and Non-cultured Regenerative Epithelial Suspension
Authors: Qiao Liang 
Published: March 2020

Abstract

Introduction
Challenging scars are detrimental for the health-related quality of life of the burn patients, increases financial burdens and, moreover, tests the clinician’s ability to treat these scars. Regenerative epithelial suspension can lead to the restoration of wound and repigmentation, which can treat scar and depigmentation diseases.The application of evidence-based practice has been shown to have the potential to improve health outcomes and strengthen health systems by providing more efficient and cost-effective care.
We challenged the noncultured regenerative epithelial suspension in 3 burn scars with hyper- or hypo-pigmentation.

Methods
The cases presented comprise of a superficial burn scar with hyperpigmentation on face of an 18 year old male, a superficial burn scar with hypopigmentation on the thoracic region of 12 year old girl and a challenging to heel burn scar with hyperpigmentation on the right leg of a 20 year old gentleman. The scars were treated with microdermabrasion, then the ratio of about 1:60–1:150 autologous noncultured regenerative epithelial suspension were obtained and sprayed to the wound. The care givers regularly assessed these wounds till healing, including a clinical, a planimetric and photographic records to 3 months.

Results
A total of 3 patients with superficial scars treated by non-cultured regenerative epithelial suspension technology combined with microdermabrasion showed significant improvement in skin texture and color.

Conclusions
Our study showed that regenerative epithelial suspension technology combined with microdermabrasion may improve scar.

Applicability of Research to Practice
The good clinical outcomes documented through these three selected cases support the use of this new promising treatment in our daily practice of superficial scar management.
563 Therapy Dog Visits in a Burn Unit: The Positive Effects on Patients and Staff
Authors: Quinn Megan , Castro Alexis , Kopari Nicole M 
Published: March 2020

Abstract

Introduction
Hospitalized burn patients encounter multiple stressors including pain, lack of sleep, concerns about outcomes, and unfamiliar environment that can impact their experience, well-being, and recovery. To help reduce these stressors, complementary therapies have been incorporated in their care. Burn Unit staff also carry emotional burdens from caring for patients and experience a high rate of “burnout.” A dog therapy program is one example of complementary interventions to help hospitalized burn patients cope, while helping nurses to focus on their patients in a unique and interactive way.

Methods
A therapy dog visitation protocol was developed which included recent literature supporting these visits and patient exclusion criteria. Exclusion criteria included: patients with burns &gt;20% TBSA for adults and &gt;15% for children, patients immediately recovering from conscious sedation/anesthesia, patients with Integra, and patients with allergies or fear of dogs. Post-visit surveys were recorded for patients and staff members. The surveys rated overall mood, enjoyment related to the visit, improvement in mood following the visit, importance of having activities such as dog therapy visits during the hospitalization, and recommendations for continued opportunities for other patients and staff to have dog therapy visits. A scaling system from 0–10 was utilized with 10 being the highest score.

Results
There were 15 patients and 24 staff members who completed the survey. All staff reported positive interactions with the dog therapy and responded that the therapy improved their mood. All patients answered that they enjoyed the therapy dog visit and 13/15 indicated improvement in their overall mood following a visit with the dog. All participants believed it is important to have activities such as dog therapy during hospitalization, with 32/39 rating the importance at 10/10. All participants recommended other patients and staff have the opportunity to have a therapy dog visit.

Conclusions
The dog therapy program allowed for positive interactions for both nurses and patients and improved patients’ moods. It also provided patients with an activity to look forward to during their hospitalization. Through this connection, nurses are able to help patients recover in a way that is different from the more traditional biomedical approach, which may also improve staff morale.

Applicability of Research to Practice
Complementary interventions such as therapy dogs may be utilized to improve morale within the Burn Unit.
586 Scalp Burn Injury Associated with Hair Highlight Treatment
Authors: Uberti Eileen , Prelack Kathrina 
Published: March 2020

Abstract

Introduction
Hair highlighting treatment has become popular at salons across the country. The ubiquity of this beauty treatment gives many people the impression that it is safe. The process of changing hair color differs between hair salons and hair stylists. We describe the cases of two teenage patients who received third degree burns from hair highlighting treatments. Differences in highlighting technique and treatment modality will be compared and contrasted.

Methods
As part of a quality assurance project looking at variation in scalp burn treatment and outcome, two patients were identified who experienced scalp burn injury due to hair highlighting. Patient 1 received a hot foil hair lighting application. After 5 minutes, the patient experienced tingling in the scalp and removed heat lamp and foils from hair. The first two weeks of treatment were administered by her primary care provider before the patient admitted to our burn facility, where topical collagenase was initiated. Forty two days after initial injury the patient underwent first surgery for debridement, followed by subsequent excision and grafting of scalp. Patient returned for tissue expansion nine months later. Patient 2 received a hair highlighting treatment of bleach and water. Patient 2 complained of burning and immediately her hair was washed out by the hairdresser. The patient was seen two weeks later in our clinic, and treated conservatively with mineral oil and antibacterial topical application. Patient was offered tissue expansion surgery but declined.

Results
Table 1. compares injury type, treatment and outcome in these two patients. Both injuries required significant time to heal, ranging between 56–70 days. Although similar injuries, mode of treatment differed at this same institution. Both patients made decisions based on school activities and fear or surgery, which prolonged time of conservative treatment. Patient 1 received psychological support and anti-anxiety medication prior to all treatments. After tissue expansion Patient 1 no longer required medication and had no sign of alopecia. Patient 2 has area of alopecia 2x2 cm. Neither patient requires further follow up, however Patient 2 could return for tissue expansion if desired.

Conclusions
Hair highlighting is a risk for serious scalp burn injury. Conservative treatment (often per patient preference) is associated with prolonged days to healing. Surgical intervention which includes subsequent tissue expansion, combined with psychological support and anxiety management results in good outcome.

Applicability of Research to Practice
Results from this analysis will be used to develop treatment protocols and staff education on scalp burn injury.