bluuebunny/crossref_metadata_2025_split huggingface dataset:
652 Burns and Incidence of Operative Treatment
Authors: Schober Marc , Hallman Taylor , Africa Robert , Wermine Kendall , Gotewal Sunny , Cuartas-Olarte Andres , Torres Mark Jason , Peterson Joshua M , Golovko George , Song Juquan , El Ayadi Amina , Wolf Steven E 
Published: April 2021

Abstract

Introduction
Over the past three decades, it has been repeatedly demonstrated that early surgical intervention is associated with improved outcomes in burns, however, large-scale studies regarding the incidence of operative treatment in burn patients are lacking. We conducted a retrospective study using the TriNetX database, a global, real-time electronic medical record driven index of patient populations, analyzing the incidence of grafting procedures in burned patients related to age and % total body surface area (TBSA) burned.

Methods
The population of burn patients and operative treatments were indexed using ICD-10 codes T31.0-T31.9 and 1013913, respectively. Queries were structured as sequential events allowing analysis of burn diagnosis to be followed by a subsequent operation. The patient population was partitioned by TBSA burned, and the number of grafting procedures were assessed. All patients were included and stratified by ages of 0–17, 18–34, 35–64, and 65–89. The data includes information collected between 2000–2020 from over 35 healthcare organizations comprising the Research network in TriNetX. Extracted data were analyzed using chi-square statistical analysis with p&lt; 0.05 considered significant.

Results
Of 116,325 burn patients identified, 11.14% underwent at least one grafting procedure. Of surgeries performed, the majority occurred in the 35–64 years age group (45.3% p = &lt; 0.001). Additionally, the incidence of grafting procedures was directly proportional to patient age: age groups of 0–17, 18–34, 35–64, and 65–89 years received grafting procedures in 6.5% (p = &lt; 0.001), 9.8% (p = &lt; 0.001), 12.9% (p = &lt; 0.001), and 15.9% (p = &lt; 0.001) of cases, respectively. When stratified by TBSA burned, those with 40–49% TBSA burns had the highest incidence of operations (50.7% p = &lt; 0.001). Large TBSA burns correlated with increasing incidence of grafting procedures until 50–59% TBSA burned, where incidence begins to decrease, likely related to referral patterns which did not capture grafting procedures performed at specialized burn treatment centers or institution of palliative care.

Conclusions
This study reveals that the incidence of operational treatment increases with both age and percent TBSA burned. The data corroborate a referral pattern for burns that demonstrates a decline in operative treatments beginning with 50–59% TBSA, inconsistent with referral guidelines to specialized burn care centers published by the ABA.
653 Resourceful Surgical Planning for Coverage of Large Burns: Optimizing Cultured Epithelial Autografts (CEAs) Outcomes by Combining with a Modified MEEK Procedure
Authors: Coffman Beretta C , Fagan Shawn P , Homsombath Bounthavy , Lack Kevin , Hassan Zaheed 
Published: April 2021

Abstract

Introduction
We previously reported a modified MEEK technique providing reliable skin transfer using a specific adhesive called, “The Rule of Sevens”.¹ This innovative approach is now part of our practice and we have experienced good outcomes as a result. With that technique perfected, we have also begun incorporating this method as part of the surgical plan for coverage of large TBSA burns with CEAs. This study is a report of our initial experiences utilizing a combination of our modified MEEK procedure and CEA grafting for larger TBSA burns.

Methods
This retrospective study was granted exemption by IntegReview IRB. Demographic data was reviewed. In some cases, incomplete documentation related to percentage take was noted. To account for this limitation, we agreed with other investigators in the literature and applied the “clinically relevant” assessment to this study analysis. This approach assumed that take and final coverage were successful when re-grafting was not required by the time of discharge or death.²

Results
Nineteen (19) patients total were treated with MEEK/CEA from April 2016 – February 2020. One patient was an outlier, acquiring infection, requiring additional surgery to close the wound, and did not meet criteria to evaluate. There were 4 females (25%) and 14 males (74%), age range 9–71, Mean 37, Median 34, Mode N/A. TBSA was 30–92%, Mean 62 Median 60, Mode 55. Length of stay was 20–188 days, Mean 89, Mode 136. This is approximately 1.5 days’ stay, per percent of burn in this group of patients with larger burns. MEEK meshing ratio was documented on 16 patients, range from 6:1 - 9:1 ratio. Five patients had a 6:1 ratio, 11 patients had 9:1 meshing ratio used.
There were 6 deaths in the total group of 18 evaluable patients (33%). Of these, all had MEEK performed initially, however; 3 did not live long enough to have CEA placed. One patient died before initial takedown of CEA could be performed. The other two died during treatment, both had documentation supporting 70% and 90% take, respectively.
To determine overall take, we determined whether any of the surviving patients treated needed further grafting. None of the 12 remaining patients required further grafting. This met our criteria of successful take and gave us a 100% success rate. There were 9 patients with documentation clearly stating a percent take rate. In this group, the documented percent take range was 60–97%, Mean 84%, Median 85% and Mode 96%,80%. Again, none of these patients required additional surgery.

Conclusions
A modified MEEK technique in providing coverage of larger burns with CEA has offered our center better options of expansion thus perfecting the technique of transfer. Most importantly, the MEEK/CEA has resulted in excellent outcomes with a documented mean take rate of 84%.
660 Decreasing Burn Excision Time by Using a Circular Dermatome
Authors: Savetamal Alisa , Wenta Samantha 
Published: April 2021

Abstract

Introduction
Excision of burn-injured tissue can be accomplished by a variety of means. The most commonly used tools in the burn community are straight blades of varying lengths fitted to guards of different depths. A traditional straight dermatome can also be used for excision. We describe here the use of a circular dermatome, which in addition to allowing curvilinear excision holds the promise of expediting burn excision as well.

Methods
IRB approval was obtained for a prospective study of the use of a circular dermatome device for the excision of burns. Patients with deep partial- and full-thickness burns were eligible for inclusion in the study. Eight patients undergoing nine procedures were included. The excisions were performed exclusively with the dermatome, with use of standard equipment only for smaller areas (hands/feet). The size of the dermatome, depth of excision, and time of excision with the dermatome were noted. Total operative time (recorded as “procedure start” to “procedure end”) was also recorded, as was the subsequent wound coverage material.

Results
A total of nine cases were included. The four-inch diameter blade was most commonly used, typically at depths of 25 or 30/1000thinch. The sizes of the areas excised ranged from 392cm2 to 4694 cm2. The total time of excision was short (2 to 10 minutes), and total case times varied greatly (31 to 262 minutes) due to differences in wound coverage. Excision time per cm2 was calculated in seconds due to the brevity of the excision and typically fell between 0.1 to 0.3 seconds per centimeter squared. The outlier (0.7s/cm2) was encountered early in the study and represented a challenge of technique. Cases where wound coverage was achieved with allograft or with standard split-thickness skin graft had case times of 2 to 5 seconds per square centimeter; the outlier (11s/cm2) was the result of a use of an unrelated new technology.

Conclusions
Rapid excision of a large area of burn can be accomplished with the circular dermatome. The device can also be used of course to take autograft. When the case consists completely of excision and allografting or conventional split-thickness skin grafting, the total operative time can be very short indeed. The dermatome may be beneficial additionally for longer cases where operating room time saved in excision may be used for other purposes.
663 Application and Management of Cultured Epithelial Autografts (CEAs) on Posterior Burns – A 5-year, Multi-center, Retrospective Review of Outcomes
Authors: Homsombath Bounthavy , Hassan Zaheed , Fagan Shawn P , Coffman Beretta C 
Published: April 2021

Abstract

Introduction
In patients with larger burns, treatment with CEAs have proven to increase survival.1 CEAs, while useful, are not without some disadvantages. For instance, if the injury involves burns to posterior surfaces, the challenge is inherent in that these fragile sheets are easily sheared, and pressure can cause disruption and graft loss. CEA grafting must be managed with specific care and with specialized protocols that help address these challenges. Graft loss due to these and other factors can delay healing, increase hospital length of stay, and increase the cost of care. The purpose of this study is to evaluate the success for graft take in patients with posterior burns treated with CEA and to discuss the techniques, protocols and approaches to managing these patients within our burn network.

Methods
This retrospective study was granted exemption by IntegReview IRB. Take rate for each application of CEA was not always found for some cases. For purposes of this study, we agreed with methods of other researchers in the literature and adapted the “clinically relevant” assessment that take and final coverage was successful when re-grafting was not required by the time of discharge or death.2

Results
Study dates was March 2016 - December 2019 and at this time, is being reported from among 3 of 6 participating centers. Our approach is to provide CEA prep the day before initial placement and then to ensure strict protocols are followed at the bedside post-op and thereafter. Total number of patients considered was 68, 41 were deemed evaluable. See tables for other demographics and results. 31 patients were discharged to rehab (75%), 6 were discharged home (15%) and 4 died (10%).

Conclusions
Meticulous attention to wound bed preparation and ensuring that post-op care is clearly stated and understood by all clinicians involved in the care of patients with larger burns with posterior trunk involvement is the key to successful coverage with CEA to this challenging anatomical location.
665 Blood Loss in Burn Surgeries: Prediction and Its Related Factors
Authors: Aurino Leorca , Menna Clara , Wardhana Aditya 
Published: April 2021

Abstract

Introduction
Blood loss is a common and important problem in burn surgery, and patients often require blood transfusions. Preparation of estimated blood transfusions needed prior to surgery is essential. Some studies have devised formulas that can predict blood loss during burn surgery. However, there were many different factors in each study that may influence the amount of blood loss, which were not included in the formulas. Until today, there is no standardized formula that is widely used.

Methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE database for cohort and trial studies that investigate blood loss in burn surgeries. Studies should have clear quantitative blood loss outcome.

Results
We included 15 studies from 1982 to 2018, 13 of which are cohort studies and 2 RCTs, with a total of 1613 subjects; all studies calculated blood loss and assessed possible relating factors, four of them proposed formulas to predict the volume of blood loss, 13 studies mentioned efforts used to reduce blood loss, and 6 studies assessed the timing of surgery. We found trends of blood loss within each variable and summarized them in tables.

Conclusions
From the studies included, there were a variety of results in the amount of blood loss and its related factors. This was due to confounding factors and dissimilarities between studies. However, several studies proposed blood loss prediction formulas, which pose promising benefits to betterment in burn surgeries.
668 Fixation of Split-Thickness Skin Grafts with Liquid Adhesive and Fibrin Glue in Place of Staples
Authors: Frost Joshua , Hallier Nathan , Moreno Tanir , Covell Jared , Keck Ryan , Griswold John A 
Published: April 2021

Abstract

Introduction
A critical component of split-thickness skin grafting is the fixation of the skin graft to the wound site. Graft displacement can result in graft failure, especially during the initial 48–72 hours following application. The most common method of securing grafts is with the use of staples, sometimes with the addition of fibrin glue in order to aid both graft adhesion and homeostasis. The use of staples, however, is associated with significant levels of patient discomfort, especially during staple removal. A possible alternative to staples is the use of liquid adhesives, in combination with steri-strips, to anchor the edges of skin grafts to intact skin. Certain liquid adhesives, such as gum-based resins, are cheaper to use than staples and offer the potential to secure small split-thickness skin grafts without the associated pain of staples. In this pilot study, we examined the effectiveness of using a combination of gum-based resin (Gum Mastic-Storax-Msal-Alcohol), fibrin glue, and steri-strips to secure partial-thickness grafts in 8 patients without the use of staples or sutures.

Methods
Patients were included in the study who required split-thickness skin grafts to treat wounds involving less than or equal to 15% total surface body area and whose wounds were not located in areas prone to graft displacement, such as the axilla and groin. For each patient, skin grafts were secured using fibrin glue (sprayed over the entire wound), and a combination of liquid adhesive and steri-strips applied around the wound perimeter. The success of each graft was determined by the percentage of graft take.

Results
From January 1st, 2020 to April 30th, 2020, 8 patients were identified who fit the inclusion criteria. Five of the patients received grafts to their lower extremities, two patients received grafts to their upper extremities, and one of the patients received a graft to the torso. The average wound site that was grafted was 116.7 cm2. Average graft take among the 8 patients was 96.9%, with a range of 90%-100%. No complications at the graft site were noted, such as hematomas or any other event that resulted in graft displacement or failure.

Conclusions
The results of the study demonstrate that a combination of liquid adhesive, fibrin glue, and steri-strips, can be used as an effective alternative to staples in small split-thickness skin grafts. The use of liquid adhesive in place of staples was advantageous because it eliminated to need for staple removal, which resulted in less discomfort for the patient and less work for the nursing staff.
669 Application of In-cell Western Blot to Study Burn-induced Cardiac Dysfunction
Authors: Wen Jake J 
Published: April 2021

Abstract

Introduction
Traditional Western blotting (WB) may not reflect true target protein amount due to interference from enzymic activity during sample preparation. In-Cell Western (ICW) blotting has proved to have advantages over the traditional WB. However, ICW has not been used to study burn-induced cardiac dysfunction. This study will explore the efficacy of ICW in the study of burn-induced cardiac dysfunction.

Methods
Human cardiomyocytes (Ac16) were cultured in serum from rats with/without 60% of total body surface area (TBSA) burn injury. Cultured cells were permeabilized by Tritons-100 X, 1st anti-targeted protein antibodies were added and incubated, and, finally, two fluorescence-conjugated 2nd antibodies (one red and one blue) were added and incubated. LI-COR Odyssey CLx scanner was employed to obtain images and LI-COR Image Studio 4.0 software was used to analyze image and GraphPad Prism 8.0 software was used to determine image density.

Results
ICW proved to be a good tool to study burn injury. Our ICW data showed that burn serum resulted in 1) increased cardiomyocyte PARP1 (leading to increased protein acetylation); 2) increased damage of cardiomyocyte mitochondrial DNA replication (via increase in mitochondrial Fis1and BCBN proteins and decrease in parkin and POLG proteins); and 3) a decrease of cardiomyocyte mitochondrial biogenesis (with increase in inflammation-related proteins, apoptosis-related proteins, and decrease Brf2-ARE-related proteins).

Conclusions
This study provides preliminary evidence that ICW may be a novel tool to study burn injury and confirms that burn-injury induced cardiomyocyte mitochondrial dysfunction occurs via damage of mitDNA replication, involving inflammation, apoptosis, and mitochondrial biogenesis pathways.
672 An Investigation of Antibiotic Loading and Release in Acid-precipitated Keratin Proteins to Treat Topical Burn Infections
Authors: Thompson Marc A , Christy Robert J 
Published: April 2021

Abstract

Introduction
Human-hair derived keratin (KOS) protein has been selected in this investigation for its ability to bind antibiotic compounds and provide sustained release while withstanding harsh proteolytic environments such as inflamed, damaged tissue. The need to control local flora has been recognized as an imperative for wound healing, as recovery is significantly hampered by infection. This study investigates the synthesis of KOS-based particulate matter, developed using acid-precipitation, to load and release the water-soluble antibiotic ciprofloxacin (CIP). We hypothesize that ionically bound CIP release is tied to the degradation of KOS, therefore, bacterial metabolism, which produces proteolytic enzymes, will trigger CIP release thereby creating a novel self-extinguishing delivery system for contaminated skin wounds.

Methods
Ciprofloxacin hydrochloride was solubilized in deionized water (pH 5.3) under constant stirring. Freeze-dried KOS powder was added for an ultimately 5% w/v and 0.8% w/v solution of KOS and CIP, respectively. To improve the stability of KOS a water-soluble diglycidyl ether crosslinker was added to solutions and stirred for 24 hours. CIP-loaded protein was precipitated out by a hydrochloric acid induced pH reduction. Samples were collected and frozen at -20 °C prior to lyophilization, thus forming the stable product. Degradation of KOS and commensurate release of CIP were measured using a bicinchoninic acid (BCA) assay and fluorescent measurements of hydrated material supernatant. The reduction of bacterial colonies was validated by a broth inhibition assay whereby CIP-loaded KOS or unloaded KOS controls where hydrated in bacterial-laden broth cultures of Pseudomonas aeruginosa or Methicillin-resistant Staphylococcus aureus. Cultures were sampled at 24, 48, or 72 hours and plated to quantify colony-forming units.

Results
The presence of CIP in the KOS protein was confirmed and release rates follow similar patterns to that of KOS degradation. CIP-loaded proteins significantly reduce bacterial colony presence in concentrated inoculant solutions up to 72 hours.

Conclusions
CIP release does appear to coincide with KOS degradation, which is bolstered in the presence of infectious levels of bacteria. Ongoing studies aim to observe more robust models of infection and more controlled antibiotic release.
Measuring the Value of Softwood Log Exports: Evidence from Oregon
Authors: Rossi David , Zhai Jun , Kuusela Olli-Pekka 
Published: April 2021

AbstractOregon softwood log exports experienced a resurgence during years after the Great Recession. Using an empirically grounded partial equilibrium model, the purpose of this study is to assess the net effects of log exports on total economic surplus by measuring the effects of a hypothetical absence of export markets from 2010:Q1 to 2015:Q4. Based on our modeling results, the net economic losses would have amounted to $248 million during the study period in total. Oregon mills would have gained $1.66 billion in total, whereas landowners would have lost $1.91 billion in total had there not been export markets. Furthermore, additional losses would have occurred from the forgone export premium. Our modeling results suggest that harvests would have been 1.97 billion board feet lower in the absence of export markets. However, Oregon mills would have used an additional 3.0 billion board feet. We also provide estimates for potential employment effects.
Planet-induced radio emission from the coronae of M dwarfs: the case of Prox Cen and AU Mic
Authors: Kavanagh Robert D , Vidotto Aline A , Klein Baptiste , Jardine Moira M , Donati Jean-François , Ó Fionnagáin Dúalta 
Published: April 2021

ABSTRACT
There have recently been detections of radio emission from low-mass stars, some of which are indicative of star–planet interactions. Motivated by these exciting new results, in this paper we present Alfvén wave-driven stellar wind models of the two active planet-hosting M dwarfs Prox Cen and AU Mic. Our models incorporate large-scale photospheric magnetic field maps reconstructed using the Zeeman–Doppler imaging method. We obtain a mass-loss rate of $0.25~\dot{\mathrm{ M}}_{\odot }$ for the wind of Prox Cen. For the young dwarf AU Mic, we explore two cases: a low and a high mass-loss rate. Depending on the properties of the Alfvén waves that heat the corona in our wind models, we obtain mass-loss rates of 27 and $590~\dot{\mathrm{ M}}_{\odot }$ for AU Mic. We use our stellar wind models to assess the generation of electron cyclotron maser instability emission in both systems, through a mechanism analogous to the sub-Alfvénic Jupiter–Io interaction. For Prox Cen, we do not find any feasible scenario where the planet can induce radio emission in the star’s corona, as the planet orbits too far from the star in the super-Alfvénic regime. However, in the case that AU Mic has a stellar wind mass-loss rate of $27~\dot{\mathrm{ M}}_{\odot }$, we find that both planets b and c in the system can induce radio emission from ∼10 MHz to 3 GHz in the corona of the host star for the majority of their orbits, with peak flux densities of ∼10 mJy. Detection of such radio emission would allow us to place an upper limit on the mass-loss rate of the star.
Expasy, the Swiss Bioinformatics Resource Portal, as designed by its users
Authors: Duvaud Séverine , Gabella Chiara , Lisacek Frédérique , Stockinger Heinz , Ioannidis Vassilios , Durinx Christine 
Published: April 2021

Abstract
The SIB Swiss Institute of Bioinformatics (https://www.sib.swiss) creates, maintains and disseminates a portfolio of reliable and state-of-the-art bioinformatics services and resources for the storage, analysis and interpretation of biological data. Through Expasy (https://www.expasy.org), the Swiss Bioinformatics Resource Portal, the scientific community worldwide, freely accesses more than 160 SIB resources supporting a wide range of life science and biomedical research areas. In 2020, Expasy was redesigned through a user-centric approach, known as User-Centred Design (UCD), whose aim is to create user interfaces that are easy-to-use, efficient and targeting the intended community. This approach, widely used in other fields such as marketing, e-commerce, and design of mobile applications, is still scarcely explored in bioinformatics. In total, around 50 people were actively involved, including internal stakeholders and end-users. In addition to an optimised interface that meets users' needs and expectations, the new version of Expasy provides an up-to-date and accurate description of high-quality resources based on a standardised ontology, allowing to connect functionally-related resources.