bluuebunny/crossref_metadata_2025_split huggingface dataset:
601 Potential Clinical Signatures for Early Inhalation Injury Prognosis in Burns Patients
Authors: Prinsloo Tarryn K , Kleintjes Wayne G , Najaar Kareemah 
Published: April 2024

Abstract

Introduction
Despite being one of the most important mortality co-factors; inhalation injury is complex and diagnosis remains variable with limitations, especially in a resource-constrained clinical setting. Potential relationships between inhalation injury and injury-related factors were investigated that could provide inferences suggestive of improving early prognosis in burns patients in the absence of diagnostic tools.

Methods
This cross-sectional, cohort study commenced following ethical approval and patient consent. Clinical information was collected from burns patients (n=59) admitted to our Burns Centre between 23 April 2016 and 15 August 2017 irrespective of etiology. The primary outcome was inhalation injury based on the patients’ total ventilation days and stratified into mild and severe (≥5 days). Parameters included sociodemographic (gender, age, etiology), burn severity (%TBSA and complications), and clinical variables (burns intensive care unit length of stay-BICU LOS, partial gas pressures, and lactate). Descriptive statistics (mean (95% CI) and/or frequency (%)), the Spearman Rank coefficient (rho) for correlation strength/direction, and partial least squares regression for variable of importance in prediction (VIP) values, were performed. Statistical significance was denoted by p&lt; 0.05 (two-tailed) and analyses were performed using IBM SPSS Statistics version 28.

Results
An average of 2.7 patients (95% CI 2.3-3.4) were diagnosed with mild inhalation injury and 11.2 patients (95% CI 9.5-12.9) with severe inhalation injury. The latter was associated with a 93.3% mortality rate. Positive values were observed with all significantly correlated factors which ranged in strength from moderate (%TBSA rho=0.357 and lactate rho=0.331) to strong (complications rho=0.690) and very strong (BICU LOS rho=0.908). Complications (VIP=1.229) and BICU LOS (VIP=1.372) had the highest VIP values in the regression model.

Conclusions
Inhalation injury degree positively correlated to the presence or progression of the assessed parameters, with complications and BICU LOS observed as the best predictors in the current model. Initial in-hospital prognosis could benefit by considering the factors that would immediately present on admission or shortly thereafter. Complications may therefore be more suitable for the latter, whereas, increased BICU LOS could rather provide insight into degree progression.

Applicability of Research to Practice
Identifying the clinical parameters that would improve timeous treatment of inhalation injury could in turn reduce the exacerbated inflammatory state of burns patients and subsequent mortality likelihood. These findings suggest that increased inhalation injury presence and/or degree should at least be considered when these factors are present/increased.
604 Single Center 4-year Review of Synthetic Polyurethane Matrix Use in Burns and Other Complex Wounds
Authors: Mukit Muntazim , Grande Payton , Hill David M , Velamuri Sai R , Hassouba Mahmoud , Liu Xiangxia 
Published: April 2024

Abstract

Introduction
As not all wounds are amenable to immediate skin grafting, the search for the ideal skin substitute is ever present. The ideal skin substitute would be resistant to infection, inexpensive, readily available, quick to integrate and applicable to a variety of wounds. Here we describe the use of a synthetic polyurethane matrix in the setting of burns and other complex wounds in the largest case series to date.

Methods
A retrospective review was conducted at a verified, regional burn center. Dual IRB approval was obtained. All patients greater than 18 years of age who received this matrix between January 2019 and July 2023 were included. Data collected included: age, sex, wound etiology, social and medical history, presence of exposed critical structures, presence of infection, length of stay, time to matrix implantation, time to skin graft, percent of matrix survival, percent skin graft survival and disposition.

Results
A total of 182 patients with 250 wounds were included in this study. The average age was 50.5 ± 18.7 years and 61% were male. Thirty-seven percent were smokers, 23.6% had diabetes and 5.5% had peripheral vascular disease. The majority were acute burn wounds (60%), followed by, trauma (24.4%), chronic wounds (5.6%), infection (4%) and donor sites (2%). Exposed structures included fat (54%), muscle (30%), bone (16%) and tendon (14.4%). Infection was present in 143 (57.2%) of cases: 98 (39.2%) pre-application and 89 (35.6%) post application. The incidence of new infection post-application was 25.6%. The pathogens are detailed in figure 1; several infections were polymicrobial. Eighteen patients (10%) died. Median length of stay was 27 (13.3, 64) days. Median time to matrix implantation was 10 (6, 17) days. And median time from matrix placement to skin grafting was 35 (24.8, 42) days. Where documented, there were 162 wounds (83.5%) with &gt; 95% matrix survival and 136 wounds (82.4%) with &gt; 95% skin graft survival. The patient dispositions are detailed in table 2.

Conclusions
We describe to date the largest clinical series utilizing a synthetic polyurethane matrix. This matrix was successfully used in a large number of patients with burns, trauma and chronic wounds. Despite the presence of active smoking, diabetes or infection, there was greater than 95% matrix and skin graft survival in more than 80% of patients. This study demonstrates the robustness of this skin substitute to achieve successful reconstruction even in the setting of adverse patient or wound characteristics.

Applicability of Research to Practice
This study highlights the utility of using a synthetic polyurethane matrix to cover full thickness, difficult to reconstruct wounds secondary to trauma or other injuries. This matrix is resistant to infection and can allow for successful coverage of wounds even in patients who are smokers or have diabetes.
706 Mobilization with Femoral Catheters in the Burn ICU: Retrospective Review of Practice Guidelines
Authors: O'Neil Audrey M , Rush Cassandra , Boyd Allison N , Roggy David , Hartman Brett C 
Published: April 2024

Abstract

Introduction
Femoral catheters are a known barrier for ICU therapy sessions and mobility progression due to the anatomical location and potential risk of complications. Mobilization with femoral catheters has been studied in ICU populations, but has not been explored specifically within the burn population. A previous case series was completed in 2022, examining the safety of mobilization with femoral catheters in the burn ICU, following a change in practice guidelines. The purpose of this study is to further examine outcomes and complication rates following implementation of femoral catheter mobilization guidelines, as well as retrospectively compare data to outcomes prior to initiation of the mobilization protocol.

Methods
Retrospective review was completed on 17 patients prior to and following implementation of new femoral catheter mobility guidelines within a 15-bed adult burn unit, 34 patients total. Burn therapy notes were reviewed for burn admissions with at least one femoral catheter in place, including arterial, central, and dialysis catheters. Demographic data, admission statistics, line placement timelines, and active mobility achieved during therapy sessions were recorded for both the non-mobilization (NMG) and mobilization groups (MG).

Results
The 34 patients reviewed had 99 total lines placed (30 NMG, 69 MG). Mobilization restrictions limited the NMG group resulting in less therapy sessions (n=281), active mobility sessions (n=5), and mobility activities (n=6). Change in mobility protocols for the MG group resulted significantly more therapy sessions (n=516) and active mobility sessions (n=83), including 146 total mobility activities including transitions to chair mode of bed, cardiac chair, tilt table, sitting edge of bed (EOB), standing, active chair transfers, and cycle ergometry. Additionally, 82% (n=14) of patients in the MG participated in mobility earlier, while intubated, while the NMG was unable to participate in out of bed activity while intubated. No catheter associated adverse events occurred during active mobility sessions and no complications were associated with participation in mobility.

Conclusions
Establishing femoral catheter mobility guidelines allowed patients with femoral catheters to participate in significantly greater active therapy sessions, compared to previously restricted groups, without compromising safety. Early mobilization within ICU settings is necessary in preventing complications, combating muscle wasting, and improving long term outcomes for survivors. This study further supports that the presence of femoral catheters alone should not limit the progression of mobility interventions.

Applicability of Research to Practice
Therapy driving mobilization guidelines are safe within the burn ICU setting, when proper training and staff resources are present. Change in practice guidelines allowed significant improvements in patient access to active therapy interventions.
730 Does Post-hospitalization Outreach Create a Sustainable Burn Survivor Community?
Authors: Stephan Rana M , Vargas Vina , Sheckter Clifford C 
Published: April 2024

Abstract

Introduction
Burn survivors face many challenges after injury. Physical challenges include persistent wounds, scar contractures, thermal body dysregulation, and loss of limb. The psychological challenges can be equally challenging. Confronting isolation, depression, anxiety, post-traumatic stress, guilt, and change in body image are some of the many obstacles burn survivors face. However, a burn survivor’s participation in a burn community has shown to help alleviate the stress of reintegration by improving social interaction, maintaining friendships, improving body image, and giving tools to communicate. We hypothesize that post-hospital outreach develops a sustainable community for burn survivors.

Methods
Burn survivor outreach begins during hospitalization. Burn center staff are versed on the spectrum of outreach services, and patients are invited to partake in events, as appropriate. Support group is the primary introduction to outreach services, as patients and survivors are invited to a monthly group. Additionally, post-hospital outreach consists of regular community events, recreational programs, one-on-one peer support, virtual support group and volunteer opportunities. Participation in burn outreach is voluntary at the time of hospitalization and at discharge, with patients agreeing to receive monthly burn newsletter with information about community outreach events, including support group. All voluntary participants were reviewed from 2018 – 2023 from an ABA verified burn center. Survivor community sustainability was measured by the number of survivors coming to support group.

Results
Support groups were held monthly from 2018-2023, totally 69 sessions involving 61 burn staff. During the COVID-19 pandemic, support group was adapted to online version for 20 months. Post-pandemic, support group has been conducted hybrid (virtual and in-person). 372 burn survivors agreed to receive information about community outreach and support group of which 49% (182) participated. Of the 182 that participated, 111 were female and 71 were male. 11 brought family to support group. 113 participants only attended one session, while 90 participants attended two or more. Attendance ranged from 2 to 50, with a median of 25 in attendance. The median number of sessions attended per survivor was 4.0 for all-comers and 9.2 for those who attended 2 or more sessions.

Conclusions
Burn survivor support group demonstrated consistent participation validating its purpose. Through building a community, psychological healing continues post-hospitalization. Furthermore, the sense of burn community is deepened by not only by continued participation in group but also by survivors extending into other outreach events.

Applicability of Research to Practice
Regular support group creates a sustainable burn survivor community for those interested in participation. The hybrid format is conducive to many lifestyles and can be adopted by burn centers across the US.
736 Health Literacy in Patients with Burn Injury
Authors: Morzycki Alexander , Eschelbach Emily , Sharma Ayana , Oh Jamie , Battiston Adrian , Wong Joshua N , Pham Tam N 
Published: April 2024

Abstract

Introduction
Burn injuries occur with a disproportionately higher frequency in vulnerable groups. Their health literacy (HL), defined as the way patients obtain, process, and understand health information, may be an important factor that influences access, care, and recovery after burns. This study aims to determine the current levels of health literacy and variables associated with poor health literacy for outpatients treated at two regional burn centres.

Methods
All eligible patients presenting to two tertiary outpatient burn centers were asked to participate. The Newest Vital Sign health literacy assessment tool and a sociodemographic survey were administered. The NVS scores were divided into poor (0-2), moderate (3-4), and adequate (5-6) health literacy. We first compared health literacy rates between sites using non-parametric Chi-squared test. We then developed a multivariable regression model using a stepwise construction with poor health literacy as our dependent variable. Included in the exploratory model were income, education level, working status, and age.

Results
Forty-nine patients with a mean age of 46.6 years (SD=17.4) were included; 57% (29/49) of patients identified as male. Most of the burn injuries (78%, 38/49) were less than 10% total body surface area. HL rates were poor, moderate, and adequate in 35% (17/49), 18% (9/29), and 47% (23/29), respectively. There were no differences in health literacy between the 2 sites. Age was the only independent predictor of poor health literacy in burn patients, with advanced age being associated with worse health literacy (95% CI: 1.001-1.119, p&lt; 0.05). Income, education level and working status did not independently predict health literacy rates (Table 1).

Conclusions
More than half of patients treated at burn outpatient clinics have only poor or moderate health literacy. This study further suggests that older adults may be most at risk. This trend is consistent across two regional burn centres. This study highlights the importance of health literacy among patients with burn injury and stresses the importance of personalized and literacy-adjusted discussions surrounding care. Our next project will address the impact of health literacy on adherence to recommended therapies.

Applicability of Research to Practice
Poor health literacy is a barrier to obtaining burn care and is an important social determinant of health. We should identify factors associated with poor health literacy among patients with burn injury and improve the delivery of health information.
Temporal genomics help in deciphering neutral and adaptive patterns in the contemporary evolution of kelp populations
Authors: Reynes Lauric , Fouqueau Louise , Aurelle Didier , Mauger Stéphane , Destombe Christophe , Valero Myriam 
Published: April 2024

Abstract
The impact of climate change on populations will be contingent upon their contemporary adaptive evolution. In this study, we investigated the contemporary evolution of 4 populations of the cold-water kelp Laminaria digitata by analyzing their spatial and temporal genomic variations using ddRAD-sequencing. These populations were sampled from the center to the southern margin of its north-eastern Atlantic distribution at 2 time points, spanning at least 2 generations. Through genome scans for local adaptation at a single time point, we identified candidate loci that showed clinal variation correlated with changes in sea surface temperature (SST) along latitudinal gradients. This finding suggests that SST may drive the adaptive response of these kelp populations, although factors such as species’ demographic history should also be considered. Additionally, we performed a simulation approach to distinguish the effect of selection from genetic drift in allele frequency changes over time. This enabled the detection of loci in the southernmost population that exhibited temporal differentiation beyond what would be expected from genetic drift alone: these are candidate loci which could have evolved under selection over time. In contrast, we did not detect any outlier locus based on temporal differentiation in the population from the North Sea, which also displayed low and decreasing levels of genetic diversity. The diverse evolutionary scenarios observed among populations can be attributed to variations in the prevalence of selection relative to genetic drift across different environments. Therefore, our study highlights the potential of temporal genomics to offer valuable insights into the contemporary evolution of marine foundation species facing climate change.
An iterative Kalman filter-based method for traveltime tomography
Authors: Zhang Yun , Li Xihai , Liu Tian , Liu Jihao , Bai Chaoying 
Published: April 2024

Abstract
In addition to directly determining the inverted velocity, it is crucial to assess the uncertainty (or confidence) of the relevant velocity imaging results. This is especially true when dealing with time-lapse seismic data, which play a crucial role in detecting changes in fluid movement in petroleum reservoirs. In this study, we developed an iterative Kalman filter-based method to monitor time-lapse changes in the subsurface using traveltime tomography. Our approach considers the uncertainty of the results. We successfully verified the validity of our proposed method through synthetic crosshole and time-lapse tests. Our iterative Kalman filter-based method provides reasonable reconstruction results suitable for accessing uncertainties, and the algorithm can be used to monitor changes in the subsurface medium.
Induced regulatory T cells as immunotherapy in allotransplantation and autoimmunity: challenges and opportunities
Authors: Alvarez-Salazar Evelyn Katy , Cortés-Hernández Arimelek , Arteaga-Cruz Saúl , Soldevila Gloria 
Published: April 2024

Abstract
Regulatory T cells play a crucial role in the homeostasis of the immune response. Regulatory T cells are mainly generated in the thymus and are characterized by the expression of Foxp3, which is considered the regulatory T-cell master transcription factor. In addition, regulatory T cells can be induced from naive CD4+ T cells to express Foxp3 under specific conditions both in vivo (peripheral regulatory T cells) and in vitro (induced regulatory T cells). Both subsets of thymic regulatory T cells and peripheral regulatory T cells are necessary for the establishment of immune tolerance to self and non-self antigens. Although it has been postulated that induced regulatory T cells may be less stable compared to regulatory T cells, mainly due to epigenetic differences, accumulating evidence in animal models shows that induced regulatory T cells are stable in vivo and can be used for the treatment of inflammatory disorders, including autoimmune diseases and allogeneic transplant rejection. In this review, we describe the biological characteristics of induced regulatory T cells, as well as the key factors involved in induced regulatory T-cell transcriptional, metabolic, and epigenetic regulation, and discuss recent advances for de novo generation of stable regulatory T cells and their use as immunotherapeutic tools in different experimental models. Moreover, we discuss the challenges and considerations for the application of induced regulatory T cells in clinical trials and describe the new approaches proposed to achieve in vivo stability, including functional or metabolic reprogramming and epigenetic editing.
ZCCHC17 knockdown phenocopies Alzheimer’s disease-related loss of synaptic proteins and hyperexcitability
Authors: Cortese Giuseppe P , Bartosch Anne Marie W , Xiao Harrison , Gribkova Yelizaveta , Lam Tiffany G , Argyrousi Elentina K , Sivakumar Sharanya , Cardona Christopher , Teich Andrew F 
Published: April 2024

Abstract
ZCCHC17 is a master regulator of synaptic gene expression and has recently been shown to play a role in splicing of neuronal mRNA. We previously showed that ZCCHC17 protein declines in Alzheimer’s disease (AD) brain tissue before there is significant gliosis and neuronal loss, that ZCCHC17 loss partially replicates observed splicing abnormalities in AD brain tissue, and that maintenance of ZCCHC17 levels is predicted to support cognitive resilience in AD. Here, we assessed the functional consequences of reduced ZCCHC17 expression in primary cortical neuronal cultures using siRNA knockdown. Consistent with its previously identified role in synaptic gene expression, loss of ZCCHC17 led to loss of synaptic protein expression. Patch recording of neurons shows that ZCCHC17 loss significantly disrupted the excitation/inhibition balance of neurotransmission, and favored excitatory-dominant synaptic activity as measured by an increase in spontaneous excitatory post synaptic currents and action potential firing rate, and a decrease in spontaneous inhibitory post synaptic currents. These findings are consistent with the hyperexcitable phenotype seen in AD animal models and in patients. We are the first to assess the functional consequences of ZCCHC17 knockdown in neurons and conclude that ZCCHC17 loss partially phenocopies AD-related loss of synaptic proteins and hyperexcitability.
Elite lawyers in Türkiye: Educational capital, status hierarchies, and feminization
Authors: Koytak Elyesa 
Published: April 2024

Abstract
Sociological studies on elite lawyers working in large law firms have recently extended to non-Western countries. Based on a quantitative dataset comprising 1,303 lawyers from 106 Turkish law firms, this article aims to be the first empirical investigation of the social profile of lawyers in the rising large law firms in Türkiye. The analysis focuses on how characteristics of Turkish elite lawyers, in terms of educational capital, gender, and status are distributed. The objective of the analysis is to discover to what extent the expansion of legal education and rise of the private universities are reflected in the structure of elite law firms. To discover the relationships between university type, gender, and position at job, chi-square, and logistic regression analyses are conducted. Main findings are that the Turkish elite lawyers constitute a stratum where the most advantageous educational capital is concentrated compared to the profession in general, the lawyers working in the employee position are relatively young and have mostly private university degrees, and the increased feminization of the profession is closely intertwined with the status hierarchies.