bluuebunny/crossref_metadata_2025_split huggingface dataset:
562 Caregivers and Clinic Providers View Soft Casts for Pediatric Hand Burns as Acceptable and Feasible
Authors: Schuh Jennifer M , Linzell Leanna L , Abebrese Emmanuel L , Flynn-O'Brien Katherine T 
Published: April 2024

Abstract

Introduction
Soft casts have been introduced as a strategy to manage hand burns that is associated with less wound care burden for families. We hypothesized that the use of soft casts in pediatric hand burns would be viewed as acceptable by patient caregivers and providers, perceived as logistically feasible, and result in satisfactory clinical outcomes.

Methods
A retrospective chart reviewed was perform for pediatric patients with hand burns who were managed with soft casts in clinic since implementation in 2022. A survey was sent to patient caregivers (n=33), and a separate survey sent to burn clinic staff and providers (n=20). The primary outcome was perception of acceptability of soft casts as a management strategy (questions targeted care burden, overall satisfaction, ease of use, healing concerns, efficacy, and comfortability). The secondary outcome was provider perception of feasibility of this new strategy (effect on clinic workflow, efficiency). Survey questions were both Likert scale and open ended. Findings were summarized and qualitatively assessed.

Results
Since implementation of soft casting in 2022, 33 English-speaking patients with hand burns were managed with soft casts and 38 soft casts applied. Total body surface area burned ranged from &lt; 0.5% to 2.5%, with both superficial and deep burns treated. There was a mean of 1.8 reapplications (mode 1, range 1-22) and a median time to healing of 13 days. There were no infections attributed to the use of soft casting, and only one patient initially in a soft cast required grafting. Survey responses were collected from 70% of caregivers (23/33) and 90% of providers (18/20). Caregivers overwhelmingly agreed with statements favoring soft cast acceptability and disagreed with negative statements regarding soft casts (Figure 1). Among clinic providers, 78% strongly agreed (9 or 10 on Likert) with the statement “The soft casting method has streamlined our clinic’s operational efficiency for managing hand burns” and 94% would recommend soft casts (range 7-10, mode 10 on Likert). Qualitative thematic analysis of open-ended questions was conducted (Table 1).

Conclusions
Overall, the introduction of soft casts as a management strategy for pediatric hand burns was well received by patient caregivers and clinic team, and felt to be acceptable (satisfactory, comfortable, practical, and efficacious) and feasible, with little disruption to clinic flow. The clinical outcomes assessed suggest soft casts are associated with good wound healing with minimal wound care for patient and family.

Applicability of Research to Practice
The perceived acceptability of soft casts for pediatric hand burn treatment and feasibility of integrating this as a new management strategy into a busy clinic speak to the pragmatism of logistically integrating soft casts into practice and support the strategy as satisfactory to parents and providers.
576 Head and Neck Burn Injuries: A Nationwide Analysis in Pediatric and Adult Populations
Authors: Najafali Daniel , Pozin Michael , Camacho Justin M , Tran Quincy K 
Published: April 2024

Abstract

Introduction
Burns to the head and neck impact a patient’s aesthetics in the most direct way and in severe cases impair function and quality of life. The purpose of this study is to compare outcomes between adult and pediatric patients sustaining burns to the head and neck region.

Methods
Head and neck burn encounters were isolated from the ABA Burn Care Quality Platform between January 2008 and December 2018. Cohorts were separated into two based on patient's age (≤14 years and 15+ years). Descriptive statistics summarized patient demographics and clinical characteristics. Multivariable regression analysis determined predictors associated with any complications, increased lengths of stay, and mortality.

Results
The analysis identified 52,272 individuals (mean age=34 years) sustaining a burn to the head and neck, of which 12,663 (24%) were pediatric cases (mean age=4 years) and 71% were male. The majority of adult and pediatric patients were White, 64% and 38% respectively. The top 3 etiologies for adults were: 1) flame, 2) scald, and 3) flash burns. For pediatric cases they were: 1) scald, 2) flame, and 3) contact burns. Burn severity as indicated by TBSA had a median [IQR] of 7% [3-17%] for adults and 6% [3-12%] for pediatric patients (p&lt; 0.001). The mean (SD) percent of the burn concentrated on the head and neck was 42% (34%). Any complication was significantly associated with pediatric cases (OR 1.60, 95%CI 1.48-1.75), identifying as Hispanic or Latino (OR 3.80, 95%CI 1.63-8.44), and increased burn surface area to the head and neck (OR 1.01, 95%CI 1.00-1.01). Black patients (OR 1.90, 95%CI 1.60-2.20), patients with inhalation injury (OR 3.10, 95%CI 1.50-6.20), and greater TBSA (OR 1.10, 95%CI 1.10-1.10) had higher odds of mortality.

Conclusions
Pediatric patients recovered faster and were more likely to survive their burn injuries to the head and neck. Adverse outcomes were observed to affect marginalized racial/ethnic communities. The existing disparities require increased attention and efforts should be made to determine any potential environmental or cultural factors that may predispose groups to more severe head and neck burn.

Applicability of Research to Practice
These findings can help guide and educate clinicians in regard to head and neck burns as well as the existing disparities and epidemiological trends implicated.
602 Too Few Burn Papers and Images, Lowering Publication Barriers for Low- and Middle-Income Country Authors
Authors: Kneib Cameron J , Shor Ryann E , Nakarmi Kiran K , Yadav Manish K , Shrestha Raslina , Miranda Ariel , Pham Tam N , Stewart Barclay T 
Published: April 2024

Abstract

Introduction
Whereas the burden of burn injury is greatest in low- and middle-income countries (LMIC), publications from these regions represent a disproportionately small volume of the published burn literature in English. This important gap in our cumulative knowledge contributes to the slow progress in global burn injury control. In addition to manuscripts, clinical photographs are important representations of injury and outcomes. We aimed to compare the current volume of burn publications and photographs to the global burn injury burden and sought to identify potential journal-level barriers to publication.

Methods
A bibliometric analysis was performed by sampling three leading burn surgery journals published in the English language (Journal of Burn Care and Research, Burns, European Burn Journal) between 2021-2023. Country of corresponding author and number of photos were tabulated and categorized by region. Volume was compared to Global Burden of Disease (GBD) 2019 estimates for incidence of thermal injury by region. Journal submission instructions were reviewed for potential barriers to publication.

Results
A total of 916 articles were reviewed from 59 countries. Analysis showed 147 articles with 1117 human photos. GBD incidence of burn, publications, and photographs by region are shown in Figure 1. North America, Europe, the Middle East, and Oceania had a higher proportion of published images to burn injury incidence than Latin America, Africa, and Asia (X2 (6, N = 915) =3585, p &lt; 0.001). Barriers to journal publication included charges for published images (up to 600 USD/image), open access costs (900-3500 USD with 1 of 3 publishers offering tiered discounts specific to LMIC), English language review (0.06-0.07 USD/word), and society affiliation discounts. Table 1 summarizes identified barriers and potential solutions.

Conclusions
There is a relative paucity of LMIC contributions to publications and clinical photos in English language burn journals. Identified publication barriers and added costs from journals likely contribute to this disparity.

Applicability of Research to Practice
Publication-level strategies to increase authorship and clinical photographs from underrepresented regions are urgently needed.
707 Is Central Venous Catheter the Main Culprit for Clinically Significant Venous Thromboembolism in Burn Patients
Authors: Caesar-Peterson Shannon , Libraro Kaitlyn M , Houng Abraham 
Published: April 2024

Abstract

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

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

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

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

Applicability of Research to Practice
Understanding the Importance of Chemoprophylaxis in Burn patients in comparison to Non-Burn Patients in Relation to Central Venous Catheter Associated VTE
708 Chemokine Signature Pattern in Toxic Epidermal Necrolysis: Diagnostic and Therapeutic Relevance
Authors: Anklowitz Andrew , Quinn Michael , Hale Justin , Poloni Dana , Kumar Sanjiv , Aranda Marcus , Prasad Balakrishna 
Published: April 2024

Abstract

Introduction
Toxic Epidermal Necrolysis (TEN) is a delayed hypersensitivity reaction to some pharmacological agents. Common drugs involved include antibiotics, anticonvulsants, and allopurinol. The pathophysiology of TEN is not well understood. The mortality of TEN is upwards of 50%, and more research is needed to help understand this disease to develop diagnostic assays and potential targeted treatments. This study aimed to identify the signature pattern of cytokine/chemokine response to TEN.

Methods
To distinguish the immune response to skin injury from pathogenic immune activation leading to TEN, we studied the cytokine profile in burn and TENS patients during the first week of hospitalization. We analyzed daily plasma samples from 25 burn and 9 TEN patients using the Luminex Multiplex assay platform.

Results
Several pro-inflammatory cytokines were increased in both burns and TENS patients. However, three chemokines were significantly elevated in almost all TENS patients analyzed compared to the burn cohort: CXCL9, CXCL10, and CXCL11. This response was sustained for the one week of hospital stay.

Conclusions
The chemokine/cytokine signature response appears to be involved in the pathophysiology of TEN. This signature response could be used to develop in-vitro diagnostic assays to identify causative agents and to develop therapeutic drugs targeting the pathologic response in TENS.

Applicability of Research to Practice
Identifying and determining the significance of specific chemokines that remain significantly elevated helps serve as preliminary data to justify a larger, clinical study that may help in understanding this disease process better, to help develop diagnostic assays and to help develop potential targeted treatments.
714 Our Experience with Enzymatic Debriding Agent, Anacaulase, for Burn Injuries: A 14 Patient Case Series
Authors: Bird Cole L , Reynolds Jessica , Bhavsar Dhaval 
Published: April 2024

Abstract

Introduction
Background: Enzymatic debridement of burn wounds facilitates early removal of eschar. It has shown to improve healing time and decrease need for surgical intervention. We wanted to review our results of use of an enzymatic debriding agent (EDA - Anacaulase) in deep partial and full thickness burns.

Methods: Methods
We undertook a retrospective review of consecutive 14 adult patients treated with EDA at our Burn Center. These patients received therapy with Anacaulase, a novel enzymatic debriding agent, spanning from the year 2020 to the present day. Burn characteristics, EDA applications details, surgical interventions if any, time of heal, scar assessments were noted. We used Microsoft Excel for a descriptive analysis of the data. We examined continuous variables within specific ranges and provided summaries including median, minimum, maximum values, and percentages.

Results: Results
Patients demographics and burn injury characteristics are included in table 1. We were able to achieve &gt;95% eschar removal with single application in all 14 patients. 57% patients required subsequent skin grafts. The time to achieve 95% wound closure averaged 35.5 days. Scars improved substantially over the study period, as indicated by mean Vancouver Scar Scale scores of 3.8 to 0.5 at 3 and 12 months, respectively. Only 2 patients required scar release surgery due to contracture.

Conclusions
Conclusion: Our review highlights potential benefits of early eschar removal with EDA. 47% patients were able to avoid autologous skin graft closure of deep partial and full thickness burn wounds. EDA (Anacaulase) may add value in care of select patients with deep partial and full thickness burn wounds.

Applicability of Research to Practice
Our review highlights potential benefits of early eschar removal with EDA. EDA (Anacaulase) may add value in care of select patients with deep partial and full thickness burn wounds.
734 Use of the Burn Care Quality Platform (BCQP) for Modern Burn Care Benchmarking
Authors: Lechtenberg Madeline G , Carter Jeffrey E , Danos Denise , Phillips Bart D , Murata Erica , Schoen Jonathan E , Phelan Herb A 
Published: April 2024

Abstract

Introduction
In 2019, the American Burn Association (ABA) launched the Burn Care Quality Platform (BCQP), a registry tailored to create consistency across other national trauma registries. With the release of BCQP version 2 (BCQPv2) in 2021, this registry now includes data from 103 participating burn centers and 375,000 total patients as of 2021. This robust registry therefore represents a unique opportunity to measure up-to-date benchmarks for outcomes among U.S. burn centers.

Methods
BCQPv2 was queried for clinically relevant burn outcomes for all data-submitting centers between the years 2018 to 2022. An additional query was run to measure outcomes for our verified, urban burn unit. Results were reported as descriptive statistics.

Results
Nationally, mortality rates for all burn center admissions was 3.3%. Mean length of stay (LOS) was 3.0 days/% Total body surface area (TBSA) burned, and severe injury (defined as burn &gt;20% TBSA) constituted 6.4% of all burn injuries nationally. Seven point nine percent of burn injuries included concomitant nonthermal traumatic injury. Payor mixes for all burn patients were 29.1% Medicaid, 15.9% Medicare, 25.6% private insurance, and 6.3% workman’s comp. National discharge dispositions followed an expected stair-step distribution when grouped by TBSA deciles. Locally, we found our mortality to be 5.1% with a mean LOS of 1.8 days/%TBSA. We saw higher proportions of severe injury (12.0%), Medicaid (41.4%), workman’s comp (10.4%), and burns with concomitant trauma (32.0%) as compared to the national findings. Additionally, higher rates of discharge home were seen on a burn-by-burn basis.

Conclusions
These results represent the current state of burn care in the U.S. Locally, our burn center’s results differ in important ways, some of them potentially modifiable. Further work is being done to determine the etiologies of these differences and whether they are potentially exportable.

Applicability of Research to Practice
This robust registry enables us to better evaluate the outcomes of current standards of care. This raises the possibility of improved modern burn care benchmarking and eventually better patient outcomes.
Occurrence of black queen cell virus in wild bumble bee communities in China
Authors: Xu Jin , Zhang Zhengyi , Guo Yulong , Yang Huipeng , Li Xiaoying , Guo Yueqin , Zeng Huayan , Wu Yueguo , Yao Jun , Li Jilian 
Published: April 2024

Abstract
Wild bumble bees (Hymenoptera: Apidae) play a vital role in agro-ecosystems as important pollinators. However, they are threatened by virus pathogens that are widespread in honey bees. Previous studies have reported that viruses were able to be transmitted across bee genera and caused potential danger to wild bumble bees. China is a global biodiversity hotspot for bumble bees. However, the impact of viruses on the wild bumble bee communities remains elusive. Black queen cell virus (BQCV) is one of the most common honey bee viruses. Here, a total of 72 wild bumble bee samples from 17 geographic regions of China were tested for BQCV. Thirteen positive samples were identified and sequence comparison of partial capsid genes demonstrated a genetic identity of 99.69% to 100%. A phylogenetic tree analysis also showed a close relationship between 13 BQCV isolates and others from a variety of recorded hosts in China. Meanwhile, a distinct evolutionary branch of China isolates was formed when clustering isolates from worldwide bumble bee species. A correlation between BQCV and their geographic locations were observed (P &lt; 0.05). This study not only provides the first evidence of widespread BQCV in wild bumble bee communities in China but also detects a distinct set of genetically identical or closely related BQCV variants that circulate and evolutionarily differ from other countries.
Comparison of Bayesian Coalescent Skyline Plot Models for Inferring Demographic Histories
Authors: Billenstein Ronja J , Höhna Sebastian 
Published: April 2024

Abstract
Bayesian coalescent skyline plot models are widely used to infer demographic histories. The first (non-Bayesian) coalescent skyline plot model assumed a known genealogy as data, while subsequent models and implementations jointly inferred the genealogy and demographic history from sequence data, including heterochronous samples. Overall, there exist multiple different Bayesian coalescent skyline plot models which mainly differ in two key aspects: (i) how changes in population size are modeled through independent or autocorrelated prior distributions, and (ii) how many change-points in the demographic history are used, where they occur and if the number is pre-specified or inferred. The specific impact of each of these choices on the inferred demographic history is not known because of two reasons: first, not all models are implemented in the same software, and second, each model implementation makes specific choices that the biologist cannot influence. To facilitate a detailed evaluation of Bayesian coalescent skyline plot models, we implemented all currently described models in a flexible design into the software RevBayes. Furthermore, we evaluated models and choices on an empirical dataset of horses supplemented by a small simulation study. We find that estimated demographic histories can be grouped broadly into two groups depending on how change-points in the demographic history are specified (either independent of or at coalescent events). Our simulations suggest that models using change-points at coalescent events produce spurious variation near the present, while most models using independent change-points tend to over-smooth the inferred demographic history.
Facial Skin Rejuvenation Using Poly-dl-Lactic Acid Injected With a Laser-Generated Needle-Free Microjet Injector
Authors: Oh Dong Yeol , Seo Suk Bae , Jang Ye Ji , Park Eun Joo , Kim Kwang Ho 
Published: April 2024

BACKGROUND
A laser-induced needle-free microjet injector was developed for rapid, high-speed drug delivery of microliters into the skin.

OBJECTIVE
This study evaluated the clinical rejuvenation effect of repeated dermal injections of the collagen simulator poly-dl-lactic acid (PDLA) using a laser-induced needle-free microjet injector.

METHODS
Five PDLA injection sessions using a laser-induced needle-free microjet injector were conducted in patients concerned about aging skin. Facial uplifting, darkness, redness, roughness, pore size, subjective satisfaction, and side effects were evaluated before each session and 4 weeks after treatment completion. Histological evaluation was also performed with immunohistochemical staining of collagen and elastic fibers.

RESULTS
The clinical results of 27 female patients were evaluated. The treatment resulted in a noticeable skin surface uplifting (0.711 ± 0.42 mm) and significant improvements in darkness (p = .013), redness (p = .009), and roughness (p = .036), with no significant difference in the pore size (p = .770). Patients were reported being satisfied with the overall therapeutic effects, despite mild and tolerable adverse effects. Histological findings revealed growth and thickening of collagen and elastic fibers, with marked increase in collagen I and III levels.

CONCLUSION
Repeated dermal injections of PDLA using a laser-induced microjet injector offer excellent drug delivery, achieving high efficacy in skin rejuvenation, patient satisfaction, and safety.