bluuebunny/crossref_metadata_2025_split huggingface dataset:
759 Burn Injury Impacts Estrogen-treated Postmenopausal Women
Authors: Song Juquan , Golovko Georgiy , Botnar Kostiantyn , ayadi Amina E I , Vincent Kathleen L , Wolf Steven E 
Published: April 2024

Abstract

Introduction
Postmenopausal women are often treated with exogenous female hormones to alleviate mental and physical symptoms. Basic research studies showed the benefit of estrogen treatment on the improvement of cardiac function following burn injury. We posit that women treated with hormone replacement (HRP) fare better following severe burn.

Methods
De-identified patient data were obtained from a global healthcare Research network in March, 2023. Female patients greater than 18 years of age with the diagnoses of menopause were enrolled if they further encountered burn injury within 10 years. Patients with pre-existing gynecologic and chronic liver/heart diseases were excluded. The study population were grouped into those with or without estrogen treatment (ET) for complication examination in both short- and long-term periods . Cohort balancing was performed regarding age, race, and ethnicity using an exact match approach and controlled by the Chi-Square test. Subsequently, the odds ratio (ORs) was computed for these harmonized cohorts. All data manipulation was executed using a custom Python (version 3.10) program in conjunction with Scipy (version 1.11.1) and Pandas (version 2.0.3) libraries.

Results
In the 3-month observational period, women with ET had lower incidence of acute kidney injury and breast cancer [0.475/0.247-0.879, (ORs/95%CI) and 0.362/0.209-0.608]. Other complications were higher in patients with ET including osteoporosis [1.29/1.243-1.596], cerebral infarction [1.735/1.087-2.81], and acute myocardial infarction [3.0/1.776-5.292]. When observation extends to 3 years after injury, patients with ET had similar observations of decreased acute kidney failure [0.236/0.056-0.749], however, increased chronic kidney disease (CKD) [1.203/1.007-1.438], osteoporosis [1.338/11.083-1.654], breast cancer [1.513/1.217-1.885], and acute myocardial infarction (MI) [6.281/1.372-58.484]. All above data were significant with p values &lt; 0.05.

Conclusions
ET in postmenopausal women was associated with decreased acute kidney injury after burn injury, however, also with increased CKD, osteoporosis and MI from 3 months to 3 years after injury. This is not consistent with the ET protective effect seen in rodent burn injury models, therefore, further study on the dose and duration of treatment is warranted as this study in postmenopausal women was primarily low dose, in the range of estrogen or hormone replacement therapy.

Applicability of Research to Practice
Current levels of estrogen provided with Estrogen or Hormone Replacement Therapy do not appear adequate to provide protection that has been seen in preclinical studies, therefore clinical studies to determine dose of estrogen at the time of burn injury should be instituted.
764 Burn Advanced Practice Provider Fluorescein Dye Staining Reduces Ophthalmology Consults
Authors: Laramie Kate E , Mueller Scott W , Wiktor Arek J , Gibson Cameron 
Published: April 2024

Abstract

Introduction
Facial burn injury patients typically receive ophthalmology consultations irrespective of the severity of their peri-ocular or ocular involvement. Minor facial burns without significant eye involvement or ocular complaints often do not require in-patient ophthalmologist assessment. We sought to assess ocular fluorescein dye staining by burn unit Advanced Practice Providers (APP; Physician Assistants and Nurse Practitioners) to decrease unnecessary ophthalmology consults.

Methods
A prospective evaluation was performed at our ABA-verified burn center for all facial burn injury patients admitted between January 1 through August 31, 2023. Patients who presented with full-thickness injuries to their eyelids or peri-ocular area, those exhibiting tense eyelids raising concern for ocular compartment syndrome, those with severe eye pain and anyone with acute vision loss were excluded from staining and received an immediate ophthalmology consult. For patients with facial burns who did not meet the aforementioned criteria, fluorescein dye stains were administered upon admission by APPs, if available. Ophthalmology consults were only ordered for patients with positive stains.

Results
83 patients were admitted with facial burns between January 1 and August 31, 2023. Of these, 42 patients received fluorescein dye stains by APPs. Among those stained, 79% were male and 21% female. The average age was 49 years old (range 19 to 82). The average TBSA affected was 8.46% (range 0.1% to 38.5%). The majority of patients (83%) had flame/flash burns, 7% had scald burns, 2% had chemical burns, 2% had sun burns and the remainder had unclear etiology. 34 patient dye stains (80%) yielded negative results, obviating the need for an ophthalmology consult. The remaining 8 had positive results, necessitating a consult. Among these, 4 were false positives with no ocular injury found by ophthalmology. The remaining 4 exhibited ocular chemosis, trace punctate epithelial erosions, thermal keratopathy and chronic central epithelial defects from prior Lasik surgery. Ophthalmology was consulted in 37 out of 83 patients, with only 8 consults resulting from APP staining. This signifies a 48% overall reduction in consults placed during this 8-month time frame, and an 80% reduction of consults in whom qualified for the pathway.

Conclusions
Fluorescein dye staining by burn unit APPs minimizes unnecessary ophthalmology consults, likely reducing healthcare costs for patients and healthcare facilities.

Applicability of Research to Practice
Burn centers should consider fluorescein dye stain screening as part of routine practice for burn patients.
787 A 13-year Experience with a 3-stage Dermal Regeneration Matrix Approach to Acute Hand Burns
Authors: Arellano Jose Antonio , Jeong Tiffany , Alessandri-Bonetti Mario , Liu Hilary , Pandya Sumaarg , Stofman Guy M , Egro Francesco 
Published: April 2024

Abstract

Introduction
Dermal regeneration matrix (DRM) has been demonstrated to be safe and beneficial in improving functional outcomes for the management of acute hand burns. DRM followed by split thickness skin graft (STSG) allows for a two-stage reconstruction for most operative hand burn injuries. Our site routinely implements a 3-staged approach with cadaver allograft at the first stage. The aim of this study is to compare the surgical and functional outcomes of 2-staged DRM reconstruction and 3-staged reconstruction.

Methods
A retrospective study was conducted to review surgical and functional outcomes of patients treated for hand burns. All patients seen from April 2009 and December 2022 with hand burns, for whom objective hand measurements were available, were considered for the study.

Results
From 2009 to 2023, 227 patients were treated for hand burns. Of them, 44 patients had objective hand measurements and were included in the study. Patient (77.3% males,22.7% females) mean age was 39.3±16.1 and the mean BMI was 27.1±6.4. Patients suffered from 1.3±1.4 comorbidities. Patients were followed for 22.0±25.0 months. Most burns were full thickness (97.7%, n=43) and involved 15.3±16.7% TBSA. Patients suffered thermal injuries (93.2%, n=41) and electrical burns (6.8%, n=3). Many patients had bilateral hand involvement (52.3%, n=23).
Most cases (n=27) received a 3-staged approach with cadaver allograft at first stage, dermal regeneration matrix (DRM) at second stage, and split thickness skin graft (STSG) for final reconstruction. Fewer cases received a 2-staged approach with DRM and STSG (n=10). No 3-staged cases required repeat STSG, while 40% of 2-staged cases required repeat STSG. Repeat STSG in acute management was significantly associated with patients who received the 2-staged (p &lt; 0.01).
There was no significant difference in mean baseline DASH scores for patients who received cadaveric allograft during acute management (46.5±22.3%) when compared to those who did not (48.7±22.5%) (p=0.8033).

Conclusions
These data suggest a 3-stage approach may conserve autologous STSG, with fewer instances of repeat grafting. This approach may be especially useful when autologous skin is limited. Patients who received a 3-staged approach had comparable mean DASH scores when compared to patients who received a 2-staged approach, suggesting that a 3-staged approach does not diminish the functional benefits of DRM previously demonstrated in the literature.

Applicability of Research to Practice
When autologous skin is limited for grafting complex burn patients, surgeons may consider a 3-stage approach to using DRM.
792 Evaluating the Efficacy of Postoperative IV Antibiotics on Graft Take: A Pilot Study
Authors: Azzam Seham Z , Bingi Sai Pranathi , Keshvani, Caezaan , Clark Junior , Pang Alan , Griswold John A 
Published: April 2024

Abstract

Introduction
Burn wounds present as one of the most devastating forms of trauma. In the United States, an estimated 486,000 patients are treated for burn injuries yearly, with 40,000 requiring hospital admission. While severe burn wound survival rates have improved significantly in recent decades due to advances in the treatment of burn-related complications, approximately 5,000 patients in the U.S. die from severe burn wounds each year.
While there are many different treatments for burn wounds depending on their severity, skin grafting remains one of the most prominent and effective solutions to achieving a good patient outcome for partial and full thickness burns. One obstacle that can prevent proper healing with a skin graft is infection of the grafted wound. To mitigate this risk, IV antibiotics are given peri-operationally and are shown to increase graft survival and decrease partial graft loss suggesting potential benefit for the patient. However, there is currently little research on the efficacy of administering antibiotics postoperatively between the initial grafting procedure and undressing of the grafted wound. To better understand this association, our pilot study investigated the impact that systemic IV antibiotics have on graft outcomes when administered between graft take and dressing takedown.

Methods
We queried the electronic health records of 166 burn patients who received grafting between January 1, 2011, through September 1, 2021 at a burn intensive care unit. All patients selected for this study were between 18 and 89 years of age and were divided based on those with graft success versus graft rejection. The patients were then subsequently divided into those who received post-operative antibiotics and those who did not. Using Fisher’s exact test, we compared the graft take percentages between the two groups.

Results
Our study revealed no significant correlation (p=0.6054) between graft take and the use of postoperative intravenous (IV) antibiotics.

Conclusions
This observation suggests that IV antibiotics given post-operative do not improve graft take in burn patients. This supports the idea that post-operative antibiotics may currently be overprescribed for patients receiving burn grafts.

Applicability of Research to Practice
Although existing grafting guidelines do not discuss post-operative IV antibiotic administration, our results suggest a need for consideration. Overuse of antibiotics is well-documented to contribute to the development of antibiotic-resistant bacteria. Furthermore, burn patients are already at risk of infections due to burn injuries resulting in a state of immunosuppression that predisposes patients to infection by various pathogens.
793 Lightning Burns and General Recommendations
Authors: Arora Shreya , Criscione Jaynie X , Koussayer Bilal , Mikhael Marian , Randolph Ellie , Le Nicole K , Whalen Kristen , Buller Kristina , Troy Jared , Laun Jake 
Published: April 2024

Abstract

Introduction
The odds of being struck by lightning are one in a million, however lightning strike accounts for 24,000 annual fatalities worldwide (Jensen et al, 2023). Due to its rarity, guidelines for the management of burns acquired by lightning strike are scarce. Current standard of treatment is to treat burns acquired as one would treat electrical burns (Stander & Wallace, 2011). We present a case series of three patients that were struck by lightning and contrast their outcomes to patients with electrical burns. We attempt to provide general recommendations for lightning burns.

Methods
We conducted retrospective chart review of patients presenting between 2015- 2022 for electrical and lightning burns. SPSS V28 was used for statistical analysis. Lightning burn patients were matched to electric burn patients by age, gender, Total Burn Surface Area (TBSA), and comorbidities. Descriptive statistical analysis was conducted between the three groups due to discrepancies in sample size.

Results
We report three lightning burn cases: 2 adult males with 1-1.5% TBSA second-degree burns and 1 pediatric case with 4% TBSA. The pediatric case had a more complex hospital course: longer stay (15 vs 4-5 days), ICU stay (13 vs 2 days), and required ventilation but no surgery.
In adults aged 19-29, electrical burns patients had longer hospital stays (6.38 vs 5.00 days), similar ICU stays (2.25 vs 2 days), and lower initial CPK (1624.29 vs 3506.00) than lightning burn patients. In those 50+ with TBSA &lt; 5% and hypertension, electrical burns patients had longer stays (6.75 vs 4 days), longer ICU stays (3.25 vs 2.00 days), and lower initial CPK levels (435.5 vs 648.00). CPK normalization took longer for electric burns (29.5 vs 6 hours). In younger patients, lightning burns had lower initial myoglobin (569.30 vs 759.01) but faster normalization (8.5 vs 15.92 hours), while in older patients, myoglobin trends favored lightning burns (6 vs 3.25 hours). Pediatric patients with TBSA &lt; 5% had shorter stays (3.83 vs 15.00 days), ICU stays (0.83 vs 13 days), lower initial CPK (508.25 vs 17393.00), lower myoglobin (91.50 vs 10000.00), and quicker CPK normalization (10.00 vs 14.00) in electric burns compared to lightning burns.

Conclusions
Electric burns and lightning burns present similarly in adults. Although initial CPK levels are elevated in lightning burn patients, time taken for CPK to trend down was less than electric burn patients. More research is needed on lightning burn management in a pediatric population.

Applicability of Research to Practice
Lightning burns can be managed similarly to electric burns. Providers ought to expect an increased length of stay in patients who sustain electric burns as well as an extended recovery time for muscular injury.
795 A 12-Year Experience in Lower Extremity Acute Burns Reconstruction
Authors: Arellano Jose Antonio , Jeong Tiffany , Alessandri-Bonetti Mario , Liu Hilary , Stofman Guy M , Egro Francesco 
Published: April 2024

Abstract

Introduction
A paucity of studies investigated the outcomes of flap reconstruction in lower extremity acute burn. The aim of this study is to report outcomes of lower extremity acute burn needing pedicled or free flap coverage.

Methods
We conducted a retrospective study to review patients with lower extremity acute burns needing either pedicled or free muscle flap coverage between August 2010 and December 2022 at an ABA-certified burn center. Gathered data included demographics, comorbidities, type of injury, total body surface area involved, anatomical location, indication for flap coverage, timing of reconstruction, follow-up, number and type of re-operations, and complications. Chi-square test was used to measure differences in complication rate between pedicled and free flaps.

Results
Over a 12-year period, 31 patients underwent 38 muscle flaps for lower extremity acute burn and were included in the study. In total, 81% were males and 19% females, with a mean age of 47±12 years and a mean BMI of 28.4±7.2. Thermal injury was the most common cause of soft tissue defects (92%), while electrocution caused the remaining 8%. Most common injured area was the lower leg (82%). Mean time between the day of injury and reconstructive surgery was 21.3±9.5 days and the mean follow up period was 11.2±11.8 months.
Out of 38 flaps, 28 were pedicled muscle flaps (14 gastrocnemius flaps, 12 soleus flaps, 1 anterior tibial muscle flap, 1 abductor digiti minimi muscle flap) and 10 were free muscle flaps (8 rectus abdominis flaps, 1 vastus lateralis flap, 1 latissimus dorsi flap).
In the free flap group complications were: total flap loss (20%), wound healing issues (30%), hematoma (20%), infection (10%). In the pedicled flap group complications were wound healing issues (14.3%), skin graft loss (10.7%), tip necrosis (7.1%) and infection (3.6%).
Free flaps showed a significantly higher rate of need for re-operation (50% vs 35.7%, p=0.048) and total flap loss (20% vs 0%, p=0.015) compared to pedicled flaps.

Conclusions
Flap coverage in lower extremity acute burns is rarely employed. Yet, in the case of critical structure exposure, it is often necessary. However, it is important to be aware of the high risk of complications, especially for more complex reconstructions needing a free tissue transfer.

Applicability of Research to Practice
Surgeons and patients will benefit from a greater awareness of the high risk of complications seen in free tissue transfer during lower extremity acute burn reconstruction.
Food and feeding strategies of the green tiger shrimp, Penaeus semisulcatus, in southeastern India
Authors: Rajkumar Muthusamy , Pillai Saraswathy L , Saravanan Raju , Thirumalaiselvan Shanmugam , Remya Lalitha 
Published: April 2024

Abstract
Observations and analysis of the food and feeding habits of penaeid shrimp are decisive for understanding food webs and ecological processes. Published information on the feeding habits of the green shrimp, Penaeus semisulcatusDe Haan, 1844, from Indian waters, however, dates back four decades, despite the fact that green tiger shrimp is one of the important shrimp species that forms a unique fishery in Palk Bay, on the southeastern India. Hence, its dietary preferences were analysed concerning sex, season, gonad maturity, and size. The species preyed on were composed of diversified components, with mollusc remains being the most common food item in females, followed by crustacean remains, whereas in males, the crustacean remains were the most common food items followed by mollusc remains. There was no significant difference in the gastrosomatic index of females and gonadal maturity stages among seasons, but a significant difference among size groups. In males, there was no significant difference among seasons, gonadal maturity, and size groups. Females were more active feeders than males, and the difference could be seen in their size groups. Larger groups fed more actively than smaller groups. Feeding was more active in the post-monsoon and summer monsoon seasons. Penaeus semisulcatus dominates the ecosystem among the shrimp species due to its carnivorous behaviour. The observations made in this study form key inputs for trophic modelling and ecosystem-based studies, which could help develop suitable strategies for managing the shrimp resource in Palk Bay.
Effect of entomopathogenic fungi on behavior and physiology of Solenopsis invicta (Hymenoptera, Formicidae)
Authors: Hassan Ali , Kang Lidong , Zhang Kaixiong , Wang Lei , Qin Xianjiao , Fang Guobin , Lu Yongyue , Huang Qiuying 
Published: April 2024

Abstract
In an ant colony, a large number of nestmates with a similar gene pool coexist, making them more vulnerable to pathogenic attacks. These pathogens influence the behavior and physiology of the fire ant Solenopsis invicta Buren. Here, we evaluated the impact of entomopathogenic fungi (EPF) Metarhizium anisopliae on the behavior (locomotion and foraging) and physiology (biological molecules, anti-fungal activity, and survival) of S. invicta. Distance traveled and velocity significantly decreased, while turn angle and angular velocity significantly increased in ants exposed to a higher concentration of M. anisopliae compared to ants exposed to control after 36 h, which showed disturbed locomotion. Fungus infection significantly affected the foraging behavior of ants. Fungus-exposed ants spent significantly less time in the food zone (area with food) than in the inner zone (area without food). The activities of 4 enzymes, peroxidase, glutathione-S-transferase, hydrogen peroxide (H2O2), and carboxylesterase were significantly decreased. In contrast, catalase and anti-fungal activities were increased after fungal exposure compared to the control. The activity of acetylcholinesterase, which hydrolyses the important neurotransmitter acetylcholine, also decreased after fungal application compared to the control. Survival of ants was also significantly reduced after fungus infection compared to the control. Our findings help to understand the influence of M. anisopliae on the behavior and physiology of S. invicta, which will help in the management of S. invicta using the EPF M. anisopliae.
Late fall synthetic acaricide application is effective at reducing host-seeking adult and nymphal Ixodes scapularis (Ixodida: Ixodidae) abundances the following spring
Authors: Williams Scott C , Linske Megan A 
Published: April 2024

Abstract
Based on increases in reported cases of tick-borne illnesses, expanding ranges of native ticks, and repeated documentation of arrivals of nonnative tick species, there is a clear need for their effective management in the United States. Synthetic acaricides have proven efficacious in tick management, but real/perceived negative impacts to the environment and nontarget, beneficial insects must be addressed. We sought to determine whether late fall synthetic acaricide application, when most susceptible beneficial insects are presumably dormant or have migrated, could effectively manage host-seeking spring Ixodes scapularis Say abundances as compared to traditional spring application. We compared results of delivery of Demand CS (lambda-cyhalothrin) via truck-mounted high-pressure spray and powered backpack blower as well as delivery of granular Demand G to experimental control (water) in peridomestic habitats in fall 2021, spring 2022, and combined fall 2021/spring 2022. High-pressure fall delivery of Demand CS and backpack delivery of Demand G significantly reduced host-seeking adult I. scapularis abundances within-season and the following spring combined by 100% and 94%, respectively. No host-seeking nymphal I. scapularis were documented in spring after fall only, spring only, or fall and spring combined delivery of Demand CS via high-pressure or powered backpack blower. No adult I. scapularis were documented at any time posttreatment on locations that received high-pressure delivery of Demand CS. We conclude that high-pressure delivery of Demand CS in late fall successfully eliminated multiple stages of host-seeking I. scapularis through the following spring while likely limiting exposure of beneficial insects to synthetic pyrethroids.