bluuebunny/crossref_metadata_2025_split huggingface dataset:
744 Characteristics of Verified and Designated Burn Centers
Authors: Carter Jeffrey , Kearns Randy , Lovick Elle , Murata Erica , Phillips Bart 
Published: May 2023

Abstract

Introduction
Burn centers serve an essential role in providing specialized care for the injured. Professional societies (verify) and state agencies (designate) these facilities through a process that evaluates the resources, processes, and capabilities of each burn center. Over 90% of the level 1 or 2 trauma centers in the US and only around 50% of burn centers are verified. The goal of our study was to evaluate the variability of verified and designated burn centers and trauma centers in the US.

Methods
The Databases for Optimal Resources for Injury Care (DORIC) is a centralized database developed by the American Hospital Association, American College of Surgeons Committee on Trauma, American Burn Association, all fifty US states’ Departments of Health, and claims databases through a collaboration with BData, LSUHSC, Spectral MD, and UNO. Categorical data was assessed using Fisher’s exact while continuous variables were assessed with paired t-test and confidence intervals. The analysis included hospital and burn ICU bed count, hospital revenue, ED visits, discharges, and urban vs rural geography.

Results
The database includes 134 burn centers of which 75 were verified (56%), 91% were in an urban setting and 87% were co-located with a trauma center. Hospitals had a median of 492 staffed beds, 79,449 ER visits, and 18,437 discharges. Burn centers had a median of 11 burn ICU beds and 3,285 hospital days/year. Urban vs rural geography was not different between verified and designated burn centers (p=0.54). All categories of revenue were associated with burn center verification.

Conclusions
Our study demonstrates no significant difference with the hospital size, location (urban vs rural), ER volume, hospital beds, or burn ICU beds. Significant differences were identified with the rate of discharge and revenues which could be attributed to services, quality, or reimbursement. Given that only half of burn care occurs at verified burn centers, additional research is needed to better understand these significant differences.

Applicability of Research to Practice
A keen understanding of burn center characteristics is essential to serve the burn professionals that work at burn centers and the communities they serve.
753 Aquatic Therapy Improves Functional Outcomes in a Pediatric Burn Patient
Authors: Arango Maria , Schulman Carl 
Published: May 2023

Abstract

Introduction
Burn injuries in the pediatric population require extended recovery time due to changes in their respiratory function and musculoskeletal system (prolonged fascia damages and muscular weakness) leading to low physical and functional capacity. Other external factors contributing to poor outcomes are pain, psychosocial changes such as depression, self-esteem and body image. In the rehabilitation process there are different modalities and techniques for that can be used to enhance recovery. Aquatic therapy is a modality that facilitates movement. The buoyancy of the water supports body weight and reduces the load on painful joints. The density of the water forces the body upwards, the relatively high water temperature promotes muscle relaxation, and the hydrostatic pressure reduces the development of edema. We hypothesized that aquatic therapy would improve motor skill, respiratory function, and musculoskeletal functional capacity in pediatric burn patients.

Methods
This is a case comparison study comparing the functional outcome on a 6 y/o burned patient utilizing aquatic therapy compared with the same age patient that had traditional therapy in a regular play gym. Both patients had second degree burns TBSA 20 to 30% in the arms and face area, requiring autografts from chest/back and legs. The study treatment consisted of intensive interdisciplinary therapy in the pool for 90 minutes, one time per week for 8 months. The therapy involved games with physical demands to improve cardiorespiratory endurance, balance, postural control, body alignment, fine and gross motor skills, and the functional use of full range of motion, strength and dexterity. At completion of the aquatic program, Active Range of Motion measurements of the joints was performed using a goniometer and the Bruininks-Oseretsky Test of Motor Proficiency in order to evaluate functional improvements.

Results
Our results showed that the aquatic program increased motivation, respiratory capacity, achieved full AROM in all joints involved. The score in the Bruininks-Oseretsky Test of Motor Proficiency for each patient is shown in Table 1. It was demonstrated that the patient that did not use aquatic therapy as a modality did not regain full range and function compared to the aquatic therapy patient.

Conclusions
The use of aquatic therapy as a modality in pediatric burn patients can provide direct benefits such as gaining full AROM to participate in fine motor and gross motor functional activities and indirect benefits like motivation due to the engagement to learn to swim, play in the water and community reintegration.

Applicability of Research to Practice
The positive results of aquatics on this pediatric burn patient and the review of other studies support further development of an aquatic program as a positive rehabilitation modality.
771 Enzymatic Burn Wound Debridement: The Learning Curve
Authors: Mertz Tamara , Sen Sankhya , Mackie Ian 
Published: May 2023

Abstract

Introduction
The European Medicines Agency (MEA) approved the use of a proteolytic enzymatic debriding agent enriched in bromelain in 2012. It has become a widely used non-surgical treatment alternative for the debridement of deep partial thickness to full thickness thermal burns.
We will present our early experience with this product candidly. We will outline our sequential learning. Moreover, we will describe the pitfalls and lessons learned as well as demonstrate the evolution of our current practice guidelines.

Methods
This is a retrospective analysis of all patients treated with a bromelain based enzymatic debridement agent at a regional burn unit. 17 patients with a mean age of 44.53 years were treated with enzymatic debridement between April 2017 and April 2022. This period includes an 18 month pause where we did not use the product. We reviewed analgesia requirements, efficacy of debridement using the product, wound care post debridement (including the use of skin substitutes), skin grafting post application and overall outcomes.

Results
17 patients were treated during this period. Nine patients had burns involving less than 5% TBSA, three patients had burns between 5 and 15% TBSA and five had burns greater than 15% TBSA.
Of the 17 patients, 10 had the enzymatic debridement agent applied on the ward and seven had it applied in theatre. For the application of the product three patients had general anaesthesia, two had a combination of general and regional anaesthesia (e.g. spinal, axillary block), three had regional analgesia alone, seven received oral analgesia and ward based sedation and two received oral analgesia and ward based Methoxyflurane.
10 patients required skin grafting. One patient was treated with allograft post enzymatic debridement. One patient had their post enzymatic debridement wounds covered with Xenograft. The remainder had their post debridement wounds treated with dressings.
There were three cases where the proteolytic agent failed to debride the burns. In the skin grafted group, 1 patient had complete graft loss.
We will provide a narrative description and outline how each case contributed to the development of our current treatment algorithm.

Conclusions
We now believe that enzymatic debridement does have a real place within the armamentarium of burn wound excision with dermal preservation. Undoubtedly, there is a learning curve associated with its use. This must be considered by any service intending to adopt its use.

Applicability of Research to Practice
We support the use of bromelain enriched proteolytic enzymatic debriding agent in appropriate cases. With experience, it is likely to be useful in the management of many patients who sustain deep partial thickness to full thickness burns.
Tissues and mechanisms associated with Verticillium wilt resistance in tomato using bi-grafted near-isogenic lines
Authors: Oh Yeonyee , Ingram Thomas , Shekasteband Reza , Adhikari Tika , Louws Frank J , Dean Ralph A 
Published: May 2023

Abstract
Host resistance is the primary means to control Verticillium dahliae, a soil-borne pathogen causing major losses on a broad range of plants, including tomato. The tissues and mechanisms responsible for resistance remain obscure. In the field, resistant tomato used as rootstocks does not confer resistance. Here, we created bi-grafted plants with near-isogenic lines (NILs) exhibiting (Ve1) or lacking (ve1) resistance to V. dahliae race 1. Ten days after inoculation, scion and rootstock tissues were subjected to differential gene expression and co-expression network analyses. Symptoms only developed in susceptible scions regardless of the rootstock. Infection caused more dramatic alteration of tomato gene expression in susceptible compared with resistant tissues, including pathogen receptor, signaling pathway, pathogenesis-related protein, and cell wall modification genes. Differences were observed between scions and rootstocks, primarily related to physiological processes in these tissues. Gene expression in scions was influenced by the rootstock genotype. A few genes were associated with the Ve1 genotype, which was independent of infection or tissue type. Several were physically clustered, some near the Ve1 locus on chromosome 9. Transcripts mapped to V. dahliae were dominated by secreted candidate effector proteins. These findings advance knowledge of molecular mechanisms underlying the tomato–V. dahliae interaction.
Quantitative Value of Bacteria Associated with Leukocytes in Differential Diagnosis of Lower Respiratory Tract Infection in Children, in Comparison to Sputum Culture and Procalcitonin
Authors: Zhang Guoqiang , Yao Yihui , Gao Ying , Yu Xiaolu , Fang Jiabin 
Published: May 2023

Abstract

Background
The mortality and morbidity rates in children with lower respiratory tract infection (LRTI) remain high.

Objective
To describe the number of bacteria that is associated with leukocytes in differential diagnosis of bacterial, mycoplasma, and viral LRTI in children.

Methods
Sputum smears were Gram stained for counting single-morphology bacteria associated with leukocytes. The differential diagnostic values of bacterial number were assessed in children with LRTI.

Results
The area under the receiver operating characteristic (ROC) curve was 0.95 for bacterial number in the differential diagnosis of bacterial infection from mycoplasma and viral infections. The area under the ROC curve was 0.62 for procalcitonin and 0.94 for bacterial number in the differential diagnosis of bacterial infection from mycoplasma infection.

Conclusion
The number of bacteria associated with leukocytes in sputum was valuable and rapid in differential diagnosis of bacterial infection in children with suspected bacterial, mycoplasma, and viral LRTI.
Examining the performance of three ballast water compliance monitoring devices for quantifying live organisms in both regulated size classes (≥50 μm and ≥10–&lt;50 μm)
Authors: Casas-Monroy Oscar , Brydges Torben , Kydd Jocelyn , Ogilvie Dawson , Rozon Robin M , Bailey Sarah A 
Published: May 2023

Abstract
A number of ballast water compliance monitoring devices (CMDs) have been made commercially available to verify the efficacy of ballast water management systems by quantifying the living organisms for both plankton size classes (≥50 μm and ≥10–&lt;50 μm). This study aimed to examine whether new CMDs can provide a reliable indication of compliance regarding Regulation D-2 and to evaluate their performance for indicative analysis of organisms by assessing their accuracy (comparison to microscopy) and precision (comparison within measurement). Challenge fresh water samples were collected in four locations of Lake Ontario, Canada, whereas marine challenge water samples were collected around the Bay of Fundy, New Brunswick, Canada. Ballast water samples were collected from ships visiting several ports across Canada. Overall, accuracy was higher (&gt;80%) in estimating organisms from prepared-challenge water (Ballast Eye and BallastWISE) than from ballast water samples (&gt;70%) (B-QUA only). The sensitivity ranged from 50 to 100% for the ≥50 μm organism size class, whereas for the ≥10–&lt;50 μm organism size class, it was higher for freshwater samples (&gt;75%) than for marine samples (&gt;50%). The performance of CMDs should be assessed under real-world conditions for a better understanding and to improve their use.
The incidence, impact, and risk factors for moderate to severe persistent pain after breast cancer surgery: a prospective cohort study
Authors: Chiang Daniel L C , Rice David A , Helsby Nuala A , Somogyi Andrew A , Kluger Michal T 
Published: May 2023

Abstract

Background
Few Australasian studies have evaluated persistent pain after breast cancer surgery.

Objective
To evaluate the incidence, impact, and risk factors of moderate to severe persistent pain after breast cancer surgery in a New Zealand cohort.

Design
Prospective cohort study

Methods
Consented patients were reviewed at 3 timepoints (preoperative, 2 weeks and 6 months postoperative). Pain incidence and interference, psychological distress and upper limb disability were assessed perioperatively. Clinical, demographic, psychological, cancer treatment-related variables, quantitative sensory testing, and patient genotype (COMT, OPRM1, GCH1, ESR1, and KCNJ6) were assessed as risk factors using multiple logistic regression.

Results
Of the 173 patients recruited, 140 completed the 6-month follow-up. Overall, 15.0% (n = 21, 95% CI: 9.5%—22.0%) of patients reported moderate to severe persistent pain after breast cancer surgery with 42.9% (n = 9, 95% CI: 21.9%—66.0%) reporting likely neuropathic pain. Pain interference, upper limb dysfunction and psychological distress were significantly higher in patients with moderate to severe pain (P &lt; .004). Moderate to severe preoperative pain (OR= 3.60, 95% CI: 1.13–11.44, P = .03), COMT rs6269 GA genotype (OR = 5.03, 95% CI: 1.49—17.04, P = .009) and psychological distress at postoperative day 14 (OR= 1.08, 95% CI: 1.02—1.16, P = .02) were identified as risk factors. Total intravenous anesthesia (OR= 0.31, 95% CI: 0.10 – 0.99, P = .048) was identified as protective.

Conclusion
The incidence of moderate to severe persistent pain after breast cancer surgery is high with associated pain interference, physical disability, and psychological distress. Important modifiable risk factors were identified to reduce this important condition.
Boundary-work and social closure in academic recruitment: Insights from the transdisciplinary subject area Swedish as a Second Language
Authors: Ganuza Natalia , Salö Linus 
Published: May 2023

Abstract
This article explores practices of evaluation in academic recruitment in Swedish as a Second Language (SSL), an expanding and transdisciplinary subject area. As is common elsewhere, Swedish academia relies on a tradition of external expert review intended to ensure a meritocratic process. Here, we present an analysis of 109 written expert reports concerning recruitment to 57 positions in SSL during 2000–20. Because SSL lacks institutional autonomy, and is spread across several sub-disciplines in the humanities and social sciences, the material encompasses experts with diverse academic backgrounds. The SSL reports are broadly characterized by qualitative assessment. In contrast to other fields, the SSL experts seldom use quantitative proxy measures. Instead, they mainly rely on received conceptions of the boundaries of SSL as a means of justifying their inclusion and exclusion of candidates. This dominant regularity consists of attempts to define and delimit SSL and its core research areas, to locate the candidates in a core-to-periphery scheme with respect to these boundaries, and to rank them accordingly. This mechanism of social closure serves to restrict access to SSL to candidates with qualifications that conform to the experts’ own conceptions of SSL. As we show, the experts’ internally ambiguous conceptions of SSL tend to be constructed in relation to their own scientific habitus and investments. Beyond evaluating applicants’ possession of scientific capital, their distinctive style of reasoning around research qualifications and skills thus involves power-laden boundary-work, which leaves ample room for individual, yet habitus-specific arbitrariness.
Adherence to dietary guidelines, and the risk of developing rheumatoid arthritis: results from a nested case-control study
Authors: Bäcklund Rebecka Teresia , Drake Isabel , Bergström Ulf , Compagno Michele , Sonestedt Emily , Turesson Carl 
Published: May 2023

Abstract

Objectives
To examine the relationship between adherence to dietary guidelines and the risk of developing RA.

Methods
Participants in the Malmö Diet and Cancer Study (MDCS) cohort diagnosed with RA were identified through register linkage and validated in a structured review. Four controls per case were selected, matched for sex, year of birth, and year of inclusion in the MDCS. Diet was assessed at baseline (1991–1996) using a validated diet history method. A Diet Quality Index (DQI) based on adherence to the Swedish dietary guidelines including intakes of fibre, vegetables and fruits, fish and shellfish, saturated fat, polyunsaturated fat, and sucrose, was used. The associations between the DQI and its components and the risk of RA were assessed using conditional logistic regression analysis, adjusting for total energy intake, smoking, leisure time physical activity and alcohol consumption.

Results
We identified 172 validated cases of incident RA in the cohort. Overall adherence to the dietary guidelines was not associated with the risk of RA. Adherence to recommended fibre intake was associated with decreased risk of RA in crude and multivariable-adjusted analyses, with odds ratios (ORs) 0.60 (95% CI 0.39, 0.93) and 0.51 (95% CI 0.29, 0.90), respectively, compared with subjects with non-adherence.

Conclusions
Reaching the recommended intake level of dietary fibre, but not overall diet quality, was independently associated with decreased risk of RA. Further studies are needed to assess the role of different food sources of dietary fibre in relation to risk of RA and the underlying mechanisms.
Tumour-associated antigens in systemic lupus erythematosus: association with clinical manifestations and serological indicators
Authors: Zhong Ying , Liu Zhichun , Ma Jinlu , Zhang Lin , Xue Leixi 
Published: May 2023

Abstract

Objectives
To explore the relationship of tumour-associated antigens (TAAs) with the clinical manifestations and serological markers of SLE.

Methods
This was a retrospective study. Clinical data of SLE patients were extracted from the electronic medical records, including serum levels of TAAs such as alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen (CA) 19-9, CA125, CA15-3 and cytokeratin 19-fragments (CYFRA21-1). TAA positivity was defined as serum level exceeding the upper limit of the corresponding reference range.

Results
A total of 149 SLE patients (SLE group) and 149 age- and sex-matched healthy subjects (control group) were enrolled. Compared with healthy controls, the SLE group had higher positivity rates for CA19-9 and CYFRA21-1, and elevated serum levels of CA125, CA15-3 and CYFRA21-1. SLE patients with TAA positivity were older, had a higher prevalence of serous effusion, pericardial effusion, albuminuria and thrombocytopenia, and lower positivity rate for anti-dsDNA than patients without TAA positivity. The levels of serum creatinine (SCR), blood urea nitrogen, glutamic oxalate transaminase and 24-h urinary protein were also higher in SLE patients with TAA positivity, but platelet count and serum albumin levels were lower. On logistic regression, thrombocytopenia and SCR levels were identified as independent risk factors for TAA positivity. CA125 positivity rate and serum levels of CA125 were associated with SLE disease activity.

Conclusion
The positivity rates and serum levels of some TAAs were elevated in SLE, and thrombocytopenia and SCR levels were independent risk factors for TAA positivity.
FATCA and CRS: Recent EU judgment on public BO registers shines a light on the direction of travel
Authors: Noseda Filippo 
Published: May 2023

Abstract
This article builds on a previous piece published in Trusts & Trustees in 2022 entitled ‘FATCA, CRS and Public BO Registers: A report on the direction of travel—the next 12 months’. Since then, the Court of Justice of the European Union (‘CJEU’) struck down the EU's public registers of beneficial ownership following a small number of appeals brought before the district court in Luxembourg, prompting the EU to engage with data protection campaigners. The next 12 months are likely to be as momentous, with the High Court in London and the Austrian Federal Administrative Court due to hear cases on the data protection implications of the US Foreign Accounts Tax Compliance Act (‘FATCA’) and the Common Reporting Standard (‘CRS’). The author has been active in all these proceedings and in this article he reflects on the significance of the recent CJEU's judgment for FATCA and the CRS.
Safety, tolerability, and efficacy of maralixibat in adults with primary sclerosing cholangitis: Open-label pilot study
Authors: Bowlus Christopher L. , Eksteen Bertus , Cheung Angela C. , Thorburn Douglas , Moylan Cynthia A. , Pockros Paul J. , Forman Lisa M. , Dorenbaum Alejandro , Hirschfield Gideon M. , Kennedy Ciara , Jaecklin Thomas , McKibben Andrew , Chien Elaine , Baek Marshall , Vig Pamela , Levy Cynthia 
Published: May 2023

Background:
Primary sclerosing cholangitis (PSC) is frequently associated with pruritus, which significantly impairs quality of life. Maralixibat is a selective ileal bile acid transporter (IBAT) inhibitor that lowers circulating bile acid (BA) levels and reduces pruritus in cholestatic liver diseases. This is the first proof-of-concept study of IBAT inhibition in PSC.

Methods:
This open-label study evaluated the safety and tolerability of maralixibat ≤10 mg/d for 14 weeks in adults with PSC. Measures of pruritus, biomarkers of BA synthesis, cholestasis, and liver function were also assessed.

Results:
Of 27 enrolled participants, 85.2% completed treatment. Gastrointestinal treatment-emergent adverse events (TEAEs) occurred in 81.5%, with diarrhea in 51.9%. TEAEs were mostly mild or moderate (63.0%); 1 serious TEAE (cholangitis) was considered treatment related. Mean serum BA (sBA) levels decreased by 16.7% (−14.84 µmol/L; 95% CI, −27.25 to −2.43; p = 0.0043) by week 14/early termination (ET). In participants with baseline sBA levels above normal (n = 18), mean sBA decreased by 40.0% (−22.3 µmol/L, 95% CI, −40.38 to −4.3; p = 0.004) by week 14/ET. Liver enzyme elevations were not significant; however, increases of unknown clinical significance in conjugated bilirubin levels were observed. ItchRO weekly sum scores decreased from baseline to week 14/ET by 8.4% (p = 0.0495), by 12.6% (p = 0.0275) in 18 participants with pruritus at baseline, and by 70% (p = 0.0078) in 8 participants with ItchRO daily average score ≥3 at baseline.

Conclusions:
Maralixibat was associated with reduced sBA levels in adults with PSC. In participants with more severe baseline pruritus, pruritus improved significantly from baseline. TEAEs were mostly gastrointestinal related. These results support further investigation of IBAT inhibitors for adults with PSC-associated pruritus. ClinicalTrials.gov: NCT02061540.