bluuebunny/crossref_metadata_2025_split huggingface dataset:
564 Simplified Dynamic Splints for Common Scar Contractures of the Hand
Authors: Andre Gregory , Dean Brooke , Vocke Scott , Rodriguez Joshua 
Published: May 2023

Abstract

Introduction
Common problems associated with immature burn scarring of the hands include proximal interphalangeal (PIP)/distal interphalangeal (DIP) flexion contracture, first webspace contracture, and metacarpal phalangeal (MCP) hyperextension that require diligent splinting intervention in therapy and at home to improve patient outcomes. Dynamic splinting can be used to provide low-load long-duration stretch; however, they can be difficult for patients to don independently at home and are often time consuming for therapists to fabricate. Alternative methods of using neoprene strapping were utilized to provide the dynamic pull to simplify the supplies required and improve ease of use for the patient.

Methods
Using the “I splint” for elbow flexion contractures as a model, we fabricated a smaller version for use in finger PIP and DIP flexion contractures using thermoplastic material and neoprene strapping (Figure 1a). A novel splint for thumb abduction/extension in treatment of first web space scar contracture (Figure 1b). Based on a traditional MCP flexion splint, we utilized neoprene strapping instead of springs or rubber bands and a plastic D ring instead of metal outrigger (Figure 2).
Splint wear started at 1x/ day for 5 minutes and progressed to 3-5x/day for 5-15 minutes as tolerated.

Results
Digit PIP or DIP extender (figure 1a.) after 1 week of daily wear improved PIP extension from 45 degrees (of flexion) to 25 degrees and DIP extension from 50 degrees to 30 degrees.
Thumb Post Splint (figure 1b.) after 2 weeks of daily wear improved radial abduction from 45 degrees to 58 degrees.
Dynamic MCP flexion splint (figure 2) after 1 month of daily wear improved left ring finger active MCP flexion from 0-20 degrees to 0-40 degrees. Left small finger active MCP flexion improved from (-50) - 0 degrees to (-40) - 5 degrees (negative parenthetical value denotes hyperextension).

Conclusions
Dynamic splints utilizing neoprene strapping contributed to improved range of motion for all patients included in this case series. Therapists noted that splint adjustments were infrequent and minimal throughout time of use. Patients reported ease of use and compliance with splint wear schedule outside of therapy sessions. The amount of time spent fabricating compared to traditional methods was not tracked and would be an interesting point to consider in the future.

Applicability of Research to Practice
We hope that this presentation may give other practitioners new tools to address common burn scar contractures of the hand and simplify both the fabrication process and materials required for dynamic splinting.
573 The Impact of Burn Injuries on Indigenous Populations
Authors: Gabriel Vincent , Verburg Leah , McCaffrey Graham 
Published: May 2023

Abstract

Introduction
Racial and ethnic minorities experience disparities in prevention and treatment of burn injury. However, research on burn injuries in Indigenous populations is limited. This review summarizes literature on burn injuries in Indigenous populations that require consideration due to systemic racism, intergenerational trauma, and health disparities to inform new research.

Methods
A search was conducted in CINAHL, Ovid MEDLINE, PSYCinfo, and SocINDEX. for “burn OR scars OR scald OR deformity OR disfigurement” and “Aboriginal OR Indigenous OR First Nation OR American Indian OR Maori OR Native OR Torres Strait Islander OR Amerindian OR Inuit OR Metis OR Pacific Islander”. Search criteria were set by the authors with librarian assistance. Inclusion 1) peer-reviewed studies of burns in Indigenous persons 2) in English. Exclusion 1) no data specific to Indigenous burns 2) not peer-reviewed 3) not in full text 4) protocol publications. Selection was performed by a member of the research team and reviewed by the co-authors.

Results
The search identified 1,091 studies with 51 for review. Fifteen were excluded. Three were editorials or letters. Five were not full text. One was a protocol only, and one did not reference Indigenous persons. Two reported accident rates in Indigenous populations but not burns data. Two excluded articles did not report burns data in the Indigenous population. One was excluded as the conclusions were not supported by the data. Included publications were published between 1987 and 2021 with 24 between 2011 - 2021. Indigenous populations have a rate of burn injury up to two times of the general population in the US, Canada, New Zealand, and Australia. Indigenous people suffered more injuries from flame and inhalation. Burns in Indigenous people are of greater total body surface area and deeper. Indigenous persons had longer lengths of stay, more complications, and need for additional surgeries. The Indigenous population in the US is associated with more hypertrophic scarring. Indigenous patients in Australia struggle with a lack of culturally safe communication and support for aftercare.

Conclusions
Current literature is limited specific to burns in Indigenous populations. Racial disparities exist in burn injury incidence and outcomes for Indigenous persons. Indigenous populations suffer burn injuries, have more complications, and longer lengths of stay in hospital. Current care practices lack cultural safety considerations.

Applicability of Research to Practice
Qualitative research in this area will help providers better understand the experiences of Indigenous burn patients to develop more culturally competent care. We are currently developing a study using qualitative hermeneutic methodology to learn about the experiences of Indigenous burn survivors’ injuries, recovery, and social reintegration.
575 Single-stage Trilaminar Skin Reconstruction Following Full-Thickness Burn Injury
Authors: Bengur Fuat Baris , Loder Shawn J , Villalvazo Yadira , Humar Pooja , Nerone Wayne V , Lee Phoebe L , Kokai Lauren E , Marra Kacey G , Eriksson Elof , Rubin J Peter 
Published: May 2023

Abstract

Introduction
Complex burns are highly morbid injuries that can cause severe disfigurement and can be devastating to one’s quality of life and psychosocial well-being. Currently, there are no simple, single-stage procedures available for extensive or multifocal burns to address full-thickness trilaminar defects. Our team has previously demonstrated the viability of an adipose-first reconstruction to address hypodermal defects. In this study, we demonstrate the efficacy of a combined adipose plus finely minced skin to achieve a single-stage trilaminar skin reconstruction.

Methods
Full-thickness burns were created on female Yorkshire swine. After 48-hours, escharectomies were performed to the level of fascia. The wounds were layered with adipose harvested from female Yorkshire swine. In one group, autologous split-thickness skin grafts were cut into pixel size (0.3x0.3 mm) grafts and layered on top of the adipose. Pigs were maintained for 4-weeks with weekly photography, ultrasound, followed by endpoint histology and tension measurements.

Results
At the end of the 4-week period, adipose combined with pixel graft demonstrated improved epithelialization and less contracture (p&lt; 0.01). Thickness and mobility measurements were consistent in both groups. This findings were similar to our previous approaches using adipose following surgical debridement. Tissue pliability in the pixel grafting group was maintained to a high degree. Cross sections were performed which showed the persistence of fat graft at the base of the wounds.

Conclusions
Immediate, single-stage trilaminar reconstruction of full-thickness complex burns reduces contracture, mitigates adhesion, and restores normal soft-tissue thickness, therefore, presenting a paradigm changing approach in the current practice of burn injuries to the mobile surfaces.

Applicability of Research to Practice
Our results support the therapeutic potential of adipose-based soft-tissue reconstruction of burns to both enhance hypodermal augmentation and mitigate fibrotic complications including contracture and adhesions. Our data suggest that this approach is compatible with the standard of care skin grafting, and in fact provides improved epidermal thickness and pliability.
579 Histopathological Changes in the Endocrine Pancreas of Rats During the Acute Period of Burns
Authors: Santelis Santiago , Abali Ayse Ebru , Ozgun Gonca , Ozdemir B Handan , Basci Tutuncu Neslihan , Haberal Mehmet 
Published: May 2023

Abstract

Introduction
Severe burn victims experience a systemic inflammatory response and a hypermetabolic response. Presence of hyperglycemia, even with concurrent hyperinsulinism, is indicative of insufficient insulin secretion from beta cells to overcome the glycemia. However, the underlying molecular mechanisms of beta-cell failure in patients with acquired insulin resistance after burn trauma are not clearly understood. Our aim in this study was to describe the histopathological changes in the pancreatic islets secondary to severe burns in an experimental animal model.

Methods
Fourteen Wistar albino rats were randomly divided into 2 groups: the sham group and the burn group. A full-thickness burn model was designed to induce a burn of 25% total body surface area. Seven days after burn induction and sham procedure, pancreatectomy was performed. Pancreatic tissues were examined under light microscopy, and islet size and cellularity were calculated.

Results
The histopathologic examination was unremarkable, but the mean number of islets per pancreatic tissue was lower in the burn group than in the sham group. We observed a significant difference in the mean number of cells per one islet between the 2 groups, with the cell count higher in the burn group (P &lt; .05).

Conclusions
During the acute phase of burn injury in rats, we observed a decrease in the number of pancreatic islets with remarkable hypercellularity. Further studies are needed to determine the histological and cellular basis of these changes.

Applicability of Research to Practice
Major burn injury causes severe alterations in beta-cell mass, which increases and decreases both function and mass to maintain the glycemic level within a very narrow physiological range. Patients with acute and prolonged hyperglycemia can have complications leading to impaired wound healing, increased skin graft loss, increased muscle protein catabolism, increased incidence of infections, and mortality. Therefore, a detailed understanding of the pancreatic changes under different preexisting conditions and therapeutic interventions in the context of a major burn trauma might guide treatment options.
724 How Nursing Turnover Rates Effected a Series of Pediatric Mock Codes
Authors: Snyder Emily 
Published: May 2023

Abstract

Introduction
Pediatric mock codes (PMC) were first introduced to the Burn Trauma ICU (BTICU) in Fall 2020. The goal of the PMCs were to increase efficiency in a code situation and to increase nursing confidence. However, due to the unique timing of initiation, this hospital also chose to look at how turnover rates affected the outcomes of the PMCs. The time period chosen was during the COVID crisis and the unit had an increasing number of nurses leaving for contract positions.

Methods
The PMCs created were specifically designed to replicate the pediatric population the team cares for. A different PMC scenario was presented every six months for a total of four mock codes. The nurses completed the PMCs with a team approach, with each team consisting of two to six nurses. During the mock code, the nurse educator kept track of time, monitored role assignments and completion of major tasks, and ensured pre and post surveys were completed. The pre and post surveys evaluated the nurse’s self-confidence, biggest concern regarding a pediatric code, and if they had previously participated in a PMC.

Results
Over the period of two years, 82 participants were captured. However, these were not unique individuals, as some nurses participated in all four mock codes. It was expected that each time the mock code was completed, the number of nurses who had participated in PMC would increase. However, as time progressed, the rate of previous participation actually decreased.
Instead of improving on time to compressions or medication administration time, the times stayed the same over the two-year time frame. When evaluating the comments on the survey, the staff concerns also did not change over time. Medication administration remained the number one concern across all four mock codes. Even though the PMC did not improve skills, 100% of those who participated expressed an increase in confidence level.

Conclusions
Nursing units depend on novice nurses gaining knowledge and skills and progressing into the expert nurses on the unit. However, the loss of permanent staff and the hiring of new nurses has had an impact on this cycle. The unit lost many of its expert nurses before the new nurses had time to advance. This can be directly seen in the turnover rate and the previous participation in the PMC. Essentially this halted the unit as a whole from growing their skill set in the pediatric population. However, as the nursing market stabilizes, there are future plans to continue to evaluate the PMC skills and outcomes.

Applicability of Research to Practice
As nursing turnover rates increase, patient complications and outcomes should also be evaluated to see if a correlation is present.
726 Enteral Tube Clogging and Medication Administration Techniques
Authors: Rathjen Esther , Oehlertz Grace 
Published: May 2023

Abstract

Introduction
Many burn patients require long term enteral tube placement. Preventing clogging is essential for patient comfort as well as for preventing pauses in nutritional supplementation required for wound healing. While many studies have been done to measure nursing compliance with policies intended to prevent tube clogging, no research has been done on whether administering pills via enteral tube one at a time with a flush between actually prevents clogs. The purpose of this pilot study was to see if small bore enteral tubes clog more often when medications are given all at once in solution compared to when given individually with a flush between pills.

Methods
Two enteral tubes were connected to continuous tube feed by pump. The ends were placed in a bucket. Medications were crushed and administered through the tubes. Pills were given through the control one at a time with a flush between, and through the experimental tube all at once in solution. Water flushes were performed before and after medication administration and care was taken that all other conditions were the same between groups. Each med pass was done approximately 24-48 hours apart. If more than gentle, continuous pressure was required to administer the medications and flushes the tube was considered clogged.

Results
Medications were given through both tubes 36 times. Of the 72 administrations there were 10 clogs, 5 to the control tube and 5 to the experimental tube.

Conclusions
Results of this pilot study suggest that individually crushing and administering each pill when giving them through an enteral tube does not reduce the incidence of clogs. Considering the time demand and potential for increased fluid intake using this practice we propose giving all medications together in solution as a safe alternative. Especially in the burn population where accurate intake is vital for calculating fluid resuscitation, having a consistent protocol is essential. While the sample size of this study is too small to definitively say there is no difference between medication administration techniques, issues related to fluid and electrolyte balance as well as nursing compliance with policy should be considered when deciding to maintain the current standard of practice which has no basis in evidence

Applicability of Research to Practice
Administering medications through enteral tubes is a frequent nursing intervention. If applied to practice, these findings would change how nurses are taught to administer medications as well as change the process by which care is delivered on a daily basis.
737 Burn Data Management and Usage Across Canada: A Nationwide Survey
Authors: Gus Eduardo , Sathiyamoorthy Thrmiga , Zhu Jane , Fish Joel 
Published: May 2023

Abstract

Introduction
Burn injuries account for significant morbidity in the Canadian population. Registries are an invaluable resource for the collection and interpretation of data surrounding disease and injury, answering research questions, and engendering benchmarking of quality-of-care indicators. Despite the rapid growth of registry science in the past decade in other jurisdictions, there has yet to be a burn registry developed for Canadian burn centres.
The objectives for this project are to characterize the current state of burn data collection, analysis, and dissemination, and to explore the interest of various burn centres in contributing to a Canada-wide burn registry.

Methods
A 23-item mixed methods survey was created using REDCap and electronically delivered to burn directors or research managers of 22 burn centres across Canada. Descriptive statistics and thematic analysis were used for quantitative and qualitative analysis, respectively.

Results
Sixteen (72%) complete survey responses were received. Many centres treat both pediatric and adult patients, and all centres collect acute inpatient burn data. Types of data collected included epidemiology (88%), outcomes (69%) and quality of care indicators (44%). Most burn units (56%) collected data using their hospital’s database. Data was largely used for institutional learning purposes (81%). Routine use included quality improvement (69%), clinical research (50%), and patient care (50%). A minority of institutions report using their data for external purposes, such as conference presentations (31%) or journal publications (19%). While all units are currently collecting data, half of the institutions did not analyze their data, and a majority (73%) of institutions did not benchmark their data against other institutions.
Feedback for creating a registry included overall strong support for the initiative. The most significant barrier perceived towards implementing a registry was cost, time, and human resources. Suggested measures to facilitate registry development included standardizing data entry and engagement with national and provincial institutions.

Conclusions
Although all Canadian burn centres are currently collecting data for institutional and quality improvement purposes, it is not routinely shared or used for benchmarking purposes. Burn centres demonstrated interest and support in contributing to a novel Canadian burn registry.

Applicability of Research to Practice
Future research may expand on initial themes outlined in our study to provide groundwork for the formation of a novel Canadian burn registry.
Geographies of dissociation: informality, ethical codes and fragmented labour regimes in the Sri Lankan apparel industry
Authors: Wickramasingha Shyamain 
Published: May 2023

Abstract
In this article, I use the emerging concept of geographies of dissociation to examine fragmented labour regimes in global production networks (GPNs). The article takes informality in the Sri Lankan apparel industry and the application of ethical codes as a case example. Using qualitative research methods, I provide a critical analytical lens through which the concept of dissociation makes visible what has been obscured through much of the debate on ethical codes. In so doing, the article makes three contributions to the debate on ethical codes and dissociation. First, I illuminate uneven geographies of ethical codes manifested through highly fragmented workplaces where some workers are excluded from the protection of ethical codes. In so doing, the article challenges the notion of homogenous workplaces, in which, dialectics of inclusion and exclusion of ethical codes often go unnoticed. Secondly, by illustrating bifurcated and inequal labour regimes, I argue that both association and dissociation practices can co-exist in the same workplace at the same time. This is in contrast to the existing works that mostly frame places of dissociation as distant and hidden from the association places. Third, I advance the concept of dissociation beyond its current framing to argue for a notion of collective dissociation emerging from fluid and complex social relations of multi-scalar actors. I argue that in GPNs, such collective practices of dissociation are possible and even necessary given the complex ways firms and non-firm actors are connected to each other from the global scale to the workplace.
Temperature as a factor controlling geographical distribution of greenNoctiluca scintillansin Southeast Asia
Authors: Furuya Ken , Kozono Kenta , Yasuda Mari , Omura Takuo , Borja Valeriano M , Lirdwitayaprasit Thaithaworn 
Published: May 2023

AbstractThe dinoflagellate Noctiluca scintillans exists in two forms, green and red Noctiluca, with and without the photosynthetic endosymbiont Pedinomonas noctilucae, respectively. In Southeast Asia, green Noctiluca has a northern boundary of distribution in the Luzon Strait and the Vietnamese coast, approximately corresponding to the 25°C isotherm. We examined whether this boundary arose from the growth dependence of Noctiluca on temperature and/or that of P. noctilucae. We analyzed the effect of temperature on growth by examining one and four unialgal cultures of red and green Noctiluca, respectively, and two monocultures of the endosymbiont. Growth dependence on temperature was markedly different between host cells of green Noctiluca and monocultures of the endosymbiont, although some variations in growing temperature were observed among strains of both Noctiluca and the endosymbiont. Green Noctiluca grew at a temperature range of 20–31°C, whereas P. noctilucae did not grow at low temperatures ≤25°C. Growth rates of green Noctiluca were considerably higher when fed compared to monocultures. Our findings demonstrate that the effect of temperature on P. noctilucae growth is a crucial factor controlling the geographical distribution of green Noctiluca in the South China Sea. An implication of this finding is discussed in the context of global warming.
Extrachromosomal circular DNA–mediated spread of herbicide resistance in interspecific hybrids of pigweed
Authors: Koo Dal-Hoe , Sathishraj Rajendran , Nakka Sridevi , Ju Yoonha , Nandula Vijay K , Jugulam Mithila , Friebe Bernd , Gill Bikram S 
Published: May 2023

Abstract
Extrachromosomal circular DNAs (eccDNAs) are found in many eukaryotic organisms. EccDNA-powered copy number variation plays diverse roles, from oncogenesis in humans to herbicide resistance in crop weeds. Here, we report interspecific eccDNA flow and its dynamic behavior in soma cells of natural populations and F1 hybrids of Amaranthus sp. The glyphosate-resistance (GR) trait is controlled by eccDNA-based amplification harboring the 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) gene (eccDNA replicon), the molecular target of glyphosate. We documented pollen-mediated transfer of eccDNA in experimental hybrids between glyphosate-susceptible Amaranthus tuberculatus and GR Amaranthus palmeri. Experimental hybridization and fluorescence in situ hybridization (FISH) analysis revealed that the eccDNA replicon in Amaranthus spinosus derived from GR A. palmeri by natural hybridization. FISH analysis also revealed random chromosome anchoring and massive eccDNA replicon copy number variation in soma cells of weedy hybrids. The results suggest that eccDNAs are inheritable across compatible species, contributing to genome plasticity and rapid adaptive evolution.