bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pancyclic And Hamiltonian Properties Of Dragonfly Networks
Authors: Huo Jin , Yang Weihua 
Published: May 2023

Abstract
Dragonfly networks have significant advantages in data exchange due to the small network diameter, low cost and modularization. A graph $G$ is $vertex$-$pancyclic$ if for any vertex $u\in V(G)$, there exist cycles through $u$ of every length $\ell $ with $3\leq \ell \leq |V(G)|$. A graph $G$ is $Hamiltonian$-$connected$ if there exists a Hamiltonian path between any two distinct vertices $u,v\in V(G)$. In this paper, we mainly research the pancyclic and Hamiltonian properties of the dragonfly network $D(n,h)$, and find that it is Hamiltonian with $n\geq 1,\,\,h\geq 2$, pancyclic, vertex-pancyclic and Hamiltonian-connected with $n\geq 4,\,\,h\geq 2$.
Association of Vascular Health Measures and Physical Function: A Prospective Analysis in the Framingham Heart Study
Authors: Sahni Shivani , Dufour Alyssa B , Wang Na , Kiel Douglas P , Hannan Marian T , Jacques Paul F , Benjamin Emelia J , Vasan Ramachandran S , Murabito Joanne M , Newman Anne B , Fielding Roger A , Mitchell Gary F , Hamburg Naomi M 
Published: May 2023

Abstract

Background
Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study.

Methods
The cross-sectional study (1998–2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least 1 measure of aortic stiffness (carotid–femoral pulse wave velocity, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and mean arterial pressure [MAP]) assessed by tonometry and brachial artery ultrasound. The longitudinal study included participants with ≥1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates.

Results
In cross-sectional analyses (n = 2 498, age 61 ± 10 years; 56% women), higher resting brachial artery diameter (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = .01) and MAP (β ± SE: 0.39 ± 0.17, p = .02) were associated with higher grip strength. Higher brachial pulse pressure (β ± SE: −0.02 ± 0.01, p = .07) was marginally associated with slower gait speed. In longitudinal analyses (n = 2 157), higher brachial pulse pressure (β ± SE: −0.19 ± 0.07, p = .005), was associated with slowing of gait speed but not with grip strength.

Conclusions
Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.
Exploring the gap between refugee-background communities’ needs and existing community-based physical activity programs in Australia
Authors: Hawkins Georgia , Malatzky Christina , Wilson Susan , Dingle Kaeleen 
Published: May 2023

Summary
Physical activity programs run by local government, public health and not-for-profit sectors are a key public health strategy for improving rates of physical activity within local communities. However, these programs are underutilized. This is especially the case among members of refugee-background communities whose participation could have far-ranging and multilevel benefits. To explore how greater engagement among refugee-background communities with these programs could be fostered in Brisbane, Queensland, Australia, a qualitative study was undertaken from the perspectives of both community-based physical activity program providers and agencies involved in delivering services to refugee-background communities. This study involved a series of semi-structured interviews with a purposive sample of personnel from agencies that work with individuals and families from refugee-background communities and organizations that provide low-cost or no-cost physical activity programs and initiatives. Reflexive thematic analysis was used to interpret meaning from these data. Three themes relating to how participation in community-based physical activity programs could be improved among refugee-background communities were identified: improving cultural safety through intersectoral collaboration; confronting constraints imposed by the broader public health policy environment; and building capacity and empowering the community to diversify the sector. The findings highlight the importance of localized, deep-level intersectoral collaborations in bridging the gap between the health and social care needs of refugee-background communities and existing physical activity programs. However, a range of systems-produced barriers to the creation of such collaborations must be addressed to enable local actors to help mitigate and address the systemic exclusion of marginalized populations from participation in broader society.
Epigenome-wide methylation study identified two novel CpGs associated with T2DM risk and a network of co-methylated CpGs capable of patient’s classifications
Authors: Giri Anil K , Prasad Gauri , Parekatt Vaisak , Rajashekar Donaka , Tandon Nikhil , Bharadwaj Dwaipayan 
Published: May 2023

Abstract
Prevention of Type 2 diabetes mellitus (T2DM) pandemic needs markers that can precisely predict the disease risk in an individual. Alterations in DNA methylations due to exposure towards environmental risk factors are widely sought markers for T2DM risk prediction. To identify such individual DNA methylation signatures and their effect on disease risk, we performed an epigenome-wide association study (EWAS) in 844 Indian individuals of Indo-European origin. We identified and validated methylation alterations at two novel CpG sites in MIR1287 (cg01178710) and EDN2-SCMH1 (cg04673737) genes associated with T2DM risk at the epigenome-wide-significance-level (P &lt; 1.2 × 10−7). Further, we also replicated the association of two known CpG sites in TXNIP, and CPT1A in the Indian population. With 535 EWAS significant CpGs (P &lt; 1.2 × 10−7) identified in the discovery phase samples, we created a co-methylation network using weighted correlation network analysis and identified four modules among the CpGs. We observed that methylation of one of the module associates with T2DM risk factors (e.g. BMI, insulin and C-peptide) and can be used as markers to segregate T2DM patients with good glycemic control (e.g. low HbA1c) and dyslipidemia (low HDL and high TG) from the other patients. Additionally, an intronic SNP (rs6503650) in the JUP gene, a member of the same module, associated with methylation at all the 14 hub CpG sites of that module as methQTL. Our network-assisted EWAS is the first to systematically explore DNA methylation variations conferring risks to T2DM in Indians and use the identified risk CpG sites for patient segregation with different clinical outcomes. These findings can be useful for better stratification of patients to improve the clinical management and treatment effects.
Intermediate outcome for the single-stage surgical repair of aortopulmonary window associated with interrupted aortic arch
Authors: Nguyen Chi Hoang Linh , Nguyen Truong Ly Thinh , Tran Vinh Quang , Nguyen Mai Tuan , Mai Duyen Dinh , Doan Anh Vuong , Nguyen Quang Ngoc 
Published: May 2023

Abstract

OBJECTIVES
Aortopulmonary window (APW) associated with an interrupted aortic arch (IAA) is a rare cardiac malformation with significant mortality and morbidity. The goal of this study was to report the intermediate outcomes of single-stage repair concentrating on the surgical techniques and postoperative reintervention for this rare cardiac lesion.

METHODS
Eleven patients were diagnosed with IAA-associated APW and underwent single-stage surgical repair at Vietnam National Children’s Hospital.

RESULTS
The APW anatomy types were types I, II and III in 1, 4 and 6 patients, respectively. The IAA morphology was type A in 9 patients and type B in 2 patients. The median age was 27 [interquartile range (IQR) 6–79] days, and the median weight was 3.5 (IQR 2.8–4.5) kg. The aortic arch was repaired using direct end-to-side tissue anastomosis in 7 patients, and patch aortoplasty was performed in 4 patients. Six patients underwent APW closure with an intra-aortic baffle, and 5 patients required right pulmonary artery detachment and reimplantation. One early death occurred. Four patients required reinterventions: 1 patient required reoperation due to aortic stenosis and 3 required balloon angioplasty for either recurrent aortic arch stenosis (n = 1) or right pulmonary stenosis (n = 2) with a mean follow-up time of 3.1 years (IQR 0.5–4.3 years).

CONCLUSIONS
Single-stage repair of IAA-associated APW can be achieved with good survival outcomes in children. However, the need for repeat reintervention or reoperation remains high, and the growth of both the aorta and pulmonary arteries should follow carefully as the patient grows.

CLINICAL REGISTRATION NUMBER
VNCH-RICH-18–96
97 Burning a Hole in Our Pockets: 12 Year Trends of Medicare Reimbursement for Burn Procedures
Authors: Tiongco Rafael Felix , Atayeva Rena , Khan Iman , Puthumana Joseph , Hultman C Scott , Cooney Carisa , Caffrey Julie , Qiu Cecil 
Published: May 2023

Abstract

Introduction
Burn injuries cost the USA ~$976.6 million annually. Physician reimbursement has lagged despite years of lobbying by physician groups. The Centers for Medicare and Medicaid Services plan to cut physician reimbursement by 4.2% in 2023. Evaluating reimbursement data for hospital-based procedures is timely, including burn procedures. We hypothesized Medicare reimbursement trends for common burn procedures decreased from 2010-2022.

Methods
We obtained pricing data from the publicly-available Medicare Physician Fee Schedule Look-Up Tool for 26 Current Procedural Terminology (CPT) codes: “Burns–preparation of wound bed” (15002-15005), “Burns–split thickness skin graft” (15100-15101 & 15120-15121), “Burns–skin substitute” (15271-15278), “Cultured epidermal autograft” (15150-15152 & 15155-15157), and “Cell Suspension Epidermal Autograft” (15110-15111 & 15115-15116). We calculated percent differences for reimbursement; compound annual growth rate (CAGR); and percent differences for work, facility, non-facility, and malpractice relative value units (RVUs). Analysis was conducted in R 4.1.2.

Results
The three largest reimbursement increases were for CPT codes 15272 (24.6%), 15155 (23.7%), and 15003 (10.9%); the three largest decreases were for 15121 (-16.8%), 15120 (-6.1%), and 15275 (-5.0%). The three largest CAGR increases were for CPT codes 15272 (2.2%), 15155 (1.8%), 15274 (0.9%), and 15003 (0.9%); the three smallest were for 15121 (-1.5%), 15120 (-0.5%), and 15275 (-0.5%). Table 1 shows trends of RVUs.

Conclusions
Our 12-year analysis of Medicare reimbursement trends for 26 burn procedures demonstrated an overall increase in hospital reimbursement and parallel net decrease in physician work RVUs. Reimbursements were increasingly allocated away from surgeons to facility fees and malpractice insurance. Cultured epidermal autograft to the head, neck, hands, and feet (15155) saw the largest increase in Medicare reimbursement with no change in direct physician reimbursement while split-thickness skin grafts to the head, neck, & genitals (15120 & 15121) showed decreased rates. Future work is needed to understand why these trends are occurring to advocate against physician reimbursement cuts.

Applicability of Research to Practice
Studies contributing to price transparency allow stakeholders to focus on why burn surgeons are receiving lower reimbursements.
576 Pixel-Grafting and Negative-Pressure Moist Wound Chambers Improve Re-epithelization After Burn Injuries
Authors: Villalvazo Yadira , Humar Pooja , Bengur Fuat Baris , Loder Shawn J , Nerone Wayne V , Vagonis Alexandra , Shaaban Bahaa , Kokai Lauren E , Marra Kacey G , Eriksson Elof , Rubin J Peter 
Published: May 2023

Abstract

Introduction
Complex burns are a challenge, often requiring prolonged reconstruction. Management requires consideration not only to the skin but to underlying structures and often requires staged-reconstruction and revision for increasingly unsatisfactory results. This standard is expensive, limited by donor-site availability, and often impacts quality of life. Here we demonstrate the efficacy of single-staged minced skin grafting in an incubator-like microenvironment with a negative-pressure moist wound chamber device to achieve rapid epithelialization after burns.

Methods
Full-thickness burns were induced to female Yorkshire swine. Escharectomies were performed to the level of fascia after seventy-two hours. One group received standard of care skin grafting with a bolster dressing. In another group, split-thickness skin was cut into pixel size (0.3x0.3 mm) grafts, followed by application of either bolster or negative-pressure moist wound chamber dressing. Wounds were followed for 4-weeks with serial photography, ultrasound, and biopsies for histology.

Results
As early as one week, epithelialization started in the group with pixel grafts with negative-pressure moist wound chamber dressings with visible epithelioid islands on the wound bed granulation tissue. This progressed with a similar trend throughout the 4-week period eventually leading to near-complete epithelization and keratinization. There was reconstruction of trilaminar cutaneous architecture demonstrated by the presence of distinct, viable epidermal, dermal and hypodermal elements as well as viability of adipose on histology. Distinct differences in contour were noted between the bolster and negative-pressure moist wound chamber groups.

Conclusions
Minced grafting minimized donor burden and alleviated the need for graft orientation. In both the bolstered and negative-pressure moist wound chambers, pixel-grafts viably survived to form a viable basal layer. Use of positive-pressure (bolster) vs. negative-pressure moist wound chamber dressings demonstrated distinct differences in the convexity/concavity and topography of the singe-stage skin graft with critical implications for aesthetic reconstruction.

Applicability of Research to Practice
This study introduces the efficacy of a single-staged trilaminar reconstruction with the use of a negative-pressure moist wound chamber for complex burns. These findings support the potential for a new paradigm in the treatment of complex burns which allows for single-stage reconstruction with minimal donor site morbidity.
580 Burn Camp in the Midst of the COVID-19 Pandemic
Authors: ONeill Keisha , Smith Tiffany , Hollowed Kathleen , Lesher Aaron , Vezin Ross , Eubanks Ryan , Nord Al , Howell Rodney , Kahn Steven 
Published: May 2023

Abstract

Introduction
Previous literature has shown that pediatric burn camps provide numerous benefits to childhood burn survivors. Unfortunately, the COVID-19 pandemic resulted in the inability to host camp for fear of viral transmission to burn survivors and camp personnel alike. A comprehensive burn center, with assistance from the firefighter community, hosted its first burn camp since the onset of the COVID pandemic in August of 2022. A camp staff of 54 volunteers modified the previous camp processes to ensure camp was safe, fun and accessible to 20 pediatric burn survivors.

Methods
This is an academic short report that reviews the process changes necessary to host a safe pediatric burn camp in the midst of the COVID pandemic. All attendees and staff were required to show a negative PCR test result 48 hours prior to arrival at camp. COVID vaccination was encouraged in all participants, however, staff and patients were not required to be vaccinated. Daily symptom tracking was implemented immediately upon arrival to camp. All participants were assigned a thermometer, and daily temperatures and symptom monitoring was performed by the camp director. Masks were mandated when indoors or within close proximity or group activities. There was a quarantine plan in place in the case a camper or staff member became symptomatic, or tested positive for COVID. Lastly, the number of people per cabin decreased from 12 to 8.

Results
In the early planning phase of camp, it was discovered that some of the participants and staff were unable to obtain a PCR test prior to camp. Therefore, onsite testing was implemented to allow testing as the participants and camp staff arrived to camp. The onsite testing facility was available for the entirety of camp in the case anyone became symptomatic. Implementation of additional camp processes resulted in a successful and safe camp. There were no reported cases of COVID during or after camp.

Conclusions
As the Public Health Emergency from COVID-19 continues, group activities, such as summer burn camps, with medically vulnerable populations must be altered to protect all stakeholders. We described the steps taken by one burn-center-run camp that enabled children and firefighter volunteers to participate in the full burn camp experience. Plans for the 2023 burn camp are already in process, and the processes implemented in 2022 will be implemented in all upcoming camps to ensure the children and staff are safe from the transmission of COVID.

Applicability of Research to Practice
N/A
700 Implementation of an Intranasal Decolonization Protocol and Line Changing Policy in Adult Burn Patients
Authors: Yahia Adalah , Barber Katie , Herbin Shelbye , White Michael , Faris Janie , Laddaran Lester , Kowalski Katherine 
Published: May 2023

Abstract

Introduction
Reducing infection in burn patients can have a major impact on clinical outcomes. The purpose of this study is to evaluate the rate of bacteremia pre/post the implementation of a line change and nasal decolonization protocol.

Methods
This quasi-experimental study assessed adult patients admitted to a single center ABA verified burn center from August 2019 - August 2020 (pre-intervention group) versus September 2020 - September 2021 (post-intervention group). Patients must have received at least 1 round of intranasal decolonization treatment (mupirocin intranasal twice a day for 5 days and repeated every 30 days during hospital stay) during the post-protocol period. A line change policy was also implemented post protocol period for central and peripheral lines. Patients were excluded if they had a total loss of nasal alae, injury deemed nonsurvivable, or transitioned to comfort care within 72 hours of admission.

Results
A total of 558 burn patients were included, 324 patients in the pre-group and 234 post-group. There was no significant difference in comorbidities between the two groups. The majority of patients were admitted for an integumentary burn (87.6%) with the most common cause being flame (49.8%) or hot water contact (19.0%). Compliance with the decolonization protocol was appropriate for 87.6% of patients post-intervention. During the pre-intervention period, there were 18 (7.7%) positive blood cultures versus only 9 (3.8%) in the post-group (p=0.426). Gram-positive infections occurred in 44.4% of the pre-group and only 11.1% in the post-group (p=0.087). The rate of Gram-negative infections was similar between the pre and post-groups at 44.4% and 55.6%, p = 0.695. MRSA bacteremia was 44.4% of total Gram-positive bacteremia, with pre and post-intervention 4 (50%) vs. 0 (0%), p = 0.1. The median time of line placement to bacteremia pre-intervention was 7(5-12) days vs. post-intervention 11(6-14) days (p = 0.220). Hospital mortality between both periods was 9(3.8%) vs. 5(2.1%), p = 0.786. No significant difference was found in hospital LOS, ICU LOS, or discharge disposition.

Conclusions
Overall, this study showed a 50% decreased rate of MRSA bacteremia with the implementation of an intranasal decolonization protocol and a delay in Gram-negative bacteremia post implementation of a line change policy, potentially leading to a decrease in morbidity and hospital bloodstream infection-related costs.

Applicability of Research to Practice
Reducing infection rates can have a major impact on burn patient outcomes and lead to significant cost savings.
701 Impact of Alcohol and Methamphetamine Use on Burn Resuscitation
Authors: Kenney, MD Connor , Rizzo Julie , Coates Elsa , Serio-Melvin Maria , Aden James , Foster Kevin , AbdelFattah Kareem , Pham Tam , Salinas Jose 
Published: May 2023

Abstract

Introduction
Mortality associated with burn injuries is declining with improved critical care, including resuscitation. However, patients admitted with concurrent substance use have increased risk of complications and poor outcomes. The impact of alcohol and methamphetamine use on acute burn resuscitation has been described in single center studies, however, has not been studied since implementation of computerized decision support for resuscitation. The purpose of this study was to evaluate resuscitation volumes for patients with alcohol and methamphetamine use within a large prospective observational trial at 5 major US burn centers.

Methods
We performed an observational trial across five institutions with &gt; 20% total body surface area (TBSA) burn, weighing &gt;40kg that were resuscitated utilizing computerized decision support. Patients were evaluated based presence of alcohol, with a minimum blood alcohol level of 0.10, or positive methamphetamines on urine drug screen. Fluid volumes and urine output were examined over 48 hours and Wilcoxon Method was utilized to compare patient groups.

Results
A total of 296 patients were analyzed. 37 (12.5%) were positive for methamphetamine use, 50 (16.9%) were positive for alcohol use, and 209 (70.1%) with negative for both. Patients positive for methamphetamine received a mean of 5.30 ±2.63 cc/kg/TBSA, patients positive for alcohol received a mean of 5.41 ± 2.49 cc/kg/TBSA, and patients with neither received a mean 4.33 ± 1.79 cc/kg/TBSA. Patients with methamphetamine or alcohol use had significantly higher fluid requirements than those who were negative for both substances. In the first 6 hours patients with alcohol use had significantly higher urinary output in comparison to patients with methamphetamine use which had similar output to patients negative for both substances.

Conclusions
This study demonstrated that patients with alcohol and methamphetamine use had statistically significantly larger fluid resuscitation requirements compared to patients without. The effects of alcohol as a diuretic align with previous literature. However, patients with methamphetamine lack the increased urinary output as a cause for their increased fluid requirements. Methamphetamine’s neurologic and cardiovascular effects due to increased release of dopamine, serotonin, and norepinephrine are known. Further investigation is required to better understand the mechanism underlying the need for increased resuscitation after burn injury in patients positive for methamphetamines.

Applicability of Research to Practice
The impact of alcohol and illicit substances on burn care, especially during the initial resuscitation, aids providers in guiding early critical care.