bluuebunny/crossref_metadata_2025_split huggingface dataset:
753 Segregation, Vulnerability, and Fundamental Causes: Understanding the Social Dimensions of Burn Injury
Authors: Ngana Colette 
Published: March 2022

Abstract

Introduction
Sociologists have long investigated the enduring link between place and health. Despite prolific research in this field, there are health issues that remain obscured in the literature. The goal of this work is to examine the spatial-health relationship(s) between place of residence and burn injuries, the socially produced vulnerability of individuals living in high-risk areas, and the experience of being burned in these identified areas. Fundamental cause theory, which focuses on an individual’s ability to either avoid health risks or minimize the consequences of these risks, is employed to demonstrate the worsening effects of socioeconomic status (classism) and race (racism) on burn injuries. Managing health risks is dependent upon access to and utilization of flexible resources (knowledge, money, freedom, power, prestige, and social networks) that are differentially distributed across populations based on social conditions like age, race-ethnicity, socioeconomic status, and neighborhood infrastructure.

Methods
Exploratory spatial and cluster analysis using ArcGIS (a geographic information system) of accidental, at-home burn incidence in an historically redlined county.

Results
Analysis shows burn injuries tend to cluster in areas marked by low-income, higher numbers of racial-ethnic minorities, and poorer quality housing. Table 1 shows preliminary descriptive data about the study population.

Conclusions
Despite advances in treatment and prevention, there are socially-constructed and salient environmental risks that leave some communities vulnerable to burn injury. Historical practices, like racial residential segregation and redlining, have concentrated racial-ethnic minority communities marked by lower-income, poorer quality housing, and other burn-risk factors.
759 Burn Care During the COVID-19 Pandemic: Assessing the Current Literature
Authors: Tranchina Stephen P , Tran Justin , Ghafoor Elias A , Moffatt Lauren T , Palmieri Tina L , Shupp Jeffrey W , Johnson Laura S , Skipton Romanowski Kathleen S 
Published: March 2022

Abstract

Introduction
The emergence of SARS-CoV-2 and the subsequent COVID-19 pandemic has been a significant disruptor to traditional medical care. Burn patients are an interesting population in which to evaluate this disruption due to the complicated, multidisciplinary nature of injury management. Understanding the current landscape of burn care during the pandemic is a crucial first step in preparing for future pandemic impacts. The purpose of this study was to identify the current status of burn treatment during COVID by evaluating existing literature surrounding burns and COVID.

Methods
A literature review of articles published between March 2020 and August 2021 was conducted to determine trends in studies evaluating burn patients and burn center operation during this time frame. All ABA abstracts published in 2020 containing the key words “burn,” “COVID,” and/or “coronavirus” were reviewed. Additionally, a Pubmed search was conducted using the same keywords. Each abstract and article was sorted into one of four themes: Census/Etiology, Burn patients with COVID, Safe Practices/Protocols, and Telemedicine.

Results
A total of 23 ABA abstracts and 126 articles were collected in the initial search. 63 articles were ultimately excluded because they did not report on burn patients. By theme, the following trends were seen: 1. Census/Etiology: Data on demographics of burn patients during this period was varied. Admissions for adult and/or pediatric burns increased for multiple burn centers, while others reported decreases. Consistently, the most common etiology of burn injury was scald, and an increased proportion of injuries were found to occur at home. Changes in the rates of first, second, and third-degree burns were also observed. 2. Burn patients with COVID: Overall, numerous reports indicated decreases in patient length of stay. However, several groups found no differences in length of stay, surgery rate, and length of follow-up. 3. Safe Practices: A recurring trend was observed of numerous burn centers having to implement increased safety protocols due to COVID-19. Select burn centers updated prevention guidelines for burn surgeons and patient care. 4. Telemedicine: The implementation of telemedicine helped minimize risk and maximize resources, However, much remains to be standardized, including the quality of images used.

Conclusions
This analysis of the current literature identified several overarching themes in the care of burn patients. Continued evaluation can identify innovations from the past year that should become best practices, as well as optimize preparation efforts for future disruptions in care.
762 Resumption of Surgical Missions in Light of COVID-19: A Paradigm Shift
Authors: Dabek Robert J , Fuzaylov Gennadiy 
Published: March 2022

Abstract

Introduction
The COVID-19 pandemic has disrupted the lives of billions of people globally. Some medical systems continue to be overburdened due to the viral illness leading to incredible public health challenges domestically as well as abroad. However, with vaccination distribution increasing globally, many are pushing for a return to some form of normalcy. In the medical community, some are weighing the risks of returning to global health missions and considering protective strategies to minimize risk of viral spread.

Methods
Here we describe our experience in returning to an annual burn reconstruction mission in a low- and middle-income country (LMIC).

Results
We have implemented protective strategies and successfully carried out a return mission trip. Our team of 10 individuals was able to perform over 80 procedures on 26 pediatric patients in 4 operative days. There were no major complications reported.

Conclusions
Protection of our team and our patients from the risk of COVID-19 infection was paramount given the high mortality rate and disease duration. We applied a variety of protective strategies and altered mission protocol to limit exposure and transmission. The primary modifications (including; eliminating day of clinic with increased utilization of telemedicine for preoperative screening, only one vaccinated care giver permitted in the hospital, COVID-19 pre-operative screening for parents and patients, and increasing operative complexity) are likely to remain in place for the duration of the pandemic.
768 The Significant Impact of Having a Dedicated Ambulatory Clinical Social Worker in the Burn Clinic
Authors: Spotts Margaret , Dines Margaret M , Foster Crystal , Wiktor Arek J , Weber Elizabeth B 
Published: March 2022

Abstract

Introduction
A licensed clinical social worker (LCSW) has been recognized as an essential role within the Burn Center inpatient multidisciplinary team. However, for ambulatory patients facing acute crisis, resources can be scarce; relying on clinic nursing staff or an inpatient LCSW to problem solve psychosocial concerns can leave large gaps of patient care unaddressed. An Ambulatory LCSW (ALCSW) assists transition of care working to prevent unnecessary Emergency Room visits and readmissions. We sought to examine our experience utilizing an ALCSW in the Burn Center.

Methods
A full-time burn ALCSW position was approved in fall of 2020 at our ABA verified Burn Center. The role includes extensive assessments of mental health, substance use, domestic violence, and safety concerns, connecting clinic patients to resources for transportation, benefits, insurance coverage, employment, food, and housing. The ALCSW also conducts short term patient centered, family & group therapy sessions. A retrospective review was performed on duties of the ALCSW comparing 9 months (December-August) pre and post hire. Data collected included visit types, hours of patient care, and interventions performed.

Results
During the first 9 months, the ALCSW completed 1,008 patient encounters (approximately 25 hours of direct patient care per week) and 510 psychosocial assessments. In the first three months alone 258 substance use screens, 166 mental health assessments, 44 ASD/PTSD therapy sessions, 205 Homeless Shelter referrals and 128 community resource encounters were performed that would have otherwise been left unaddressed or added to the workload of our Burn Clinic RN or provider.
The ALCSW was able to see up to 89.39% more patients per month (n=89) compared to the inpatient LCSW who only responding to clinic patients with emergent needs (n=13). The increase of ALCSW encounters showed a 35.37% increase of completed visits without IP admission (n=pre 665 vs post 1029), 39.73% decrease of IP admissions after clinic visit (n=pre 73 vs post 44), and 17.82% increase of patients without inpatient admissions entirely (n=pre 572 vs post 696). In addition, the added effort of an ambulatory LCSW, has increased SOAR support group participation by 60.13% in calendar year 2021 compared to calendar year 2020 (n= pre 63 vs post 158).

Conclusions
Hiring a dedicated Burn ALCSW can substantially increase the resources available to outpatients, fill voids of patient care, limit unnecessary hospital resources, and prevent admissions.
775 The Ongoing Impact of the COVID Pandemic on Young Burn Survivors and their Families
Authors: Jackson Brad , Mikolaj Kerry , Boulter Trudy , Schiffer Nichole M 
Published: March 2022

Abstract

Introduction
The COVID pandemic continues to bring numerous challenges for young burn survivors and their families. This project addressed the ongoing impact that COVID-19 is still having on youth burn survivors and their caregivers.
Our burn camp program moved to a virtual format for 2020 but returned to an in person camp experience for 2021. This project is an extension of our assessment in 2020 by asking youth and their families to reflect on the persistent effects of COVID-19 into 2021.

Methods
Prior to each camp year, we asked campers (ages 8 – 18) and their caregivers / parents to complete questionnaires about their year, rating and specifying the personal impacts of COVID as part of their overall camp application. We also asked “what has helped you get through tough times this year?” In 2020 we had 47 campers and caregivers / parents participate with an increase to 60 campers and caregivers / parents for 2021.

Results
The majority of youth continued to rate the impact of COVID-19 as “Somewhat” or “Highly” from 2020 to 2021, however the percent of youth rating these higher levels of impact decreased in 2021. The majority of caregivers rated the impact in 2020 as “Somewhat” while the percentage rating these higher levels of impact increased in 2021 with more caregivers also endorsing “Highly”.
Campers AND caregivers / parents identified the same top 3 impacts in 2020 and 2021:
1. Online school / virtual learning
2. Friends / Social
3. Quarantine
The impact on the fourth highest area of Sports / Activities decreased from 2020 to 2021. In both years, youth and caregivers rated Quality time with Family as a positive impact.
Campers and caregivers endorsed Family, Friends, Faith, and What I learned recovering from my burn injury as factors helping them get through tough times.

Conclusions
Children, youth, and families who have experienced a burn injury continue to report both negative and positive impacts from the COVID-19 pandemic.
Not all youth and families are equally affected, but burn survivors and their caregivers rated the highest impacts as online school / virtual learning, friends / social, and quarantine in both 2020 and 2021.
Family and friends were the greatest sources of support during tough times
Burn camp provided the opportunity for connection in the face of ongoing impacts of COVID-19.
786 Electrical Injury Resulting In Bilateral Upper Extremity Amputation: Improving Independence And Quality Of Life
Authors: Adams Emily , Murtaugh Brooke 
Published: March 2022

Abstract

Introduction
Fifty seven year old male who sustained an electrical burn injury that resulted in bilateral below elbow amputation began inpatient rehabilitation program. Patient was motivated to increase independence to return home prior to prosthetic fitting and training being completed. Quality options for adaptive equipment required to increase independence were not sufficient to meet patients needs, thus innovative specialty fabrication of adaptive equipment were required to meet patient’s goals of independence.

Methods
Occupational therapist to use thermoplastic material to fabricate various adaptive equipment in order to address patient's goals to increase independence with self care tasks. Occupational therapist and patient to have one time consult with hospital maintenance employee to create pant hook to use for ease of donning/doffing over hips. Patient participated in daily Occupational therapy sessions focused on trialing adaptive equipment and to provide feedback for any desired changes of equipment to maximize patient progress and success with reaching independence with self cares and return to life roles.

Results
Patient met all goals to become independent with self care tasks including: toileting, dressing and showering as a result of using fabricated adaptive equipment and techniques addressed during therapy sessions. Patient able to return home independently following discharge from inpatient rehabilitation stay.

Conclusions
Use of easily accessible ezeform thermoplastic material can result in fabrication of adaptive equipment to increase patient's independence. It is important to maintain a creative outlook as a clinician and to continue to collaborate with our patient's to identify barriers to success and explore options to increase patient's desired independence.
788 Upper Extremity and Lower Extremity Net Devices for Use after Application of Cultured Epidermal Autograft
Authors: Hayes Callie J , Anyan Walter R , Lucio Xavier , Perry Daphne A , Hopkins Ronda , Clark Jillian S , Durose Lily 
Published: March 2022

Abstract

Introduction
Early positioning of the burn patient to prevent scar contracture is a fundamental aspect of the therapy treatment plan1. Positioning is complicated by different types of grafting including cultured epidermal autograft (CEA). Use of CEA requires a period of airing out and therefore positioning devices must allow adequate air flow to the posterior aspect of the grafted limb while immobilizing the extremity. Previous lower extremity net devices have been presented for use2-3, however this design increases hip flexion which can promote contracture. Additionally, there is no similar net device presented for use for the upper extremity.

Methods
Both the upper extremity and lower extremity net device designs are made using 1” PVC pipe. A mix of Tee, 90⁰ and 45⁰ couplers are used to link together the PVC pipe. A PVC cutter is needed to cut the pieces. Once the pieces have been fit together and are aligned, the pieces are secured with a bonding PVC adhesive. The devices are then sanitized for patient use. A double layer of burn netting is used over the device to support the extremity while not allowing too much slack. The following graphics provide a basic template for an average adult adjusting lengths and width as needed. For the lower extremity, a measurement from the fold of the buttocks to the heel is needed to determine overall length of the device. The average cost for 1 lifter is $15-20. Additional custom plantar foot plates can be added to the lower extremity device to prevent ankle dorsiflexion as demonstrated by the poster presentation by Dean et. al. 3 For the upper extremity, an armboard or use of bedside table can be used to support the device. These particular designs are an outline for adult patients, although could be modified for pediatrics.

Results
Net devices for the upper and lower extremity allow good positioning of limb while providing adequate air flow and off-loading during the required air out periods using CEA. These designs provide a template for burn therapists to utilize as a baseline. This particular lower extremity device decreases hip flexion as compared to other existing devices. The upper extremity template provides an option that has not previously been articulated.

Conclusions
Positioning the upper and lower extremity after CEA application can be achieved using custom net devices. Net devices provide a cost-effective, quick and simple solution that allow adequate ventilation to the posterior aspect of the limb while maintaining a good position during immobilization.
805 Case Report: Atrial Perforation in the Setting of Electrical Injury and Subsequent Cardiopulmonary Resuscitation
Authors: Gallagher Kathleen C , Beyene Robel , Gondek Stephen , Smith Joshua , Mubang Ronnie 
Published: March 2022

Abstract

Introduction
Electrical injuries cause 500 to 1000 deaths per year in the United States and are the fourth leading cause of death in the workplace. Rates and types of cardiac complication secondary to electrical injuries vary widely throughout the literature. Case reports describing cardiac perforation in the setting of electrical injury are exceedingly sparse. To our knowledge, there are no documented cases of cardiac perforation as a direct result of electrical injury.

Methods
This is a case report and review of relevant literature.

Results
Case Description:
We present a case of myocardial perforation in the setting of high voltage electrical injury. An otherwise healthy 46-year old male sustained a 13.8 kV electrical. Resuscitation included bystander cardiopulmonary resuscitation (CPR), defibrillation by emergency medical responders, finger thoracostomies and massive transfusion protocol in the trauma bay, and finally emergent sternotomy and repair of two injuries to the right atrial appendage. Given this patient’s pattern of injury, including a sternal fracture and bilateral upper anterior rib fractures, the etiology of his right atrial perforation is more likely due to mechanical injury from CPR instead of thermal or electrical injury to the myocardium. However, intraoperative findings confound this theory as no defects were identified in the pericardium of the mediastinal pleura during the operation. This would argue against mechanical injury during CPR. However, the presence of a left hemothorax may could indicate that a pericardial injury was missed in the operation. We argue that the most likely cause of injury is mechanical perforation of the pericardium and myocardium during CPR with a possible missed pericardiotomy during surgical exploration. An alternative hypothesis is an isolated electrical injury to the myocardium and left hemothorax from rib fractures without communication between the two cavities. This patient expired on postoperative day two due to anoxic brain injury.

Conclusions
This case highlights myocardial injury as a rare but lethal complication of high voltage electrical injury and serves as a reminder that cardiac perforation and hemodynamic collapse due to hypovolemic shock can compound and complicate the resuscitation and management of a patient with electrical injury. Further, the widely varying data regarding cardiac complications secondary to electrical injury warrants further investigation and large-scale prospective data.
816 Up-regulation of Immune Related Key Genes in Burn Induced Cardiac Dysfunction
Authors: Mobli Keyan , Wen Jake J , Radhakrishnan Geetha , Radhakrishnan Ravi S 
Published: March 2022

Abstract

Introduction
The cytokine cascade is a prime factor in inflammation following burn injury, leading to cardiac dysfunction. Studies on immune-related key cardiac genes after burn injury remain limited. The TLRs act individually or as heterodimers, interacting with adaptor proteins to initiate MyD88 or TICAM1 (TRIF) dependent responses. This results in signaling cascades through NFkB, which activates downstream JNK/p38 signaling or cytokine secretion. Dysregulation of TLR and related signaling pathways has severe consequences and is implicated in autoimmune diseases and chronic inflammation. The objective of this study is to identify the immune-related key genes and explore the pathways by microarray specific to members of the TLR signaling family as well as adaptor and effector proteins, and downstream members of TLR activation including the NFkB, JNK/p38, IRF and JAK/STAT signaling pathways.

Methods
The microarray was applied to profile expression of 84 genes inTLR-mediated signal transduction and innate immunity. The Qiagen web-based tools in GeneGlobe Data Analysis Center was used to analyze burn-induced up-regulation of these genes. String-DB version 11.5 was employed to analyze differentially expressed gene function and interaction. Real-time qPCR was utilized to validate the data. GO enrichment analysis (FDR&lt; 0.05) using "clusterProfiler" predicted the roles of immune-key genes in the 3 aspects of biological processes (BP), cellular components (CC), and molecular functions (MF). The biological pathway analysis was performed to obtain the pathways. The protein-protein interaction (PPI) network was built using "Multiple Protein" of the string database (http://stringdb.org/, version 15.0). The DEGs were visualized by using the qPCR.

Results
32 up-regulated genes were identified. Functional enrichment analysis showed that these genes were enriched in cytokine receptor activity, immune receptor activity, and integrin family cell surface interactions.14 of 32 genes belong to the TLR signaling pathway; 5 of 32 genes to cytokines and inflammation; 5 of 32 genes belong to apoptosis; 6 in the MARP signaling pathway; 4 genes belong to the IL-1 signaling pathway; 4 genes in the IL-6 signaling pathway); 3 genes in toIL-2 signaling pathway and 3 genes belong to oxidative stress responses. Process study demonstrated the genes are associated with regulation of cytokine production (GO:0001817), immune response (GO:0006955), and defense response (GO:0006952).

Conclusions
This study provides evidence that microarray plays a role in identification of burn-induced cardiac dysfunction DEGs. Deep analysis of up-regulated genes after burn injury supported the idea that the proinflammatory cascade results in cardiac inflammation.
Regulatory Interventions in Consumer Financial Markets: The Case of Credit Cards
Authors: Galenianos Manolis , Gavazza Alessandro 
Published: March 2022

Abstract
We build a framework to understand the effects of regulatory interventions in credit markets, such as caps on interest rates. We focus on the credit card market, in which we observe US consumers borrowing at high and very dispersed interest rates despite receiving many credit card offers. Our framework includes two main features to account for these patterns: the endogenous effort of examining offers and product differentiation. Our calibration suggests that most borrowers examine few of the offers they receive, and thereby forego cards with low interest rates and high non-price benefits. The calibrated model implies that interest-rate caps reduce credit supply and significantly curb lenders’ market power, thereby increasing consumer surplus. Moderate caps may yield larger gains in consumer surplus than tighter ones.