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Substance use and inhalation injury in adult burn patients:retrospective study of the impact on outcomes

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Burns & Trauma 2019年第1期7卷 132-138页

作者： kevin m.klifto Luis Quiroga C.Scott Hultman Department of Plastic and Reconstructive Surgery Johns Hopkins Burn CenterThe Johns Hopkins Hospital4940 Eastern AvenueBaltimore 21224USA

Background:Substance use,alcohol use,and smoking use have all been associated with burn *** studies have investigated associations with substances,alcohol,smoking,inhalational only burns,and patient *** purpose of the study was to identify risk factors for pulmonary failure in patients suffering inhalation injury,focusing on the impact of substance,alcohol,and cigarette ***:This is a single-center retrospective analysis of 115 patients admitted to the Johns Hopkins Bayview Burn Center with inhalational injury from January 1,2010,through September 30,*** were excluded if they were under the age of 18 years or had burn involvement of the skin>5%.Primary outcome variables measured were if patients were intubated,length of total time intubated,substance use,alcohol use,and smoking *** outcome variables measured were types of substances used(amphetamines,barbiturates,benzodiazepines,cannabinoids,cocaine,methadone,codeine/morphine),total number of substances used,intensive care unit(ICU)length of stay(LOS),hospital LOS,secondary complications,and patient *** was performed with Fisher’s exact test and the mann-Whitney U test.A sub-group analysis for each substance,alcohol,smoking,and control subgroup was compared to its respective sub-group without substance,alcohol,smoking,and control within the no intubation and intubation group.A sub-group analysis of substance use,alcohol use,smoking use,and control was further analyzed with binomial logistic regression within the intubation ***:Following inhalation injury,50/115(43%)patients required ***-two of the 50(84%)patients intubated had substance use(pmoking(p=0.038).Among the specific substances used,26/50(52%)patients intubated were using benzodiazepines(p<0.001)and 7/50(14%)patients were using cocaine(p=0.022).The lengths of intubation,ICU LOS,and hospital LOS with no substanc

关键词： Intubation Smoking Burn Risk factors Cocaine Benzodiazepines morphine Inhalation

Acute surgical vs non-surgical management for ocular and peri-ocular burns:a systematic review and meta-analysis

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Burns & Trauma 2019年第1期7卷 233-247页

作者： kevin m.klifto Ala Elhelali Caresse F.Gurno Stella m.Seal mohammed Asif C.Scott Hultman Department of Plastic and Reconstructive Surgery The Johns Hopkins University School of MedicineBaltimoreMDUSA The Johns Hopkins University School of Nursing BaltimoreMDUSA Welch medical Library The Johns Hopkins University School of MedicineBaltimoreMDUSA The Johns Hopkins Burn Center 4940 Eastern AvenueBaltimoreMD 21224USA

Background:Burn-related injury to the face involving the structures of the eyes,eyelids,eyelashes,and/or eyebrows could result in multiple reconstructive procedures to improve functional and cosmetic outcomes,and correct complications following poor acute phase *** objective of this article was to evaluate if nonsurgical or surgical interventions are best for acute management of ocular and/or peri-ocular ***:This systematic review and meta-analysis compared 272 surgical to 535 non-surgical interventions within 1 month of patients suffering burn-related injuries to 465 eyes,253 eyelids,90 eyelashes,and 0 eyebrows and evaluated associated outcomes and *** Pubmed,Embase,Cochrane Library,Web of Science,and Scopus databases were systematically and independently *** and clinical characteristics,surgical and medical interventions,outcomes,and complications were ***:Eight of the 14,927 studies queried for this study were eligible for the systematic review and meta-analysis,with results from 33 of the possible 58 outcomes and complications using Preferred Reporting Items for Systematic Reviews and meta-analysis(PRISmA)and Cochrane *** was associated with standard mean differences(SmD)0.44 greater visual acuity on follow-up,SmD 1.63mm shorter epithelial defect diameters on follow-up,SmD 1.55 mm greater changes in epithelial diameters from baseline,SmD 1.17 mm^(2) smaller epithelial defect areas on follow-up,SmD 1.37 mm^(2) greater changes in epithelial defect areas from baseline,risk ratios(RR)1.22 greater numbers of healed epithelial defects,RR 11.17 more keratitis infections,and a 2.2 greater reduction in limbal ischemia compared to no surgical ***:This systematic review and meta-analysis found that compared to non-surgical interventions,acute surgical interventions for ocular,eyelid,and/or eyelash burns were found to have greater visual acuity on follow-up,shorter epithelial de

关键词： Burns Eyelashes Eyebrows Eye Visual acuity Keratitis Stem cell transplantation Ocular Peri-ocular

Surgical outcomes in adults with purpura fulminans:a systematic review and patientlevel meta-synthesis

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Burns & Trauma 2019年第1期7卷 279-289页

作者： kevin m.klifto Caresse F.Gurno michael J.Grzelak Stellam.Seal mohammed Asif C.Scott Hultman Julie A.Caffrey Department of Plastic and Reconstructive Surgery The Johns Hopkins University School of MedicineBaltimoreMDUSA The Johns Hopkins University School of Nursing BaltimoreMDUSA Welch medical Library The Johns Hopkins University School of MedicineBaltimoreMDUSA Johns Hopkins Burn Center 4940 Eastern AvenueBaltimoreMD 21224USA

Background:Cutaneous manifestations of purpura fulminans(PF)present many challenges for clinicians and *** a state of septic shock complicated by limb ischemia,surgical interventions are necessary to control the pathological cascade and improve patient *** objective of this article was to report etiologies and surgical outcomes associated with cutaneous manifestations in ***:This systematic review and meta-analysis compared 190 adult patients with etiologies,signs and symptoms,and surgical outcomes associated with cutaneous manifestations of *** Pubmed,EmBASE,Cochrane Library,Web of Science,and Scopus databases were systematically and independently *** and clinical characteristics,surgical interventions,outcomes,and complications were ***:Seventy-nine studies were eligible for the systematic review,and 77 were eligible for meta-analysis using Preferred Reporting Items for Systematic Reviews and meta-analysis(PRISmA)and Cochrane guidelines.A total of 71/190(38%)cases reported surgical *** were reported in 12/190(6%)cases and 20 *** were reported in 154/190(81%)*** was reported in 45 *** grafts were applied in 31 *** were used for reconstruction in 28 ***(IQR)surgical procedures per patient were 4(4,5)*** organisms causing PF were 32%Neisseria meningitidis(n=55)and 32%Streptococcus pneumonia(n=55).Coagulase-negative Staphylococcus(95%confidence interval(CI)(8.2–177.9),p=0.032),Haemophilus influenza(95%CI(7.2–133),p=0.029),Streptococcus pneumonia(95%CI(13.3–75.9),p=0.006),and West Nile Virus(95%CI(8.2–177.9),p=0.032)were associated with significantly more extensive amputations compared to other ***:This systematic review and patient-level meta-analysis found the most common presentation of PF was septic shock from an infectious *** meningitidis and Streptococcus pneumonia were equally

关键词： Amputation Burn units Neisseria Purpura fulminans Reconstructive surgical procedures Shock Septic Surgeons Treatment outcome

Laser management of hypertrophic burn scars:a comprehensive review

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Burns & Trauma 2020年第1期8卷 466-474页

作者： kevin m.klifto mohammed Asif C.Scott Hultman Department of Plastic and Reconstructive Surgery The Johns Hopkins University School of Medicine733 North BroadwayBaltimoreMarylandUSA21205 Johns Hopkins Burn Center The Johns Hopkins University School of Medicine4940 Eastern AveBaltimoreMarylandUSA21224

Hypertrophic scars often develop following burn-related *** scars can be cosmetically unappealing,but associated symptoms of pruritus,pain and restricted range of motion can impair a person’s quality of *** and light therapies offer a minimally invasive,low-risk approach to treatment,with a short postoperative recovery *** laser technology developed,studies have shown decreased scar thickness,neuropathic pain and need for surgical excision,as well as improved scar pigmentation,erythema,pliability,texture,height and *** this review,we present the evolution of laser therapy for hypertrophic burn scars,how different types of lasers work,indications,perioperative considerations and guidelines for practice management.

关键词： Burn Cicatrix Hypertrophic Contracture Keloid Laser therapy Pruritus Quality of life Scar

Prevalence and associated predictors for patients developing chronic neuropathic pain following burns

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Burns & Trauma 2020年第1期8卷 319-325页

作者： kevin m.klifto A.Lee Dellon C.Scott Hultman Department of Plastic and Reconstructive Surgery The Johns Hopkins University School of MedicineBaltimoreMarylandUSA Department of Neurosurgery The Johns Hopkins University School of MedicineBaltimoreMarylandUSA

Background:Chronic pain,unrelated to the burn itself,can manifest as a long-term complication in patients sustaining burn *** purpose of this study was to determine the prevalence of chronic neuropathic pain(CNP)and compare burn characteristics between patients who developed CNP and patients without CNP who were treated at a burn ***:A single-center,retrospective analysis of 1880 patients admitted to the adult burn center was performed from 1 January 2014 to 1 January *** included were over the age of 15 years,sustained a burn injury and were admitted to the burn *** was diagnosed clinically following burn *** were excluded from the definition of CNP if their pain was due to an underlying illness or *** between patients admitted to the burn center with no pain and patients admitted to the burn center who developed CNP were ***:One hundred and thirteen of the 1880 burn patients developed CNP as a direct result of burn injury over 5 years with a prevalence of 6.01%.Patients who developed CNP were a significantly older median age(54 years vs.46 years,p=0.002),abused alcohol(29%vs.8%,pmokers(73%vs.33%,pmore full-thickness burns(58%vs.43%,pmedian percent of total body surface area(%TBSA)burns(6 vs.3.5,pmore often intubated on mechanical ventilation(33%vs.14%,pmedian number of surgeries(2 vs.0,pmedian hospital length of stay(LOS)(10 days vs.3 days,pmpared to those who did not develop CNP,*** patient follow-up was 27 ***:The prevalence of CNP over 5 years was 6.01%in the burn *** ages,alcohol abuse,substance abuse,current daily smoking,greater percent of total body surface area(%TBSA)burns,third degree burns,being intubated on mechanical ventilation,having more surgeries and longer hospital LOS were as

关键词： Alcohol Burns Chronic pain Length of stay Nerve Neuralgia Prevalence Smoking Substance Surgery

Genetic analyses of ancient tea trees provide insights into the breeding history and dissemination of Chinese Assam tea(Camellia sinensis ***)

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Plant Diversity 2024年第2期46卷 229-237页

作者： miao-miao Li muditha K.meegahakumbura moses C.Wambulwa kevin S.Burgess michael möller Zong-Fang Shen De-Zhu Li Lian-ming Gao CAS Key Laboratory for Plant Diversity and Biogeography of East Asia Kunming Institute of BotanyChinese Academy of ScienceKunming650201China Germplasm Bank of Wild Species Kunming Institute of BotanyChinese Academy of ScienceKunming650201China Kunming College of Life Science University of Chinese Academy of SciencesKunming650201YunnanChina Department of Export Agriculture Faculty of Animal Science and Export AgricultureUva Wellassa UniversityBadulla90000Sri Lanka Department of Life Sciences School of Science and ComputingSouth Eastern Kenya University170-90200KituiKenya Department of Biology Columbus State UniversityUniversity System of GeorgiaColumbusGA31907-5645USA Royal Botanic Garden Edinburgh 20A Inverleith RowEdinburghEH35LRScotlandUK Lijiang Forest Biodiversity National Observation and Research Station Kunming Institute of BotanyChinese Academy of SciencesLijiang674100YunnanChina

Chinese Assam tea(Camellia sinensis ***)is an important tea crop with a long history of cultivation in Yunnan,*** its potential value as a genetic resource,its genetic diversity and domestication/breeding history remain *** address this issue,we genotyped 469 ancient tea plant trees representing 26 *** *** populations,plus two of its wild relatives(six and three populations of *** and ***,respectively)using 16 nuclear microsatellite *** showed that Chinese Assam tea has a relatively high,but comparatively lower gene diversity(H_(S)=0.638)than the wild relative ***(H_S=0.658).Clustering in STRUCTURE indicated that Chinese Assam tea and its two wild relatives formed distinct genetic groups,with considerable interspecific *** Chinese Assam tea accessions clustered into three gene pools,corresponding well with their geographic ***,New Hybrids analysis indicated that 68.48%of ancient Chinese Assam tea plants from Xishuangbanna were genetic intermediates between the Puer and Lincang gene *** addition,10%of the ancient Chinese Assam tea individuals were found to be hybrids between Chinese Assam tea and *** results suggest that Chinese Assam tea was domesticated separately in three gene pools(Puer,Lincang and Xishuangbanna)in the mekong River valley and that the hybrids were subsequently selected during the domestication *** the domestication history of Chinese Assam tea in southwestern Yunnan remains complex,our results will help to identify valuable genetic resources that may be useful in future tea breeding programs.

关键词： Tea plant Hybrid origin Genetic diversity Domestication history Camellia sinensis var.assamica Camellia taliensis

Poisoning effect of polyvinyl chloride on the catalytic pyrolysis of mixed plastics over zeolites

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Science China Chemistry 2024年第7期67卷 2265-2273页

作者： Jiangchun Yuan Wenjie Wang Weixiao Sun Zhirong Yang Yueqiang Cao Wenyao Chen Xiaohu Ge Gang Qian Xiang Feng Xuezhi Duan Xinggui Zhou kevin m.Van Geem Jing Zhang State Key Laboratory of Chemical Engineering East China University of Science and TechnologyShanghai 200237China School of Chemical Engineering Zhengzhou UniversityZhengzhou 450001China Laboratory for Chemical Technology(LCT) Department of MaterialsTextiles and Chemical EngineeringFaculty of Engineering&ArchitectureGhent UniversityZwijnaarde B-9052Belgium State Key Lab of Heavy Oil Processing China University of PetroleumQingdao 266580China

Nowadays,the chemical recycling is applied for only 1%of total waste plastics,largely due to contaminants in plastic waste and difficulty in product *** the major contaminant,polyvinyl chloride(PVC)often forms corrosive hydrogen chloride(HCl)during the chemical recycling,which may cause severe catalyst deactivation and equipment ***,the investigation on catalytic pyrolysis(the major route for plastics chemical recycling)of the PVC containing mixed plastics has been rarely ***,catalytic co-pyrolysis of PVC and polyethylene(PE)was studied over an aromatization catalyst,Pt/ZSm-5,since the basic building block aromatics are desired products from plastics chemical *** poisoning effect of PVC vapor on the catalyst stability was explored by collective efforts of thorough product analysis and catalyst *** was found that the HCl evolving from PVC has an autocatalytic effect that promotes the scission of dehydrochlorinated PVC,resulting in the high yield of benzene and acetylene from *** the other hand,the presence of PVC suppressed the aromatics formation from PE,largely due to the poisoning effect of PVC-derived HCl on the Pt/*** deactivation is irreversible as evidenced by the decreased zeolite crystallinity and the loss of strong acid sites that are key to the aromatization,possibly due to the removal of framework Al upon the interaction with *** modification with octadecylphosphonic acid only slightly alleviated the PVC poisoning *** insights on the PVC poisoning of zeolite catalysts provided in this work may guide the process design of chemical recycling of PVC containing waste plastics.

关键词： polyvinyl chloride polyethylene zeolite aromatics deactivation

Speed and surface steepness affect internal tibial loading during running

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Journal of Sport and Health Science 2024年第1期13卷 118-124页

作者： Hannah Rice markus Kurz Patrick mai Leon Robertz kevin Bill Timothy R.Derrick Steffen Willwacher Department of Physical Performance Norwegian School of Sport SciencesOslo 0806Norway Sports Tech Research Centre Mid Sweden UniversityÖstersund SE-83125Sweden Department of mechanical and Process Engineering Offenburg University of Applied SciencesOffenburg 77652Germany Institute of Biomechanics and Orthopaedics German Sport University CologneCologne 50933Germany Department of Kinesiology Iowa State UniversityAmesIA 50011USA

Background:Internal tibial loading is influenced by modifiable factors with implications for the risk of stress *** encounter varied surface steepness(gradients)when running outdoors and may adapt their speed according to the *** study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different ***:Twenty recreational runners ran on a treadmill at 3 different speeds(2.5 m/s,3.0 m/s,and 3.5 m/s)and gradients(level:0%;uphill:+5%,+10%,and+15%;downhill:-5%,-10%,and-15%).Force and marker data were collected synchronously *** moments were estimated at the distal third centroid of the tibia about the medial-lateral axis by ensuring static equilibrium at each 1%of *** was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ***-way repeated-measures analysis of variance were conducted using both functional and discrete statistical ***:There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior *** running speeds resulted in greater tibial *** uphill at+10%and+15%resulted in greater tibial loading than level *** downhill at-10%and-15%resulted in reduced tibial loading compared to level *** was no difference between+5%or-5%and level ***:Running at faster speeds and uphill on gradients≥+10%increased internal tibial loading,whereas slower running and downhill running on gradients≥-10%reduced internal *** running speed according to the gradient could be a protective mechanism,providing runners with a strategy to minimize the risk of tibial stress injuries.

关键词： Bending moments Gradient musculoskeletal modeling Overuse injury Tibial stress Training factors

Cognitive function among military veterans with STEm occupations

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military medical Research 2024年第2期11卷 308-310页

作者： Justin T.mcDaniel kevin N.Hascup Erin R.Hascup Ugochukwu G.Ezigbo Amanda m.Weidhuner Harvey Henson David L.Albright Dale and Deborah Smith Center for Alzheimer's Research and trEatment(CARE) Southern Illinois University School of MedicineSpringfieldIL 62794USA STEm Education Research Center Southern Illinois UniversityCarbondaleIL 62901USA Department of Political Science The University of AlabamaTuscaloosaAL 35487USA

Dear Editor,There is limited research on the relationship between science,technology,engineering,and mathematics(STEm)occupational history and cognitive function in later life,especially among military veterans,who may be at greater risk for later-life cognitive *** study examines a nationally representative sample of military veterans to address this gap in knowledge.

关键词： Alzheimer's disease Veterans Science technology engineering and mathematics(STEm) Animal fluency test Dementia