|
1
|
Kim P, Kim D, Scotch R, Jeong D, Kowalske K. Geospatial analysis of community-level social and environmental barriers for adult burn injury survivors in North Texas. Burns 2025; 51:107512. [PMID: 40286608 DOI: 10.1016/j.burns.2025.107512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 03/25/2025] [Accepted: 04/15/2025] [Indexed: 04/29/2025]
Abstract
PURPOSE This study investigates geographic variations in community integration among burn injury survivors in North Texas and identifies community-level social and environmental factors that influence their post-injury community reintegration. METHODS We utilized data from the Burn Model System (BMS) National Database, focusing on 153 adult burn injury survivors in North Texas who sustained injuries between 2015 and 2022. We conducted county-level mapping to visualize temporal changes in Community Integration Questionnaire (CIQ) scores by comparing pre-injury scores to post-injury scores at 6 and 12 months. Next, we categorized counties into two groups: (1) counties with consistent declines in CIQ scores over the 12-month post-injury period, and (2) all other counties with burn injury survivors. We then compared county-level community characteristics between these two groups, focusing on four factors: socioeconomic conditions, access to healthcare, public safety, and the built environment. RESULTS There were geographic disparities in CIQ score changes among counties after burn injury. Counties with consistent decreases in CIQ scores had significantly higher levels of poverty, higher unemployment rates, increased crime rates, and lower access to healthy food options compared to other counties. CONCLUSIONS The findings suggest that rural counties may lack a supportive environment for burn injury survivors, highlighting the need for targeted interventions to promote community integration. Implementing strategies to reduce socioeconomic disparities, enhance public safety, and improve access to nutritious food could help facilitate better community reintegration outcomes for burn injury survivors. Furthermore, clinicians can leverage these insights by offering patient-level supports-such as localized telehealth services, peer support group referrals at discharge, and guidance on local resources-to help individuals navigate environmental barriers and maintain community engagement after returning home.
Collapse
Affiliation(s)
- Pyung Kim
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, United States.
| | - Dohyeong Kim
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, United States
| | - Richard Scotch
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, United States
| | - Dohyo Jeong
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, United States
| | - Karen Kowalske
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, United States
| |
Collapse
|
|
2
|
Byrd JJ, Leonard AK, Samson KK, Larson JE, Shaw J, Halanski MA. Optimal Timing for Safe Bivalving of Fiberglass Casts Is Before the Exothermic Peak. J Am Acad Orthop Surg 2025; 33:e480-e490. [PMID: 39638315 DOI: 10.5435/jaaos-d-24-00729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 10/11/2024] [Indexed: 12/07/2024] Open
Abstract
INTRODUCTION Cast saw injury is a notable source of medicolegal risk. Previous work with plaster casts demonstrated that cast saw injury was minimized by waiting 12 minutes before removal. In this study, we evaluate the safety parameters of fiberglass casting materials. METHODS Eight-ply plaster and fiberglass casts were applied to a pediatric forearm model at variable dip-water temperatures, and the mean time to reach their exothermic peak was determined. Fiberglass casts were then maintained at the manufacturer's recommended dip-water temperature and removed at intervals of 2 (before exothermic peak), 6 (approximately fiberglass's exothermic peak), or 12 (after exothermic peak) minutes. All casts were removed by a pediatric orthopaedic surgeon blinded to the cast set time. Cast/blade temperature, saw force, blade-to-skin contact, bivalve time, cast spreading force, and cut completeness were assessed individually and as short (<6-minutes) or long (≥6-minutes) set times. RESULTS Fiberglass casts exothermically peaked markedly earlier (5.2 [IQR = 5-5.4] minutes) than plaster (14.8 [IQR = 13.7-15.3] minutes), P < 0.0001, at maximum temperatures, which did not markedly differ. Downward force applied during fiberglass cast removal was markedly lower in the short versus long set time groups [average forces of 8.3 (IQR = 6.4-10.4) versus 12.9 (IQR = 11.1-14.5) Newtons, P < 0.0001, as were maximum forces: 23.2 (IQR = 18.9-26.6) versus 43.8 (IQR = 38.6-48.5) Newtons, P < 0.0001]. Bivalve time and maximum cast spreading force were decreased in short set times with 40.5 (IQR = 39.2-44.7) versus 44.4 (IQR = 40.6-47.3) seconds ( P = 0.06) and 15.5 (IQR = 14-18.5) versus 21.5 (IQR = 18-26.5) N ( P = 0.07), respectively. Maximum saw blade temperature was markedly lower in the short (99.6°C [IQR = 98.2-105.6°C]) versus long (130.6°C [IQR = 121.9-141°C]) set times ( P = 0.04). No notable differences in blade-to-skin touches or touch duration were detected. DISCUSSION Unlike plaster, fiberglass casts cut before exothermically peaking were associated with less downward force, faster bivalve times, and decreased spread force without increased blade temperature or skin contacts. This suggests that fiberglass casts can be bivalved markedly earlier without increased risk of injury.
Collapse
Affiliation(s)
- Jay J Byrd
- From the College of Medicine, University of Nebraska Medical Center, Omaha, NE (Byrd), the Department of Orthopaedic Surgery and Rehabilitation (Leonard), Department of Biostatistics (Samson), University of Nebraska Medical Center, Omaha, NE, Northwestern University, Division of Orthopaedic Surgery and Sports Medicine, Chicago, IL (Larson), Phoenix Children's Hospital, Division of Orthopedics and Sports Medicine, Phoenix, AZ (Shaw and Halanski)
| | | | | | | | | | | |
Collapse
|
|
3
|
Zheng JL, Ashebo LJ, Lawrence JTR, Sarkar S, Velez G, Horn BD. Decreasing cast saw injuries: Developing a novel real-time temperature sensor system for cast saw blades. J Orthop Surg (Hong Kong) 2025; 33:10225536251345190. [PMID: 40491364 DOI: 10.1177/10225536251345190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2025] Open
Abstract
Introduction: Cast saws may cause burns secondary to generated heat. This study aimed to develop a real-time temperature feedback system to alert users of increasingly unsafe saw blade temperatures. Methods: A sensor device was designed for the Stryker 940 cast saw, measuring temperature at the two blade ends and providing real-time feedback through an LED-light system (green, yellow, red, blinking red) with adjustable temperature ranges. LED ranges were determined using temperature data from four cast technicians. "Skin" touches were assessed with conductivity from the blade to copper strips within cast padding. Users were asked to remove standardized casts, completing three test runs with LED indicators off and three with the light on. Time spent within each temperature range and number of "skin" touches per run were analyzed. Results: With the LED on, the percentage of time spent in the green zone increased (p < .0001) while percentage of time in the red zone decreased (p < .0001) across all test groups. Average time per run increased with the LED on. Although not statistically significant, the number of "skin" touches decreased across all groups with LED on (p = .0630). Conclusions: A temperature-sensitive LED light connection to cast saw blades can potentially decrease user time spent in unsafe temperatures and risk of cast saw burns.
Collapse
Affiliation(s)
- Jenny L Zheng
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Leta J Ashebo
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - J Todd R Lawrence
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sulagna Sarkar
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Giangabriel Velez
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B David Horn
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|
|
4
|
Mydske S, Brattebø G, Helland AM, Wiggen Ø, Aßmus J, Thomassen Ø. Treatment of accidental hypothermia: Impact of insulation placement above or below an active external rewarming device on temperature and burn risk. J Therm Biol 2025; 129:104126. [PMID: 40344754 DOI: 10.1016/j.jtherbio.2025.104126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 03/26/2025] [Accepted: 04/23/2025] [Indexed: 05/11/2025]
Abstract
INTRODUCTION Prehospital treatment of accidental hypothermia typically involves using active external rewarming, usually either with chemical or electrical heating pads. Active external rewarming is a recommended treatment method, but carries the risk of burn injury, which can occur if tissue temperature exceeds 43 °C. Some device manufacturers discourage direct skin contact; however, there are no recommendations regarding type or amount of insulating material that should be placed between the patient and the device. We aimed to describe the impact of different insulating materials above and below various devices on the temperature at the contact area. METHODS Three different active external rewarming devices were suspended above a thermal imaging camera capable of recording the peak and average temperature of a surface area. Nine different scenarios with varying layers of insulation above and below the device, were tested over a 20-min period. The devices included an electric resistive heat pad, an oxygen-activated chemical heating blanket, and a sodium acetate chemical heat pack. Peak surface temperature was recorded every 30 s, and average surface temperature was calculated after each test. RESULTS Nine scenarios for three different devices were tested, resulting in 27 experiments. Development of peak surface temperature varied between devices. The electric device reached a highest average temperature of 42.9 °C and a peak temperature of 51.4 °C. The oxygen-reactive chemical heating device reached a highest average temperature of 27.2 °C, with a peak temperature of 57.5 °C. The sodium acetate chemical heat pack reached a highest average temperature of 50.4 °C and a peak temperature of 56.2 °C. CONCLUSIONS The devices demonstrated different temperature development characteristics depending on amount and relative placement of insulation, and all had the potential to exceed the threshold of potential thermal injury to the skin. Rescuers need to be aware of both the benefits and risks associated with the rewarming devices they use.
Collapse
Affiliation(s)
- Sigurd Mydske
- Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway.
| | - Guttorm Brattebø
- Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway; Norwegian National Advisory Unit on Emergency Medical Communication, Haukeland University Hospital, Bergen, Norway
| | - Ane Marthe Helland
- Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - Øystein Wiggen
- Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway; SINTEF Technology and Society, Preventive Health Research, Trondheim, Norway
| | - Jörg Aßmus
- Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - Øyvind Thomassen
- Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway
| |
Collapse
|
|
5
|
Cussons D, Perusseau-Lambert A, Frew Q, Barnes D, Myers S, Dziewulski P. The effect of nitrile gloves on temperature perception during hot water immersion. Burns 2025; 51:107392. [PMID: 39874884 DOI: 10.1016/j.burns.2025.107392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 12/15/2024] [Accepted: 01/12/2025] [Indexed: 01/30/2025]
Abstract
INTRODUCTION Scalds account for 40 % of burn injuries in developed countries, with a subset occurring during caregiving activities, particularly when gloves are worn. Gloves, a standard precaution against infection and body fluid exposure, may impair sensory feedback critical for detecting temperature changes, potentially increasing the risk of burns during personal care tasks. METHODS This study investigated the impact of glove use on heat perception. Twelve healthy participants (6 male, 6 female) immersed their index fingers in water baths set at 40°C, 45°C, 50°C, 55°C, and 60°C. Heat perception thresholds were assessed under three conditions: no gloves, single gloves, and double gloves. Participants withdrew their fingers upon feeling discomfort, and the withdrawal temperatures were recorded. RESULTS Our trial showed that gloves significantly delayed heat discomfort detection, with the longest delays observed at 50°C and 55°C when double gloves were worn. Wearing a single glove raised the discomfort threshold by approximately 5°C, while double gloves increased it by 10°C. This logarithmic relationship between temperature and perception delay indicates a substantial sensory alteration, especially at higher temperatures. CONCLUSION The findings underscore the heightened risk of scald injuries in vulnerable individuals due to delayed heat detection caused by gloves. Awareness of altered temperature thresholds during glove use is essential to prevent burns during caregiving tasks, particularly in activities requiring precise temperature assessment, such as bathing or showering. Enhanced education and preventive measures are crucial for ensuring safety in these contexts.
Collapse
Affiliation(s)
- David Cussons
- St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK
| | - Aude Perusseau-Lambert
- St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK.
| | - Quentin Frew
- St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK; St. Andrew's Anglia Ruskin Research (StAAR) Group, Anglia Ruskin University, Chelmsford, UK
| | - David Barnes
- St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK
| | - Simon Myers
- St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK; Chair of Burns, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Peter Dziewulski
- St. Andrew's Centre for Plastic Surgery and Burns, Mid and South Essex NHS Foundation Trust, Chelmsford CM1 7E, UK; St. Andrew's Anglia Ruskin Research (StAAR) Group, Anglia Ruskin University, Chelmsford, UK
| |
Collapse
|
|
6
|
Chouhan D, Akhilesh, Tiwari V. Focal Adhesion Kinase Inhibition Ameliorates Burn Injury-Induced Chronic Pain in Rats. Mol Neurobiol 2025; 62:4466-4483. [PMID: 39460902 DOI: 10.1007/s12035-024-04548-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 10/11/2024] [Indexed: 10/28/2024]
Abstract
Burn injury-induced pain (BIP) is a significant global health concern, affecting diverse populations including children, military veterans, and accident victims. Current pharmacotherapeutics for the management of BIP are associated with severe side effects including drug addiction, respiratory depression, sedation, and constipation posing significant barrier to their clinical utility. In the present study, we have investigated the potential role of focal adhesion kinase (p-FAK) for the very first time in BIP and elucidated the associated underlying mechanisms. Defactinib (DFT), a potent p-FAK inhibitor, administered at doses of 5, 10, and 20 mg/kg via intraperitoneal injection, demonstrates significant efficacy in reducing both evoked and spontaneous pain without causing addiction or other central nervous system toxicities. Burn injury triggers p-FAK-mediated phosphorylation of Erk1/2 and NR2B signaling in the DRG, resulting in heightened hypersensitivity through microglial activation, neuropeptide release, and elevated proinflammatory cytokines. Defactinib (DFT) counteracts these effects by reducing NR2B upregulation, lowering substance P levels, inhibiting microglial activation, and restoring IL-10 levels while leaving CGRP levels unchanged. These findings provide valuable insights into the pivotal role of p-FAK in regulating BIP and highlight the potential for developing novel therapeutics for burn injury-induced pain with minimal side effects.
Collapse
Affiliation(s)
- Deepak Chouhan
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, 221005, Uttar Pradesh, India
| | - Akhilesh
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, 221005, Uttar Pradesh, India
| | - Vinod Tiwari
- Neuroscience and Pain Research Laboratory, Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi, 221005, Uttar Pradesh, India.
| |
Collapse
|
|
7
|
Gao T, Liang L, Ding H, Zhang C, Wang X, Hu W, Zhang K, Wang G. A ConvLSTM-based model for predicting thermal damage during laser interstitial thermal therapy. Phys Med Biol 2025; 70:055005. [PMID: 39919370 DOI: 10.1088/1361-6560/adb3ea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Accepted: 02/07/2025] [Indexed: 02/09/2025]
Abstract
Objective.Accurate prediction of thermal damage extent is essential for effective and precise thermal therapy, especially in brain laser interstitial thermal therapy (LITT). Immediate postoperative contrast-enhanced T1-weighted imaging (CE-T1WI) is the primary method for clinically assessingin vivothermal damage after image-guided LITT. CE-T1WI reveals a hyperintense enhancing rim surrounding the target lesion, which serves as a key radiological marker for evaluating the thermal damage extent. Although widely used in clinical practice, traditional thermal damage models rely on empirical parameters fromin vitroexperiments, which can lead to inaccurate predictions of thermal damagein vivo. Additionally, these models predict only two tissue states (damaged or undamaged), failing to capture three tissue states observed on post-CE-T1WI images, highlighting the need for improved thermal damage prediction methods.Approach.This study proposes a novel convolutional long short-term memory-based model that utilizes intraoperative temperature distribution history data measured by magnetic resonance temperature imaging (MRTI) during LITT to predict the enhancing rim on post-CE-T1WI images. This method was implemented and evaluated on retrospective data from 56 patients underwent brain LITT.Main results.The proposed model effectively predicts the enhancing rim on postoperative images, achieving an average dice similarity coefficient of 0.82 (±0.063) on the test dataset. Furthermore, it generates real-time predicted thermal damage area variation trends that closely resemble those of the traditional thermal damage model, suggesting potential for real-time prediction of thermal damage extent.Significance.This method could provide a valuable tool for visualizing and assessing intraoperative thermal damage extent.
Collapse
Affiliation(s)
- Tingting Gao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, People's Republic of China
| | - Libin Liang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, People's Republic of China
| | - Hui Ding
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, People's Republic of China
| | - Chao Zhang
- Neurosurgical Department, Beijing Tiantan Hospital, Beijing 100084, People's Republic of China
| | - Xiu Wang
- Neurosurgical Department, Beijing Tiantan Hospital, Beijing 100084, People's Republic of China
| | - Wenhan Hu
- Beijing Neurosurgical Institute, Beijing 100084, People's Republic of China
| | - Kai Zhang
- Neurosurgical Department, Beijing Tiantan Hospital, Beijing 100084, People's Republic of China
| | - Guangzhi Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, People's Republic of China
| |
Collapse
|
|
8
|
Güneri FD, Karaarslan F, Özen H, Odabaşi E. Medical mud-pack treatment with different temperatures in patients with knee osteoarthritis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2025:10.1007/s00484-025-02864-0. [PMID: 39928107 DOI: 10.1007/s00484-025-02864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 01/27/2025] [Accepted: 01/29/2025] [Indexed: 02/11/2025]
Abstract
To compare the effects of medical mud-pack (MMP) treatments applied at different temperatures on the pain and joint functions of patients with knee osteoarthritis (KOA). Kellgren Lawrence (KL) stage 3 or 4 KOA patients were included and randomized into three groups. Patients in groups 1, 2, and 3 took MMP treatment to both knees at 39 °C, 42 °C, and 45 °C, respectively. The treatment was performed for 12 days (only weekdays) and was 30 min long per day. The same blinded physician evaluated the patients at baseline and at the end of the treatment. The assessments were done before and after the intervention. The primary outcome was to achieve a minimal clinically important improvement (MCII) for KOA (decrease of at least 19 mm (-40.8%) on the VAS for pain, a decrease of 18.3 mm (-39%) on the patient's global assessment (PGA), and/or a decrease of at least 9.1 points (-26%) on the Western Ontario and McMaster Universities Osteoarthritis Index function subscale (WOMAC-FS). Secondary outcomes were pain (VAS), patient's global assessment (VAS), physician's global assessment (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Patient's health state, Patient Acceptable Symptom State (PASS). 217 patients were analyzed. Groups 1, 2, and 3 had 68, 81,68 patients, respectively. The MCII measurement revealed that MMP treatment did not show a significant difference between groups 2 and 3 (p > 0.05). Also, it was observed that more patients in groups 2 and 3 reached the MCII compared to group 1 (p < 0.001). For the secondary outcomes, significant improvements were observed within-group evaluations for each of the three groups (p < 0.001). Between groups comparisons, the improvements at the end of the treatment were found to be superior for group 2 and group 3 compared to group 1 (p < 0.001). There was no statistically significant difference between groups 2 and 3 for any parameters (p > 0.05). The number of patients who achieved the PASS was statistically lower for group 1 compared to groups 2 and 3 (p < 0.001). We observed significant improvements in all groups after treatment. The main result, as measured by MCII, suggests that MMP treatments at 42-45 °C is more effective than at 39 °C in managing severe KOA patients' pain and functional status. We found no significant difference in pain and joint function improvement between 42 °C and 45 °C after MMP.
Collapse
Affiliation(s)
- Fulya Demircioğlu Güneri
- Department of Medical Ecology and Hydroclimatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
| | - Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Hülya Özen
- Department of Medical Informatics, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ersin Odabaşi
- Department of Medical Ecology and Hydroclimatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
|
9
|
Wachenfeld-Teschner V, Beier JP, Boos AM, Schäfer B. Factors Influencing Surgical Care and Outcome of Pediatric Burn Injuries and the Use of Synthetic Skin Substitutes. J Burn Care Res 2025; 46:94-100. [PMID: 38859796 DOI: 10.1093/jbcr/irae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Indexed: 06/12/2024]
Abstract
Burn trauma is one of the most common causes of inpatient treatment in children and is associated with severe physical and psychological consequences. Synthetic skin substitutes are designed to reduce the risk of infection, minimize wound pain, and reduce the frequency of dressing changes. However, data regarding premature detachment of these materials is scarce. The aim of this study was to identify factors associated with early detachment and subsequent consequences for surgical treatment. A retrospective analysis of 392 children with superficial and deep partial thickness burns undergoing inpatient treatment with the application of a skin substitute (Suprathel) was performed. Patient age, wound localization and progression, as well as burned total body surface area (TBSA%) were investigated as possible risk factors for early detachment of wound dressings and surgical intervention. Premature material detachment was significantly associated with burn localization (P < .001) and correlated with burn depth progression (r = 0.23, <0.001) and patient age (r = 0.22, <0.001). Surgical revision after material detachment was required in 13% of patients. Patient age and burn localization seem to increase the risk of premature material detachment. In addition, we observed increased premature detachment of Suprathel® in areas that elicited higher wound progression rates. Identifying these areas might prove pivotal in the improvement of pediatric burn trauma management.
Collapse
Affiliation(s)
- Victoria Wachenfeld-Teschner
- Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen 52074, Germany
| | - Justus P Beier
- Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen 52074, Germany
| | - Anja M Boos
- Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen 52074, Germany
| | - Benedikt Schäfer
- Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen 52074, Germany
| |
Collapse
|
|
10
|
Kim S, Oh G, Kim YR, Chung E, Kwon HS. Infrared thermal modulation endoscopy for label-free tumor detection. Sci Rep 2024; 14:31575. [PMID: 39738048 PMCID: PMC11685564 DOI: 10.1038/s41598-024-76173-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 10/10/2024] [Indexed: 01/01/2025] Open
Abstract
In optical imaging of solid tumors, signal contrasts derived from inherent tissue temperature differences have been employed to distinguish tumor masses from surrounding tissue. Moreover, with the advancement of active infrared imaging, dynamic thermal characteristics in response to exogenous thermal modulation (heating and cooling) have been proposed as novel measures of tumor assessment. Contrast factors such as the average rate of temperature changes and thermal recovery time constants have been investigated through an active thermal modulation imaging approach, yielding promising tumor characterization results in a xenograft mouse model. Here, to assess its clinical potential, we developed and deployed an endoscopic infrared thermal modulation imaging system, incorporating anti-reflection germanium lenses. Employing tissue cooling, we evaluated the feasibility of detecting in situ tumors in a syngeneic rectal tumor mouse model. Consequently, early-stage tumors were successfully localized and evaluated based on their heat signatures. Notably, tumors exhibited a higher rate of temperature change induced by thermal modulation compared to adjacent tissues. Through the introduction of this label-free technology, Infrared Thermal Modulation Endoscopy (ITME), our study showcased an effective method for optically delineating and assessing solid tumors. This innovative diagnostic technology holds significant promise for enhancing our ability to detect, classify, and characterize abnormal tissues.
Collapse
Affiliation(s)
- Suhyeon Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
| | - Gyungseok Oh
- Medical Technology Examination Division, Korean Intellectual Property Office, Daejeon, 35208, South Korea
| | - Young Ro Kim
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA, 02115, USA
| | - Euiheon Chung
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
- AI Graduate School, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
- Research Center for Photon Science Technology, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea
| | - Hyuk-Sang Kwon
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
- AI Graduate School, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
- Research Center for Photon Science Technology, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
| |
Collapse
|
|
11
|
Wang S, Kang S, Fu Y, Yu Q, Tan L, Gao C, Lin C. Fiber-Shaped Temperature Sensor with High Seebeck Coefficient for Human Health and Safety Monitoring. ACS APPLIED MATERIALS & INTERFACES 2024; 16:69617-69625. [PMID: 39629834 DOI: 10.1021/acsami.4c17468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2024]
Abstract
Wearable thermoelectric (TE)-based temperature sensors capable of detecting and transmitting temperature data from the human body and environment show promise in intelligent medical systems, human-machine interfaces, and electronic skins. However, it has remained a challenge to fabricate the flexible temperature sensors with superior sensing performance, primarily due to the low Seebeck coefficient of the TE materials. Here, we report an inorganic amorphous TE material, Ge5As55Te40, with a high Seebeck coefficient of 1050 μV/K, which is around 3 times higher than the organic TE materials and 2 times higher than the inorganic crystal TE materials. Due to the strong anticrystallization ability, the amorphous state of Ge5As55Te40 can be well maintained during the thermal fiber-drawing process. The resulting TE fibers demonstrate superior temperature sensing properties, encompassing a broad working range (25-115 °C), a precise temperature resolution of 0.1 K, and a rapid response time of 5 s. Importantly, the TE properties of the fiber show high stability after repeated temperature variations between 5 and 10 K. Moreover, the fibers can be integrated into a mask and a wearable fabric for monitoring human respiratory rate and providing early warning for fire source proximity. These results highlight that the TE fiber with both natural flexibility and superior temperature sensing performance may find potential applications in wearable systems.
Collapse
Affiliation(s)
- Shengpeng Wang
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| | - Shiliang Kang
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| | - Yanqing Fu
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| | - Qingquan Yu
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| | - Linling Tan
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| | - Chengwei Gao
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| | - Changgui Lin
- Laboratory of Infrared Materials and Devices, The Research Institute of Advanced Technologies, Ningbo University, Ningbo 315211, China
- Engineering Research Center for Advanced Infrared Photoelectric Materials and Devices of Zhejiang Province, Ningbo University, Ningbo 315211, China
- Zhejiang Key Laboratory of Advanced Optical Functional Materials and Devices, Ningbo University, Ningbo 315211, China
| |
Collapse
|
|
12
|
Liu J, Li Z, Sun M, Zhou L, Wu X, Lu Y, Shao Y, Liu C, Huang N, Hu B, Wu Z, You C, Li L, Wang M, Tao L, Di Z, Sheng X, Mei Y, Song E. Flexible bioelectronic systems with large-scale temperature sensor arrays for monitoring and treatments of localized wound inflammation. Proc Natl Acad Sci U S A 2024; 121:e2412423121. [PMID: 39589888 PMCID: PMC11626133 DOI: 10.1073/pnas.2412423121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 10/23/2024] [Indexed: 11/28/2024] Open
Abstract
Continuous monitoring and closed-loop therapy of soft wound tissues is of particular interest in biomedical research and clinical practices. An important focus is on the development of implantable bioelectronics that can measure time-dependent temperature distribution related to localized inflammation over large areas of wound and offer in situ treatment. Existing approaches such as thermometers/thermocouples provide limited spatial resolution, inapplicable to a wearable/implantable format. Here, we report a conformal, scalable device package that integrates a flexible amorphous silicon-based temperature sensor array and drug-loaded hydrogel for the healing process. This system can enable the spatial temperature mapping at submillimeter resolution and high sensitivity of 0.1 °C, for dynamically localizing the inflammation regions associated with temperature change, automatically followed with heat-triggered drug delivery from hydrogel triggered by wearable infrared light-emitting-diodes. We establish the operational principles experimentally and computationally and evaluate system functionalities with a wide range of targets including live animal models and human subjects. As an example of medical utility, this system can yield closed-loop monitoring/treatments by tracking of temperature distribution over wound areas of live rats, in designs that can be integrated with automated wireless control. These findings create broad utilities of these platforms for clinical diagnosis and advanced therapy for wound healthcare.
Collapse
Affiliation(s)
- Junhan Liu
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- State Key Laboratory of Integrated Chips and Systems, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Zhongzheng Li
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Mubai Sun
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- Institute of Agro-food Technology, Jilin Academy of Agricultural Sciences (Northeast Agricultural Research Center of China), Changchun130033, China
| | - Lianjie Zhou
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Xiaojun Wu
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- State Key Laboratory of Integrated Chips and Systems, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
| | - Yifei Lu
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Yuting Shao
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai200065, China
| | - Chang Liu
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Ningge Huang
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- State Key Laboratory of Integrated Chips and Systems, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Bofan Hu
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Zhongyuan Wu
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Chunyu You
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Lizhu Li
- Sichuan Provincial Key Laboratory for Human Disease Gene Study and the Center for Medical Genetics, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu611731, China
| | - Ming Wang
- State Key Laboratory of Integrated Chips and Systems, Fudan University, Shanghai200438, China
| | - Ling Tao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai200030, China
| | - Zengfeng Di
- State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai200050, China
| | - Xing Sheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Tsinghua University, Beijing100084, China
- Institute for Precision Medicine, Center for Flexible Electronics Technology, IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing100084, China
| | - Yongfeng Mei
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| | - Enming Song
- Department of Materials Science and Institute of Optoelectronics, Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Fudan University, Shanghai200438, China
- State Key Laboratory of Integrated Chips and Systems, Fudan University, Shanghai200438, China
- International Institute for Intelligent Nanorobots and Nanosystems, Center for Neural Regulation and Brain-Computer Interface Research, Fudan University, Shanghai200438, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang322000, China
| |
Collapse
|
|
13
|
Yao K, Zhuang Q, Zhang Q, Zhou J, Yiu CK, Zhang J, Ye D, Yang Y, Wong KW, Chow L, Huang T, Qiu Y, Jia S, Li Z, Zhao G, Zhang H, Zhu J, Huang X, Li J, Gao Y, Wang H, Li J, Huang Y, Li D, Zhang B, Wang J, Chen Z, Guo G, Zheng Z, Yu X. A fully integrated breathable haptic textile. SCIENCE ADVANCES 2024; 10:eadq9575. [PMID: 39423259 PMCID: PMC11488569 DOI: 10.1126/sciadv.adq9575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 09/13/2024] [Indexed: 10/21/2024]
Abstract
Wearable haptics serve as an enhanced media to connect humans and VR/robots. The inevitable sweating issue in all wearables creates a bottleneck for wearable haptics, as the sweat/moisture accumulated in the skin/device interface can substantially affect feedback accuracy, comfortability, and create hygienic problems. Nowadays, wearable haptics typically gain performance at the cost of sacrificing the breathability, comfort, and biocompatibility. Here, we developed a fully integrated breathable haptic textile (FIBHT) to solve these trade-off issues, where the FIBHT exhibits high-level integration of 128 pixels over the palm, great stretchability of 400%, and superior permeability of over 657 g/m2/day (moisture) and 40 mm/s (air). It is a stand-alone haptic system totally composed of stretchable, breathable, and bioadhesive materials, which empowers it with precise, sweating/movement-insensitive and dynamic feedback, and makes FIBHT powerful for virtual touching in broad scenarios.
Collapse
Affiliation(s)
- Kuanming Yao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Qiuna Zhuang
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Qiang Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Jingkun Zhou
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
| | - Chun Ki Yiu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
| | - Jianpeng Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Denglin Ye
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Yawen Yang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Ki Wan Wong
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Lung Chow
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Tao Huang
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Yuze Qiu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
| | - Shengxin Jia
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
| | - Zhiyuan Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Guangyao Zhao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Hehua Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Jingyi Zhu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Xingcan Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Jian Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
| | - Yuyu Gao
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Huiming Wang
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jiyu Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
| | - Ya Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Dengfeng Li
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Binbin Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
| | - Jiachen Wang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Zhenlin Chen
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Guihuan Guo
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Zijian Zheng
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Intelligent Wearable Systems (RI-IWEAR), The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Energy (RI-RISE), The Hong Kong Polytechnic University, Hong Kong SAR, China
- Soft Electronics Research Centre, PolyU-Wenzhou Technology and Innovation Research Institute, Wenzhou, Zhejiang Province, China
- The Hong Kong Polytechnic University-Daya Bay Technology and Innovation Research Institute, Huizhou, Guangdong Province, China
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
- Hong Kong Centre for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong Science Park, Hong Kong SAR, China
- Institute of Digital Medicine, City University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
|
14
|
Mallette MM, Gur-Arie N, Gerrett N. A Local Heating Profile to Manage Lower Back Pain in an Automotive Seat: A Pilot Study. Bioengineering (Basel) 2024; 11:1040. [PMID: 39451416 PMCID: PMC11505544 DOI: 10.3390/bioengineering11101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 10/02/2024] [Accepted: 10/14/2024] [Indexed: 10/26/2024] Open
Abstract
Lower back pain (LBP) is one of the most prevalent health losses in adults worldwide. Historically, heat has been successfully used for treating pain and relieving tight muscles. Given the effective contact with the occupant's back and proximity to the heat source, coupled with increasing commute times, automotive seats offer an opportunity to intervene. Fifteen adults (nine female) who experienced acute, subacute, and chronic lower back pain were recruited to examine the effectiveness of heat delivered to the lower back in providing temporary pain relief. Participants sat in a car seat for 38 min on two days, which included a 5-min baseline followed by a 33-min intervention; control, or localized. For the control condition, participants sat for 33 min without any thermal devices on, while the localized condition heated and maintained the seat surface temperature of the lower seat back area to ~45 °C. Over the 33-min control condition, the back skin temperature increased by ~1-2 °C and did not impact the subjective LBP. Heating the lower back for 33 min to ~39 °C reduced the subjective LBP by 10%. We demonstrated that lower back pain can be alleviated from an automotive seat providing heat to the lower back within normal commute times in those with lower back pain.
Collapse
Affiliation(s)
| | | | - Nicola Gerrett
- Integrative Human Research Lab, Gentherm, 38455 Hills Tech Dr., Farmington Hills, MI 48331, USA; (M.M.M.); (N.G.-A.)
| |
Collapse
|
|
15
|
Wang SH, Chien CY, Fu CY, Bokhari F. Evaluating the association between time to skin grafting for truncal burn patients and complications: a comparative cohort study using the National Trauma Data Bank. Int J Surg 2024; 110:4581-4587. [PMID: 39143705 PMCID: PMC11325990 DOI: 10.1097/js9.0000000000001461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/31/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND The split-thickness skin graft (STSG) procedure is frequently used in the reconstruction of burn-injured patients. This study assessed the impact of graft timing on associated skin complications in patients with torso burns using a comprehensive national database. METHODS Truncal burn (2nd-degree and 3rd-degree burns covering 20-89% TBSA) patients who underwent STSG in the National Trauma Data Bank from 2011 to 2015 were studied. The outcomes examined were graft-related complications (superficial surgical site infections, deep surgical site infections, and graft failure), overall mortality and hospital length of stay (LOS). Patients were compared based on the presence or absence of grafting complications. A linear regression model was used to assess the relationship between hospital LOS and graft timing, considering other variables. RESULTS Among the 853 studied patients, the cohort with graft complications exhibited a significantly prolonged time to STSG (413.0 h compared to 264.6 h, P<0.001) and a higher percentage of patients with pre-existing diabetes (18.5 vs. 8.0%, P=0.008). The multiple logistic regression analysis revealed that both the extended time to STSG (odds=1.001, P=0.003) and pre-existing diabetes (odds=2.790, P=0.010) significantly elevated the likelihood of complications associated with STSG. Notably, this delay did not elevate mortality risks. A positive relationship was found between grafting delay and LOS. CONCLUSION The findings underscore that a prolonged duration to skin grafting contributes to extended hospital stays and increased graft-related complications. However, the role of grafting delay in influencing the mortality of truncal burn patients appeared inconsequential, indicating that mortality may be influenced by various factors.
Collapse
Affiliation(s)
- Szu-Han Wang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung
- Graduate Institute of Biomedical Informatics, Taipei Medical University
| | - Chih-Ying Chien
- Department of General Surgery, Chang Gung Memorial Hospital, Keelung Branch, Chang Gung University, Taipei
| | - Chih-Yuan Fu
- Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taiwan
- Department of Trauma and Burn Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago
| | - Faran Bokhari
- Department of Trauma and Burn Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago
- Emergency Surgical Services, St. Francis Hospital, OSF Healthcare System, Peoria, Illinois, USA
| |
Collapse
|
|
16
|
Lu SS, Yang LL, Yang W, Wang J, Zhang XL, Yang L, Wen Y. Complications and adverse events of high-intensity focused ultrasound in its application to gynecological field - a systematic review and meta-analysis. Int J Hyperthermia 2024; 41:2370969. [PMID: 38945548 DOI: 10.1080/02656736.2024.2370969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024] Open
Abstract
OBJECTIVE To analyze and summarize the types, incidence rates and relevant influencing factors of adverse events (AEs) after high-intensity focused ultrasound ablation of gynecological diseases and provide reference and basis for handling such events in clinical practice. METHOD We searched PubMed, Cochrane Library, Web of Science and Embase databases to retrieve all literature since its establishment until February 2024. We evaluated the quality of included literature and publication bias and conducted a meta-analysis of single group rates for various AEs using Stata 17.0. RESULTS This systematic review finally included 41 articles. We summarized 34 kinds of AEs in 7 aspects and conducted a single group rate meta-analysis and sub-group analysis of 16 kinds of AEs. Among the common AEs of High-Intensity Focused Ultrasound (HIFU), the incidence of lower abdominal pain/pelvic pain is 36.1% (95% CI: 24.3%∼48.8%), vaginal bleeding is 20.6% (95% CI: 13.9%∼28.0%), vaginal discharge is 14.0% (95% CI: 9.6%∼19.1%), myoma discharge is 24% (95% CI: 14.6%∼34.8%), buttock pain is 10.8% (95% CI: 6.0%∼16.5%) and sacral pain is 10% (95% CI: 8.8%∼11.2%). Serious complications include uterine rupture, necrotic tissue obstruction requiring surgical intervention, third degree skin burns and persistent lower limb pain or movement disorders. CONCLUSION The common AEs after HIFU surgery are mostly mild and controllable, and the incidence of serious complications is extremely low. By reasonable prevention and active intervention, these events can be further reduced, making it a safe and effective treatment method. It is a good choice for patients who crave noninvasive treatment or have other surgical contraindications.
Collapse
Affiliation(s)
- Shan-Shan Lu
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lei-Lei Yang
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Yang
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Wang
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xia-Lin Zhang
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Liu Yang
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yi Wen
- Gynecology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| |
Collapse
|
|
17
|
Bouarfa M, Chebaibi M, Ez-Zahra Amrati F, Souirti Z, Saghrouchni H, El atki Y, Bekkouche K, Mourabiti H, Bari A, Giesy JP, Mohany M, Al-Rejaie SS, Aboul-Soud MAM, Bousta D. In vivo and in silico studies of the effects of oil extracted from Cannabis sativa L. seeds on healing of burned skin wounds in rats. Front Chem 2024; 12:1381527. [PMID: 38919274 PMCID: PMC11197104 DOI: 10.3389/fchem.2024.1381527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/06/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction This study investigates the potential effects of cannabis seed oil (CSO) on the wound healing process. The aim was to assess the efficacy of CSO in treating skin wounds using an animal model and to explore its anti-inflammatory properties through in silico analysis. Methods Eighteen male albino Wistar rats, weighing between 200 and 250 g, were divided into three groups: an untreated negative control group, a group treated with the reference drug silver sulfadiazine (SSD) (0.01 g/mL), and a group treated topically with CSO (0.962 g/mL). The initial wound diameter for all groups was 1 cm. In silico studies were conducted using Maestro 11.5 to evaluate the anti-inflammatory effects of phytoconstituents against cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Results CSO and SSD treatments led to a significant reduction (p <0.05) in the size of burned skin wounds by day 5, with contraction rates of 53.95% and 45.94%, respectively, compared to the untreated negative control group. By day 15, wounds treated with CSO and SSD had nearly healed, showing contraction rates of 98.8% and 98.15%, respectively. By day 20, the wounds treated with CSO had fully healed (100%), while those treated with SSD had almost completely healed, with a contraction rate of 98.97%. Histological examination revealed granulated tissue, neo-blood vessels, fibroblasts, and collagen fibers in wounds treated with CSO. In silico studies identified arachidic acid, γ-linolenic acid, and linolenic acid as potent inhibitors of COX-1 and COX-2. Serum biochemical parameters indicated no significant changes (p > 0.05) in liver and kidney function in rats treated with CSO, whereas a significant increase (p < 0.01) in ALAT level was observed in rats treated with SSD. Discussion The findings demonstrate that CSO has a promising effect on wound healing. The CSO treatment resulted in significant wound contraction and histological improvements, with no adverse effects on liver and kidney function.However, the study's limitations, including the small sample size and the need for detailed elucidation of CSO's mechanism of action, suggest that further research is necessary. Future studies should focus on exploring the molecular pathways and signaling processes involved in CSO's pharmacological effects.
Collapse
Affiliation(s)
- Mouna Bouarfa
- Laboratory of Biotechnology, Environment, Agri-Food and Health (LBEAS), Faculty of Sciences Dhar El Mehraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Mohamed Chebaibi
- Ministry of Health and Social Protection, Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Fatima Ez-Zahra Amrati
- Laboratory of Biotechnology, Environment, Agri-Food and Health (LBEAS), Faculty of Sciences Dhar El Mehraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Zouhair Souirti
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Neurology Department, Sleep Center Hassan II University Hospital, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hamza Saghrouchni
- Department of Biotechnology, Institute of Natural and Applied Sciences, Çukurova University, Adana, Türkiye
| | - Yassine El atki
- High Institute of Nursing Professions and Health Techniques, Fez, Morocco
| | - Khalid Bekkouche
- Laboratory of Agri-Food, Biotechnologies and Valorization of Plant Bioresources (AGROBIOVAL), Department of Biology, Team of Protection and Valorization of Plant Resources (AgroBiotech Center, URL-CRNST 05), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - Hajar Mourabiti
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Service de Toxico-pharmacologie, Fès, Morocco
| | - Amina Bari
- Laboratory of Biotechnology, Environment, Agri-Food and Health (LBEAS), Faculty of Sciences Dhar El Mehraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - John P. Giesy
- Department of Veterinary Biomedical Sciences and Toxicology Centre, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Environmental Sciences, Baylor University, Waco, TX, United States
- Department of Integrative Biology and Centre for Integrative Toxicology, Michigan State University, East Lansing, MI, United States
| | - Mohamed Mohany
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Salim S. Al-Rejaie
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mourad A. M. Aboul-Soud
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Dalila Bousta
- Laboratory of Biotechnology, Environment, Agri-Food and Health (LBEAS), Faculty of Sciences Dhar El Mehraz, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| |
Collapse
|
|
18
|
Franken J, Mikler J. Reactive skin decontamination lotion (RSDL) safety with clinical antiseptics and hemostatic agents. Toxicol Lett 2024; 395:11-16. [PMID: 38484828 DOI: 10.1016/j.toxlet.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 04/21/2024]
Abstract
Reactive skin decontamination lotion (RSDL) is a Health Canada approved product used by the Canadian Armed Forces for removal and inactivation of toxic chemicals on skin. Although it is considered very safe when used as directed, questions have been raised regarding whether topical RSDL in the medical setting will react exothermically with antiseptic compounds on the casualty's epidermis that could result in thermal burns. Benchtop experiments were conducted to investigate reactivity of RSDL with various antiseptic compounds or hemostatic agents. Temperature changes were closely monitored in three different volume ratios, 1:10, 1:1, and 10:1 over a time course of 16 minutes. Chlorine based bleaches versus RSDL were included as a positive control and were the only combination that exhibited a significant exothermic reaction capable of causing minor thermal burns. RSDL was also evaluated with antiseptic solution applied to swine epidermal tissue without observation of visual irritation; then in lacerated skeletal muscle tissue which resulted in no measured temperature change. The conclusion of this study is that antiseptics and hemostatic agents can be used as required on a patient decontaminated with RSDL as no exothermic reaction will occur.
Collapse
Affiliation(s)
- Jessica Franken
- Defence Research and Development Canada - Suffield Research Centre, Department of National Defence, Suffield, Alberta, Canada.
| | - John Mikler
- Defence Research and Development Canada - Suffield Research Centre, Department of National Defence, Suffield, Alberta, Canada
| |
Collapse
|
|
19
|
Li Y, Leng Y, Liu Y, Zhong J, Li J, Zhang S, Li Z, Yang K, Kong X, Lao W, Bi C, Zhai A. Advanced multifunctional hydrogels for diabetic foot ulcer healing: Active substances and biological functions. J Diabetes 2024; 16:e13537. [PMID: 38599855 PMCID: PMC11006623 DOI: 10.1111/1753-0407.13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/26/2023] [Accepted: 01/18/2024] [Indexed: 04/12/2024] Open
Abstract
AIM Hydrogels with excellent biocompatibility and biodegradability can be used as the desirable dressings for the therapy of diabetic foot ulcer (DFU). This review aimed to summarize the biological functions of hydrogels, combining with the pathogenesis of DFU. METHODS The studies in the last 10 years were searched and summarized from the online database PubMed using a combination of keywords such as hydrogel and diabetes. The biological functions of hydrogels and their healing mechanism on DFU were elaborated. RESULTS In this review, hydrogels were classified by their active substances such as drugs, cytokines, photosensitizers, and biomimetic peptide. Based on this, the biological functions of hydrogels were summarized by associating the pathogenesis of DFU, including oxidative stress, chronic inflammation, cell phenotype change, vasculopathy, and infection. This review also pointed out some of the shortcomings of hydrogels in present researches. CONCLUSIONS Hydrogels were classified into carrier hydrogels and self-functioning hydrogels in this review. Besides, the functions and components of existing hydrogels were clarified to provide assistance for future researches and clinical applications.
Collapse
Affiliation(s)
- Yuetong Li
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Yuxin Leng
- Department of Critical Care MedicinePeking University Third HospitalBeijingChina
| | - Yang Liu
- Department of Laboratory Medicine, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Jianhua Zhong
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Jiaxin Li
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Shitong Zhang
- Department of General Practice, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Zhenlin Li
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Kaming Yang
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Xinyi Kong
- Department of Laboratory Medicine, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Wanwen Lao
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Changlong Bi
- Department of Endocrinology, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Aixia Zhai
- Department of Laboratory Medicine, The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| |
Collapse
|
|
20
|
Yang H, Ding H, Wei W, Li X, Duan X, Zhuang C, Liu W, Chen S, Wang X. Skin-interfaced microfluidic sweat collection devices for personalized hydration management through thermal feedback. LAB ON A CHIP 2024; 24:356-366. [PMID: 38108440 DOI: 10.1039/d3lc00791j] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Non-electronic wearables that utilize skin-interfaced microfluidic technology have revolutionized the collection and analysis of human sweat, providing valuable biochemical information and indicating body hydration status. However, existing microfluidic devices often require constant monitoring of data during sweat assessment, thereby impeding the user experience and potentially missing anomalous physiological events, such as excessive sweating. Moreover, the complex manufacturing process hampers the scalability and large-scale production of such devices. Herein, we present a self-feedback microfluidic device with a unique dehydration reminder through a cost-effective "CAD-to-3D device" approach. It incorporates two independent systems for sweat collection and thermal feedback, including serpentine microchannels, reservoirs, petal-like bursting valves and heating chambers. The device operates by sequentially collecting sweat in the channels and reservoirs, and then activating thermal stimulators in the heating chambers through breaking the valves, initiating a chemical exothermic reaction. Human trials validate that the devices effectively alert users to potential dehydration by inducing skin thermal sensations triggered by sweat sampling. The proposed device offers facile scalability and customizable fabrication, and holds promise for managing hydration strategies in real-world scenarios, benefiting individuals engaged in sporting activities or exposed to high-temperature settings.
Collapse
Affiliation(s)
- Hanlin Yang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Hongyan Ding
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Wenkui Wei
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Xiaofeng Li
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Xiaojun Duan
- Respiratory medicine department, Hunan Children's Hospital, Changsha, Hunan 410007, China
| | - Changgen Zhuang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Weiyi Liu
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Shangda Chen
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Xiufeng Wang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| |
Collapse
|
|
21
|
Chendian T, Guohua H, Wang Z, Fang L, Luo S, Liu X, Shi Q. Factors associated with thermal injury of abdominal skin in focused ultrasound ablation of uterine fibroids. Int J Hyperthermia 2023; 41:2295232. [PMID: 38159557 DOI: 10.1080/02656736.2023.2295232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE To investigate the factors which may cause thermal injury of abdominal skin in patients with uterine fibroids (UFs) who underwent ultrasound-guided focused ultrasound ablation surgery (FUAS). METHOD A total of 123 patients were enrolled in the injury group. In contrast, 246 patients without thermal injury were assigned to the non-injury group. The relationship between patient and treatment parameters and injury were explored using univariate analysis and multiple logistic regression analyses. In addition, the factors influencing the degree of thermal injury were analyzed using Kruskal-Wallis H. RESULTS (1) Abdominal scars (p = .007, OR = 2.187, 95% CI: 1.242-3.849), abdominal wall thickness (p < .001, OR = 1.042, 95% CI: 1.019-1.067), fundus fibroids (p = .038, OR = 1.790, 95% CI: 1.033-3.100), UFs with hyperintense/mixed T2-weighted imaging (T2WI) signals (p = .022, OR = 1.843, 95% CI: 1.091-3.115), average sonication power (AP) (p = .025, OR = 1.021, 95% CI: 1.003-1.039), and treatment time (TT) (p < .001, OR = 1.017, 95% CI: 1.011-1.023) were independent risk factors for thermal injury, while treatment volume (TV) (p = .002, OR = 0.775, 95% CI: 0.661-0.909) was a protective factor for injury. (2) Four groups were subdivided according to the degree of thermal injury(Group A: without skin injury. Group B: with changed T2WI signal in the abdominal wall, Group C: mild skin injury, Group D: severe skin injury), comparison of each with every other showed that the abdominal wall in Groups A and D was thinner than Groups B and C, with statistically significant differences (PAB<0.05, PAC<0.01, PDC<0.05, PDB<0.05); Group A was slightly thicker than D, however, without statistical difference. The ratio of sonication time (ST) to TV in Group A was the lowest of all (PAB, PAC, PAD all < 0.05). And as the level of thermal injury rose, the ratio gradually increased, however, without statistical difference. CONCLUSIONS Based on our limited results, the following conclusion was made. (1) Abdominal scars, abdominal wall thickness, fundus fibroids, UFs with T2WI hyperintense/mixed signals, AP and TT were independent risk factor. (2) Neither too thick nor too thin abdominal walls would be recommended, as both might increase the risk of skin injury. (3) Noticeably, the risk of skin injury might increase considerably when the ST was longer and the sonication area was more fixed.
Collapse
Affiliation(s)
- Tang Chendian
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynecology, Suining Central Hospital, Suining, China
| | - Huang Guohua
- Department of Obstetrics and Gynecology, Suining Central Hospital, Suining, China
| | - Zhibiao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Liu Fang
- Department of Obstetrics and Gynecology, Suining Central Hospital, Suining, China
| | - Shuang Luo
- Department of Obstetrics and Gynecology, Suining Central Hospital, Suining, China
| | - Xiaofang Liu
- Department of Obstetrics and Gynecology, Suining Central Hospital, Suining, China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- School of Public Health, Chongqing Medical University, Chongqing, China
| |
Collapse
|
|
22
|
Greene M, Long G, Greene K, Wilkes M. Performance of a Chemical Heat Blanket in Dry, Damp, and Wet Conditions Inside a Mountain Rescue Hypothermia Wrap. Wilderness Environ Med 2023; 34:483-489. [PMID: 37696723 DOI: 10.1016/j.wem.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION Casualties with accidental hypothermia are evacuated using multilayer wraps, typically including a chemical heat blanket (CHB), a vapor barrier, and an insulating outer bag. We investigated CHB performance against dry, damp, and wet fabric, in a multilayer wrap, in response to a case report indicating diminished performance when wet. METHODS We wrapped a torso manikin in a base layer, CHB, vapor barrier, casualty bag, and vacuum mattress, recording CHB panel temperatures at intervals of up to 7 h. Experimental conditions were dry, damp, and wet clothing, with 2 blankets tested in each condition. We subsequently used a forward-looking infrared camera to assess whether the panels heated evenly and heat flux sensors to quantify heat transfer across 2 dry, 1 damp, and 1 wet fleece under CHB panels. RESULTS Chemical heat blankets maintained heat output for >7 h inside the wraps. Median (IQR) panel steady state temperatures were 52°C (39-56°C) against dry fleece, 41°C (36-45°C) against damp fleece, and 30°C (29-33°C) against wet fleece. Peak panel temperature was 67°C. The heat flux results indicated that CHBs generated similar quantities of heat in dry and damp conditions, as the lower temperatures were compensated by more efficient transfer of heat across the moist clothing layer. Chemical heat blanket heat output was diminished in wet conditions. CONCLUSIONS Rescuers should cut off saturated clothing in a protected environment before wrapping casualties, but damp clothing need not be removed. Because of the high peak temperatures recorded on the surfaces of CHBs, they should not be placed directly against skin, and compression straps should not be placed directly over CHBs.
Collapse
Affiliation(s)
| | - Geoff Long
- School of Sport, Health and Exercise Science, University of Portsmouth, UK
| | | | - Matt Wilkes
- School of Sport, Health and Exercise Science, University of Portsmouth, UK.
| |
Collapse
|
|
23
|
Park W, Liu Y, Jiao Y, Shi R, Nan J, Yiu CK, Huang X, Chen Y, Li W, Gao Y, Zhang Q, Li D, Jia S, Gao Z, Song W, Lam MMH, Dai Z, Zhao Z, Li Y, Yu X. Skin-Integrated Wireless Odor Message Delivery Electronics for the Deaf-blind. ACS NANO 2023; 17:21947-21961. [PMID: 37917185 DOI: 10.1021/acsnano.3c08287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Deaf-blindness limits daily human activities, especially interactive modes of audio and visual perception. Although the developed standards have been verified as alternative communication methods, they are uncommon to the nondisabled due to the complicated learning process and inefficiency in terms of communicating distance and throughput. Therefore, the development of communication techniques employing innate sensory abilities including olfaction related to the cerebral limbic system processing emotions, memories, and recognition has been suggested for reducing the training level and increasing communication efficiency. Here, a skin-integrated and wireless olfactory interface system exploiting arrays of miniaturized odor generators (OGs) based on melting/solidifying odorous wax to release smell is introduced for establishing an advanced communication system between deaf-blind and non-deaf-blind. By optimizing the structure design of the OGs, each OG device is as small as 0.24 cm3 (length × width × height of 11 mm × 10 mm × 2.2 mm), enabling integration of up to 8 OGs on the epidermis between nose and lip for direct and rapid olfactory drive with a weight of only 24.56 g. By generating single or mixed odors, different linked messages could be delivered to a user within a short period in a wireless and programmable way. By adopting the olfactory interface message delivery system, the recognition rates for the messages have been improved 1.5 times that of the touch-based method, while the response times were immensely decreased 4 times. Thus, the presented wearable olfactory interface system exhibits great potential as an alternative message delivery method for the deaf-blind.
Collapse
Affiliation(s)
- Wooyoung Park
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Yiming Liu
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Yanli Jiao
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
- Hong Kong Center for Cerebra-Cardiovascular Health Engineering, Hong Kong Science Park, New Territories, 999077, Hong Kong, People's Republic of China
| | - Rui Shi
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
- Hong Kong Center for Cerebra-Cardiovascular Health Engineering, Hong Kong Science Park, New Territories, 999077, Hong Kong, People's Republic of China
| | - Jin Nan
- Institute of Solid Mechanics, Beihang University (BUAA), Beijing 100191 People's Republic of China
| | - Chun Ki Yiu
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
- Hong Kong Center for Cerebra-Cardiovascular Health Engineering, Hong Kong Science Park, New Territories, 999077, Hong Kong, People's Republic of China
| | - Xingcan Huang
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Yao Chen
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Wenyang Li
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Yuyu Gao
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Qiang Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Dengfeng Li
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
- Hong Kong Center for Cerebra-Cardiovascular Health Engineering, Hong Kong Science Park, New Territories, 999077, Hong Kong, People's Republic of China
| | - Shengxin Jia
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
- Hong Kong Center for Cerebra-Cardiovascular Health Engineering, Hong Kong Science Park, New Territories, 999077, Hong Kong, People's Republic of China
| | - Zhan Gao
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Weike Song
- China Special Equipment Inspection and Research Institute, Beijing 100029 People's Republic of China
| | - Marcus Man Ho Lam
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
| | - Zhenxue Dai
- College of Construction Engineering, Jilin University, Changchun 130026, People's Republic of China
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao 266520, People's Republic of China
| | - Zhao Zhao
- China Special Equipment Inspection and Research Institute, Beijing 100029 People's Republic of China
| | - Yuhang Li
- Institute of Solid Mechanics, Beihang University (BUAA), Beijing 100191 People's Republic of China
- Aircraft and Propulsion Laboratory, Ningbo Institute of Technology Beihang University (BUAA), Ningbo 315100, People's Republic of China
- Tianmushan Laboratory Xixi Octagon City, Yuhang District, Hangzhou 310023, China
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon 999077, Hong Kong, People's Republic of China
- Hong Kong Center for Cerebra-Cardiovascular Health Engineering, Hong Kong Science Park, New Territories, 999077, Hong Kong, People's Republic of China
| |
Collapse
|
|
24
|
Yasuda K, Shishido I, Murayama M, Kaga S, Yano R. Venous dilation effect of hot towel (moist and dry heat) versus hot pack for peripheral intravenous catheterization: a quasi-experimental study. J Physiol Anthropol 2023; 42:23. [PMID: 37858250 PMCID: PMC10585830 DOI: 10.1186/s40101-023-00340-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Heat application before peripheral intravenous catheterization is recommended for venous dilation. Hot pack application enlarges the venous diameter in healthy adults; however, hot towels (moist and dry heat) are used often in some medical cases. However, it is unclear whether hot towel application promotes venous dilation better than hot pack application. This study compared the venous dilation effect of using a hot towel (moist and dry heat) to a hot pack before applying the tourniquet at an access site for peripheral intravenous catheterization. METHODS Eighty-eight healthy females aged 18-29 years were recruited for this quasi-experimental study. They underwent three types of heat applications (hot pack, moist hot towel, and dry hot towel [moist hot towel wrapped in a dry plastic bag], all of which were warmed to 40 ± 2 °C and performed for 7 min) to their forearm and tourniquet application for 30 s after each heating. Venous diameter and depth were measured using ultrasonography, and venous palpability and visibility (venous assessment score) was observed as venous dilatation effects. In addition, the skin temperature, stratum corneum hydration, and subjective evaluation of the warmth were measured. RESULTS There were no significant differences in venous diameter and assessment scores after intervention between the dry hot towel and the hot pack groups, and the effect size was negligible (Cohen's d < 0.20). However, these measurements were significantly lower for the moist hot towel than for the other two heat applications (P < .001). Although there was no significant difference in skin temperature and warmth rating score between the dry hot towel and the hot pack, these were significantly lower for the moist hot towel than for the other two heat applications (P < .001). The amount of change in stratum corneum hydration of the dry hot towel was not significantly different from that of the hot pack; however, that of the moist hot towel was significantly larger than that of the other two heat applications (P < . 001.) CONCLUSIONS: A method in which a towel warmed in hot water is wrapped in a dry barrier may be an alternative to a hot pack. TRIAL REGISTRATION This study was registered with University Hospital Medical Information Network in Japan (Registration No.: UMIN000048308. Registered on July 7, 2022).
Collapse
Affiliation(s)
- Kae Yasuda
- Graduate School of Health Sciences, Hokkaido University, N12, W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Inaho Shishido
- Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Michito Murayama
- Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Sanae Kaga
- Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan.
| |
Collapse
|
|
25
|
Yang R, Zhang X, Chen B, Yan Q, Yin J, Luan S. Tunable backbone-degradable robust tissue adhesives via in situ radical ring-opening polymerization. Nat Commun 2023; 14:6063. [PMID: 37770451 PMCID: PMC10539349 DOI: 10.1038/s41467-023-41610-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023] Open
Abstract
Adhesives with both robust adhesion and tunable degradability are clinically and ecologically vital, but their fabrication remains a formidable challenge. Here we propose an in situ radical ring-opening polymerization (rROP) strategy to design a backbone-degradable robust adhesive (BDRA) in physiological environment. The hydrophobic cyclic ketene acetal and hydrophilic acrylate monomer mixture of the BDRA precursor allows it to effectively wet and penetrate substrates, subsequently forming a deep covalently interpenetrating network with a degradable backbone via redox-initiated in situ rROP. The resulting BDRAs show good adhesion strength on diverse materials and tissues (e.g., wet bone >16 MPa, and porcine skin >150 kPa), higher than that of commercial cyanoacrylate superglue (~4 MPa and 56 kPa). Moreover, the BDRAs have enhanced tunable degradability, mechanical modulus (100 kPa-10 GPa) and setting time (seconds-hours), and have good biocompatibility in vitro and in vivo. This family of BDRAs expands the scope of medical adhesive applications and offers an easy and environmentally friendly approach for engineering.
Collapse
Affiliation(s)
- Ran Yang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, China
| | - Xu Zhang
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| | - Binggang Chen
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China.
| | - Qiuyan Yan
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China.
| | - Jinghua Yin
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China
| | - Shifang Luan
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, 130022, China.
- School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, China.
| |
Collapse
|
|
26
|
Wang Y, Lu X, Zheng W, Wang Z. Bio-thermal response and thermal damage in biological tissues with non-equilibrium effect and temperature-dependent properties induced by pulse-laser irradiation. J Therm Biol 2023; 113:103541. [PMID: 37055117 DOI: 10.1016/j.jtherbio.2023.103541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/08/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Comprehension of thermal behavior underlying the living biological tissues helps successful applications of current heat therapies. The present work is to explore the heat transport properties of irradiated tissue during tis thermal treatment, in which the local thermal non-equilibrium effect as well as temperature-dependent properties arose from complicated anatomical structure, is considered. Based on the generalized dual-phase lag (GDPL) model, a non-linear governing equation of tissue temperature with variable thermal physical properties is proposed. The effective procedure constructed on an explicit finite difference scheme is then developed to predict numerically the thermal response and thermal damage irradiated by a pulse laser as a therapeutic heat source. The parametric study on variable thermal physical parameters including the phase lag times, heat conductivity, specific heat capacity and blood perfusion rate has been performed to evaluate their influence on temperature distribution in time and space. On this basis, the thermal damage with different laser variables such as laser intensity and exposure time are further analyzed.
Collapse
Affiliation(s)
- Yingze Wang
- Department of Energy and Power Engineering, Jiangsu University, Zhenjiang, 212013, PR China.
| | - Xiaoyu Lu
- Department of Energy and Power Engineering, Jiangsu University, Zhenjiang, 212013, PR China
| | - Wenbo Zheng
- Department of Energy and Power Engineering, Jiangsu University, Zhenjiang, 212013, PR China
| | - Zhe Wang
- Department of Energy and Power Engineering, Jiangsu University, Zhenjiang, 212013, PR China
| |
Collapse
|
|
27
|
Multilayer In Vitro Human Skin Tissue Platforms for Quantitative Burn Injury Investigation. Bioengineering (Basel) 2023; 10:bioengineering10020265. [PMID: 36829759 PMCID: PMC9952576 DOI: 10.3390/bioengineering10020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
This study presents a multilayer in vitro human skin platform to quantitatively relate predicted spatial time-temperature history with measured tissue injury response. This information is needed to elucidate high-temperature, short-duration burn injury kinetics and enables determination of relevant input parameters for computational models to facilitate treatment planning. Multilayer in vitro skin platforms were constructed using human dermal keratinocytes and fibroblasts embedded in collagen I hydrogels. After three seconds of contact with a 50-100 °C burn tip, ablation, cell death, apoptosis, and HSP70 expression were spatially measured using immunofluorescence confocal microscopy. Finite element modeling was performed using the measured thermal characteristics of skin platforms to determine the temperature distribution within platforms over time. The process coefficients for the Arrhenius thermal injury model describing tissue ablation and cell death were determined such that the predictions calculated from the time-temperature histories fit the experimental burn results. The activation energy for thermal collagen ablation and cell death was found to be significantly lower for short-duration, high-temperature burns than those found for long-duration, low-temperature burns. Analysis of results suggests that different injury mechanisms dominate at higher temperatures, necessitating burn research in the temperature ranges of interest and demonstrating the practicality of the proposed skin platform for this purpose.
Collapse
|
|
28
|
The Role of Subcutaneous Radiofrequency-Assisted Liposculpture in the Facial Plastic Surgeon's Practice. Facial Plast Surg Aesthet Med 2022; 24:S11-S16. [DOI: 10.1089/fpsam.2022.0225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
|
29
|
Aronson D. The interstitial compartment as a therapeutic target in heart failure. Front Cardiovasc Med 2022; 9:933384. [PMID: 36061549 PMCID: PMC9428749 DOI: 10.3389/fcvm.2022.933384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/15/2022] [Indexed: 12/23/2022] Open
Abstract
Congestion is the single most important contributor to heart failure (HF) decompensation. Most of the excess volume in patients with HF resides in the interstitial compartment. Inadequate decongestion implies persistent interstitial congestion and is associated with worse outcomes. Therefore, effective interstitial decongestion represents an unmet need to improve quality of life and reduce clinical events. The key processes that underlie incomplete interstitial decongestion are often ignored. In this review, we provide a summary of the pathophysiology of the interstitial compartment in HF and the factors governing the movement of fluids between the interstitial and vascular compartments. Disruption of the extracellular matrix compaction occurs with edema, such that the interstitium becomes highly compliant, and large changes in volume marginally increase interstitial pressure and allow progressive capillary filtration into the interstitium. Augmentation of lymph flow is required to prevent interstitial edema, and the lymphatic system can increase fluid removal by at least 10-fold. In HF, lymphatic remodeling can become insufficient or maladaptive such that the capacity of the lymphatic system to remove fluid from the interstitium is exceeded. Increased central venous pressure at the site of the thoracic duct outlet also impairs lymphatic drainage. Owing to the kinetics of extracellular fluid, microvascular absorption tends to be transient (as determined by the revised Starling equation). Therefore, effective interstitial decongestion with adequate transcapillary plasma refill requires a substantial reduction in plasma volume and capillary pressure that are prolonged and sustained, which is not always achieved in clinical practice. The critical importance of the interstitium in the congestive state underscores the need to directly decongest the interstitial compartment without relying on the lowering of intracapillary pressure with diuretics. This unmet need may be addressed by novel device therapies in the near future.
Collapse
Affiliation(s)
- Doron Aronson
- Department of Cardiology, Rambam Health Care Campus, B. Rappaport Faculty of Medicine, Technion Medical School, Haifa, Israel
| |
Collapse
|
|
30
|
Having Patience With Our Patients: A Key Technique in Cast Saw Burn Prevention. J Am Acad Orthop Surg 2022; 30:e1025-e1032. [PMID: 35617643 DOI: 10.5435/jaaos-d-21-01272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/08/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Although regarded as conservative treatment, casting is not without risk. Injuries may be sustained during application, during cast valving, through the immobilization process, or during cast removal. We developed an experimental model to investigate safe parameters for the appropriate length of time between fiberglass cast application and bivalving for cast saw use. METHODS A hospital sheet was rolled into a mock "arm" on which short-arm fiberglass casts were formed. An appropriate cast saw technique was used with complete withdrawal of the saw blade from the cast material between cuts. A total of 10 casts were made for control/no vacuum (N = 5) and study/vacuum (N = 5) groups. The temperature of the saw blade was measured at 1-minute increments beginning at 3 minutes after fiberglass submersion in water. A mixed factor analysis of variance assessed differences in temperature change over time between groups with a statistical threshold of P < 0.05. RESULTS Casts that set for 7 minutes were associated with lower blade temperatures compared with casts that set for 3, 4, 5, and 6 minutes. The average temperature increases for the 3- to 7-minute set times without the use of vacuum were 10.08 (± 1.42), 9.38 (±1.31), 9.32 (±1.85), 8.54 (±2.10), and 5.62°F (±2.42), respectively, and with the use of vacuum, they were 9.40 (±1.14), 8.36 (±1.64), 7.84 (±2.05), 7.30 (±3.14), and 4.82°F (±2.59), respectively. Independent of vacuum use, the change in temperature was significantly different from the maximum temperature (3 minutes) beginning at 7 minutes (all P < 0.043). DISCUSSION A minimum of 7 minutes of set time for a fiberglass cast before attempting to bivalve using segmented cuts is associated with the smallest increase in temperature of the saw blade. Blade temperature was not affected with the vacuum enabled. Clinicians can demonstrate best practices to minimize the risk of cast saw injuries.
Collapse
|
|
31
|
Phytochemical profile, in vivo anti-inflammatory and wound healing activities of the aqueous extract from aerial parts of Cistus ladanifer L. J Pharm Biomed Anal 2022; 219:114960. [PMID: 35914506 DOI: 10.1016/j.jpba.2022.114960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 01/22/2023]
Abstract
Cistus ladanifer L. is a Mediterranean shrub, well recognized for its many pharmacological properties. The present study aimed to investigate the phytochemical profile, the in vivo anti-inflammatory and the wound healing activities of the aqueous extract from its aerial parts (AECL). The in vivo anti-inflammatory and the wound healing properties were evaluated by carrageenan-induced paw edema (CAECL) and burn wound in rats, respectively. The results showed that six compounds belonging to flavonoids and tannins were identified in the AECL extract. Moreover, the AECL administrated orally at a dose of 500 mg/kg significantly reduced edema with a percentage of 72 % in terms of inflammation inhibition, using indomethacin as reference drug. On the other hand, when administrated topically, both doses of CAECL cream (5 % and 10 %) manifested a significant anti-inflammatory action using diclofenac as reference drug with a percentage reduction of inflammation that reached 85 % (CAECL-10). As far as wound healing is concerned, the CAECL showed higher effect at a dose of 10 % (CAECL-10) producing a wound contraction of 96 %, similar to that of the reference drug. The findings of the present study indicate that the aqueous extract from aerial parts of Cistus ladanifer L. display strongly anti-inflammatory and wound healing effects to be advantageously used for medical purposes.
Collapse
|
|
32
|
Shrivastava C, Berry T, Cronje P, Schudel S, Defraeye T. Digital twins enable the quantification of the trade-offs in maintaining citrus quality and marketability in the refrigerated supply chain. NATURE FOOD 2022; 3:413-427. [PMID: 37118034 DOI: 10.1038/s43016-022-00497-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/17/2022] [Indexed: 04/30/2023]
Abstract
Supply chains of fresh fruit must maintain a very narrow window of hygrothermal conditions after harvest. Any excursions outside this range can markedly lower the consumer acceptability of the fruit. However, the loss in fruit quality and marketability largely remains invisible to stakeholders throughout the supply chain. Here we developed a physics-based digital twin of citrus fruit to pinpoint when, why and to what extent fruit quality and marketability are reduced. Sensor data on 47 commercial shipments are thereby translated into actionable metrics for supply chain stakeholders by mapping the variability using principal component analysis. We unveiled a large spread (between 3% and 60%) in the shipments for different metrics of quality and marketability. Half of the shipments currently lie outside the ideal trade-off range between maintaining quality, killing fruit fly larvae and avoiding chilling injury. The digital twin technology opens the possibility to obtain the real-time coupling with sensor data to monitor food quality and marketability.
Collapse
Affiliation(s)
- Chandrima Shrivastava
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
- University of Bern, ARTORG Center for Biomedical Engineering Research, Bern, Switzerland
| | - Tarl Berry
- Citrus Research International, Department of Horticultural Science, University of Stellenbosch, Stellenbosch, South Africa
| | - Paul Cronje
- Citrus Research International, Department of Horticultural Science, University of Stellenbosch, Stellenbosch, South Africa
| | - Seraina Schudel
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Thijs Defraeye
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland.
| |
Collapse
|
|
33
|
Cutaneous steam burns and steam inhalation injuries: a literature review and a case presentation. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.1007/s00238-022-01955-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Scald is one type of burn that s often mentioned alone and occurs mostly in the paediatric population. Inhaled steam is mostly cooled off in the airways, why thermal damage is rarely seen. A sudden exposure to hot steam/inhalation can cause a thermal inhalation injury. A scoping review was performed, with the aim to summarize all published papers in English, about steam-related injuries. The search was conducted using the PubMed® and Cochrane libraries on 19th of May 2021, without a set time period. Out of a total of 1186 identified records, 31 were chosen for review. Burns related to the contact with steam are generally rare and can be both minor and severe. The more severe cases related to steam exposure are mostly workplace accidents and the minor injuries reported in the literature are often related to steam inhalation therapy, especially in the paediatric population. This review describes the challenges that can be found dealing with patients suffering from cutaneous steam burns and/or steam inhalation injuries. A steam injury to the airways or the skin can be directly life-threatening and should be treated with caution. This type of injury can lead to acute respiratory insufficiency and sometimes death. A case of a male patient with extensive cutaneous steam burns and a steam inhalation injury who passed away after 11 days of treatment is also presented to illustrate this review.
Level of evidence: Level V, Therapeutic; Risk/Prognostic Study.
Collapse
|
|
34
|
Han D, Wei Y, Li Y, Zha X, Li R, Xia C, Li Y, Yang H, Xie J, Tian S. Epidemiological and Clinical Characteristics of 5,569 Pediatric Burns in Central China From 2013 to 2019. Front Public Health 2022; 10:751615. [PMID: 35425744 PMCID: PMC9001893 DOI: 10.3389/fpubh.2022.751615] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background Pediatric burns of all the ages are prevalent worldwide, posing a severe health risk to children. This study aims to examine pediatric burns' clinical characteristics and epidemiology in central China. Methods The pediatric patients of the Burn Research Center, Department of the First People's Hospital of Zhengzhou City from 2013 to 2019 were retrospectively studied and the relevant data were collected from the hospitalized medical records [e.g., demographic, etiology, length of stay (LOS), age, gender, burn area and depth, number of surgeries, cost, and outcome]. Results A total of 5,569 pediatric burn patients were included, accounting for 43.9% of the total burn population. Electric burns represented a relatively small proportion (1.17%) but were more likely to lead to disabilities or death than scalds (90.63%) and flames (5.12%). The median age was 2 years [interquartile range (IQR): 1–4] and the boys/girls ratio ranged from 1.3:1 to 1.6:1. The most commonly burnt anatomic sites were the limbs (38.3%), with a median %TBSA (total body surface area) of 6 (IQR: 4–10). The complications of shock and pneumonia accounted for 7.6 and 19.2%, respectively. The peak months of pediatric burns included January, May, and August and the rural/urban ratio reached 1.61:1. The percentage of burn wounds treated surgically increased considerably from 2013 to 2019 (3.8 vs. 37.8%). The median hospital LOS was 15 days (IQR: 8–28 days), with the three high-risk factors (e.g., more surgeries, more %TBSA, full-thickness skin burns). The median cost of hospitalization was 1,511 USD (IQR: 848–2,648 USD) and the main risk factors consisted of full-thickness burns, more %TBSA, longer LOS, and more surgical procedures. Among all the patients, LA50 was 78.63% (95% CI = 75.12–83.45) and the overall mortality reached 0.1% since seven deaths were recorded. Conclusion Scalds, flames, contact, and chemicals are the main causes of burns among children aged 1–5 years in central China. Accordingly, various prevention strategies should be employed depending upon the cause of the burn.
Collapse
Affiliation(s)
- Dawei Han
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Ying Wei
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Yancang Li
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Xinjian Zha
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Rui Li
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chengde Xia
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Yun Li
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Huanna Yang
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Jiangfan Xie
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Shemin Tian
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou, China
| |
Collapse
|
|
35
|
GÜRBÜZ K, DEMİR M. Comparison of Patterns of Burn Severity and Clinical Characteristics of Pediatric Patients in a Referral Burn Center: Retrospective Analysis. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1066021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
|
36
|
Effect of Heating on Physicochemical Property of Aerosols during Vaping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031892. [PMID: 35162914 PMCID: PMC8835267 DOI: 10.3390/ijerph19031892] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 11/17/2022]
Abstract
Many electronic cigarette manufacturers have offered different types of “high-end mods” that allow for controlled heating of the e-liquid. However, the controlled heating condition can drastically alter the inhaled aerosols’ physical properties and chemical substances, causing potential health risks. To investigate the contribution of heating on aerosol properties, we used four common power settings in the mods to conduct a physicochemical analysis. Our data showed that the aerosol mass and nicotine content in the aerosols increased at high power. Additionally, high power led to aerosolization of a viscous component in the e-liquid, increasing the viscosity of aerosol. However, the pH of the aerosol was constant regardless of the applied power. In addition, high-power operation made nicotine prone to oxidation, resulting in the color of the aerosol turning yellow. Lastly, we demonstrated that e-cigarette aerosol could contain various metals, including aluminum, arsenic, cadmium, chromium, copper, iron, magnesium, nickel, lead, and zinc. Even though these metal contents proportionally increased with the power setting, they remained far below the recommended exposure limits. Our finding demonstrates that the heating conditions of the e-cigarette change the physicochemical properties of the aerosols and their metal contents, thereby possibly affecting users’ oral and respiratory systems.
Collapse
|
|
37
|
Hussain Z, Thu HE, Rawas-Qalaji M, Naseem M, Khan S, Sohail M. Recent developments and advanced strategies for promoting burn wound healing. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103092] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
|
38
|
Lee RW, Ju HJ, Lee JH, Jung HM, Bae JM. A Case of Low-Temperature Full-Thickness Burn after Suction Blister Harvesting in a Patient with Vitiligo. Ann Dermatol 2022; 34:318-319. [PMID: 35948339 PMCID: PMC9365652 DOI: 10.5021/ad.20.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ro Woo Lee
- Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Hyun Jeong Ju
- Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ji Hae Lee
- Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Han Mi Jung
- Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jung Min Bae
- Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| |
Collapse
|
|
39
|
Dvir E, Epstein D, Berzon B, Raz A, Lehavi A. Differences in the thermal properties and surface temperature of prehospital antihypothermia devices: an in vitro study. Emerg Med J 2021; 39:833-838. [PMID: 34740889 DOI: 10.1136/emermed-2020-211057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 10/24/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Preventing and treating hypothermia in prehospital settings is crucial. Several products have been developed to prevent heat loss and actively warm patients in prehospital settings. We compared the efficacy and the surface temperature of different antihypothermia products, using a fluid-based model at two ambient temperatures. METHODS We tested five active (Blizzard Heat with active pads, Ready-Heat, Ready-Heat-II, Hypothermia Prevention and Management Kit (HPMK), Bair Hugger) and five passive (Blizzard Heat, Heat Reflective Shell, sleeping bag, 'space blanket', wool blanket) antihypothermia products. A torso model consisting of four 8 L bags of fluid preheated to 36°C±0.5°C (97±0.5°F) was used to compare the devices' performances at 20°C (68°F) and 8°C (46°F). Inner and surface temperatures were recorded for up to 480 min. RESULTS We found significant differences in heat loss in fluid bags among the tested devices at both temperatures (p<0.001). At 20°C, only HPMK and Ready-Heat-II increased the inner temperature for 480 min while Blizzard Heat with active pads prevented heat loss. Ready-Heat prevented heat loss for 90 min. All the other devices did not prevent heat loss beyond 30 min. At 8°C, none of the products heated the model. Bair Hugger, HPMK, Ready-Heat II and sleeping bag prevented heat loss for 30 min. At 60, 90 and 120 min HPMK, Ready-Heat II and Bair Hugger were the most effective. Over 480 min, Bair Hugger was most effective, with a heat loss of 2.3°C±0.4°C. The surface temperature exceeded 44°C (111°F) for all the exothermic warming devices when used for a prolonged period of time. CONCLUSION At 20°C, HPMK and Ready-Heat-II increased fluid temperature in the model, while the other devices decreased heat loss. At 8°C, none of the tested devices increased the temperature. However, active heating devices prevented heat loss slightly better than passive methods. A protective insulation layer should be used with all active heating blankets.
Collapse
Affiliation(s)
- Erez Dvir
- Department of Anaesthesiology, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Danny Epstein
- Critical Care Division, Rambam Health Care Campus, Haifa, Israel .,Medical Corps, IDF, Tel-Hashomer, Israel
| | - Baruch Berzon
- Department of Emergency Medicine, Assuta Ashdod Hospital, Ashdod, Israel
| | - Aeyal Raz
- Department of Anaesthesiology, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Amit Lehavi
- Department of Anaesthesiology, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
|
40
|
Burn-induced heterotopic ossification from incidence to therapy: key signaling pathways underlying ectopic bone formation. Cell Mol Biol Lett 2021; 26:34. [PMID: 34315404 PMCID: PMC8313878 DOI: 10.1186/s11658-021-00277-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/20/2021] [Indexed: 01/02/2023] Open
Abstract
Burn injury is one of the potential causes of heterotopic ossification (HO), which is a rare but debilitating condition. The incidence ranges from 3.5 to 5.6 depending on body area. Burns that cover a larger percentage of the total body surface area (TBSA), require skin graft surgeries, or necessitate pulmonary intensive care are well-researched risk factors for HO. Since burns initiate such complex pathophysiological processes with a variety of molecular signal changes, it is essential to focus on HO in the specific context of burn injury to define best practices for its treatment. There are numerous key players in the pathways of burn-induced HO, including neutrophils, monocytes, transforming growth factor-β1-expressing macrophages and the adaptive immune system. The increased inflammation associated with burn injuries is also associated with pathway activation. Neurological and calcium-related contributions are also known. Endothelial-to-mesenchymal transition (EMT) and vascularization are known to play key roles in burn-induced HO, with hypoxia-inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) as potential initiators. Currently, non-steroidal anti-inflammatory drugs (NSAIDs) and radiotherapy are effective prophylaxes for HO. Limited joint motion, ankylosis and intolerable pain caused by burn-induced HO can be effectively tackled via surgery. Effective biomarkers for monitoring burn-induced HO occurrence and bio-prophylactic and bio-therapeutic strategies should be actively developed in the future.
Collapse
|
|
41
|
A Novel Design of Water-Activated Variable Stiffness Endoscopic Manipulator with Safe Thermal Insulation. ACTUATORS 2021. [DOI: 10.3390/act10060130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In natural orifice transluminal endoscopic surgery (NOTES), an ideal endoscope platform should be flexible and dexterous enough to go through the natural orifices to access the lesion site inside the human body, and meanwhile provide sufficient rigidity to serve as a base for the end-effectors to operate during the surgical tasks. However, the conventional endoscope has limited ability for maintaining high rigidity over the length of the body. This paper presents a novel design of a variable stiffness endoscopic manipulator. By using a new bioplastic named FORMcard, whose stiffness can be thermally adjusted, water at different temperatures is employed to switch the manipulator between rigid mode and flexible mode. A biocompatible microencapsulated phase change material (MEPCM) with latent heat storage properties is adopted as the thermal insulation for better safety. Experiments are conducted to test the concept design, and the validated advantages of our proposed variable stiffness endoscopic manipulator include: shorter mode activation time (25 s), significantly improved stiffness in rigid mode (547.9–926.3 N·cm2) and larger stiffness-adjusting ratio (23.9–25.1 times).
Collapse
|
|
42
|
Whittam A, Stone M, Anwar MU. Contact Burns From Central Heating Radiators in Adults-An Increasing Problem in an Aging Population. J Burn Care Res 2021; 42:495-498. [PMID: 33136123 DOI: 10.1093/jbcr/iraa190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The primary method of heating residential dwellings in the developed world is through central heating radiators. These appliances are a major risk factor for contact burns, especially in individuals at the extremes of age. This article presents our findings of radiator contact burns in adults treated at a regional burns service during a 6-year period. We identified a total of 116 patients and 60% were male. The mean age was 58 (range 16-97), 71% had at least one comorbidity, with a mean of 1.88 comorbidities for each patient (range 0-8). The mean TBSA was 1.7% (range 0.1-8). Thirty-three patients (26%) required at least one operation with the average number of procedures being 1.45 (range 1-4). The mean length of stay was 16 days (range 0-98) compared to 7.5 days for all admitted patients across the same period. Four patients died within 30 days of their injury, 7 within 90 days, and 16 had died within 1 year of their injury. There have been previous smaller studies looking at contact burns from radiators in both adult and pediatric populations, demonstrating a bi-modal distribution at the extremes of age. This study is the largest of its kind looking specifically at an adult population and demonstrates that these injuries tend to occur in a population with a number of other comorbidities. These patients often required prolonged hospital care.
Collapse
Affiliation(s)
- Alexander Whittam
- The Regional Burns Service, The Mid Yorkshire Hospitals NHS Trust, Pinderfields General Hospital, Wakefield, UK
| | - Matthew Stone
- The Regional Burns Service, The Mid Yorkshire Hospitals NHS Trust, Pinderfields General Hospital, Wakefield, UK
| | - Mohammad Umair Anwar
- The Regional Burns Service, The Mid Yorkshire Hospitals NHS Trust, Pinderfields General Hospital, Wakefield, UK
| |
Collapse
|
|
43
|
Cast Saw Burn Prevention: An Evidence-Based Review. J Am Acad Orthop Surg 2021; 29:380-385. [PMID: 33475304 DOI: 10.5435/jaaos-d-20-00723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023] Open
Abstract
Cast saw burns are an avoidable complication of cast removal and cast splitting. These iatrogenic injuries often lead to unacceptable clinical sequalae with significant financial and legal consequences. Therefore, a considerable body of research has been directed toward cast saw burn prevention. This review of currently published data provides clinicians with a summary of the literature to guide practice based on the best available evidence, with the goal of preventing iatrogenic cast saw burns. The PubMed database was queried for articles published from 1980 until present with the following key words: cast saw burns, cast saw blades, cast saws, orthopaedic education or surgical simulation. Relevant articles were reviewed and summarized. The prevention of cast saw burns involves awareness of clinical risk factors, maintenance of equipment, use of the proper technique, and the education of novice providers. By implementing evidence-based methods, orthopaedic surgeons and associated healthcare providers can aim to eliminate these preventable complications from their practice.
Collapse
|
|
44
|
Iyoho A, Ng LJ. Model to Predict Probability of Significant Skin Burn Injury From a Directed-Energy Source. Mil Med 2021; 186:408-415. [PMID: 33499509 DOI: 10.1093/milmed/usaa277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/19/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Millimeter wave directed energy in the frequency regime of 94-95 GHz has potential for use in numerous military applications including crowd control and area denial. Although proven to be very safe, millimeter wave energy has the potential, because of accidental over exposure, to produce significant injuries. Currently, the Dynamic Thermal Model (DTM), developed by Beason and colleagues, is used to calculate the temperature profile in skin undergoing (millimeter wave) heating, using an all-or-nothing threshold of injury. Risk of significant injury (RSI) is determined by product of the probability of an injury outcome on a region of the body times the probability of that the injury will occur. Thus, a threshold injury determination may over predict burn probability and fail safety requirements. This work augments the DTM, replacing the current threshold value of injury with a probabilistic risk of injury to better quantify the risk of significant injury. MATERIALS AND METHODS In this study, continuous probabilistic dose-response models using logistic regression analysis have been developed to account for mild second-degree, deep second-degree, and third-degree burn injuries based on a historic experimental burn dataset. Statistical analysis methods such as Hosmer-Lemeshow statistics, McFadden's pseudo R2 and receiver operator characteristic were used to validate the models against an independent experimental burn dataset. RESULTS Comparison of logistic models fit using damage coefficients from the literature showed that Mehta and Wong provided the best fits historic burn data, which was corroborated by the McFadden pseudo R2 statistic for mild second-degree, deep second-degree, and third-degree severity. CONCLUSION The dose-response models developed in this study are shown to be an excellent predictor of burn injury for each severity. The DTM was repackaged with the probabilistic burn models to more accurately determine the risk of significant burn injury.
Collapse
Affiliation(s)
| | - Laurel J Ng
- L3 Applied Technologies Inc, Simulation, Engineering, & Testing, San Diego, California 92121, USA
| |
Collapse
|
|
45
|
Gonçalves RC, Signini R, Rosa LM, Dias YSP, Vinaud MC, Lino RDS. Carboxymethyl chitosan hydrogel formulations enhance the healing process in experimental partial-thickness (second-degree) burn wound healing. Acta Cir Bras 2021; 36:e360303. [PMID: 33825787 PMCID: PMC8026200 DOI: 10.1590/acb360303] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/19/2021] [Accepted: 02/15/2021] [Indexed: 01/15/2023] Open
Abstract
PURPOSE This study aimed to elaborate a hydrogel constituted by carboxymethyl chitosan (CMC), hyaluronic acid (HA) and silver (Ag) and to evaluate its healing effect on partial-thickness burn wounds experimentally induced in rats. METHODS CMC was obtained by chitosan reacting with monochloroacetic acid. The carboxymethylation was confirmed by Fourier-transform infrared spectroscopy and hydrogen nuclear magnetic resonance (NMR). Scanning electron microscopy was used to determine the morphologicalcharacteristics of chitosan and CMC. After the experimental burn wound induction, the animals (n = 126) were treated with different CMC formulations, had their occlusive dressings changed daily and were followed through 7, 14 and 30 days. Morphometric, macroscopic and microscopic aspects and collagen quantification were evaluated. RESULTS Significative wound contraction, granulation tissue formation, inflammatory infiltration and collagen fibers deposit throughout different phases of the healing process were observed in the CMC hydrogels treated groups. CONCLUSIONS The results showed that, in the initial phase of the healing process, the most adequate product was the CMC/HA/Ag association, while in the other phases the CMC/HA association was the best one to promote the healing of burn wounds.
Collapse
Affiliation(s)
- Randys Caldeira Gonçalves
- PhD. Universidade Federal de Goiás – Instituto de Patologia Tropical
e Saúde Pública – Programa de Pós-Graduação em Medicina Tropical e Saúde Pública –
Goiânia (GO), Brazil
| | - Roberta Signini
- PhD. Universidade Estadual de Goiás – Campus de Ciências Exatas e
Tecnológicas – Anápolis (GO), Brazil
| | - Luciana Martins Rosa
- Graduate student. Universidade Federal de Goiás – Faculdade de
Medicina – Goiânia (GO), Brazil
| | | | - Marina Clare Vinaud
- PhD. Universidade Federal de Goiás – Instituto de Patologia Tropical
e Saúde Pública – Departamento de Biociências e Tecnologia – Goiânia (GO),
Brazil
| | - Ruy de Souza Lino
- PhD. Universidade Federal de Goiás – Instituto de Patologia Tropical
e Saúde Pública – Departamento de Biociências e Tecnologia – Goiânia (GO),
Brazil
| |
Collapse
|
|
46
|
Ikegami R, Eshima H, Nakajima T, Toyoda S, Poole DC, Kano Y. Type I diabetes suppresses intracellular calcium ion increase normally evoked by heat stress in rat skeletal muscle. Am J Physiol Regul Integr Comp Physiol 2021; 320:R384-R392. [PMID: 33407019 DOI: 10.1152/ajpregu.00168.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/24/2020] [Indexed: 12/13/2022]
Abstract
Heat stress, via its effects on muscle intracellular Ca2+ concentrations ([Ca2+]i), has been invoked as a putative therapeutic countermeasure to type 1 diabetes-induced muscle atrophy. Using a circulation- and neurally intact in vivo muscle preparation, we tested the hypothesis that impaired muscle Ca2+ homeostasis in type 1 diabetic rats is due to attenuated heat stress tolerance mediated via transient receptor potential vanilloid 1 (TRPV1). Male Wistar rats were randomly assigned to one of the following four groups: 1) healthy control 30°C (CONT 30°C); 2) CONT 40°C; 3) diabetes 30°C (DIA 30°C); and 4) DIA 40°C. The temperature of 40°C was selected because it exceeds the TRPV1 activation threshold. Spinotrapezius muscles of Wistar rats were exteriorized in vivo and loaded with the fluorescent Ca2+ probe Fura-2 AM. [Ca2+]i was estimated over 20 min using fluorescence microscopy (340/380 nm ratio) in quiescent muscle held at the required temperature, using a calibrated heat source applied to the ventral muscle surface. Western blotting was performed to determine the protein expression levels of TRPV1 in spinotrapezius muscle. After 20 min of heat stress, the CONT 40°C condition induced a 12.3 ± 5% [Ca2+]i (P < 0.05) elevation that was markedly absent in the DIA 40°C or other conditions. Thus, no significant differences were found among DIA 40°C, DIA 30°C, and CONT 30°C. TRPV1 protein expression was decreased by 42.0 ± 9% in DIA compared with CONT (P < 0.05) and, unlike CONT, heat stress did not increase TRPV1 phosphorylation. In conclusion, diabetes suppresses TRPV1 protein expression and function and inhibits the elevated myocyte [Ca2+]i evoked normally by heat stress. These results suggest that capsaicin or other therapeutic strategies to increase Ca2+ accumulation via TRPV1 might be more effective than hyperthermic therapy for type 1 diabetic patients.
Collapse
Affiliation(s)
- Ryo Ikegami
- Department of Engineering Science, University of Electro-Communications, Chofu, Japan
- Department of Health Science, Health Science University, Yamanashi, Japan
| | - Hiroaki Eshima
- Department of Engineering Science, University of Electro-Communications, Chofu, Japan
- Diabetes & Metabolism Research Center, University of Utah, Salt Lake City, Utah
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Tochigi, Japan
| | - David C Poole
- Departments of Anatomy, Physiology and Kinesiology, Kansas State University, Manhattan, Kansas
| | - Yutaka Kano
- Department of Engineering Science, University of Electro-Communications, Chofu, Japan
- Center for Neuroscience and Biomedical Engineering, University of Electro-Communications, Chofu, Japan
| |
Collapse
|
|
47
|
Cheung LK, Osei-Kuffour D, Drake PJ. Full thickness burn after Thai herbal hot compress massage ball therapy. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
|
48
|
Han X, Yang M, Yin B, Cai L, Jin S, Zhang X, Li F. The Efficacy and Safety of Subcutaneous Radiofrequency After Liposuction: A New Application for Face and Neck Skin Tightening. Aesthet Surg J 2021; 41:NP94-NP100. [PMID: 32004377 DOI: 10.1093/asj/sjz364] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Minimally invasive or noninvasive skin-tightening procedures have become trends in facial and neck rejuvenation. Radiofrequency-assisted liposuction (RFAL) is a new choice for the treatment of skin relaxation that is more effective than noninvasive surgery without surgical incision. OBJECTIVES The authors recommend a 2-step method in which radiofrequency is applied after appropriate liposuction is performed. This approach is safer and more effective than traditional RFAL, and the authors detail the safety guidelines, operative techniques, postoperative satisfaction results, and complications. METHODS A total of 227 patients with lower face and neck skin laxity underwent RFAL between April 2012 and June 2019. The following data were collected: age, body mass index, operative duration, volume of fat aspirated, amount of energy delivered, and number and type of complications. Patient satisfaction was surveyed postoperatively and assessed by third-party surgeons at 3 and 6 months. RESULTS At 6 months after operation, 78.8% of patients considered the results moderate to excellent, whereas 21.2% of the patients considered the results to be poor or thought there was no change. The photograph evaluation performed by independent plastic surgeons showed moderate to excellent results in 89.1% of patients. There were no major complications that required further medical or surgical intervention. CONCLUSIONS This 2-step method is a safe and effective improvement in the application of radiofrequency for face and neck skin tightening. Patients can achieve significant contour correction via minimally invasive surgery with a lower risk of side effects. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Xuefeng Han
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingxia Yang
- Hospital of Renmin University of China, Beijing, China
| | - Bo Yin
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Cai
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaodong Jin
- Beijing Yezi Plastic and Beauty Hospital, Beijing, China
| | - Xinyu Zhang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Facheng Li
- Professor and Director of the Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
|
49
|
Kam J, Frost A, Bloom JD. Radiofrequency Rejuvenation of the "Tweener" Patient: Under, Over, or Through the Skin. Facial Plast Surg 2021; 37:240-248. [PMID: 33511577 DOI: 10.1055/s-0041-1722890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The demand for noninvasive facial rejuvenation continues to increase as younger, well-informed patients enter the aesthetic market. We refer to a subset of these patients as "tweeners," those who present with early signs of neck and facial aging, but who have not yet developed changes significant enough to warrant a traditional excisional surgery approach. Many of these patients are in search of a minimally invasive intervention, a bridge in between observation and surgery. The authors describe their experience with radiofrequency (RF) technology as an in-office tool to address the aging face in a select patient population. This review also attempts to comprehensively search the existing body of literature to describe the RF technologies and devices available for facial rejuvenation. The efficacy and safety profiles of the devices are discussed, and the devices are categorized by their method of RF delivery-over (contact), through (microneedle), and under (percutaneous) the skin.
Collapse
Affiliation(s)
- Joanna Kam
- Division of Facial Plastic Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ariel Frost
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jason D Bloom
- Division of Facial Plastic Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.,Bloom Facial Plastic Surgery, Bryn Mawr, Pennsylvania
| |
Collapse
|
|
50
|
Combination treatment utilizing fractional ablative and continuous wave CO 2 lasers for hypertrophic burn scars. Burns 2020; 47:1084-1093. [PMID: 33199081 DOI: 10.1016/j.burns.2020.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 10/18/2020] [Accepted: 10/29/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hypertrophic scars are devastating outcomes of severe burn injuries, producing physical and mental burdens. Adequate treatment is of benefit to relieve these burdens. Laser therapy has shown scar reducing effects. In this study, we compared outcomes after combination of two different lasers or single laser treatment to treat severe hypertrophic burn scars. METHODS Forty patients with hypertrophic burn scars were included in one of two therapeutic groups: continuous wave CO2 laser and fractional ablative CO2 laser group (group 1, n = 20) or fractional ablative CO2 laser alone group (group 2, n = 20). Hypertrophic scars were evaluated by the observer-rated Vancouver Scar Scale (VSS) before and after treatment and by patient-completed questionnaires after treatment. Comparative analyses were performed before and after treatment, and time-dependent improvement was also analyzed. RESULTS Forty patients (54 hypertrophic scars) completed the laser treatment protocols. Group 1 exhibited significantly more improvement in VSS vascularity, pliability, and height indices than group 2 (p < 0.05). Time-dependent analysis of total VSS scores suggested that group 1 experienced more improvement during a shorter treatment period (p < 0.05). For patient-reported outcomes, group 1 noted better grades than group 2 in four indices, namely scar appearance, scar thickness, pain, and pruritus (p < 0.05). CONCLUSION Effective scar reduction was achieved using combination laser treatment, with significant improvement in multiple observer- and patient-reported outcomes. The shorter treatment period of the combination method can be a merit, as prolonged hypertrophic scars may increase morbidity. Nonetheless, cautious treatment protocols are necessary to avoid undesirable sequelae related to laser application.
Collapse
|