ARTICLE | doi:10.20944/preprints202003.0204.v1
Subject: Mathematics & Computer Science, Artificial Intelligence & Robotics Keywords: Burns; Pressure Ulcer; Bruises; Deep Learning; Classification
Online: 12 March 2020 (09:04:23 CET)
While visual assessment is the standard technique for burn evaluation, computer-aided diagnosis is increasingly sought due to high number of incidences globally. Patients are increasingly facing challenges which are not limited to shortage of experienced clinicians, lack of accessibility to healthcare facilities, and high diagnostic cost. Certain number of studies were proposed in discriminating burn and healthy skin using machine learning leaving a huge and important gap unaddressed; whether burns and related skin injuries can be effectively discriminated using machine learning techniques. Therefore, we specifically use pre-trained deep learning models due to deficient dataset to train a new model from scratch. Experiments were extensively conducted using three state-of-the-art pre-trained deep learning models that includes ResNet50, ResNet101 and ResNet152 for image patterns extraction via two transfer learning strategies: fine-tuning approach where dense and classification layers were modified and trained with features extracted by base layers, and in the second approach support vector machine (SVM) was used to replace top-layers of the pre-trained models, trained using off-the-shelf features from the base layers. Our proposed approach records near perfect classification accuracy of approximately 99.9%.
REVIEW | doi:10.20944/preprints202205.0269.v1
Subject: Medicine & Pharmacology, Other Keywords: inflammation; calcium-sensing receptor; burns; chemokines; NLRP3 inflammasome
Online: 20 May 2022 (04:01:33 CEST)
Burn injury serves as an example of a condition with a robust inflammatory response. The elevation of circulating interleukins (IL)- 1 beta and -6 in children with severe burn injury up-regulate the parathyroid calcium sensing receptor (CaSR) resulting in hypocalcemic hypoparathyroidism with urinary calcium wasting. This effect protects the body from the hypercalcemia resulting from bone resorption liberating calcium into the circulation. Extracellular calcium can exacerbate and prolong the inflammatory response by stimulating mononuclear cell chemokine production as well as the NLRP3 inflammasome of the innate immune system, resulting in increased IL-1 production by monocytes and macrophages. Interestingly, the CaSR response to inflammatory cytokines disappears with age, potentially trapping calcium from bone resorption in the circulation and allowing it to contribute to increased inflammation and possibly increased calcium deposition in small arteries, , such as the coronaries, as conditions with increased chronic inflammation, such as spinal cord injury, osteoarthritis and rheumatoid arthritis have an incidence of cardiovascular disease and coronary artery calcium deposition significantly higher than the unaffected age-matched population.
REVIEW | doi:10.20944/preprints202010.0047.v1
Subject: Medicine & Pharmacology, Allergology Keywords: children; adolescents; burns; dressing changes; virtual reality; pain.
Online: 2 October 2020 (15:29:05 CEST)
Children and adolescents with severe burns require dressing changes, associated with pain. As immersive virtual reality (VR) gained prominence as non-pharmacological adjuvant analgesia, we conducted a systematic review and meta-analysis on the efficacy of full immersive VR on pain experienced during dressing changes in hospitalized children and adolescents with severe burns. This exercise included quality and risk of bias assessment. The systematic reviewsearch resulted in eight studies and 142 patients. This exercise included quality and risk of bias assessment. Due to missing data, four studies were excluded from the meta-analysis. Fixed effects meta-analysis of the four included studies (n = 104) revealed a large effect size (ES) (SMD=0.94; 95% CI=0.62, 1.27; Z=5.70; p<0.00001) for adjuvant full immersive VR compared to standard care. In conclusion, adjuvant full immersive VR significantly reduces pain experienced during dressing changes in children and adolescents with burns. We therefore recommend implementing full immersive VR as an adjuvant in this specific setting and population. However, this requires further research into the hygienic use of VR appliances in health institutions. Furthermore, due to the high cost of the hardware, a cost-benefit analysis is required. Finally, research should also verify the long term physical and psychological benefits of VR.
REVIEW | doi:10.20944/preprints201711.0204.v1
Subject: Medicine & Pharmacology, Pediatrics Keywords: burns; treatment; pediatric; autograft; biological skin substitute; thermal
Online: 30 November 2017 (14:12:10 CET)
Burns is a pervasive and oppressive basic care issue. In children, burn injuries are a major reason for bleakness and mortality. The quirks in the physiology of liquid and electrolyte taking care of, the vital necessity and the distinctions in the different body extends in children direct that the pediatric wounds administration ought to be brought with an alternate point of view than for adults. Notwithstanding, for the intensivist, challenges regularly exist that muddle quiet help and adjustment. Moreover, burn injuries are mind-boggling and can show exceptional challenges that require deep-rooted recovery. Investigation in burn wound care has yielded progressions that will keep on improving practical recuperation. What's more, pain management all through this period is essential. Managing these wounds requires escalated therapeutic treatment for multi-organ dysfunction, and forceful surgical treatment to forestall sepsis and other inconveniences. The biological therapeutic bilayered skin substitutes with a long shelf life that recapitulates the normal barrier function of the intact human skin and stimulate wound repair and skin regeneration. A definitive objective is to accomplish a perfect skin substitute that gives a successful and without scar wound recuperating. This review article features the headway in pediatric burn wounds with an emphasis on the pathophysiology and treatment of burn wounds.
ARTICLE | doi:10.20944/preprints201911.0062.v2
Subject: Physical Sciences, Fluids & Plasmas Keywords: electro-hydrodynamics; constant vorticity; Burns condition; weakly nonlinear analysis
Online: 15 April 2020 (10:05:39 CEST)
In 1895, Korteweg and de Vries (KdV), derived their celebrated equation describing the motion of waves of long wavelength in shallow water. In doing so they made a number of quite reasonable assumptions, incompressibility of the water and irrotational fluid. The resulting equation, the celebrated KdV equation, has been shown to be a very reasonable description of real water waves. However there are other phenomena which have an impact on the shape of the wave, that of vorticity and viscosity. This paper examines how a constant vorticity affects the shape of waves in electrohydrodynamics. For constant vorticity, the vertical component of the velocity obeys a Laplace equation and also has the usual lower boundary condition. In making the vertical component of the velocity take central stage, the Burns condition can be thus bypassed.
ARTICLE | doi:10.20944/preprints202205.0044.v1
Subject: Medicine & Pharmacology, Pediatrics Keywords: child maltreatment; administrative data; domestic violence/abuse; physical abuse; burns; neglect; emotional abuse; poverty
Online: 5 May 2022 (15:47:14 CEST)
Good child protection systems and processes require reliable and accurate data. A retrospective study of the case records of 452 children referred to a major UK children’s tertiary centre for suspected child maltreatment was undertaken to determine whether routinely collected data on a child’s journey through the child protection system, together with a study of related multidimensional factors, can be used to develop an enhanced dataset to protect children in the UK and in other countries. Child maltreatment was substantiated in 65% of referred cases, with the vast majority of referrals coming from children living in the most deprived neighbourhoods in the country. Domestic violence and abuse, and the child’s previous involvement with statutory bodies was associated with case substantiation. Physical abuse predominated, with soft tissue injuries, including dog bites, and burns. Burns were related almost exclusively to supervisory neglect. There were also cases of medical neglect. Emotional abuse was associated with exposure to domestic violence and abuse, and to self-harm. The strengths and weaknesses for single centre data systems were explored, concluding with a recommendation to establish an agreed national and international minimum data set to protect children from maltreatment.
ARTICLE | doi:10.20944/preprints202209.0475.v1
Subject: Medicine & Pharmacology, General Medical Research Keywords: catheter-associated infection; CAUTI; urinary tract infection; healthcare-associated infection; active drain line clearance; burns; intra-abdominal pressure; measurement
Online: 30 September 2022 (04:13:24 CEST)
OBJECTIVE A quality improvement study to assess catheter-associated urinary tract infection (CAUTI) rate post-implementation of a bladder catheter with integrated active drain line urine clearance and automated intra-abdominal pressure monitoring in a burn intensive care unit (ICU). DESIGN Eight-year retrospective before and after study (2015–2022). SETTING A single American Burn Association verified Burn Center with fourteen inpatient beds. PATIENTS Patients meeting criteria for admission to a Burn Center METHODS Retrospective cohort study following the implementation of a novel urine output monitoring system with integrated drain line and urine clearance. Data from a 48-month (from January 2015-December 2018) historical control (period 1) were compared to data from a 28-month (from January 2020 to April 2022) post-implementation period (period 2). Pre- and post-implementation CAUTI event incidences were compared. Charts were reviewed to characterize the patients. RESULTS A total of 42 CAUTIs in 2243 patients were identified using the National Health and Safety Network (NHSN) definition during the analyzed period. There were 40 CAUTI events in period 1 and two CAUTIs in period 2. The incidence of CAUTI events pre-implementation was 0.030 (mean of 10 CAUTI events per year) compared to 0.002 (mean of 1 CAUTI event per year) post-implementation of an automatic drain line clearing UO monitoring system showing a significant reduction in CAUTI events (P<0.01, risk ratio novel vs. gravity bladder catheter 0.071, 95% confidence interval: 0.017-0.294). CONCLUSIONS CAUTIs were reduced in the period following the implementation of a novel urinary catheter system with an integrated active drain line and urine clearance in burn patients.