Galina Gramotnev

Predictors of re-epithelialization in pediatric burn

INTRODUCTION An important treatment goal for burn wounds is to promote early wound closure. This study identifies factors associated with delayed re-epithelialization following pediatric burn. METHODS Data were collected from August 2011 to August 2012, at a pediatric tertiary burn center. A total of 106 burn wounds were analyzed from 77 participants aged 4-12 years. Percentage of wound re-epithelialization at each dressing change was calculated using Visitrak™. Mixed effect regression analysis was performed to identify the demographic factors, wound and clinical characteristics associated with delayed re-epithelialization. RESULTS Burn depth determined by laser Doppler imaging, ethnicity, pain scores, total body surface area (TBSA), mechanism of injury and days taken to present to the burn center were significant predictors of delayed re-epithelialization, accounting for 69% of variance. Flame burns delayed re-epithelialization by 39% compared to all other mechanisms (p = 0.003). When initial presentation to the burn center was on day 5, burns took an average of 42% longer to re-epithelialize, compared to those who presented on day 2 post burn (p < 0.000). Re-epithelialization was delayed by 14% when pain scores were reported as 10 (on the FPS-R), compared to 4 on the first dressing change (p = 0.015) for children who did not receive specialized preparation/distraction intervention. A larger TBSA was also a predictor of delayed re-epithelialization (p = 0.030). Darker skin complexion re-epithelialized 25% faster than lighter skin complexion (p = 0.001). CONCLUSIONS Burn depth, mechanism of injury and TBSA are always considered when developing the treatment and surgical management plan for patients with burns. This study identifies other factors influencing re-epithelialization, which can be controlled by the treating team, such as effective pain management and rapid referral to a specialized burn center, to achieve optimal outcomes.

Physiological stress in koala populations near the arid edge of their distribution.

Recent research has shown that the ecology of stress has hitherto been neglected, but it is in fact an important influence on the distribution and numbers of wild vertebrates. Environmental changes have the potential to cause physiological stress that can affect population dynamics. Detailed information on the influence of environmental variables on glucocorticoid levels (a measure of stress) at the trailing edge of a species’ distribution can highlight stressors that potentially threaten species and thereby help explain how environmental challenges, such as climate change, will affect the survival of these populations. Rainfall determines leaf moisture and/or nutritional content, which in turn impacts on cortisol concentrations. We show that higher faecal cortisol metabolite (FCM) levels in koala populations at the trailing arid edge of their range in southwestern Queensland are associated with lower rainfall levels (especially rainfall from the previous two months), indicating an increase in physiological stress when moisture levels are low. These results show that koalas at the semi-arid, inland edge of their geographic range, will fail to cope with increasing aridity from climate change. The results demonstrate the importance of integrating physiological assessments into ecological studies to identify stressors that have the potential to compromise the long-term survival of threatened species. This finding points to the need for research to link these stressors to demographic decline to ensure a more comprehensive understanding of species’ responses to climate change.

Thermal tweezers for surface manipulation with nanoscale resolution

In this letter, we demonstrate that random Brownian forces can be used for effective trapping and manipulation of nanoparticles and molecules on surfaces in the presence of strong temperature modulation. Substantial (~ 2 orders of magnitude) increase in the modulation of particle concentration (trapping efficiency) compared to thermophoresis in a bulk medium is predicted and explained by a periodic potential of interaction between a particle/molecule and the crystalline surface. As a result, a new nanofabrication and manipulation technique for creating optically-induced complex surface structures with nano-scale resolution below tens of nanometers is proposed and developed.

Monitoring and analysis of combustion aerosol emissions from fast moving diesel trains

In this paper we report the results of the detailed monitoring and analysis of combustion emissions from fast moving diesel trains. A new highly efficient monitoring methodology is proposed based on the measurements of the total number concentration (TNC) of combustion aerosols at a fixed point (on a bridge overpassing the railway) inside the violently mixing zone created by a fast moving train. Applicability conditions for the proposed methodology are presented, discussed and linked to the formation of the stable and uniform mixing zone. In particular, it is demonstrated that if such a mixing zone is formed, the monitoring results are highly consistent, repeatable (with typically negligible statistical errors and dispersion), stable with respect to the external atmospheric turbulence and result in an unusual pattern of the aerosol evolution with two or three distinct TNC maximums. It is also shown that the stability and uniformity of the created mixing zone (as well as the repeatability of the monitoring results) increase with increasing length of the train (with an estimated critical train length of ~10 carriages, at the speed of ~150km/h). The analysis of the obtained evolutionary dependencies of aerosol TNC suggests that the major possible mechanisms responsible for the formation of the distinct concentration maximums are condensation (the second maximum) and thermal fragmentation of solid nanoparticle aggregates (third maximum). The obtained results and the new methodology will be important for monitoring and analysis of combustion emissions from fast moving trains, and for the determination of the impact of rail networks on the atmospheric environment and human exposure to combustion emissions.

Community motivations to engage in conservation behavior to conserve the Sumatran Orangutan

Community-based conservation programs in developing countries are often based on the assumption that heteronomous motivation (e.g., extrinsic incentives such as economic rewards and pressure or coercion to act) will incite local communities to adopt conservation behaviors. However, this may not be as effective or sustainable as autonomous motivations (e.g., an intrinsic desire to act due to inherent enjoyment or self-identification with a behavior and through freedom of choice). We analyzed the comparative effectiveness of heteronomous versus autonomous approaches to community-based conservation programs through a case study of Sumatran orangutan (Pongo abelii) conservation in 3 villages in Indonesia. Each village had a different conservation program design. We surveyed people (n = 240) to determine their motivations for and behavior changes relative to orangutan and orangutan habitat (forest) protection. Heteronomous motivations (e.g., income from tourism) led to greater self-reporting of behavior change toward orangutan protection. However, they did not change self-reported behavior toward forest (i.e., orangutan habitat) protection. The most effective approach to creating self-reported behavior change throughout the community was a combination of autonomous and heteronomous motivations. Individuals who were heteronomously motivated to protect the orangutan were more likely to have changed attitudes than to have changed their self-reported behavior. These findings demonstrate that the current paradigm of motivating communities in developing countries to adopt conservation behaviors primarily through monetary incentives and rewards should consider integrating autonomous motivational techniques that promote the intrinsic values of conservation. Such a combination has a greater potential to achieve sustainable and cost-effective conservation outcomes. Our results highlight the importance of using in-depth sociopsychological analyses to inform the design and implementation of community-based conservation programs.

Psychological Stress and Psychosomatic Treatment: Major Impact on Serious Blood Disorders?

Objective: To demonstrate evidence of possible major impacts of psychological stress and psychosomatic interventions on myeloproliferative blood disorders and develop new approaches for the unification and quantified analysis of stress and psychosomatic treatments. Methods: This 3.5- year longitudinal study was based upon the regular blood tests of a person with myelofibrosis who experienced severe and repeated work-related psychological stress and was subjected to psychosomatic treatment in the form of regular (∼4 h per day) self-hypnosis sessions. Statistical data analysis was conducted on the basis of an introduced concept of generalized stress that mathematically unifies psychological stress and psychosomatic treatment. Results: Severe stress and psychosomatic treatment were statistically shown to have a major (dominant) impact on blood platelet counts well described by an exponential dependence on cumulative levels of generalized stress. The typical relaxation time for the impacts of both stress and treatment was shown to be ∼2 months. Only ∼12% of the total variation in platelet counts could be attributed to factors other than psychological stress and psychosomatic treatment. The psychosomatic intervention resulted in a consistent reduction of high platelet counts from ∼1,400 × 109 l–1 to approximately the middle of the normal range, with other blood parameters being either approximately stable or showing indications of a strengthening immune system. Conclusions: Our findings give hope for a possible development of psychosomatic treatments of at least some blood disorders. They also indicate a highly instrumental role of platelets in the quantified analysis of stress, psychosomatic interventions, and their neuroimmunological pathways.

A method for the analysis of thermal tweezers for manipulation and trapping of nanoparticles and adatoms on crystalline surfaces

We develop a computationally efficient method for the theoretical analysis of thermophoresis of nanoparticles and adatoms on crystalline surfaces (thermal tweezers) for efficient parallel nanofabrication. The analysis of surface diffusion of particles or adatoms in the presence of strong temperature gradients is conducted through the direct determination of probability distributions for diffusing particles, using the numerical solution of the Smoluchowski diffusion equation with varying (temperature-dependent) diffusion constant. The local values of the diffusion constant are determined from the Fokker–Planck equation for the considered crystalline potential of the substrate and local temperature. Steady-state and nonsteady-state particle distributions on the surface are obtained and analyzed in the presence of optically-induced strong temperature gradients. Detailed comparison of this approach with the previously obtained results from the Monte Carlo simulations of the Langevin equation is conducted, demonstrating high computational efficiency, and accuracy of the new method in the high-friction regime. Applicability conditions for the developed method are also determined and discussed.

27. : Validation of the DRAGON score in an Australian Safe Implementation of Treatment in Stroke (SITS) cohort

Intravenous thrombolysis with tissue plasminogen activator (IV-tPA) is standard treatment for acute ischaemic stroke in Australia for those who meet the criteria. Its benefit, in terms of favourable outcome, is restricted to approximately 50% of patients with the remainder left severely disabled or dead. In 2012 the DRAGON score was developed and based on pre-treatment clinical parameters to predict the functional outcome post-thrombolysis in acute stroke. We aim to validate the DRAGON score in an Australian Safe Implementation of Treatment in Stroke (SITS) cohort and further refine parameters to enhance its prognostic power. We performed a retrospect review of 1561 thrombolysis patients (853 male, 708 female) from 15 Australian hospitals registered in the SITS registry between 2004 and June 2013. Relevant pre-treatment DRAGON score variables and 3 month outcome data were available for 1172 patients (649 male, 523 female). Further refinement of the score was achieved via analysis to estimate effect of independent variables on good versus miserable outcome. Logistic regression with clustering (with respect to different participating hospitals and their location) was used to derive the improved DRAGON score. Further comparison of the DRAGON scores was conducted by means of the receiver operating characteristic curve approach. As a result of the conducted logistic regression analysis, the original DRAGON score has been validated and refined (including the new weights for the considered risk factors) in the Australian context of a SITS cohort. Complete results will be presented at ANZAN Annual Scientific meeting 2014. The DRAGON score is an important pre-treatment prognostic tool to predict the functional outcome of patients undergoing thrombolysis for acute stroke and is validated in an Australian SITS cohort.