The Effect of Diabetes Mellitus Severity on Foot & Ankle Burn Recovery.

Background: Diabetic patients often present with complex limb pathology, resulting in impaired sensation in the distal extremities making tactile injuries such as burns difficult to notice. We posit that poorly controlled diabetes mellitus, evidenced by increasing elevations in hemoglobin A1c, is associated with delayed wound healing and increased complications in burn patients.

Methods: The TriNetX Network, a database of 89 million patients across the U.

Nonsteroidal Anti-Inflammatory Drugs Decrease Coagulopathy Incidence in Severe Burn Patients.

The study investigated the impact of nonsteroidal anti-inflammatory drugs (NSAIDs) on burn-induced coagulopathy in severely burned patients. Patients with a greater than 20% TBSA were identified in the TriNetX research network and categorized into receiving or not receiving NSAIDs in the first week after the burn. The statistical significance of the rate of burn-induced coagulopathy, mortality and sepsis in the week following injury was analysed.

Stress-Induced Oculogyric Crisis in Septo-Optic Dysplasia: Case Report.

Introduction: Oculogyric crisis (OGC) is a dystonic movement disorder of varying durations that manifests as bilateral paroxysmal upward eye deviation accompanied by involuntary blinking, tongue protrusion, and autonomic symptoms. Separately, septo-optic dysplasia (SOD) is a congenital disorder involving hypoplasia of the optic nerve as well as hypothalamic and pituitary abnormalities. In the presented case, we report a case of OGC in the setting of SOD with proposed pathogenesis.

The Utilisation of INR to identify coagulopathy in burn patients.

Studies conflict on the significance of burn-induced coagulopathy. We posit that burn-induced coagulopathy is associated with injury severity in burns. Our purpose was to characterize coagulopathy profiles in burns and determine relationships between % total burn surface area (TBSA) burned and coagulopathy using the International Normalized Ratio (INR).

Opioid prescription and opioid disorders in burns: A large database analysis from 1990 to 2019.

Background: Opioids remain crucial in the management of burn pain. A comprehensive analysis of opioid use in burns and their complications has not been investigated.

Methods: Data were collected from TriNetX, a large multicenter database with de-identified patient information.

Patterns of antibiotic administration in patients with burn injuries: A TriNetX study.

Background: In the advent of increasing antibiotic resistance, several studies sought to determine antibiotic prescription trends; however, no pattern has been firmly identified particularly for the burned population. We performed a query of burned patients in a large established database to understand differences in antibiotic use related to patient-specific factors.

Methods: Burned patients with systemic antibiotics given within 7 days of injury were identified on the TriNetX database.

Lymphocytic Panhypophysitis Mimicking Glaucoma: Case Report.

Lymphocytic hypophysitis (LH) is a primary inflammatory disorder of the pituitary gland and infundibulum that commonly manifests in both mass effect and endocrinologic symptoms. Although the exact pathophysiology remains unclear, it has been increasingly linked to an autoimmune process. Complications arise by two separate mechanisms.

Early wound excision within three days decreases risks of wound infection and death in burned patients.

Introduction: In lieu of limited studies on the timing of burn wound eschar excision for burns, a more comprehensive analysis is indicated to determine the effects of early wound excision following burns. This study aims to address the outcomes of early wound excision in burn patients.

Methods: Data collection were from TriNetX research database.

Probing Beyond the Pain Scale: A Rare Case of Cutibacterium Acnes Septic Arthritis.

Patients with sickle cell disease frequently present to the hospital for pain control secondary to vaso-occlusive crises (VOCs). Diagnostic challenges exist for healthcare providers in distinguishing joint pain secondary to a VOC from an intraarticular infection at initial presentation due to the lack of established clinical markers exclusive to one or the other. We present a 35-year-old female with sickle cell disease and avascular necrosis of bilateral hips and the right shoulder with several previous admissions for VOC pain control complaining of a "different" kind of pain in her shoulder.

Large scale coherent magnetohydrodynamic oscillations in a sunspot.

Although theoretically predicted, the simultaneous excitation of several resonant modes in sunspots has not been observed. Like any harmonic oscillator, a solar magnetic flux tube can support a variety of resonances, which constitute the natural response of the system to external forcing. Apart from a few single low order eigenmodes in small scale magnetic structures, several simultaneous resonant modes were not found in extremely large sunspots.

High-resolution wave dynamics in the lower solar atmosphere.

The magnetic and convective nature of the Sun's photosphere provides a unique platform from which generated waves can be modelled, observed and interpreted across a wide breadth of spatial and temporal scales. As oscillations are generated or emerge through the photospheric layers, the interplay between the rapidly evolving densities, temperatures and magnetic field strengths provides dynamic evolution of the embedded wave modes as they propagate into the tenuous solar chromosphere. A focused science team was assembled to discuss the current challenges faced in wave studies in the lower solar atmosphere, including those related to spectropolarimetry and radiative transfer in the optically thick regions.

Magnetoacoustic wave energy dissipation in the atmosphere of solar pores.

The suitability of solar pores as magnetic wave guides has been a key topic of discussion in recent years. Here, we present observational evidence of propagating magnetohydrodynamic wave activity in a group of five photospheric solar pores. Employing data obtained by the Facility Infrared Spectropolarimeter at the Dunn Solar Telescope, oscillations with periods of the order of 5 min were detected at varying atmospheric heights by examining Si ɪ 10827 Å line bisector velocities.

High-frequency oscillations in small chromospheric bright features observed with Atacama Large Millimetre/Submillimetre Array.

We report detection of oscillations in brightness temperature, size and horizontal velocity of three small bright features in the chromosphere of a plage/enhanced-network region. The observations, which were taken with high temporal resolution (i.e.

Accurately constraining velocity information from spectral imaging observations using machine learning techniques.

Determining accurate plasma Doppler (line-of-sight) velocities from spectroscopic measurements is a challenging endeavour, especially when weak chromospheric absorption lines are often rapidly evolving and, hence, contain multiple spectral components in their constituent line profiles. Here, we present a novel method that employs machine learning techniques to identify the underlying components present within observed spectral lines, before subsequently constraining the constituent profiles through single or multiple Voigt fits. Our method allows active and quiescent components present in spectra to be identified and isolated for subsequent study.

On the effect of oscillatory phenomena on Stokes inversion results.

Stokes inversion codes are crucial in returning properties of the solar atmosphere, such as temperature and magnetic field strength. However, the success of such algorithms to return reliable values can be hindered by the presence of oscillatory phenomena within magnetic wave guides. Returning accurate parameters is crucial to both magnetohydrodynamics (MHD) studies and solar physics in general.

Tiered Approach to Resilience Assessment.

Regulatory agencies have long adopted a three-tier framework for risk assessment. We build on this structure to propose a tiered approach for resilience assessment that can be integrated into the existing regulatory processes. Comprehensive approaches to assessing resilience at appropriate and operational scales, reconciling analytical complexity as needed with stakeholder needs and resources available, and ultimately creating actionable recommendations to enhance resilience are still lacking.

Megacity precipitationsheds reveal tele-connected water security challenges.

Urbanization is a global process that has taken billions of people from the rural countryside to concentrated urban centers, adding pressure to existing water resources. Many cities are specifically reliant on renewable freshwater regularly refilled by precipitation, rather than fossil groundwater or desalination. A precipitationshed can be considered the "watershed of the sky" and identifies the origin of precipitation falling in a given region.

Revealing Invisible Water: Moisture Recycling as an Ecosystem Service.

An ecosystem service is a benefit derived by humanity that can be traced back to an ecological process. Although ecosystem services related to surface water have been thoroughly described, the relationship between atmospheric water and ecosystem services has been mostly neglected, and perhaps misunderstood. Recent advances in land-atmosphere modeling have revealed the importance of terrestrial ecosystems for moisture recycling.

Evaluating the cost-effectiveness of tiotropium versus salmeterol in the treatment of chronic obstructive pulmonary disease.

Objective: To assess the cost-effectiveness of 3 treatments (tiotropium, salmeterol, and no treatment) in patients with moderate chronic obstructive pulmonary disease (COPD).

Methods: A Markov model with a time horizon of 1 year was developed. A hypothetical cohort of 100,000 subjects with moderate COPD with mean age of 65 years, smoking history of 50 pack-years, and disease duration of 9.

Computer-guided academic detailing as part of a drug benefit program.

A service for identifying opportunities for drug cost savings in managed care plans and intervening by giving drug information to physicians is described. A clinical pharmacy company developed a computerized drug-use-review program to (1) identify and track variances in prescribing from drug-use criteria, (2) formulate plans for correcting the variances, and (3) document the impact of those interventions on drug costs. The software program weights prescriptions claims data against drug-use criteria to identify opportunities to save money.