Conservation of the Threatened Species, Pulsatilla vulgaris Mill. (Pasqueflower), is Aided by Reproductive System and Polyploidy.

Population loss due to habitat disturbance is a major concern in biodiversity conservation. Here we investigate the genetic causes of the demographic decline observed in English populations of Pulsatilla vulgaris and the consequences for conservation. Using 10 nuclear microsatellite markers, we compare genetic variation in wild populations with restored and seed-regenerated populations (674 samples). Emergence of genetic structure and loss of allelic variation in natural populations are not as evident as expected from demographic trends. Restored populations show genetic variation comparable to their source populations and, in general, to the wild ones. Genetic homogeneity is observed in regeneration trials, although some alleles not captured in source populations are detected. We infer that polyploidy, longevity, and clonal reproduction have provided P. vulgaris with the standing genetic variation necessary to make the species resilient to the effects of demographic decline, suggesting that the use of multiple sources for reintroduction may be beneficial to mimic natural gene flow and the availability of multiple allele copies typical of polyploid species.

Capturing, protecting and restoring plant diversity in the UK: RBG Kew and the Millennium Seed Bank.

Ex situ seed banking is a practical and cost-effective means of preserving wild plant diversity and a crucial complement to the in situ conservation and restoration of species and habitats. As pressures on the natural environment have grown, so has the call for seed banks to provide scientifically-robust, practical solutions to seed-related problems in nature conservation, from single-species recovery and reintroduction to the restoration of complex, dynamic communities at the largest scales. In this paper, we discuss how the Royal Botanic Gardens, Kew and its Millennium Seed Bank have responded to this call in the United Kingdom. We demonstrate that banked seed collections can provide a range of otherwise-unavailable, high quality, known-origin, genetically-diverse biological materials. The data, expertise and specialist facilities that accompany these collections are also valuable, helping overcome constraints to the collection, production and effective use of native seed. Challenges remain - to ensure ex situ collections protect the species and genetic diversity that will enable plants to adapt to a changing environment, and to find new ways for seed banks to mobilise their resources at a landscape scale.

Computerized manufacturing of transparent face masks for the treatment of facial scarring.

In this work an integrated system of computer-aided design and computer-aided manufacturing specifically designed to fabricate affordable transparent face masks is discussed. FaceScan, a custom-designed software system, integrates shape capture, mask design, and pattern fabrication. The software controls a linear scan noncontact laser imager for facial topography acquisition and a milling machine for pattern fabrication. Compared with conventional methods of mask fabrication, this system is faster, more accurate, and less stressful for the patient and allows for greater control of the finished product. Masks for two subjects have been successfully fabricated using this system.

Combat casualty hand burns: evaluating impairment and disability during recovery.

This study evaluated the use of the American Medical Association (AMA) impairment guides and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire in U.S. military casualties recovering from burn injury to the hand. Study sample included patients with burns to at least one hand and complete evaluations of impairment and disability upon discharge from the hospital and at a follow-up visit less than four months later. AMA and DASH scores were calculated for each visit and standardized response means (SRMs) were calculated to indicate responsiveness. Correlation between impairment and disability was assessed at discharge and follow-up and scores were examined for ability to discriminate between casualties returned to duty (RTD) and casualties not returned to duty (N-RTD). Both outcome instruments revealed a statistically significant change in scores between visits (p<0.001) with corresponding SRM indexes greater than 0.8 (large effect). There was a moderate correlation (r=0.50) between impairment and disability at discharge and a moderately high correlation (r=0.74) at follow-up. Both AMA and DASH scores clearly discriminated between casualties RTD (AMA 10+/-10 and DASH 12+/-12) and casualties N-RTD (AMA 39+/-19 and DASH 41+/-17) with improved accuracy at follow-up visit. The AMA and DASH can provide a comprehensive assessment of impairment and disability and may be used to detect changes in patient health status over time while clearly discriminating between RTD and N-RTD in combat casualties recovering from burn injury to the hand(s).

Military return to duty and civilian return to work factors following burns with focus on the hand and literature review.

Functional recovery and outcome from severe burns is oftentimes judged by the time required for a person to return to work (RTW) in civilian life. The equivalent in military terms is return to active duty. Many factors have been described in the literature as associated with this outcome. Hand function, in particular, is thought to have a great influence on the resumption of preburn activities. The purpose of this investigation was to compare factors associated with civilian RTW with combat injured military personnel. A review of the literature was performed to assimilate the many factors reported as involved with RTW or duty. Additionally, a focus on the influence of hand burns is included. Thirty-four different parameters influencing RTW have been reported inconsistently in the literature. In a military population of combat burns, TBSA burn, length of hospitalization and intensive care and inhalation injury were found as the most significant factors in determining return to duty status. In previous RTW investigations of civilian populations, there exists a scatter of factors reported to influence patient disposition with a mixture of conflicting results. In neither military nor civilian populations was the presence of a hand burn found as a dominant factor. Variety in patient information collected and statistical approaches used to analyze this information were found to influence the results and deter comparisons between patient populations. There is a need for a consensus data set and corresponding statistical approach used to evaluate RTW and duty outcomes after burn injury.

A clarion to recommit and reaffirm burn rehabilitation.

Burn rehabilitation has been a part of burn care and treatment for many years. Yet, despite of its longevity, the rehabilitation outcome of patients with severe burns is less than optimal and appears to have leveled off. Patient survival from burn injury is at an all-time high. Burn rehabilitation must progress to the point where physical outcomes parallel survival statistics in terms of improved patient well-being. This position article is a treatise on burn rehabilitation and the state of burn rehabilitation patient outcomes. It describes burn rehabilitation interventions in brief and why a need is felt to bring this issue to the forefront. The article discusses areas for change and the challenges facing burn rehabilitation. Finally, the relegation and acceptance of this responsibility are addressed.

The reliability and concurrent validity of the figure-of-eight method of measuring hand edema in patients with burns.

OBJECTIVE: Water volumetry is considered the "gold standard" for hand edema assessment. This technique requires considerable time, staff, and specialized equipment. The figure-of-eight method for hand edema assessment has been tested only in the orthopedic population. The objective of this study was to test the reliability and concurrent validity of the figure-of-eight method of measuring hand edema in the burn patient population. METHODS: We conducted a prospective blinded study with 20 burned patients (33 edematous hands) admitted from February to May 2005. Two testers performed three separate blinded measurements on each edematous hand, using the figure-of-eight technique. A third tester performed two measurements, using water volumetry. An independent investigator recorded all measurements. Intratester and intertester reliability were analyzed. Concurrent validity was examined and compared with water volumetry measurements. RESULTS: Intraclass correlation coefficients (ICC) for the intratester reliability of the figure-of-eight method were 0.96 for tester 1 and 0.97 for tester 2. The ICC for intertester reliability of the figure-of-eight measurements was 0.94. The intratester ICC for volumetric measurements was 0.99. Correlation coefficient (Pearson's) for tester 1 was 0.83 (P < .01), and for tester 2, 0.89 (P < .01). CONCLUSION: The figure-of-eight technique is a reliable and valid measurement tool for measuring hand edema. This technique is a more clinically feasible tool than water volumetry in the burn patient population.

A review of compression glove modifications to enhance functional grip: a case series.

A common complaint among patients with burns is their inability to grasp items while wearing compression gloves. Recent technological innovations permit the addition of grip-enhancing material to garment fabric. The purpose of this case series was to describe the course of development of compression gloves with enhanced grip modifications. Five different types of grip modifications were made during a period of 18 months. Five subjects who were prescribed compression gloves tested each type of glove. The gloves were fabricated with grip-enhancing material on the palmar surface in five ways: 1) rectangular rubber tabs; 2) honeycomb pattern silicone; 3) wave-like pattern silicone; 4) line pattern silicone beads; 5) line pattern silicone beads embedded into the fabric. Each glove was evaluated on a three-point Likert scale (0 = poor, 1 = moderate, 2 = good) for grip-enhancing qualities and durability. All five subjects reported similar experiences with each glove type: 1) the rectangular rubber tabs demonstrated poor grip and moderate durability; 2) the honeycomb pattern provided good grip but poor durability; 3) the wave pattern had good grip and moderate durability; 4) the silicone beads adhered to the fabric had moderate grip but poor durability; 5) the silicone beads embedded into the fabric had moderate grip and good durability. The wave pattern provided the best gripping capability and silicone embedded into the fabric demonstrated the best durability. A wave-like pattern silicone material embedded into the fabric seems to provide the best combination of grip and durability to enhance activities of daily living performance.

Two simple leg net devices designed to protect lower-extremity skin grafts and donor sites and prevent decubitus ulcer.

Burn therapists routinely are tasked to position the lower extremities of burn patients for pressure ulcer prevention, skin graft protection, donor site ventilation, and edema reduction. We developed two durable and low-maintenance devices that allow effective positioning of the lower extremities. The high-profile and low-profile leg net devices were simple to fabricate and maintain. The frame was assembled using a three-quarter-inch diameter copper pipe and copper fittings (45 degrees, 90 degrees, and tees). A double layer of elasticized tubular netting was pulled over the frame and doubled back for leg support to complete the devices. The devices can be placed on any bed surface. The netting can be exchanged when soiled and the frame can be disinfected between patients using standard techniques. Both devices were used on approximately 250 patients for a total of 1200 treatment days. No incidence of pressure ulcer was observed, and graft take was not adversely affected. The devices have not required repairs or replacement. Medical providers reported they are easy to apply and effectively maintain proper positioning throughout application. Neither device interfered with the application of other positioning devices. Both devices were found to be an effective method of positioning lower extremities to prevent pressure ulcer, minimize graft loss and donor site morbidity, and reduce edema. The devices allowed for proper wound ventilation and protected grafted lower extremities on any bed surface. The devices are simple to fabricate and maintain. Both devices can be effectively used simultaneously with other positioning devices.