Improved Short-Term Prognosis of Pediatric Partial-Thickness Burns: Emergency Conservative Debridement Under Topical Anesthesia.

OBJECTIVES: Early wound management for pediatric patients with partial-thickness burns in the emergency department remains debatable. This study aims to evaluate the value of emergency conservative debridement under topical anesthesia in improving short-term prognosis of pediatric partial-thickness burns. METHODS: This retrospective cohort study enrolled children with partial-thickness thermal burns presenting to the emergency department within 6 hours postburn. All the enrolled patients were divided into 2 groups: the debridement group and the dressing group. The associations between emergency conservative debridement and time to reepithelialization was analyzed by using Kaplan-Meier curves with log rank test and multivariate Cox regression analysis. Moreover, the associations between emergency conservative debridement and in-hospital cost and length of stay were also evaluated. RESULTS: All baseline characteristics between groups were comparable (all P > 0.05). Emergency conservative debridement under topical anesthesia significantly decreased the median value of time to reepithelialization (13 vs 14 days, P = 0.02). Cox regression analysis showed that emergency conservative debridement significantly improved wound reepithelialization after adjusting for burn size (odds ratio, 4.07; 95% confidence interval, 1.64-10.11; P < 0.01). The mean length of stay of patients receiving conservative wound debridement was lower than that of patients in the wound dressing group (14.3 ± 7.3 vs 18.8 ± 10.4 days, P < 0.01), but not in terms of mean in-hospital cost per 1% total body surface area (2.8 ± 1.9 vs 3.0 ± 2.1 × 103 RMB per 1% total body surface area, P = 0.58). CONCLUSIONS: Emergency conservative debridement of pediatric partial-thickness burns under topical anesthesia significantly improves the wound healing outcomes without increasing health care burden.

High-Value Utilization of Marine Biological Resources.

The ocean covers 71% of the surface of our planet and comprises a diverse variety of biological resources-a combination of marine animals, marine plants, and marine microorganisms that have economic value for human beings [...].

Effectiveness assessment of using water environmental microHI to predict the health status of wild fish.

Aquatic wildlife health assessment is critically important for aquatic wildlife conservation. However, the health assessment of aquatic wildlife (especially aquatic wild animals) is difficult and often accompanied by invasive survey activities and delayed observability. As there is growing evidence that aquatic environmental microbiota could impact the health status of aquatic animals by influencing their symbiotic microbiota, we propose a non-invasive method to monitor the health status of wild aquatic animals using the environmental microbiota health index (microHI). However, it is unknown whether this method is effective for different ecotype groups of aquatic wild animals. To answer this question, we took a case study in the middle Yangtze River and studied the water environmental microbiota and fish gut microbiota at the fish community level, population level, and ecotype level. The results showed that the gut microHI of the healthy group was higher than that of the unhealthy group at the community and population levels, and the overall gut microHI was positively correlated with the water environmental microHI, whereas the baseline gut microHI was species-specific. Integrating these variations in four ecotype groups (filter-feeding, scraper-feeding, omnivorous, and carnivorous), only the gut microHI of the carnivorous group positively correlated with water environmental microHI. Alcaligenaceae, Enterobacteriaceae, and Achromobacter were the most abundant groups with health-negative-impacting phenotypes, had high positive correlations between gut sample group and environment sample group, and had significantly higher abundance in unhealthy groups than in healthy groups of carnivorous, filter-feeding, and scraper-feeding ecotypes. Therefore, using water environmental microHI to indicate the health status of wild fish is effective at the community level, is effective just for carnivorous fish at the ecotype level. In the middle Yangtze River, Alcaligenaceae, Enterobacteriaceae (family level), and Achromobacter (genus level) were the key water environmental microbial groups that potentially impacted wild fish health status. Of course, more data and research that test the current hypothesis and conclusion are encouraged.

Transmission Mueller matrix imaging with spatial filtering.

In this Letter, we report a study on the effects of spatial filtering for a transmission Mueller matrix imaging system. A spatial filter (SF) is placed on the back Fourier plane of the imaging lens in a dual-rotating-retarders Mueller matrix imaging system to select photons within a certain scattering angle. The system is then applied to three types of human cancerous tissues. When imaging with a small-aperture SF, some polarimetry basis parameters show sharp changes in contrast in the cancerous regions. Monte Carlo simulations using a simple sphere-cylinder scattering model also show that spatial filtering of the scattered photons provides extra information on the size and shape of the scattering particles. The results indicate that spatial filtering enhances the capability of polarization imaging as a powerful tool for biomedical diagnosis.

Infrared thermography for assessment of thoracic paravertebral block: a prospective observational study.

BACKGROUND: There was no "gold standard" to assess the success or failure of thoracic paravertebral block (TPVB). Measurement of skin temperature with infrared thermography (IT) would be a reliable method to evaluate the effectiveness of regional blocks. This study aimed to explore the feasibility of using skin temperature difference (Td) determined by IT between the blocked and unblocked side to predict the spread of TPVB. METHODS: Sixty-one patients undergoing elective unilateral breast or thoracoscopic surgery were enrolled in this prospective observational study. TPVB was performed at T4 and T5 under real-time ultrasound guidance with 10 mL of 0.4% ropivacaine for each patient, respectively. Td between the blocked and unblocked side were measured with IT from T2 to T10 at the anterior chest wall before TPVB and 5 min, 10 min, 15 min and 20 min after TPVB. Pinprick test was performed at 20 min after TPVB. Successful TPVB was defined as no sensation to pinprick in 3 or more adjacent dermatomes corresponding to the site of injection at 20 min after TPVB. Td was compared to pinprick test for evaluating its effectiveness in predicting the success of TPVB. The sensitivity, specificity, and cut-off value of Td for predicting successful TPVB were determined by receiver operator characteristic (ROC) curve analysis. RESULTS: Compared with the baseline value before block, Td from T2 to T10 were significantly increased at each time point in successful blocks. In failed blocks, Td was not increased in any dermatome. The increase of Td at T4-T7 was more than 1 °C 20 min after successful TPVB. Fifteen minutes after block, Td increase at T4 had the greatest potential to predict block success. The area under the ROC curve was 0.960 at a cut-off value of 0.63 °C with a sensitivity of 83.3% and a specificity of 100.0%. CONCLUSIONS: This study suggested that the increase of Td at T4 dermatome determined by IT between the blocked and unblocked side is an early, quantitative, and reliable predictor of successful TPVB. TRIAL REGISTRATION: Clinical trial registration: NCT04078347 .

Characteristic Mueller matrices for direct assessment of the breaking of symmetries.

Mueller polarimetry is a powerful optical technique in the analysis of micro-structural properties of optical samples. However, there is no explicit relationship between individual Mueller matrix elements and the physical properties of the sample. Several matrix decomposition algorithms corresponding to specific optical models have been proposed, which extract the physical information from measured Mueller matrices. Nevertheless, we still need a prior assessment method to decide which model is more suitable for the experimental data. In this Letter, we propose a set of characteristic Mueller matrices that allows us to obtain information about the breaking of rotation, mirror, and reciprocal symmetry properties in the sample by direct inspection of several elements of the Mueller matrix. By further analyzing the possible origin of symmetry breaking, we can learn the type and mixing status of anisotropies in the measured sample. We have verified our theory with Monte Carlo simulations of polarized light scattering in an isotropic or anisotropic medium containing different configurations of spherical and cylindrical scatterers. This study may help experimenters choose more suitable Mueller matrix decomposition methods.

Analysis of tissue microstructure with Mueller microscopy: logarithmic decomposition and Monte Carlo modeling.

Significance: Definitive diagnostics of many diseases is based on the histological analysis of thin tissue cuts with optical white light microscopy. Extra information on tissue structural properties obtained with polarized light would help the pathologist to improve the accuracy of his diagnosis.

Aim: We report on using Mueller matrix microscopy data, logarithmic decomposition, and polarized Monte Carlo (MC) modeling for qualitative and quantitative analysis of thin tissue cuts to extract the information on tissue microstructure that is not available with a conventional white light microscopy.

GPU acceleration of Monte Carlo simulations for polarized photon scattering in anisotropic turbid media.

In earlier studies, we developed scattering models and the corresponding CPU-based Monte Carlo simulation programs to study the behavior of polarized photons as they propagate through complex biological tissues. Studying the simulation results in high degrees of freedom that created a demand for massive simulation tasks. In this paper, we report a parallel implementation of the simulation program based on the compute unified device architecture running on a graphics processing unit (GPU). Different schemes for sphere-only simulations and sphere-cylinder mixture simulations were developed. Diverse optimizing methods were employed to achieve the best acceleration. The final-version GPU program is hundreds of times faster than the CPU version. Dependence of the performance on input parameters and precision were also studied. It is shown that using single precision in the GPU simulations results in very limited losses in accuracy. Consumer-level graphics cards, even those in laptop computers, are more cost-effective than scientific graphics cards for single-precision computation.

Assessment of tissue perfusion changes in port wine stains after vascular targeted photodynamic therapy: a short-term follow-up study.

The occlusion effect of vascular targeted photodynamic therapy (V-PDT) for malformed vessels in port wine stains (PWS) often last for some time after the treatment. A relatively longer period after V-PDT is needed to accurately assess the final response of PWS microcirculation to the treatment. In this study, we intended to use laser speckle imaging (LSI) to assess the tissue perfusion changes of PWS at follow-up after V-PDT and preliminarily analyze the relationship between perfusion change and color bleaching. Seventeen patients with 40 PWS lesions were scanned by LSI before and 3-6 months after they received V-PDT. The speckle flow indices of PWS lesions and normal skin before and at follow-up after V-PDT were recorded. We also performed analyses on the correlation between perfusion changes and color bleaching. Before V-PDT, the 40 PWS lesions showed higher perfusion than the normal skin (1,421 ± 463 and 1,115 ± 386 perfusion unit (PU), respectively, P < 0.01). The PWS lesions scanned at follow-up showed decreased perfusion level compared to the preoperative values (1,282 ± 460 and 1,421 ± 463 PU, respectively, P < 0.01). After V-PDT, the perfusion change rates coincide well with the color bleaching rates (correlation coefficient, 0.73). In conclusion, the LSI system is capable of imaging PWS perfusion precisely, and it has shown promising results in assessing the changes of tissue perfusion of V-PDT for PWS, with objective and quantitative data, real-time images, and a shorter detection time. It may also provide an effectiveness assessment method for the treatment of PWS.