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.

Discovery of a lipid synthesising organ in the auditory system of an insect

Weta possess typical Ensifera ears. Each ear comprises three functional parts: two equally sized tympanal membranes, an underlying system of modified tracheal chambers, and the auditory sensory organ, the crista acustica. This organ sits within an enclosed fluid-filled channel-previously presumed to be hemolymph. The role this channel plays in insect hearing is unknown. We discovered that the fluid within the channel is not actually hemolymph, but a medium composed principally of lipid from a new class. Three-dimensional imaging of this lipid channel revealed a previously undescribed tissue structure within the channel, which we refer to as the olivarius organ. Investigations into the function of the olivarius reveal de novo lipid synthesis indicating that it is producing these lipids in situ from acetate. The auditory role of this lipid channel was investigated using Laser Doppler vibrometry of the tympanal membrane, which shows that the displacement of the membrane is significantly increased when the lipid is removed from the auditory system. Neural sensitivity of the system, however, decreased upon removal of the lipid-a surprising result considering that in a typical auditory system both the mechanical and auditory sensitivity are positively correlated. These two results coupled with 3D modelling of the auditory system lead us to hypothesize a model for weta audition, relying strongly on the presence of the lipid channel. This is the first instance of lipids being associated with an auditory system outside of the Odentocete cetaceans, demonstrating convergence for the use of lipids in hearing.

Thermal characterization of microheaters from the dynamic response

Thermal characterization of surface-micromachined microheaters is carried out from their dynamic response to electrothermal excitations. An electrical equivalent circuit model is developed for the thermo-mechanical system. The mechanical parameters are extracted from the frequency response obtained using a laser Doppler vibrometer. The resonant frequencies of the microheaters are measured and compared with FEM simulations. The thermal time constants are obtained from the electrical equivalent model by fitting the model response to the measured frequency response. Microheaters with an active area of 140 µm × 140 µm have been realized on two different layers (poly-1 and poly-2) with two different air gaps (2 µm and 2.75 µm). The effective time constants, combining thermal and mechanical responses, are in the range of 0.13–0.22 ms for heaters on the poly-1 layer and 1.9 µs–0.15 ms for microheaters on the poly-2 layer. The thermal time constants of the microheaters are in the range of a few microseconds, thus making them suitable for sensor applications that need a faster thermal response.

The TRAM flap for breast reconstruction : Studies on perioperative cutaneous blood flow, vasoconstriction, and indices of obesity

Breast reconstruction is performed for 10-15 % of women operated on for breast cancer. A popular method is the TRAM (transverse rectus abdominis musculocutaneous) flap formed of the patient’s own abdominal tissue, a part of one of the rectus abdominis muscles and a transverse skin-subcutis area over it. The flap can be raised as a pedicled or a free flap. The pedicled TRAM flap, based on its nondominant pedicle superior epigastric artery (SEA), is rotated to the chest so that blood flow through SEA continues. The free TRAM flap, based on its dominant pedicle deep inferior epigastric artery (DIEA), is detached from the abdomen, transferred to the chest, and DIEA and vein are anastomosed to vessels on the chest. Cutaneous necrosis is seen in 5–60 % of pedicled TRAM flaps and in 0–15 % of free TRAM flaps. This study was the first one to show with blood flow measurements that the cutaneous blood flow is more generous in free than in pedicled TRAM flaps. After this study the free TRAM flap has exceeded the pedicled flap in popularity as a breast reconstruction method, although the free flap it is technically a more demanding procedure than the pedicled TRAM flap. In pedicled flaps, a decrease in cutaneous blood flow was observed when DIEA was ligated. It seems that SEA cannot provide sufficient blood flow on the first postoperative days. The postoperative cutaneous blood flow in free TRAM flaps was more stable than in pedicled flaps. Development of cutaneous necrosis of pedicled TRAM flaps could be predicted based on intraoperative laser Doppler flowmetry (LDF) measurements. The LDF value on the contralateral skin of the flap decreased to 43 ± 7 % of the initial value after ligation of the DIEA in flaps developing cutaneous necrosis during the next week. Endothelin-1 (ET-1) is a powerful vasoconstrictory peptide secreted by vascular endothelial cells. A correlation was found between plasma ET-1 concentrations and peripheral vasoconstriction developing during and after breast reconstructions with a pedicled TRAM flap. ET-1 was not associated with the development of cutaneous necrosis. Felodipine, a vasodilating calcium channel antagonist, had no effect on plasma ET-1 concentrations, peripheral vasoconstriction or development of cutaneous necrosis in free TRAM flaps. Body mass index and thickness of abdominal were not associated with cutaneous necrosis in pedicled TRAM flaps.

Integrated CMOS Gas Sensors

We present a low power gas sensor system on CMOS platform consisting of micromachined polysilicon microheater, temperature controller circuit, resistance readout circuit and SnO2 transducer film. The design criteria for different building blocks of the system is elaborated The microheaters are optimized for temperature uniformity as well as static and dynamic response. The electrical equivalent model for the microheater is derived by extracting thermal and mechanical poles through extensive laser doppler vibrometer measurements. The temperature controller and readout circuit are realized on 130nm CMOS technology The temperature controller re-uses the heater as a temperature sensor and controls the duty cycle of the waveform driving the gate of the power MOSFET which supplies heater current. The readout circuit, with subthreshold operation of the MOSFETs, is based oil resistance to time period conversion followed by frequency to digital converter Subthreshold operatin of MOSFETs coupled with sub-ranging technique, achieves ultra low power consumption with more than five orders of magnitude dynamic range RF sputtered SnO2 film is optimized for its microstructure to achive high sensitivity to sense LPG gas.

Mechanical response of the tympanal membranes of the tree cricket Oecanthus henryi

Crickets have two tympanal membranes on the tibiae of each foreleg. Among several field cricket species of the genus Gryllus (Gryllinae), the posterior tympanal membrane (PTM) is significantly larger than the anterior membrane (ATM). Laser Doppler vibrometric measurements have shown that the smaller ATM does not respond as much as the PTM to sound. Hence the PTM has been suggested to be the principal tympanal acoustic input to the auditory organ. In tree crickets (Oecanthinae), the ATM is slightly larger than the PTM. Both membranes are structurally complex, presenting a series of transverse folds on their surface, which are more pronounced on the ATM than on the PTM. The mechanical response of both membranes to acoustic stimulation was investigated using microscanning laser Doppler vibrometry. Only a small portion of the membrane surface deflects in response to sound. Both membranes exhibit similar frequency responses, and move out of phase with each other, producing compressions and rarefactions of the tracheal volume backing the tympanum. Therefore, unlike field crickets, tree crickets may have four instead of two functional tympanal membranes. This is interesting in the context of the outstanding question of the role of spiracular inputs in the auditory system of tree crickets.

The Effect of Intrauterine Growth Restriction on Long-Term Outcome in Very or Extremely Low Birth Weight Infants

The project consisted of two long-term follow-up studies of preterm children addressing the question whether intrauterine growth restriction affects the outcome. Assessment at 5 years of age of 203 children with a birth weight less than 1000 g born in Finland in 1996-1997 showed that 9% of the children had cognitive impairment, 14% cerebral palsy, and 4% needed a hearing aid. The intelligence quotient was lower (p<0.05) than the reference value. Thus, 20% exhibited major, 19% minor disabilities, and 61% had no functional abnormalities. Being small for gestational age (SGA) was associated with sub-optimal growth later. In children born before 27 gestational weeks, the SGA had more neuropsychological disabilities than those appropriate for gestational age (AGA). In another cohort with birth weight less than 1500 g assessed at 5 years of age, echocardiography showed a thickened interventricular septum and a decreased left ventricular end-diastolic diameter in both SGA and AGA born children. They also had a higher systolic blood pressure than the reference. Laser-Doppler flowmetry showed different endothelium-dependent and -independent vasodilation responses in the AGA children compared to those of the controls. SGA was not associated with cardio-vascular abnormalities. Auditory event-related potentials (AERPs) were recorded using an oddball paradigm with frequency deviants (standard tone 500 Hz and deviant 750-Hz with 10% probability). At term, the P350 was smaller in SGA and AGA infants than in controls. At 12 months, the automatic change detection peak (mismatch negativity, MMN) was observed in the controls. However, the pre-term infants had a difference positivity that correlated with their neurodevelopment scores. At 5 years of age, the P1-deflection, which reflects primary auditory processing, was smaller, and the MMN larger in the preterm than in the control children. Even with a challenging paradigm or a distraction paradigm, P1 was smaller in the preterm than in the control children. The SGA and AGA children showed similar AERP responses. Prematurity is a major risk factor for abnormal brain development. Preterm children showed signs of cardiovascular abnormality suggesting that prematurity per se may carry a risk for later morbidity. The small positive amplitudes in AERPs suggest persisting altered auditory processing in the preterm in-fants.

Ultrasonic Guided Wave Characterization and Damage Detection in Foam-core Sandwich Panel using PWAS and LDV

Lamb wave type guided wave propagation in foam core sandwich structures and detectability of damages using spectral analysis method are reported in this paper. An experimental study supported by theoretical evaluation of the guided wave characteristics is presented here that shows the applicability of Lamb wave type guided ultrasonic wave for detection of damage in foam core sandwich structures. Sandwich beam specimens were fabricated with 10 mm thick foam core and 0.3 mm thick aluminum face sheets. Thin piezoelectric patch actuators and sensors are used to excite and sense guided wave. Group velocity dispersion curves and frequency response of sensed signal are obtained experimentally. The nature of damping present in the sandwich panel is monitored by measuring the sensor signal amplitude at various different distances measured from the center of the linear phased array. Delaminations of increasing width are created and detected experimentally by pitch-catch interrogation with guided waves and wavelet transform of the sensed signal. Signal amplitudes are analyzed for various different sizes of damages to differentiate the damage size/severity. A sandwich panel is also fabricated with a planer dimension of 600 mm x 400 mm. Release film delamination is introduced during fabrication. Non-contact Laser Doppler Vibrometer (LDV) is used to scan the panel while exciting with a surface bonded piezoelectric actuator. Presence of damage is confirmed by the reflected wave fringe pattern obtained from the LDV scan. With this approach it is possible to locate and monitor the damages by tracking the wave packets scattered from the damages.

Changing resonator geometry to boost sound power decouples size and song frequency in a small insect

Despite their small size, some insects, such as crickets, can produce high amplitude mating songs by rubbing their wings together. By exploiting structural resonance for sound radiation, crickets broadcast species-specific songs at a sharply tuned frequency. Such songs enhance the range of signal transmission, contain information about the signaler's quality, and allow mate choice. The production of pure tones requires elaborate structural mechanisms that control and sustain resonance at the species-specific frequency. Tree crickets differ sharply from this scheme. Although they use a resonant system to produce sound, tree crickets can produce high amplitude songs at different frequencies, varying by as much as an octave. Based on an investigation of the driving mechanism and the resonant system, using laser Doppler vibrometry and finite element modeling, we show that it is the distinctive geometry of the crickets' forewings (the resonant system) that is responsible for their capacity to vary frequency. The long, enlarged wings enable the production of high amplitude songs; however, as a mechanical consequence of the high aspect ratio, the resonant structures have multiple resonant modes that are similar in frequency. The drive produced by the singing apparatus cannot, therefore, be locked to a single frequency, and different resonant modes can easily be engaged, allowing individual males to vary the carrier frequency of their songs. Such flexibility in sound production, decoupling body size and song frequency, has important implications for conventional views of mate choice, and offers inspiration for the design of miniature, multifrequency, resonant acoustic radiators.

Ultrasonic guided wave sensing properties of PVDF thin film with inter digital electrodes

Ultrasonic strain sensing performance of the large area PVDF with Inter Digital Electrodes (IDE) is studied in this work. Procedure to obtain IDE on a beta-phase PVDF is explained. PVDF film with IDE is bonded on a plate structure and is characterized for its directional sensitivity at different frequencies. Guided waves are induced on the IDE-PVDF sensor from different directions by placing a piezoelectric wafer actuator at different angles. Strain induced on the IDE-PVDF sensor by the guided waves in estimated by using a Laser Doppler Vibrometer (LDV) and a wave propagation model. Using measured voltage response from IDE-PVDF sensor and the strain measurements from LDV the piezoelectric coefficient is estimated in various directions. The variation of 11 e at different angles shows directional sensitivity of the IDE-PVDF sensor to the incident guided waves. The present study provides an effective technique to characterize thin film piezoelectric sensors for ultrasonic strain sensing at very high frequencies of 200 kHz. Often frequency of the guided wave is changed to alter the wavelength to interrogate damages of different sizes in Structural Health Monitoring (SHM) applications. The unique property of directional sensitivity combined with frequency tunability makes the IDE-PVDF sensor most suitable for SHM of structures.

Stress Engineering using Si3N4 for stiction free release of SOI beams

We report on the effect of thin silicon nitride (Si3N4) induced tensile stress on the structural release of 200nm thick SOI beam, in the surface micro-machining process. A thin (20nm / 100nm) LPCVD grown Si3N4 is shown to significantly enhance the yield of released beam in wet release technique. This is especially prominent with increase in beam length, where the beams have higher tendency for stiction. We attribute this yield enhancement to the nitride induced tensile stress, as verified by buckling tendency and resonance frequency data obtained from optical profilometry and laser doppler vibrometry.

Fluid-Solid Interaction in Particle-Laden Flows

Liu Qingquan, Singh V.P

Experiments and Lagrangian simulations on the formation of droplets in continuous mode

Experimental and computational studies on the dynamics of millimeter-scale cylindrical liquid jets are presented. The influences of the modulation amplitude and the nozzle geometry on jet behavior have been considered. Laser Doppler anemometry (LDA) was used in order to extract the velocity field of a jet along its length, and to determine the velocity modulation amplitude. Jet shapes and breakup dynamics were observed via shadowgraph imaging. Aqueous solutions of glycerol were used for these experiments. Results were compared with Lagrangian finite-element simulations with good quantitative agreement. © 2011 The American Physical Society.

Experiments and Lagrangian simulations on the formation of droplets in drop-on-demand mode

The creation and evolution of millimeter-sized droplets of a Newtonian liquid generated on demand by the action of pressure pulses were studied experimentally and simulated numerically. The velocity response within a model, large-scale printhead was recorded by laser Doppler anemometry, and the waveform was used in Lagrangian finite-element simulations as an input. Droplet shapes and positions were observed by shadowgraphy and compared with their numerically obtained analogues. © 2011 American Physical Society.

Wind Tunnel Experimental Investigation Of Sand Velocity In Aeolian Sand Transport

Sand velocity in aeolian sand transport was measured using the laser Doppler technique of PDPA (Phase Doppler Particle Analyzer) in a wind tunnel. The sand velocity profile, probability distribution of particle velocity, particle velocity fluctuation and particle turbulence were analyzed in detail. The experimental results verified that the sand horizontal velocity profile can be expressed by a logarithmic function above 0.01 in, while a deviation occurs below 0.01 m. The mean vertical velocity of grains generally ranges from -0.2 m/s to 0.2 m/s, and is downward at the lower height, upward at the higher height. The probability distributions of the horizontal velocity of ascending and descending particles have a typical peak and are right-skewed at a height of 4 turn in the lower part of saltation layer. The vertical profile of the horizontal RMS velocity fluctuation of particles shows a single peak. The horizontal RMS velocity fluctuation of sand particles is generally larger than the vertical RMS velocity fluctuation. The RMS velocity fluctuations of grains in both horizontal and vertical directions increase with wind velocity. The particle turbulence intensity decreases with height. The present investigation is helpful in understanding the sand movement mechanism in windblown sand transport and also provides a reference for the study of blowing sand velocity. (C) 2007 Elsevier B.V All rights reserved.