Search Results (364)

Background: Severe burn injuries are associated with prolonged consequent wound healing, substantial symptoms burden, and delayed, sometimes incomplete, functional recovery. Photobiomodulation using Multiwave Locked System (MLS) LASER therapy has been proposed as an adjunctive intervention to support tissue repair and thereby improve rehabilitation outcomes, but related clinical evidence in burn populations remains limited. Materials and Methods: This comparative study included 65 patients with severe burn injuries, of whom 35 were prospectively treated with adjunctive MLS LASER therapy, in addition to standard care, and 30 retrospectively identified patients, who received standard care alone, served as controls. The primary outcome was the time until complete epithelialization, while secondary outcomes included: reduction in wound surface, pain intensity, pruritus severity, scar quality, and functional improvements. Assessments were performed at baseline and after a standardized follow-up period of up to 20 days. Results: Patients treated with MLS LASER therapy achieved complete epithelialization significantly earlier than controls (median 40 vs. 73 days, p < 0.001) and demonstrated greater wound area reduction (median 434 vs. 137 cm², p = 0.0012). In multivariable analyses adjusted for burn extent, burn depth, age, and diabetes mellitus, considered as factors worsening evolution, MLS LASER therapy remained independently associated with shorter time to epithelialization and greater reduction in wound dimension. Significant improvements favoring the MLS group were also observed regarding pain, pruritus, scar quality, and functional outcomes, all assessed using specific evaluation tools (p < 0.001). Conclusions: Adjunctive MLS LASER therapy appears to be associated with improved wound healing dynamics and enhanced rehabilitation outcomes in patients with severe burn injuries. These findings should be interpreted with caution given the study limitations, including the non-randomized design and relatively small sample size. MLS LASER therapy may represent a promising adjunctive option in the conservative management of burn injuries; however, further prospective randomized studies are required to confirm these results and to define optimal treatment protocols. Full article

Background: Accurate assessment of burn depth remains a clinical challenge and requires specific training. To improve diagnostic accuracy, various technical methods have been developed. This review summarizes current evidence on indocyanine green (ICG) fluorescence imaging for burn depth assessment and compares its performance with clinical, histological, and alternative modalities such as Laser Doppler imaging (LDI). Methods: A systematic literature search was conducted in PubMed/MEDLINE, Cochrane and Google Scholar to identify studies evaluating burn depth using ICG fluorescence imaging. Studies from 1995 to 2024 were included if they compared ICG to at least one reference method (clinical assessment, biopsy, or other technical modalities). Data extraction was performed independently by two reviewers. Risk of bias was assessed using the Newcastle–Ottawa Scale. The study selection workflow is shown in the PRISMA 2020 flow diagram for systematic reviews. Results: Nine studies with a total of 151 patients, published between 1995 and 2024, met the inclusion criteria. Results were synthesized descriptively due to substantial methodological heterogeneity. Two studies reported high accuracy of ICG fluorescence imaging for identifying nonviable tissue and supporting surgical planning, although differentiation between superficial and deep partial-thickness burns (SPTBs/DPTBs) was inconsistent. In one study, ICGA-guided assessment reduced or avoided excision in 10 of 20 burn sites (50%). Yet heterogeneity in measurement protocols, cut-off values, and reference standards limited comparability across studies. Conclusions: Due to its limited accuracy in differentiating SPTBs and DPTBs, ICG imaging has restricted utility for burn depth assessment, though it may still offer intraoperative benefit during necrosectomy. Registration: PROSPERO International prospective register of SRs by the National Institute of Health Research (CRD420251161190). Full article

Wildfires have become more frequent and intense worldwide due to climate change and anthropogenic activities, which is why accurate and timely burned area mapping is essential for estimating damage and effective post-fire recovery planning. Synthetic Aperture Radar (SAR) data, which operates under all weather conditions and day-night cycles, offers a reliable source for burned area mapping. In this context, several studies have explored the use of dual-polarization SAR imagery and machine learning, yet the influence of multi-date, dual-orbit pass data and texture features remained unexplored. Therefore, this study aims to assess the Sentinel-1 acquisition configurations, varying in temporal depth and orbital direction, for wildfire burned area mapping, considering the recent Palisades wildfire event as a study area. A comparative study was conducted across different scenarios to evaluate the effectiveness of using single-date versus multi-date SAR imagery, the integration of ascending and descending orbit passes, and the contribution of Grey-Level Co-occurrence Matrix texture features. The performance of Random Forest (RF) and Extreme Gradient Boosting classifiers was analyzed through the scenarios mentioned above. The single-date configuration using RF achieved an accuracy of 82.34%, F1-score of 81.43%, precision of 83.07%, recall of 80.84%, and ROC-AUC of 90.88%, whereas the multi-date approach reached 85.78%, 85.15%, 86.45%, 84.56%, and 93.28%, respectively. Our study highlights the importance of acquisition configuration and texture information for reliable SAR-based wildfire burned area assessment. Full article

Following bushfires (also known as wildfires), impacted free-living wildlife with welfare or conservation concerns are captured and presented for veterinary assessment where possible. This study represents an in-depth retrospective analysis of the veterinary records of 259 animals in Victoria, Australia, impacted by bushfire in 2019–2020. In total, 35 different species were assessed, including 196 koalas. Multivariable analyses of 126 koalas with complete medical records identified several clinical prognostic factors affecting 6-month survival outcomes. Increased odds of negative outcomes (death or euthanasia) were associated with increasing age (tooth wear class; odds ratio 2.70 for one unit increase), lower body condition score (one-unit decrease OR 7.27), and the earlier animals were presented after the fire event (OR 0.94 for each passing day). In 83 koalas with burn injuries, negative outcomes were also associated with burns more severe than minor (85% survival for minor burns only, compared to 31% survival with moderate or severe burns), and burns to more than 10 digits (12% survival). In burnt koalas, the combination of burn severity and digital involvement appear to be important prognostic factors for long-term outcomes. These findings can support veterinarians to more accurately evaluate prognosis for bushfire-affected koalas during initial assessment and will facilitate the strategic allocation of limited treatment and rehabilitation resources to the animals most likely to recover. The scope of this study was limited to the consideration of health outcomes, with the recognition of health as just one of many factors that must inform decisions about rehabilitating injured wildlife. Full article

Background: Major cervical burns often require tracheostomy (TT); however, it remains unclear whether TT timing relative to cervical wound coverage (WC) and the choice of coverage modality affect peristomal wound healing. Methods: In this retrospective single-center cohort study, we included 48 adults with thermally induced cervical burns who underwent TT between 2015 and 2024 in a specialized burn ICU. Eleven patients died before decannulation and were excluded from the primary endpoint analysis. Cervical wound-healing disturbance (CWHD) as a primary endpoint was assessed in the remaining 37 patients, including 13 treated with advanced cervical dressings and 24 treated with split-thickness skin grafts (STSG). Results: CWHD occurred in 2/13 (15.4%) with advanced dressings and 11/24 (45.8%) after STSG. Within the grafted subgroup, complication rates did not differ significantly according to TT sequencing relative to WC, TT–WC interval, grafting technique (mesh vs. Meek), or tracheostoma closure method (all p > 0.05). In multivariable logistic regression, only cervical burn depth independently predicted CWHD. Conclusion: In patients with cervical burns requiring TT, burn depth/severity, rather than TT timing, grafting strategy, or closure technique, appears to drive peristomal wound complications, supporting individualized planning instead of rigid algorithms. Full article

Southern Africa is highly sensitive to climate variability associated with the El Niño Southern Oscillation (ENSO), which strongly influences hydroclimate, vegetation dynamics, and atmospheric composition. This study examined the impacts of the 2015/16 El Niño on vegetation, meteorological conditions, and atmospheric emissions over Southern Africa using satellite observations and reanalysis data. Time-lagged cross-correlation analysis of seasonally adjusted time-series was applied to characterize synchronous and delayed interactions among vegetation indices, hydrological variables, meteorological drivers, and air-quality parameters. Bayesian causal impact analysis was further used to quantify El Niño-induced anomalies by comparing observed conditions with counterfactual scenarios representing the absence of the event. The results showed that vegetation greenness responds primarily to concurrent moisture availability, with strong positive associations between NDVI, precipitation, soil moisture, and canopy water. Moisture-related variables exert delayed influences on atmospheric composition, highlighting the role of wet scavenging and dilution. Carbonaceous aerosols (black carbon [BC] and organic carbon [OC]), particulate matter [PM_2.5], and aerosol optical depth exhibit strong synchronous coupling, indicating a dominant biomass-burning source. The causal impact analysis reveals statistically significant and sustained post-2015 increases in fire-related emissions (carbon monoxide [CO], BC, OC, PM_2.5, and aerosol optical depth [AOD]), particularly during austral winter and dry seasons. In contrast, precipitation, soil moisture, evapotranspiration, and vegetation greenness show persistent negative anomalies, reflecting widespread drought stress under elevated temperatures. Overall, the findings demonstrate that the 2015/16 El Niño amplified fire emissions while suppressing ecosystem functioning across Southern Africa, underscoring strong climate–fire–vegetation feedback with important air-quality and environmental implications. Full article

Atmospheric aerosols in Southeast Asia, influenced by climate and seasonal circulation, are examined here. This study analyzes the impact of the 2015 El Niño and monsoonal variability on aerosol properties over Penang, Malaysia, from 2015–2019. Aerosol Optical Depth (AOD), Ångström Exponent (AE), Fine Mode Fraction (FMF), and Single Scattering Albedo (SSA) were analyzed using AERONET observations, complemented by satellite-derived fire data and NOAA HYSPLIT back-trajectory analysis. Pronounced seasonal variability was observed, with elevated AOD during the Southwest Monsoon (0.72 ± 0.15) associated with biomass burning and mixed urban aerosols, and lower AOD during the Northeast Monsoon (0.47 ± 0.12) due to cleaner maritime air masses. The inter-monsoon period exhibited the lowest AOD (0.28 ± 0.10), reflecting enhanced wet scavenging and mixed aerosol sources. Interannually, the 2015 El Niño recorded substantially higher aerosol loading, including extreme AOD events (>1.75), driven by intensified regional fire activity under dry conditions. A statistically significant but weak correlation (R² = 0.12, p = 0.047) indicates biomass burning contributed to AOD, though transport processes were the dominant driver. Trajectory analysis confirmed that aerosols originated from fire-affected Sumatra during the Southwest Monsoon and from the South China Sea during the Northeast Monsoon. These results show that climate and winds drive aerosol changes, so regional monitoring and cross-border air management in Southeast Asia are needed. Full article

Background: Electrical injuries occur when an electric current comes into contact with or passes through the body. Electrical injuries can result from contact with faulty electrical appliances and machinery or from contact with open household wiring or electrical power lines. Aim: The aim of this study was to evaluate the psychosocial difficulties experienced by individuals who suffered electrical burns due to work accidents, using a phenomenological approach. Study Design: This phenomenological study was conducted with semi-structured in-depth interviews with 15 electrical burn survivors living in different regions of Turkey via the WhatsApp mobile application. The snowball sampling method was used to reach the sample group. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed. The data were analyzed using Colaizzi’s phenomenological analysis method. The study was conducted and reported according to the COREQ checklist. Results: In the analysis of the data, two categories and five themes were identified: the effects of electrical burn at the time of occurrence and during the hospital process (psychological, social and physical), and adaptation to life after electrical burn treatment (emotions experienced, difficulties experienced and coping). Conclusions: This study revealed the life experiences, psychosocial difficulties and coping experiences of individuals with electrical burns. According to the results of the research, it is understood that individuals experienced negative emotions such as depression, helplessness and hopelessness as a result of electrical burns, could not cope with the psychosocial difficulties experienced and received psychological support. It was determined that social appearance anxiety due to deterioration in body image was very important in individuals. Full article

The efficacy of oil spill response depends on the speed of detecting the oil. Detecting submerged oil is more difficult than oil on the water surface, because most conventional sensors are not effective. Oil Detection Canines (ODCs) have been reliably used to detect oil during shoreline spill surveys, and preliminary laboratory studies also showed promising results for detecting oil submerged under water. To confirm their potential, a field study was conducted in a boreal freshwater lake in Northwestern Ontario, Canada to investigate the capability of an ODC to detect submerged weathered oils at depths of 1 to 5 m. Triplicate targets at each depth used weathered diluted bitumen (dilbit), Bunker C residual fuel oil, and Maya crude oil burn residue and both the ODC and handler blinded to the location of each target. Boat-based searches were conducted and the handler identified “alerts” based on ODC behaviour changes that were compared to georeferenced oil target locations. The ODC positively identified seven (7) of the eight (8) dilbit targets at 1 to 5 m, five (5) of the six (6) Bunker C targets at 1 and 3 m, and none of the burn residue targets at 1-m depth. The ability of ODCs to detect submerged or sunken oil in shallow water was clearly demonstrated, adding another technique for submerged and sunken oil surveys with the advantages of real-time data returns, the ability to detect small oil deposits, and an operational capability in shallow waters with potential for detection in deeper water. Full article

Accurate documentation of burn wounds is essential for evaluating treatment outcomes and monitoring healing progression. Traditional two-dimensional (2D) photography remains the clinical standard but lacks depth and volumetric accuracy. Three-dimensional (3D) scanning offers enhanced visualization of wound morphology and tissue vitality, potentially improving objectivity in burn assessment. This study compares two handheld 3D scanning systems—Artec Eva and Revopoint Miraco—in documenting acute and healing burn wounds, using standard clinical photography as the reference. Fifteen patients with second-degree and third-degree burns were prospectively examined at the Burn Unit of AGEL Hospital Košice-Šaca, with five representative cases selected for detailed analysis. For each patient, clinical photographs and paired 3D scans were obtained under standardized conditions and evaluated for color fidelity, wound margin clarity, representation of epithelialisation islands, necrotic tissue, and correlation with clinical findings. Across all cases, Artec Eva demonstrated superior color accuracy, clearer wound delineation, and more realistic visualization of tissue vitality and re-epithelialisation. Revopoint Miraco reliably captured wound shape but produced darker tones and exaggerated surface relief, occasionally distorting depth perception. Overall, both systems successfully identified key healing features; however, Artec Eva provided more clinically accurate and visually consistent results. Three-dimensional scanning represents a valuable adjunct to conventional burn documentation. Full article

Objective: To identify key predictors of clinical outcomes in burn survivors and clarify the role of mixed-depth burns and confounding by indication in observational rehabilitation research. Design: Retrospective cohort study using data from a burn rehabilitation registry (January 2024 to July 2025). Setting: Burn rehabilitation center. Participants: 120 adult patients (age ≥ 18 years) with burns affecting ≥1% total body surface area (TBSA) and complete baseline data. Interventions: Not applicable. Main Outcome Measures: Primary outcome was functional improvement (ΔFIM). Secondary outcomes included pain reduction (ΔPain), scar severity (Vancouver Scar Scale; VSS), Activities of Daily Living (ADL) improvement, and Range of Motion (ROM) recovery. Multivariable linear and logistic regression models were used to identify predictors. Results: Patients achieved significant improvements in function (mean ΔFIM = 11.3 ± 8.9 points) and pain (mean ΔPain = 1.28 ± 0.81). Having a mixed-depth burn was the strongest predictor of worse scar outcomes (β = 2.52, 95% CI: 0.93 to 4.12, p = 0.002) and failure to achieve full ROM (OR = 0.089, 95% CI: 0.008 to 0.930, p = 0.043). An apparent association between inpatient ward care and better scar outcomes (β = −1.30, p = 0.020) was determined to be an artifact of confounding by indication, as the outpatient group had a higher proportion of high-risk mixed-depth burns (6.2% vs. 3.5%). Longer therapy duration was the only significant predictor of achieving ADL goals (OR = 1.014, 95% CI: 1.002 to 1.026, p = 0.025). Conclusions: Injury characteristics, particularly the presence of a mixed-depth burn, emerged as the dominant predictors of long-term scar and functional outcomes. This study identifies mixed-depth burns as a potentially high-risk clinical phenotype requiring targeted therapeutic strategies and demonstrates the critical importance of accounting for confounding by indication when evaluating rehabilitation outcomes in observational burn research. Full article

Maintaining adequate root-zone temperature in solar greenhouses during extreme cold is crucial for crop production. This study investigated the optimization of an auxiliary biomass heating system in a solar greenhouse. The heating performance was evaluated using an integrated methodology that combined orthogonal experimental design, Computational Fluid Dynamics (CFD) simulation, and Machine Learning (ML) surrogate modeling. First, a reliable CFD model, validated against experimental data (Index of Agreement, IA = 0.954), was used to generate high-fidelity temperature field data for nine layout schemes. Parameter sensitivity analysis revealed that the burning cave Diameter is the dominant factor (R = 6.01), followed by burial Depth (R = 2.00), with inter-pool Spacing having the least impact (R = 0.89). Subsequently, six ML algorithms were compared for use as a predictive surrogate model, with Lasso Regression demonstrating superior performance (R² = 0.934). Comprehensive optimization focused on maximizing the Suitable Area Ratio (R_s) in the critical 0.2 m depth root zone. The analysis conclusively identified the 2.5 m diameter group as optimal, achieving a maximum R_s of 90% and the lowest temperature standard deviation. The final recommended optimal design (2.5 m diameter, 0.7 m depth, 10 m spacing) significantly improves heating uniformity and efficiency. This integrated CFD-ML approach provides a scientific basis and a rapid assessment tool for the design and structural optimization of similar underground thermal systems in cold-climate agriculture. Full article

Background: Burns cause about 180,000 deaths annually and lead to substantial morbidity, especially in low- and middle-income countries. Clinical assessment of burn depth and TBSA relies on visual and bedside examination and remains subjective. Convolutional neural networks (CNNs) have been proposed to improve objectivity in image-based burn assessment, but clinical generalizability and acceptance remain uncertain. Aims: To map current evidence on CNN performance for burn TBSA, burn depth and treatment-related tasks and to explore whether a large language model (LLM) can organize extracted findings into a transparent, literature-derived orientation decision tree. Methods: We performed a scoping review following PRISMA-ScR. PubMed, Web of Science and Cochrane were searched on 5 April 2025. Eligible studies reported CNN analysis of 2D burn images and quantitative performance metrics. We summarized reported values descriptively. We then provided a structured summary of extracted findings to ChatGPT to draft a one-page orientation decision tree. Two consultant burn surgeons reviewed the figure for clarity and plausibility. Results: Of 659 records, 24 studies were included. Across studies, reported performance for TBSA and depth assessment was often high, but study designs, datasets, labels, imaging modalities and validation strategies varied substantially. High reported performance does not necessarily imply clinical robustness or real-world accuracy. A single study reported high test-set accuracy for graft versus non-graft using heavily expanded data. This value should not be generalized. Conclusions: CNNs show promise for image-based burn TBSA and depth assessment, but heterogeneity, dataset limitations and limited external validation restrict interpretation and clinical transfer. The LLM-derived decision tree is a literature-synthesis orientation figure, not a clinical decision-support tool. Full article

The utilization of metal roofing as natural air terminals is a standard practice in lightning protection; however, the risk of thermal perforation and subsequent ignition of internal hazardous atmospheres remains a critical safety concern. While current standards (e.g., IEC 62305) primarily focus on material thickness and total charge (Q), this study demonstrates that these parameters alone are insufficient for predicting burn-through failure. We present a comprehensive electrothermal analysis based on the method of images to simulate three-dimensional heat diffusion in finite-thickness plates (0.5–7 mm) made of aluminum, copper, and steel. Unlike simplified 1D models, our approach considers the spatial distribution of the heat source and the varying depth of the thermal penetration. The results confirm that the continuing current component ($Q_{long}\approx 200$ C) is the primary driver of volumetric melting. Crucially, the sensitivity analysis reveals that the lightning channel radius ($r_{mbo}$) acts as a governing factor for perforation risk; a reduction in the lightning channel radius from 5 mm to 2 mm can shift the outcome from minor surface heating to complete perforation for thin sheets ($0.5$ mm), even under identical charge conditions. This paper identifies a “safety gap” in current engineering practices, demonstrating that neglecting this parameter constriction effect results in an underestimation of the thermal threat. The proposed analytical model provides a precise tool for determining the safety margins of natural air terminals, offering direct applicability for designing lightning protection systems in high-risk industrial facilities. Full article

This study investigates the fire behaviour of building-integrated photovoltaic (PV) claddings, focusing on the progression from glass failure to ignition under different cavity conditions. Experimental tests were conducted on two common PV cladding types: bifacial dual-glass (GG) and monofacial glass–plastic (GP) modules. Results revealed that GP modules exhibited faster burning and higher peak heat release rates (HRR), reaching up to 600 kW, while GG modules burned more slowly with peak HRR between 50 and 100 kW. Cavity conditions, including depth, ventilation, and operational energization, were found to be vital in determining glass breakage, occurring between 400 and 550 °C, and cavity ignition and subsequent flame spread. The relationship between cavity fire dynamics and glass breakage suggests the importance of system design, particularly regarding cavity ventilation and flame barriers, for mitigating upward fire propagation. These results establish a basis for advancing numerical fire models through integration of critical parameters such as material properties, glass breakage, cavity ignition, and cavity configuration. This approach supports comprehensive real-scale analysis to guide the development of effective design recommendations, ultimately improving fire safety in PV-integrated construction. Full article