Search Results (8,789)

Over the past years, burn care has evolved from a discipline focused on survival to one centered on restoring long-term health, function, and quality of life. Significant advances in critical care, early excision and grafting, infection control, and metabolic support have transformed survival outcomes for even the most severe injuries. As a result, the field now faces a new frontier: understanding and managing the long-term physical, psychological, and systemic sequelae of survival. This review traces the evolution of burn care over the last century and outlines the challenges and priorities for the next 25 years. The first era of progress, defined by innovations in resuscitation, surgery, and critical care, has given rise to a growing cohort of long-term survivors. Research over the past decade has revealed that major burns induce chronic multisystem alterations, including metabolic, cardiovascular, neurocognitive, and immunological dysfunctions. Emerging concepts such as burn-associated heart failure exemplify this shift from acute to chronic disease understanding. Looking ahead, the future of burn medicine lies in personalized and lifelong care, supported by translational research, digital health, regenerative therapies, and interdisciplinary collaboration. Overall, burn care stands at a pivotal crossroads. By integrating precision medicine, rehabilitation science, and psychosocial care, we aim to move the field from survival toward sustained, holistic recovery over the next 25 years. Full article

Keloid is a benign skin disease with excessive growth of fibroblasts, characterized by too much abnormal extracellular matrix deposited in the dermis. It is generally believed that transforming growth factor-β (TGF-β) is the core cytokine that causes keloid. Previously, it was thought that its pathogenic effect was mainly attributed to the classical Smad-dependent pathway. It directly shuttles signals to the nucleus to trigger pro-fibrotic gene transcription. However, accumulating evidence now points to the equally vital role of Smad-independent signaling. Unlike the direct nuclear translocation of Smads, these alternative pathways transmit signals through rapid intracellular kinase cascades. They jointly direct the proliferation, migration, anti-apoptosis, fibrogenesis, and chronic inflammation of fibroblasts in keloids. This review attempts to comprehensively clarify the molecular processes regulated by TGF-β through non-Smad pathways (such as MAPK, PI3K/Akt, Rho GTPase, Wnt/β-catenin, JAK/STAT). Translating these non-Smad insights helps to overcome the high recurrence rates of traditional therapies. Targeting these specific molecular hubs through combination and precision therapies serves to reprogram the fibrotic microenvironment. Full article

Wildfire monitoring systems increasingly rely on satellite-derived risk surfaces to support resource-constrained prioritization. However, less attention has been paid to how spatial aggregation interacts with alarm sparsity in shaping event-level wildfire capture. This study conducts a retrospective evaluation of percentile-based wildfire alarm regimes in California during the 2024 fire season. Using VIIRS-derived risk surfaces and MTBS burned-area perimeters, the analysis examines three aggregation scales (375, 1000, and 5000 m) under fixed alarm budgets (top 1%, top 5%, and top 10%). Event-level capture was evaluated by aggregating row-level capture values within each MTBS event, with the primary specification based on maximum event-level capture and a threshold of 0.02. Across 2078 unique wildfire events, the effect of spatial aggregation was conditional on alarm sparsity. Under the most restrictive budget (top 1%), scale effects were weak and non-monotonic. In contrast, under the top 5% and top 10%, the coarsest scale (5000 m) consistently produced the highest event-level threshold-exceedance rates. Robustness checks using mean event-level capture and a stricter threshold of 0.05 yielded qualitatively similar patterns under moderate alarm budgets. These findings indicate that the effect of spatial aggregation cannot be interpreted independently of alarm-budget design. Rather than treating spatial resolution as inherently beneficial or detrimental, the study shows that its implications depend on how event-level capture is evaluated under constrained alarm allocation. Full article

Background/Objectives: Burning mouth syndrome (BMS) is a chronic idiopathic orofacial pain disorder characterized by persistent intraoral burning in the absence of detectable mucosal alterations. Diagnosis is challenging due to the lack of specific biomarkers and the need to exclude numerous systemic and local conditions that can mimic oral burning. This literature review aims to summarize current and emerging therapeutic strategies for BMS. Methods: A structured and filtered search of PubMed, Scopus, and Web of Science identified studies evaluating pharmacological, phytotherapeutic, and non-pharmacological interventions. Results: Various antidepressants, anticonvulsants, benzodiazepines, H2 receptor antagonists, and low-dose naltrexone have demonstrated varying degrees of symptom reduction, while alpha lipoic acid (ALA) and phytomedicines such as capsaicin, Hypericum perforatum, Catuama, lycopene, crocin, and melatonin show mixed clinical benefits. Non-pharmacological approaches, including photobiomodulation (PBM), oral cryotherapy, neuromodulation techniques, and cognitive behavioral therapy, also provide meaningful symptom improvement in many patients. Conclusions: Across all modalities, therapeutic responses remain heterogeneous and generally incomplete, underscoring the absence of a universally effective treatment. Current evidence supports an individualized and multidisciplinary approach that integrates pharmacological, psychological, and adjunctive therapies to address the multifactorial nature of BMS. Full article

Background: Evaporative water loss from burn wounds is a major but often neglected component of early fluid requirements. Despite its physiological importance, no dedicated review has quantified acute post-burn evaporative water loss (TEWL) and its interaction with modern resuscitation strategies in over 40 years. Recent mass-casualty burn events in specialized centers have re-emphasized the clinical importance of accurate early fluid balance, which is particularly challenging. Methods: A scoping review (PRISMA-ScR) of historical quantitative studies and 23 contemporary (2015–2025) adult major-burn resuscitation cohorts was conducted. Expected TEWL was derived from Lamke benchmarks; interstitial edema was estimated from the only available regression of simultaneous fluid input and 24 h weight change. A novel TEWL/edema ratio was tested against resuscitation volume (mL/kg/%TBSA) and the established input/output (I/O) ratio. Results: In the acute phase, the median TEWL normalized to total body surface area was 71 mL/m²/h [52–79 mL/m²/h], allowing for calculation of the TEWL/edema ratio. The TEWL/edema ratio was inversely correlated with the resuscitation fluid dose (R² = 0.811) and the I/O ratio as well (R² = 0.86), crossing unity at 2.85 mL/kg/%TBSA. A ratio > 1 signals high evaporative drive and/or possible under-resuscitation; a ratio < 1 alerts to fluid creep before significant weight gain. Conclusions: The TEWL/edema ratio is the first physiology-grounded, easily calculable resuscitation endpoint that complements urine output by providing insight into whether administered fluid is lost as obligatory evaporation or sequestered as edema. Routine estimation of expected TEWL and early monitoring of the TEWL/edema ratio may help guide goal-directed burn resuscitation, especially when early excision is delayed or impossible. Given the substantial inter-individual variability, the ratio derived from aggregate data should not be interpreted as a patient-specific predictor. Full article

Accurate modeling of the burning rate of char particles in particle-laden flows is essential. However, because of the strong inhomogeneity and nonlinearity of the process, accurately resolving the surface burning rate of char particles remains challenging. In this study, an eXtreme Gradient Boosting (XGBoost)-based framework is developed to reformulate the conventional char oxidation rate model, namely the Baum&Street (B&S) model, resulting in a modified model referred to as the XGB-B&S model. In this model, a correction term ${\beta }_{\mathrm{turb}}$ is incorporated and formulated using the particle Reynolds number together with a dimensionless temperature. A turbulent mixing layer with char particle combustion is simulated by means of particle-resolved direct numerical simulation with three-dimensions, generating a high-fidelity dataset for model training and validation. To assess the predictive capability of the XGBoost model, its results are benchmarked against those obtained from an Artificial Neural Network model. The comparison indicates that XGBoost provides better overall accuracy, as reflected by a larger coefficient of determination (${\mathrm{R}}^2$) and smaller values of both the root mean square error and the mean absolute error. Finally, the XGB-B&S model is validated against the test dataset. The ${\mathrm{R}}^2$ between the XGB-B&S predictions and the PR-DNS results is significantly higher than that between the conventional B&S model and the PR-DNS results, confirming the strong predictive capability of XGBoost for modeling char particle oxidation rate. Full article

Brazil is the main coffee producer in the world. However, the impacts of climate change driven by greenhouse gas (GHG) emissions pose a major challenge for agriculture in tropical regions. This study established a GHG inventory of coffee production on farms in southern Minas Gerais, Brazil, over a two-year period, adopting a cradle-to-farm-gate approach. It considered scopes 1 and 2 emissions from on-farm activities. The emission inventories were based on Intergovernmental Panel on Climate Change (IPCC) methodologies adapted for Brazilian conditions. The emissions were categorized in direct and biogenic and by area (in hectares) and production (kg of coffee). Electricity consumption, fossil fuel use, wood burning and fertilizer application were considered. Direct total emissions ranged from 2617 to 6211 t CO₂e, 2.67 to 3.81 t CO₂e ha⁻¹, and from 1.52 to 4.59 kg CO₂e kg⁻¹ of coffee. Biogenic emissions ranged from 336 to 4955 t CO₂e, 0.28 to 2.95 t CO₂e ha⁻¹, and from 0.32 to 2.21 kg CO₂e kg⁻¹ of coffee. Urea-based nitrogen fertilizers were the main source of direct emission and wood burning was the main source of biogenic emission. Management practices such as applying non-urea-based fertilizers, adjusting nitrogen rates according to soil analyses and manual harvesting contributed to mitigating GHG emissions. The observed emission intensities were consistent with other reported values for Brazilian coffee production. Further reductions may be achieved by adopting agroforestry systems, increasing coffee straw retention in the soil and replacing urea with alternative nitrogen sources, including slow-release fertilizers and urease-inhibitor technologies. Full article

Quercus suber bark, known as cork, is an important fire-adaptive trait of this Mediterranean species. However, the increased frequency of wildfires and poor forest management practices can be significant challenges in managing the sustainable exploitation of cork oak stands. This study evaluates cork’s thermal behavior and organoleptic quality for commercial applications under three experimental fire scenarios: prescribed burn, low-intensity wildfire, and high-intensity wildfire. Bench-scale tests were conducted using a vertical mass loss calorimeter to simulate heat exposure levels, measuring temperature changes at four cork depths and quantifying heat-induced damage. Morphological traits—cork thickness, corkback thickness, and relative humidity—were recorded as predictor variables. Additionally, organoleptic and aromatic analyses were performed to assess the suitability of fire-exposed cork for wine stopper production. Results were consistent with the available literature, confirming that cork thickness significantly reduces the maximum temperature at the phellogen level. Specifically, mean cork thickness showed a significant negative effect on Tmax4 (β = −0.02, p < 0.001), indicating a consistent decrease in internal temperatures with increasing thickness across all heat flux levels. By contrast, cork consumption (mass loss) was primarily driven by heat flux intensity rather than cork structural traits. Aromatic profiling and organoleptic analysis revealed the presence of smoke-related compounds in cork samples exhibiting external carbonization. This effect was observed under higher heat flux exposure (particularly at 25 and 50 kW m⁻²), where visible charring occurred. Under these conditions, commercial quality may be partially compromised, whereas samples without external carbonization did not show comparable aromatic alteration. Further field validation is recommended. Full article

Flame residence time (FRT) is an important indicator of flaming duration and is closely related to local heat release and associated ecological effects. However, the intrinsic mechanisms through which fuel bed structure affects FRT remains insufficiently understood. Clarifying how fuel bed structure affects FRT under flat, wind-free conditions is important for prescribed burning and ecological restoration. This study investigated surface fuels from typical forest types in southwestern China through controlled laboratory experiments conducted under flat, wind-free conditions, with moisture content, loading, thickness, and bulk density systematically varied. The driving mechanisms of fuel bed structural characteristics on FRT were systematically analyzed. Coniferous forests and moso bamboo had significantly lower FRT than broadleaved forests. Moisture content was the most influential factor, followed by thickness and bulk density, whereas loading had a relatively limited effect. Prediction models developed using machine learning methods significantly outperformed traditional regression approaches. Fuel bed structure is a critical factor controlling FRT. The high-accuracy prediction models established in this study enhance the mechanistic understanding of FRT. The findings provide a theoretical basis and practical support for prescribed burning and fire behavior modeling and may contribute to improved forest fire management. Full article

Estimating wildfire greenhouse gas (GHG) emissions in Mediterranean landscapes is challenging due to heterogeneous fuel mosaics and limited scalability of field-based approaches. This study presents a Geographic Information System (GIS) based framework that integrates land-cover data, pre-fire biomass estimates, fire severity mapping, and established emission factors to produce spatially explicit estimates of biomass consumption and GHG emissions. Fire severity was derived from multitemporal Sentinel-2 imagery using the differenced Normalized Burn Ratio (ΔNBR) and combined with land-cover information to define vegetation–severity classes for emission estimation. A key innovation is the identification of co-occurring vegetation types within the same spatial units, allowing emissions to be quantified across vegetation mixtures rather than single classes, providing a more realistic representation of Mediterranean forests. Applied to the 2022 Bejis wildfire, pre-fire biomass within the burned area was 673,601 tons. Coniferous forests dominated, but co-occurrence with shrubland and herbaceous layers produced the highest emission contributions, highlighting the role of vegetation interactions. Total emissions were estimated at 625,938 tons of equivalent CO₂, and comparison with large-scale datasets (CAMS Global Fire Assimilation System, Global Fire Emissions Database) shows general coherence. This severity-driven, vegetation-explicit framework demonstrates robust potential for quantifying wildfire emissions across heterogeneous Mediterranean landscapes, though uncertainties remain due to pre-defined biomass, burning efficiency, emission factors, assumptions in fire severity mapping, and limited field validation. The approach can support improved regional GHG inventories and wildfire management strategies. Full article

Accurate wildfire impact assessment and understanding post-disturbance recovery are essential for land management in fire-prone regions. This study develops a Sentinel-2–based burned-area extraction framework and integrates NDVI time-series analysis with explainable machine learning to quantify vegetation resilience across five fire-affected regions in China. The burned-area map achieves an overall accuracy of 99.8%, substantially outperforming MODIS products (77.9% and 92.7%) by better detecting fragmented patches in complex terrain. NDVI trajectories reveal three resilience pathways: compensatory recovery, stable recovery without compensation, and persistent degradation. Recovery times ranged from approximately 2 months to over 6 months, with some high-altitude areas showing no effective recovery. An XGBoost–SHAP model explains spatial recovery variability (R² = 0.50–0.88) and identifies a consistent shift from early climate control to later topographic regulation. Landscape heterogeneity promotes recolonization only within intermediate thresholds, temperature exhibits optimal windows, and precipitation shows diminishing returns. Topography acts primarily by redistributing hydrothermal conditions rather than as an independent driver. The results demonstrate strong spatial variability in ecosystem stability and highlight nonlinear interactions among climate, terrain, and landscape structure as key determinants of resilience. The proposed framework improves burned-area monitoring and supports targeted ecological restoration and adaptive land-use planning in heterogeneous landscapes. Full article

As part of efforts to support the transition toward a zero-carbon future, this research evaluates how the use of natural gas and liquefied petroleum gas under lean burn conditions affects the energy efficiency and environmental outcomes of a diesel engine that has been retrofitted to operate with spark ignition. The assessment of the ecological potential of these low-carbon gaseous fuels was performed at the engine test bed at optimum spark advance set from the condition of achieving maximum brake thermal efficiency (i.e., lowest carbon dioxide emission, CO₂). The results found with lean mixtures are compared to those obtained under stoichiometric conditions, as well as to those from a commercial gasoline engine of comparable size, equally operated at stoichiometry. With lean burning, a clear improvement is observed for all operating points in terms of brake thermal efficiency with respect to the stoichiometric operation. The results highlight a slightly greater improvement when operating with natural gas lean mixtures: between (1.35 and 2.35) percentage points gained in this case, compared to (1.15–2.10) percentage points gained in the case of liquefied petroleum gas. As for CO₂, a maximum 28% reduction when using natural gas is achieved with lean operation with respect to the commercial gasoline engine. Using lean mixtures also brings an important reduction in the engine-out pollutants (carbon monoxide, nitric oxides and particulate number). However, with respect to stoichiometric operation, cyclic variability of the prototype degrades with lean burning but remains lower than one of the baseline commercial gasoline engines. Full article

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical efficacy and safety of PBMT in managing orofacial conditions in older adults. Methods: A systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify randomized controlled trials (RCTs) published between January 2000 and March 2025. Eligible studies included patients aged ≥60 years receiving PBMT for orofacial conditions. Study selection followed predefined criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and findings were narratively synthesized. Results: Twenty-three RCTs were included. Evidence for PBMT was most frequently reported in cancer therapy-induced oral mucositis (n = 8), with consistent reductions in lesion severity and pain. Studies on burning mouth syndrome (n = 7) and hyposalivation (n = 2) generally reported improvements in symptoms, although placebo effects were noted. Fewer studies evaluated postoperative pain (n = 2), oral lichen planus (n = 1), peri-implant conditions (n = 1), and implant osseointegration (n = 2). No clinically significant adverse events were reported. However, heterogeneity in PBMT parameters and outcome measures limited comparability. Conclusions: PBMT is a safe and clinically effective adjunctive therapy for managing orofacial conditions in older adults, particularly oral mucositis. These findings support its integration into geriatric oral care. Standardized protocols and well-designed RCTs are needed to determine optimal treatment parameters and long-term effectiveness. Full article

Prolonged grief disorder (PGD) affects approximately 10% of bereaved individuals and is now formally recognized in both the DSM-5-TR and ICD-11. Despite its prevalence, PGD often responds poorly to traditional therapeutic approaches. This manuscript outlines the protocol for an early-stage open-label feasibility trial investigating the use of psilocybin, a psychedelic compound, in treating PGD in adults, with a focus on young adults. The study will involve 20 participants diagnosed with PGD. Each participant will undergo a structured therapeutic process that includes a preparatory session, a single 25 mg dose of psilocybin, and post-session integration. Throughout the study, participants will be monitored via symptom assessments, including qualitative and quantitative data, with the main aims related to safety, feasibility and acceptability. Functional MRIs will be obtained pre- and post-dosing and collected during a standardized grief-elicitation methodology. Key outcome measures include changes in the severity of PGD and trauma symptoms, cognitive flexibility, openness to experience, meaning in life and subjective experiences during the psilocybin session. Neural activity will also be evaluated through fMRI to better understand the neurobiological effects of the treatment. This research represents one of the first clinical protocols specifically focused on the potential of psilocybin for treating PGD. The goal is to assess feasibility and safety while laying the groundwork for future randomized controlled trials. Full article

Annual area burned correlates with temperature and fuel aridity, yet extreme wildfire outcomes arise from a small fraction of fires and rapid-growth days. This asymmetry indicates that thermodynamic favorability sets background susceptibility but does not determine when extreme growth occurs. This Perspective proposes a cross-scale framework that distinguishes susceptibility from regime-conditioned event-scale realization. At seasonal and regional scales, temperature and humidity influence fuel dryness, ignition likelihood, and fire-season length, explaining substantial interannual variability in area burned. These variables vary smoothly in space and retain signal under aggregation. By contrast, extreme fire growth occurs during short-lived synoptic configurations that organize winds, pressure gradients, and stability into discrete opportunity windows that permit sustained spread. The strongest winds governing rapid spread are intermittent, terrain-structured, and often unresolved in coarse datasets or aggregated indices. Within these windows, terrain interactions, organized flow, and fire–atmosphere feedbacks can amplify growth until circulation patterns shift. Extreme wildfire behavior therefore operates as a gated joint-probability process requiring the coincidence of susceptibility (S), dynamical weather opportunity (W), and ignition (I). Separating susceptibility from realization reconciles strong climate–fire correlations with the dynamical control of event-scale extremes. Full article