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Burn wound conversion is the observed process where superficial partial thickness burns convert into deep partial or full thickness burn injuries. This conversion process often involves surgical excision to achieve timely wound healing. Unfortunately, the pathophysiology of this phenomenon is multifactorial and poorly understood. Thus, a therapeutic intervention that may prevent secondary progression and cell death in burn-injured tissue is desirable. Recent work by our group and others has established that tranexamic acid (TXA) has significant anti-inflammatory properties in addition to its well-known anti-fibrinolytic effects. This study investigates TXA as a novel therapeutic treatment to mitigate burn wound conversion and reduce systemic inflammation. Sprague-Dawley rats were subjected to a hot comb burn contact injury. A subset of animals underwent a similar comb burn with an adjacent 30%TBSA contact injury. The interspaces represent the ischemic zones simulating the zone of stasis. The treatment group received injections of TXA (100 mg/kg) immediately after injury and once daily until euthanasia. Animals were harvested for analyses at 6 h and 7 days after injury. Full-thickness biopsies from the ischemic zones and lung tissue were assessed with established histological techniques. Plasma was collected for measurement of damage associated molecular patterns (DAMPs), and liver samples were used to study inflammatory cytokines expression. Treatment with TXA was associated with reduced burn wound conversion and decreased burn-induced systemic inflammatory response syndrome (SIRS). Lung inflammation and capillary leak were also significantly reduced in TXA treated animals. Future research will elucidate the underlying anti-inflammatory properties of TXA responsible for these findings. • Burn wound conversion is the observed process where partial thickness burns convert into full thickness burn injuries. • Burn wound conversion has been attributed to a combination of prolonged inflammation, ischemia, ROS, and autophagy. • Animals treated with systemic tranexamic acid had reduced burn wound conversion and decreased burn-induced SIRS. • Future research will elucidate the underlying anti-inflammatory properties of TXA responsible for these findings. [ABSTRACT FROM AUTHOR]

Community-level disadvantage is associated with reduced quality of life after burn injury. We evaluated the association between community-level disadvantage and return to work after burn injury. A multicenter burn injury database was queried from 1998–2021. Participants 18–65 years old with documented employment status and ZIP codes were included. Exposures were community distress (Distressed Communities Index, DCI), patient demographics, and burn characteristics. The primary outcome was odds of employment 6 months after burn injury using stepwise logistic regression models, first with patient-level variables, then DCI. An interaction term was included to evaluate the modification of DCI and post-injury employment by race. 1960 participants were included, with a median age of 39.2 years (IQR 29.2, 49.3); 81 % were White, 75 % male, and 74 % were working at the time of injury. Participants unemployed 6 months post-injury were more often older, female, non-White, and unemployed at injury, with larger burn sizes and longer hospitalizations. 59 % of participants unemployed at 6 months were employed at the time of injury. Residence in the highest distress ZIP codes was associated with 2.21 (95 % CI 1.39–3.52) odds of 6 month unemployment. Older age, larger burn size, more operations, Black race, and pre-injury unemployment were associated with the greatest odds of unemployment. The interaction between race and DCI was not statistically significant. Patients from the highest distress communities have twice the odds of unemployment 6 months after injury. This association did not vary by race. Screening for DCI by ZIP code may be a useful tool to focus vocational rehabilitation resources. • High Community Distress and minoritized race are associated with twice the odds of unemployment 6 months after burn injury. • The effect of community distress on odds of unemployment did not vary when stratified by self-reported race. • Using ZIP code to screen patients for community distress may be a useful clinical too to focus post-discharge vocational resources. [ABSTRACT FROM AUTHOR]

• Under current law, there is no universal helmet requirement for motorcyclists. • Our trauma center manages 20% of the motorcycle injuries in the State. • Helmeted riders sustained fewer head and neck injuries. • Non-helmeted riders sustained worse injuries, longer ICU hospitalization and more frequent need for mechanical ventilation. • Helmets provide a significant safety advantage in a large rural catchment. Introduction: Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders. Methods: Retrospective review (2014–2018) of a single level 1 trauma center's registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student's t -test or Pearson's χ 2 p -value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained. Results: Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS. Conclusions: Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation. [ABSTRACT FROM AUTHOR]

The β -phase of Au 7 Cu 5 Al 4 undergoes a reversible shape-memory phase transformation for which several conflicting martensite phases have been reported. Here we show the significance of the cooling temperature used to obtain the martensite. If Au 7 Cu 5 Al 4 is cooled from the parent phase condition to cryogenic temperatures, e.g. below 200 K, the martensitic phase is orthorhombic (space group Pcmn , a = 4.4841 Å, b = 5.8996 Å, c = 17.8130 Å); however, when this composition is cooled to only ∼260 K it will in general consist of a mixture of orthorhombic and monoclinic phase (the latter has space group P 2 1 / m , a = 4.4742 Å, b = 5.9265 Å, c = 13.3370 Å, β = 91.425°). In contrast, a sample with decreased Al content (Au 7 Cu 5.7 Al 3.3 ) transforms fully to monoclinic phase if cooled to ∼260 K. [ABSTRACT FROM AUTHOR]