MESHR: A Modular, Economical Skin Graft Hand Roller

In South Africa and around the world, the rates of severe burns are a significant health issue. Skin grafts are used to improve the function and appearance of the burned area and reduce the amount of time a patient is in the hospital. To minimize the amount of skin needed and maximize the coverage of the graft, the harvested sample is meshed in a lattice pattern so it can expand and graft a much larger surface area. Unfortunately, the current methods and devices used in both high and low-income countries have been optimized for hospitals with larger budgets and more readily available resources. In this project, we developed a frugal skin graft expansion device for low resource settings in developing countries. After identifying the needs of low-resource countries, we prototyped possible solutions and tested them, achieving both the meshing pattern and graft expansion. We then created further iterations of our design to more fully meet the needs of developing countries. We believe our frugal device will fill a need in the current field of burn care devices in developing countries and significantly increase the number of burn patients successfully treated in low resource settings, allowing them to reintegrate into society and live healthy and productive lives

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted

Recent Developments of Carboxymethyl Cellulose.

Carboxymethyl cellulose (CMC) is one of the most promising cellulose derivatives. Due to its characteristic surface properties, mechanical strength, tunable hydrophilicity, viscous properties, availability and abundance of raw materials, low-cost synthesis process, and likewise many contrasting aspects, it is now widely used in various advanced application fields, for example, food, paper, textile, and pharmaceutical industries, biomedical engineering, wastewater treatment, energy production, and storage energy production, and storage and so on. Many research articles have been reported on CMC, depending on their sources and application fields. Thus, a comprehensive and well-organized review is in great demand that can provide an up-to-date and in-depth review on CMC. Herein, this review aims to provide compact information of the synthesis to the advanced applications of this material in various fields. Finally, this article covers the insights of future CMC research that could guide researchers working in this prominent field

Eremitic landscape dwelling in Confucian China and Enlightenment Europe: structuring the moral self in reclusion and performing public duty

This thesis explores how the experience of reclusion in free landscapes and private gardens of Confucian China and Enlightenment Europe contributed to people’s moral improvement by cultivating good passions such as temperance, encouraging introspection, increasing the sense of responsibility towards society and rendering erudite individuals prompt to perform their public duty as politicians and civil servants. The thesis is based on the comparative analysis of philosophical concepts, works of art, poems and cultural practices in order to highlight the similarities and divergences between Chinese and European – particularly British and French - eremitic landscape dwelling. Taking into account the historical context in which two important systems of thought were developed in different geographic regions, the research brings together the state-sanctioned Confucian ethics with Enlightenment Deism which, inspired by Roman Stoics, played a pivotal role in the promulgation of reclusive landscape culture and the creation of non-geometrical gardens used as retreats in the eighteenth-century Europe. Investigating human relationships with the natural environment and organized society, as well as views on interpersonal relationships, established religion and matters of cultural heritage, the thesis shows that gardens where Confucian literati and socially privileged Europeans, who had espoused Enlightenment ideals, liked to retire comprised mediating spaces between the private realm and the public sphere, solitude and public action. Eremitic landscape dwelling did not derive from a sentiment of contempt for the world or from a selfish desire to avoid hardships. Rather, this noble form of reclusion whose purpose was the cultivation of virtue and humaneness revolved around the greatest interest of individuals and the welfare of society

Design and in vivo verification of a stress radiography device towards it's suitability for multi-ligament laxity measurements

The human knee is a hinge joint, primarily facilitating locomotion. Knee joint instability, due to ligament injuries, is a result of direct or indirect trauma, non-anatomical stresses during pivoting movements about the knee, imbalanced landing during jumping and rapid deceleration during high intensity locomotion. Biomechanical indications of an unstable knee joint include decreased joint integrity, hyperlaxity, abrupt locking and catching combined with clicking noises during locomotion. Approximately, two hundred and fifty thousand ACL injuries occur in the United States of America annually. Current diagnostic procedures are subjective according to the clinician's experience. This potentially leads to misdiagnosis of the injury and improper treatment. Non-invasive diagnostic techniques make use of manual methods, MRI and laxity measurement devices (e.g. arthrometers and stress radiography devices). Laxity measurement devices (the focus of this study) determine ligament health by measuring their elasticity and stiffness. Directional tibial and fibular bone translation is induced by applying an external load to the joint. The bone translation is measured in relation to the load applied, which denotes ligament laxity. The Laxmeter is a novel, cost effective and radiolucent multi-ligament laxity measurement stress radiography device. This device facilitates the measurement of MCL and LCL laxity at multiple degrees of knee joint flexion, however, it lacks the essential means to perform the laxity measurement technique. The current study aims to redesign the Laxmeter to perform ACL, PCL, MCL and LCL laxity measurement procedures at multiple fixed degrees of knee joint flexion. The in vitro functional verification of the device was limited to (according to scope) a single cadaver trial; to validate functionality, structural integrity, usability as well as demonstrate the Laxmeter concept prior to a prospective full clinical trial. The redesigned Laxmeter Prototype consists of a load applicator capable of applying a 250N load to various aspects of the proximal lower leg, to induce bone translation for laxity measurements. The load applicator is designed to integrate with the ergonomic patient support structure, the later potentially improving reproducibility and accuracy of the laxity measurement results. The cadaver trial demonstrated the device's capability of measuring the laxity of the ACL, MCL and LCL at predetermined knee flexion angles. To measure the ligament laxity, equal loads were applied to both proximal lower limbs independently. The bilateral average displacement of the tibia with respect to the femur for each ligament was noted. In the case of the ACL, the Laxmeter measured an average laxity of 3.07mm at 30° knee flexion and a load of 150N. The average laxities for the MCL and LCL at 30° knee flexion and 150N were 1.11mm and 2.02mm. The trial yielded preclinical results that were comparable with existing clinical and healthy cadaver based studies (using similar techniques), and suggests that the Laxmeter is capable of measuring the laxity of the ACL, MCL and LCL at various degrees of knee flexion. PCL laxity measurements could not be performed due to compromised structural integrity, which was essential to make the Laxmeter portable and lightweight. Future recommendations for the device include rotational ankle fixation; improved overall limb fixation; improved structural integrity to allow for PCL laxity measurements as well as further preclinical (functional) verification procedures prior to a full clinical trial

The management of burn wounds by nurses

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Doctor of Philosophy Johannesburg, 2015A standardised approach to wound care is vital if a positive outcome is expected. The positive outcomes of standardisation and evidence based wound care protocols have been well documented, yet nurses in South Africa do not have a standard that informs burn wound management. The purpose of this study is to describe the best available evidence for management of burn wounds and to explore nurses’ current practices in a single burns unit with the aim of developing guidelines to inform nursing practices. A QUAN (quantitative dominant) QUAN+ QUAL (quantitative and quantitative concurrently), a non- experimental explanatory sequential descriptive design was used. The process was divided into three phases: Phase One involved the search for quality evidence through an integrative review. The main review question was: “What new knowledge or information related to non-surgical management of burn wounds has emerged in the literature between 2000 and 2014?” Eleven sub questions were used to guide the literature search according to the themes of the nursing process of: Assessment, Diagnosis, Intervention, Outcome and Evaluation. The review process included a problem identification stage, literature search stage, data evaluation stage, data analysis stage and presentation stage. The included literature was based on a hierarchy of evidence. The search strategy included: multiple electronic databases, hand searching, reference lists of relevant articles, comments of experts, textbook chapters compiled by experts and guidelines. The final sample consisted of n= 354 studies. A qualitative descriptive approach was used to synthesise the research findings. Phase Two involved the study of current practice through structured observation and semi-structured interviews. The purpose of Phase Two was to obtain first-hand information in a naturally occurring situation to identify the strengths, weaknesses and gaps in current practices. Purposive sampling was undertaken and included all nurses providing care to patients with superficial to partial thickness burn wounds. A total of n= 303 dressings were observed and eight interviews were conducted. Phase Three was the verification of findings from Phases One and Two by experts in the field using the AGREE II instrument. Conclusions drawn from observations and interviews were integrated and synthesised with the conclusions from the integrative review. These conclusions were used to develop guidelines for the management of burn wounds by nurses

2020 Touro College & University System Faculty Publications

2020 edition of the Faculty Publications Book of the Touro College & University System. This bibliography contains the published works of TCUS affiliated authors during 2020, arranged by academic unit.https://touroscholar.touro.edu/facpubs/1010/thumbnail.jp

The Absence of America on the Early Modern Stage.

Renaissance drama’s response to English settlement in the New World was muted, even though the so-called golden age of Shakespeare coincided with the so-called golden age of exploration. No play performed before the closure of the theatres in 1642 is set in the Americas. A handful represents Native American characters. Few plays treat colonization as central to the plot. Nevertheless, advocates of colonialism bemoaned how the stage treated transatlantic enterprise, and proclaimed London’s playing companies to be its enemies. In order to understand the nature of the criticisms made by colonialist supporters, as well as the attitudes of players, playwrights, and playgoers towards English expansionism in the New World, this study juxtaposes a number of sites of cultural performance: playhouse drama, court masques, civic pageants, propaganda tracts and sermons, travel accounts, overseas trading company documents, and maps and other cartographic/geographical records. This interdisciplinary approach reveals that, although drama did not represent America directly, it appropriated and circulated rumours about what was occurring in the transatlantic colonies, much to the chagrin of their promoters, and by so doing it disseminated mockery and concern about English activity in the New World. Renaissance Drama perpetuated the idea that Atlantic trade was unwise or the purview of the corrupt; it associated colonists and investors with excessive wealth, materialism, lust, corruption, and greed; it branded the project of converting the natives as a failure and a folly. That America was articulated indirectly did not lessen its impact. Renaissance drama's active engagement of its audience's imagination meant that what might now be considered at the periphery was the point of contact between the world invoked by a play and the world outside that play. America emerges most often at these points of intersection between stage and audience, between playing-company and playgoer: in plays which feature Christian Europeans disguising themselves as Indians, in plays which are set in London or on unnamed, unknown islands, and even in plays whose plots seem to have little to do with America.Ph.D.English Language & LiteratureUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/60798/1/ghollis_1.pd