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The objective of the GéoCarbone-PICOREF project was to select and characterize geological sites where CO2 storage in permeable reservoir could be tested at the pilot scale. Both options of storage in deep saline aquifer and in depleted hydrocarbon field were considered. The typical size envisioned for the pilot was 100 kt CO2 per year. GéoCarbone-PICOREF initially focused on a “Regional Domain”, ca. 200 × 150 km, in the Paris Basin. It was attractive for the following reasons: detailed geological data is available, due to 50 years of petroleum exploration; basin-scale deep saline aquifers are present, with a preliminary estimate of storage capacity which is at the Gt CO2 level, namely the carbonate Oolithe Blanche Formation, of Middle Jurassic age, generally located between 1500 and 1800 m depths in the studied area, and several sandstone formations of Triassic age, located between 2000 and 3000 m; several depleted oil fields exist: although offering storage capacities at a much lower level, they do represent very well constrained geological environments, with proven sealing properties; several sources of pure CO2 were identified in the area, at a flow rate compatible with the pilot size, that would avoid capture costs. 750 km of seismic lines were reprocessed and organized in six sections fitted on well logs. This first dataset provided improved representations of: the gross features of the considered aquifers in the Regional Domain; the structural scheme; lateral continuity of the sealing cap rocks. An inventory of the environmental characteristics was also made, including human occupancy, protected areas, water resource, natural hazards, potential conflicts of use with other resources of the subsurface, etc. From all these criteria, a more restricted geographical domain named the “Sector”, ca. 70 × 70 km, was chosen, the most appropriate for further selection of storage site(s). The geological characterization of the Sector has been as exhaustive as possible, with the reprocessing of additional 450 km of seismic lines, and the collection of a complete well-data base (146 petroleum wells). At this scale a relatively detailed characterization of the sedimentary layers could be done, in particular the formations potentially rich in aquifer units. For the Middle Jurassic carbonates observations were made on analogue sediments outcropping 150 km to the east of the Sector. A geological and numerical 3-D representation of the whole sedimentary pile of the Sector area was built. It forms a basis for constructing grids used by codes able to simulate various processes induced by CO2 injection (displacement of the fluids, pressure build-up and release, mechanical deformation, mineral interactions, control of the parameters used to check the local sealing efficiency, etc.). In parallel with that work on aquifers, GéoCarbone-PICOREF has access to all the petroleum data, including production data and reservoir modelling, of the Saint-Martin de Bossenay oil field, localized in the eastern part of the Sector. This was an opportunity to apply a comparable methodology and to test the capabilities of modelling codes to the specific case of a depleted hydrocarbon field, and to show some of the advantages of such a context with respect to a pilot-scale CO2 injection. Le projet GéoCarbone-PICOREF avait pour objectif de caractériser des sites propices à la réalisation d’un pilote national de stockage du CO2 en réservoir géologique perméable. Deux types de réservoir ont été examinés : des aquifères profonds, et des gisements d’hydrocarbures en voie d’épuisement. Les sites devaient être choisis de manière que le pilote puisse tester des problématiques qui concernent les futurs stockages de grande taille. GéoCarbone-PICOREF a d’abord sélectionné une “Zone régionale” d’environ 200 × 150 km dans le bassin de Paris, qui présente les avantages suivants : l’information géologique y est largement disponible, grâce aux travaux d’exploration pétrolière depuis 50 ans ; de grands aquifères salins y sont présents, dans les carbonates du Jurassique moyen situés en général entre 1500 et 1800 m de profondeur, et dans les formations gréseuses du Trias, entre 2000 et 3000 m; il existe plusieurs gisements d’hydrocarbures en voie d’épuisement : offrant des capacités de stockage moindres, leur intérêt est d’être bien connus sur le plan géologique et d’être dotés de bonnes qualités en termes de piégeage géologique. Après avoir retraité 750 km de lignes sismiques, et avoir assemblé celles-ci selon six coupes calées sur des données de puits, on a précisé sur la Zone régionale : les grandes caractéristiques des aquifères concernés ; la localisation des failles ; la continuité des couches très peu perméables situées au-dessus des réservoirs. Ces études ont permis de choisir un “Secteur”, d’environ 70 × 70 km, au sein duquel on a ensuite affiné l’investigation géologique : 450 km supplémentaires de lignes sismiques, collecte exhaustive des données de puits, caractérisation fine des propriétés réservoir. Des observations de terrain ont été faites sur des roches équivalentes portées à l’affleurement. Un modèle géologique et informatique complet du Secteur a été construit à partir de ces données. Il permet de générer des maillages pour la simulation de divers comportements attendus suite à l’injection de CO2 (déplacement et dissipation du gaz dans les couches réservoir, modification des pressions et des contraintes, déformation mécanique des terrains, interaction entre l’eau acidifiée et les minéraux, etc.). Parallèlement, le projet a pu avoir accès à toutes les données pétrolières du gisement de Saint-Martin de Bossenay, situé dans la partie Est du Secteur. Grâce à cette opportunité, on a montré quel parti pouvait être tiré, pour un pilote, d’un gisement d’hydrocarbures déjà largement exploité, doté d’un piège géologique qui a retenu des hydrocarbures pendant des millions d’années, et sur lequel un opérateur industriel dispose d’une infrastructure et d’un savoir-faire.

Background The clinical use of non-invasive instrumentation to evaluate skin characteristics for diagnostic purposes and to evaluate treatment outcomes has become more prevalent. The purpose of this study was to generate normative data for skin elasticity, erythema (vascularity), melanin (pigmentation), and thickness across a broad age range at a wide variety of anatomical locations using the Cutometer® (6 mm probe), Mexameter®, and high-frequency ultrasound in a healthy adult sample. Methods We measured skin characteristics of 241 healthy participants who were stratified according to age and gender. Sixteen different anatomical locations were measured using the Cutometer® for maximum skin deformation, gross elasticity, and biological elasticity, the Mexameter® for erythema and melanin, and high-frequency ultrasound for skin thickness. Standardized measurement procedures were applied for all participants. Results The means and standard deviations for each measured skin characteristic for females and males across five different age groups (20-29, 30-39, 40-49, 50-59, 60-69, and 70-85 years old) are presented. As previously described, there were variations in skin characteristics across age groups, anatomical locations, and between females and males highlighting the need to use site specific, age and gender matched data when comparing skin characteristics. Conclusion The reported data provides normative data stratified by anatomical location, age, and gender that can be used by clinicians and researchers to objectively determine whether patients' skin characteristics vary significantly from healthy subjects. [ABSTRACT FROM AUTHOR]

The Burn Therapist Certification (BT-C) was introduced in 2018 to acknowledge occupational therapists (OT) and physical therapists (PT) with specialized knowledge, skill, and experience in the promotion of quality burn rehabilitation. Currently, BT-Cs make up 11.7% of therapists working in burn rehabilitation (n = 39/333). The purpose of this review is to report on the contributions of BT-Cs to organizational leadership of the American Burn Association (ABA) and in the generation of new knowledge through peer-reviewed publications. Despite the small percentage of burn therapists who are certified, they have a disproportionately large involvement in leadership within the ABA and burn research in the Journal of Burn Care and Rehabilitation (JBCR). From 2018 to 2023, BT-Cs have contributed to nearly one-half (n = 26/56) of therapy authored publications in the JBCR and almost one-third (n = 65/202) of accepted abstracts at the ABA annual meeting. Certified burn therapists demonstrate substantial involvement throughout the ABA, including maintaining an 85% membership rate and, on average, serve in 53% (n = 31/59) of the therapy allotted committee positions. Therapist pursuit of certification can have a profound impact on the burn community through publication, leadership, and development of care standards. Although therapists have indicated a desire to pursue certification, barriers related to a lack of association and center support have been identified. The burn community has endorsed certification as a mark of excellence for nurses and physicians. Maximizing the value of a transdisciplinary approach to burn care is also dependent on the excellence of therapies. If the burn community desires improved engagement and contribution from therapies, it should support therapist certification., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Fear avoidance (FA) describes beliefs and behaviors related to avoiding movements or activities after a painful event. FA is a prevalent issue that limits the recovery outcomes and social reintegration of burn survivors. However, as current literature focuses on chronic conditions, understanding the impact and treatment of FA within sudden onset musculoskeletal (MSK) conditions, specifically in the burn survivor population, is lacking. The purpose of this scoping review is to synthesize evidence-based rehabilitation interventions aimed at improving FA behaviors and beliefs after sudden onset MSK conditions, and to provide suggestions for clinical application with the burn survivor population. Ovid Medline, Ovid EMBASE, CINAHL and PsycINFO were sourced from inception to May 2023. Monthly Google Scholar searches and hand searching of included articles' reference lists were done to add additional relevant publications. Eligibility criteria included: 1) adults with sudden onset MSK condition, 2) intervention from a rehabilitation professional, and 3) FA as primary outcome. Four authors performed data extraction using the TIDIER checklist. Seven intervention types were identified: 1) education; 2) exercise; 3) graded motor imagery; 4) manual therapy (MT); 5) multimodal - education with exercise; 6) multimodal - education with MT and exercise; and 7) multimodal - interactive gaming console with exercise. All intervention types, except MT, demonstrated significant decreases in FA. This review summarizes effective rehabilitation interventions to address FA while highlighting the role of rehabilitation professionals in improving function and alleviating potential disability stemming from FA despite physical recovery., (© The Author(s) 2025. Published by Oxford University Press on behalf of the American Burn Association.)

Background: Vacuum massage, or endermotherapy, is applied to scar tissue with the primary therapeutic goal of promoting structural or physiological changes. These changes are intended to enhance pliability, enabling the skin to possess the strength and elasticity required for normal mobility. The advantage of vacuum massage compared to therapist-generated manual massage is that it provides a standardized dosage using rollers and suction valves to mobilize the tissue. However, research documenting and supporting its impact on post-burn hypertrophic scar is lacking. Thus, this study was designed to objectively characterize the changes in scar elasticity, erythema, melanin, thickness, and transepidermal water loss immediately after a vacuum massage session and after a 12-week course of treatment compared to intra-individual matched control scars., Methods: We conducted a prospective, randomized, controlled, within-patient, single-blinded clinical trial, initially designed as a fully-powered study but limited to a pilot study due to COVID-19 restrictions. Nineteen burn survivors consented to participate and 16 completed the study. Two homogeneous, intra-individual scars were randomized to usual care control or vacuum massage therapy plus usual care. Vacuum massage interventions were provided by a certified massage therapist three times per week for 12 weeks. Scar characteristics were evaluated every four weeks immediately before and after mechanical massage treatment. The evaluations included measurements of elasticity (Cutometer), erythema and melanin (Mexameter), transepidermal water loss (TEWL) (Tewameter), and thickness (high-frequency ultrasound). Linear mixed-model analyses were performed to test for immediate and long-term treatment effects., Results: The ANOVA analyses revealed a non-significant time:treatment interaction for elasticity, erythema, melanin, thickness, or TEWL. There was a significant increase in elasticity and erythema and a decrease in TEWL in both the control and treatment sites over time with consistent standard care. However, there was no statistically significant immediate or long-term treatment effect for any of the skin characteristics. Nonetheless, the mean participant satisfaction was 4/5 (SD = 1.5) and the mean participant perception of effectiveness was 8/10 (SD = 1.9)., Conclusions: This pilot study did not find a treatment benefit of vacuum massage therapy for elasticity, erythema, melanin, thickness or TEWL, but it did find an improvement with time in elasticity, erythema and TEWL. Despite the lack of objective improvement of the treated scar site, participants were satisfied with the results and believed vacuum massage was very effective. Further high-quality research is required to better inform clinicians patient education and treatment decisions for this costly, burdensome treatment approach that has high participant satisfaction., Competing Interests: Conflicts of Interest The endermologie® machine used in this study was donated by a private company, however, they were not involved in data collection, analyses, or manuscript publication., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Conservative management for hypertrophic scars (HSc) and scar contractures is of utmost importance to optimally reintegrate burn survivors into society. Many conservative treatment interventions have been described in the literature for the management of HSc. Recent advancements in the literature pertaining to post-burn scarring and HSc formation, have advanced our understanding of the mechanisms that support or refute the use of common rehabilitation treatment modalities after burn injury. This is particularly relevant for recent advancements in the fields of mechanotransduction and neurogenic inflammation resulting in the need for rehabilitation clinicians to reflect upon commonly employed treatment interventions. The aim of this review article is to summarize and clinically apply the evidence that supports or refutes the use of common conservative treatment interventions for scar management employed after burn injury. The following treatments are discussed and mechanotransduction and neurogenic inflammation concepts are highlighted: 1) edema management (compression, positioning/elevation, pumping exercises, retrograde massage, manual edema mobilization), 2) pressure therapy (including custom fabricated pressure garments, inserts, face masks, and other low-load long duration orthotic devices), 3) gels or gel sheets, 4) combined pressure therapy and gels, 5) serial casting, 6) scar massage, and 7) passive stretching. This review supports the following statements: 1) Compression for edema reduction should be initiated 48-72 hrs post-injury and continued for wounds that require longer than 21 days to heal until scar maturation; 2) Elevation, pumping exercises and retrograde massage/MEM should be used in combination with other edema management techniques; 3) Custom fabricated pressure garments should be applied once the edema is stabilized and adequate healing has occurred. Garments should be monitored on a regular basis to ensure that optional pressure, >15 mm Hg, is maintained, adding inserts when necessary. The wearing time should be >16 hrs/day; 4) Gels for post-burn scar management should extend beyond the scar; 5) Serial casting should be applied when contractures interfere with function; 6) Forceful scar massage should be avoided early in the wound healing process or when the scar is inflamed or breaks down; 7) Other treatment modalities should be prioritized over passive stretching for scar management., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association.)

Congenital microcoria (MCOR) is a rare hereditary developmental defect of the iris dilator muscle frequently associated with high axial myopia and high intraocular pressure (IOP) glaucoma. The condition is caused by submicroscopic rearrangements of chromosome 13q32.1. However, the mechanisms underlying the failure of iris development and the origin of associated features remain elusive. Here, we present a 3D architecture model of the 13q32.1 region, demonstrating that MCOR-related deletions consistently disrupt the boundary between two topologically associating domains (TADs). Deleting the critical MCOR-causing region in mice reveals ectopic Sox21 expression precisely aligning with Dct, each located in one of the two neighbor TADs. This observation is consistent with the TADs' boundary alteration and adoption of Dct regulatory elements by the Sox21 promoter. Additionally, we identify Tgfb2 as a target gene of SOX21 and show TGFΒ2 accumulation in the aqueous humor of an MCOR-affected subject. Accumulation of TGFB2 is recognized for its role in glaucoma and potential impact on axial myopia. Our results highlight the importance of SOX21-TGFB2 signaling in iris development and control of eye growth and IOP. Insights from MCOR studies may provide therapeutic avenues for this condition but also for glaucoma and high myopia conditions, affecting millions of people., Competing Interests: Declaration of interests The SOX21-TGFB2 pathway in iris development, axial myopia, and GLC has been officially patented under the title “Methods and pharmaceutical compositions for treating ocular diseases” (WO/2021/245224). The inventors of this patent are J.-M.R., L.F.T., B.N., C.A., and J.K., (Copyright © 2024 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.)

According to the Fear-avoidance (FA) model, FA beliefs can lead to disability due to avoidance of activities expected to result in pain or further injury. Extensive research on the relationship of FA, pain, catastrophizing, and disability has been generated with patients suffering from chronic neck and back pain, but little research has been conducted with burn survivors. To address this need, the Burn Survivor FA Questionnaire (BSFAQ) was developed (Langlois J, Vincent-Toskin, S, Duchesne, P et al. Fear-avoidance beliefs and behaviors of burn survivors: A mixed-methods approach. Burns 2021;47:175-89.) but has not been validated. Thus, the primary objective of this study was to investigate the construct validity of the BSFAQ among burn survivors. The secondary objective was to examine the relationship between FA and 1) pain intensity and 2) catastrophizing at baseline, 3 months and 6 months postburn, and 3) disability among burn survivors at 6 months postburn. A prospective mixed-methods approach was used to examine the construct validity by comparing the quantitative scores of the BSFAQ to independently performed qualitative interviews of burn survivors (n = 31) that explored their lived experiences, to determine if the BSFAQ discriminated those who had, from those who did not have FA beliefs. Data for the secondary objective, scores of burn survivors (n = 51) pain intensity (numeric rating scale), catastrophizing (pain catastrophizing scale), and disability (Burn Specific Health Scale-brief), were collected through a retrospective chart review. For the primary objective, Wilcoxon rank sum test results showed a statistically significant difference (P = .015) between the BSFAQ scores of participants who were identified from the qualitative interviews as fear avoidant compared to those who were identified as non fear avoidant, with a receiver operating characteristic curve indicating that the BSFAQ correctly predicted FA 82.4% of the time. For the secondary objective, Spearman correlation test results showed a moderate correlation between FA and 1) pain at baseline (r = .466, P = .002), 2) catastrophizing thoughts over time (r = .557, P = .000; r = .470, P = .00; r = .559, P = .002 respectively at each time point), and 3) disability at 6 months postburn (r = -.643, P = .000). These results support that the BSFAQ is able to discriminate which burn survivors are experiencing FA beliefs. It is also consistent with the FA model since burn survivors who express FA are more likely to report higher levels of pain early during their recovery that correlates with persistently elevated catastrophizing thoughts and ultimately results in higher self-reported disability. The BSFAQ demonstrates construct validity and is able to correctly predict fear-avoidant burn survivors; however, additional research is required to further examine the BSFAQ's clinimetric properties., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The aim of this review was to summarise the current evidence regarding the effectiveness of rehabilitation interventions in improving hand function, range of motion (ROM), hand strength, scar outcome, return to work, level of impairment/disability, level of burn knowledge and decreasing edema following hand burns in adult burn survivors. This review provides evidence-based support for the use of rehabilitation interventions for burn rehabilitation professionals. The following data sources were searched: MEDLINE, EMBASE and CINAHL from their inception up to February 2021, reference lists from all the included full-text articles were screened for additional relevant publications and monthly Google Scholar searches until December 23rd 2021 to make sure all new pertinent published articles after February 2021 would be included. Thirty-five studies were included in this review including 14 RCTs. Most of the included studies were Level 4 (46%; 16/35) and Level 2 (40%; 14/35) evidence. Only four studies were classified as Level 3 (14%; 5/35) evidence and none were considered Level 1. Most studies received a score of 5-9 (54%; 19/35) (Moderate quality). Fourteen studies received a score of ≥ 10 (40%; 14/35) (High quality) and only 2 studies received a score of< 5 (6%; 2/35) (Low quality). Articles were categorized according to the primary outcome targeted by the intervention. Clinical recommendations on higher-level evidence interventions are presented. This review supports the clinical practice of the following interventions: 1) The use of adhesive compression wraps for patients who have increased edema to increase hand function and ROM; 2) The use of compression (adhesive compressive wrap, compression bandage or intermittent compression pump) to decrease hand edema following burn injury; 3) Participating in general rehabilitation to increase hand function and patient perceived level of disability; 4) The use of an orthosis to increase ROM and a dynamic MCP orthosis to increase hand function; 5) If available, incorporate the use of VR based rehabilitation to increase hand function and hand strength; 6) The use of paraffin to increase hand PROM; 7) The use of gels to reduce hand scar thickness; 8) The use of an education component in rehabilitation to increase the level of burn knowledge. The limitations of this study are also discussed. Further research with robust methodology is needed to investigate the potential benefits of treatment interventions included in this review., Competing Interests: Conflicts of interests The authors do not have any conflicts of interest to disclose., (Copyright © 2022 Elsevier Ltd and ISBI. All rights reserved.)

This Clinical Practice Guideline addresses early mobilization and rehabilitation (EMR) of critically ill adult burn patients in an intensive care unit (ICU) setting. We defined EMR as any systematic or protocolized intervention that could include muscle activation, active exercises in bed, active resistance exercises, active side-to-side turning, or mobilization to sitting at the bedside, standing, or walking, including mobilization using assistance with hoists or tilt tables, which was initiated within at least 14 days of injury, while the patient was still in an ICU setting. After developing relevant PICO (Population, Intervention, Comparator, Outcomes) questions, a comprehensive literature search was conducted with the help of a professional medical librarian. Available literature was reviewed and systematically evaluated. Recommendations were formulated through the consensus of a multidisciplinary committee, which included burn nurses, physicians, and rehabilitation therapists, based on the available scientific evidence. No recommendation could be formed on the use of EMR to reduce the duration of mechanical ventilation in the burn ICU, but we conditionally recommend the use of EMR to reduce ICU-acquired weakness in critically ill burn patients. No recommendation could be made regarding EMR's effects on the development of hospital-acquired pressure injuries or disruption or damage to the skin grafts and skin substitutes. We conditionally recommend the use of EMR to reduce delirium in critically ill burn patients in the ICU., (© American Burn Association 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Significance: The physical and psychological sequalae of burn injuries account for 10 million disability-adjusted life years lost annually. Hypertrophic scarring (HSc) after burn injury results in reduced mobility, contracture, pain, itching, and aesthetic changes for burn survivors. Despite the prevalence of scarring and the number of scar therapies available, none are highly effective at preventing HSc after burn injury. Recent Advances: Recent studies modulating the mechanical environment surrounding incisional and excisional wounds have shown off-loading of tension to be a powerful strategy to prevent scar formation. Preclinical studies applying force perpendicular to the surface of the skin or using a combination of pressure both circumferentially and perpendicularly have shown substantial reductions in scar thickness and contraction after burn injury. Critical Issues: Though pressure therapy is highly effective in preclinical studies, outcomes in clinical studies have been variable and may be a result of differing therapy protocols and garment material fatigue. A recent adult clinical study reported a significant reduction in pressure after 1 month of use and significant reduction between 1 and 2 months of use, resulting in below therapeutic doses of pressure applied after only 1 month of use. Future Directions: To enhance efficacy of pressure garments, new low-fatigue materials must be developed for use in standard garments or garments must be redesigned to allow for adjustment to compensate for the loss of pressure with time. Additionally, measurements of applied pressure should be performed routinely during clinic visits to ensure that therapeutic doses of pressure are being delivered.