Methods: This is a retrospective cohort study of all admissions to Hospital Sultan Ismail's BICU from January 2010 till October 2015. Admission criteria were in accordance with the American Burn Association guidelines, and risk factors of interest were recorded. Data was analyzed using simple logistic regression to determine significant predictors of mortality. Survival analysis with time to death event was performed using the Kaplan-Meier survival curve with log-rank test.
Results: Through the 6-year period, 393 patients were admitted with a male preponderance of 73.8%. The mean age and length of stay were 35.6 (±15.72) years and 15.3 (±18.91) days. There were 48 mortalities with an overall mortality rate of 12.2%. Significant risk factors identified on simple logistic regression were total body surface area (TBSA) > 20% (p 20%, presence of SIRS, mechanical ventilation and inhalation injury which were associated with poorer survival (p 20%, early SIRS, mechanical ventilation and inhalation injury which were associated with poorer survival outcome. The immunological response differs from individual patients and influenced by the severity of burn injury. Early SIRS on admission is an important predictor of death and may represent the severity of burn injury. Patients who required mechanical ventilation were associated with mortality and it is likely related to the severity of pulmonary insults sustained by individual patients. This data is important for outcome prognostication and mortality risk counselling in severely burned patients.
MATERIALS AND METHODS: We conducted fieldwork in 12 African and six Asian countries, collecting data on sleep sites, timing of sleep and predation during daytime. We obtained additional information from literature and through correspondence. Using a phylogenetic approach, we established ancestral states of sleep site selection in lorisiforms and traced their evolution.
RESULTS: The ancestral lorisiform was a fur-clinger and used dense tangles and branches/forks as sleep sites. Use of tree holes and nests as sleep sites emerged ∼22 Mya (range 17-26 Mya) in Africa, and use of bamboo emerged ∼11 (7-14) Mya in Asia and later in Africa. Fur clinging and some sleep sites (e.g., tree holes, nests, but not bamboo or dense tangles) show strong phylogenetic signal. Nests are used by Galagoides, Paragalago, Galago and Otolemur; tree holes by Galago, Paragalago, Sciurocheirus and Perodicticus; tangles by Nycticebus, Loris, Galagoides, Galago, Euoticus, Otolemur, Perodicticus and Arctocebus; all but Sciurocheirus and Otolemur additionally sleep on branches/forks. Daytime predation may affect sleep site selection and sleep patterns in some species of Nycticebus, Galago, Galagoides, Otolemur and Perodicticus. Most lorisiforms enter their sleep sites around sunrise and leave around sunset; several are active during twilight or, briefly, during daytime.
CONCLUSION: Variations in sleep behavior, sleep patterns and vulnerability to daytime predation provide a window into the variation that was present in sleep in early primates. Overall, lorisiforms use the daytime for sleeping and no species can be classified as cathemeral or polycyclic.
METHODS: Patients that were treated at the Hospital Sultan Ismail's Burns Intensive Care (BICU) unit for acute burn injuries between 1 January 2010 to 31 December 2017 were included. Risk factors to predict in-patient burn mortality were gender, age, mechanism of injury, total body surface area burn (TBSA), inhalational injury, mechanical ventilation, presence of tracheotomy, time from of burn injury to BICU admission and initial centre of first emergency treatment was administered. These variables were analysed using univariate and multivariate analysis for the outcomes of death. All patients were scored retrospectively using the five-burn mortality prognostic scores. Predictive ability for burn mortality was analysed using the area under receiver operating curve (AUROC).
RESULTS: A total of 525 patients (372 males and 153 females) with mean age of 34.5 ± 14.6 years were included. There were 463 survivors and 62 deaths (11.8% mortality rate). The outcome of the primary objective showed that amongst the burn mortality risk factors that remained after multivariate analysis were older age (p = 0.004), wider TBSA burn (p