Optimizing Medical Care during a Nerve Agent Mass Casualty Incident Using Computer Simulation.

Introduction: Chemical mass casualty incidents (MCIs) pose a substantial threat to public health and safety, with the capacity to overwhelm healthcare infrastructure and create societal disorder. Computer simulation systems are becoming an established mechanism to validate these plans due to their versatility, cost-effectiveness and lower susceptibility to ethical problems.

Methods: We created a computer simulation model of an urban subway sarin attack analogous to the 1995 Tokyo sarin incident.

Places for Healthy Play: A Multi-Pronged Evaluation of Context, Design, and Perceptions for Play Space Improvements.

Community design interventions have prioritized the creation of quality play space, especially in easy to access public places, to improve health outcomes and to reduce health inequities. Evaluations of health-relevant play interventions often fail to assess essential context, design, and perceptions. The Play Everywhere Philadelphia Challenge, led by KABOOM!, funded 16 play spaces to support child health and development and literacy skills for low-income neighborhoods across Philadelphia.

Which clip? A prospective comparative study of retention rates of endoscopic clips on normal mucosa and ulcers in a porcine model.

Background/aim: There are currently no data on the relative retention rates of the Instinct clip, Resolution clip, and QuickClip2Long. Also, it is unknown whether retention rate differs when clips are applied to ulcerated rather than normal mucosa. The aim of this study is to compare the retention rates of three commonly used endoscopic clips.

Extracorporeal fetal support: a new animal model with preservation of the placenta.

Background: Previous models of support for premature sheep fetuses have consisted of cesarean delivery followed by catheterization of umbilical or central vessels and support with extracorporeal membrane oxygenation (ECMO). The limitations of these models have been insufficient blood flow, significant fetal edema, and hemorrhage related to anticoagulation.

Methods: We performed a gravid hysterectomy on 13 ewes between 135 and 145days gestational age.

A modified heterotopic swine hind limb transplant model for translational vascularized composite allotransplantation (VCA) research.

Vascularized Composite Allotransplantation (VCA) such as hand and face transplants represent a viable treatment option for complex musculoskeletal trauma and devastating tissue loss. Despite favorable and highly encouraging early and intermediate functional outcomes, rejection of the highly immunogenic skin component of a VCA and potential adverse effects of chronic multi-drug immunosuppression continue to hamper widespread clinical application of VCA. Therefore, research in this novel field needs to focus on translational studies related to unique immunologic features of VCA and to develop novel immunomodulatory strategies for immunomodulation and tolerance induction following VCA without the need for long term immunosuppression.