Dealing with heterogeneous populations in randomized wound trials: challenges and potential solutions.

Chronic wounds have a great variety of etiologies and manifestations that influence wound healing. Such heterogeneity potentially threatens the validity and clinical usefulness of trials if not considered appropriately. In 82 randomized wound trials retrieved from 10 Cochrane reviews, we assessed if and how authors considered wound and other prognostically important characteristics in the conduct and analysis of wound trials.

Post-surgical scalp wounds with exposed bone treated with a plant-derived wound therapeutic.

Objective: To evaluate the efficacy of a plant-derived wound dressing, a mixture of hypericum oil (Hypericum perforatum) and neem oil (Azadirachta indica), in scalp wounds with exposed bone.

Method: A retrospective review was conducted of all patients presenting with scalp wounds with exposed bone following the excision of skin tumours and treated with a plant-derived wound dressings (1 Primary Wound Dressing; Phytoceuticals AG), from January to July 2011. Time to healing, wound size, area of exposed bone, ease of handling, pain and complications were evaluated.

Adult emergency department patients with sickle cell pain crisis: results from a quality improvement learning collaborative model to improve analgesic management.

Objectives: The aims of this study were to 1) estimate differences in pain management process and patient-reported outcomes, pre- and postimplementation of analgesic protocols for adults with sickle cell disease (SCD), and 2) examine the effects of site and visit frequency on changes in pain scores and time to analgesic.

Methods: A multicenter, prospective, longitudinal study enrolled patients from three academic medical centers between October 2007 and September 2009. All ED patients 18 years or older with a chief complaint of a sickle cell pain episode were enrolled.

Quantitative immunoproteomics analysis reveals novel MHC class I presented peptides in cisplatin-resistant ovarian cancer cells.

Platinum-based chemotherapy is widely used to treat various cancers including ovarian cancer. However, the mortality rate for patients with ovarian cancer is extremely high, largely due to chemo-resistant progression in patients who respond initially to platinum based chemotherapy. Immunotherapy strategies, including antigen specific vaccines, are being tested to treat drug resistant ovarian cancer with variable results.

"Stayin' alive": a novel mental metronome to maintain compression rates in simulated cardiac arrests.

Background: A novel and yet untested memory aid has anecdotally been proposed for aiding practitioners in complying with American Heart Association (AHA) cardiopulmonary resuscitation (CPR) compression rate guidelines (at least 100 compressions per minute).

Objectives: This study investigates how subjects using this memory aid adhered to current CPR guidelines in the short and long term.

Methods: A prospective observational study was conducted with medical providers certified in 2005 AHA guideline CPR.

Spin crossover transition of Fe(phen)2(NCS)2: periodic dispersion-corrected density-functional study.

Periodic dispersion corrected DFT calculations have been performed to study the spin-crossover transition of Fe(phen)(2)(NCS)(2) in the molecular and in the crystalline state. We show that London dispersion interactions play a crucial role in the cohesion of the crystals. Based on calculations of vibrational eigenstates of the isolated molecule and of the crystalline phase in both the low- and high-spin states, the transition entropies and enthalpies have been calculated.

Sclerotherapy of lymphatic cysts of the leg with OK-432.

Lymphatic cysts can either represent lymphatic malformations (LMs) or may occur after trauma or operation. Independent of their etiology lymphatic cysts can cause functional impairment and recurrent skin infections. We report the successful use of OK-432 injected transcutanously to treat lymphatic macrocysts.

Pt on graphene monolayers supported on a Ni(111) substrate: relativistic density-functional calculations.

The structural, energetic, and magnetic properties of Pt atoms and dimers adsorbed on a Ni-supported graphene layer have been investigated using density-functional calculations, including the influence of dispersion forces and of spin-orbit coupling. Dispersion forces are found to be essential to stabilize a chemisorbed graphene layer on the Ni(111) surface. The presence of the Ni-substrate leads not only to a stronger interaction of Pt atoms and dimers with graphene but also to a locally increased binding between graphene and the substrate and a complex reconstruction of the adlayer.

Structure and properties of metal-exchanged zeolites studied using gradient-corrected and hybrid functionals. III. Energetics and vibrational spectroscopy of adsorbates.

The influence of the exchange-correlation functional (semilocal gradient corrected or hybrid functional) on density-functional studies of the adsorption of CO and NO in Cu- and Co-exchanged chabazite has been investigated, extending the studies of the structural and electronic properties of these materials [F. Göltl and J. Hafner, J.

Structure and properties of metal-exchanged zeolites studied using gradient-corrected and hybrid functionals. II. Electronic structure and photoluminescence spectra.

The influence of the choice of the exchange-correlation functional (semilocal gradient corrected or hybrid functionals) on the electronic properties of metal-exchanged zeolites has been investigated for Cu- and Co-exchanged chabazite. The admixture of exact exchange in hybrid functionals increases the fundamental gap of purely siliceous chabazite, leading to better agreement with experiment and many-body perturbation theory for close-packed SiO(2) polymorphs where detailed experimental information is available. For the metal-exchanged chabazite the increased exchange splitting strongly influences the position of the cation states relative to the framework bands-in general, gradient-corrected functionals locate the occupied cation states close to the valence-band maximum of the framework, while hybrid functionals shift the occupied cation states to larger binding energies and the empty states to higher energies within the fundamental gap.

Structure and properties of metal-exchanged zeolites studied using gradient-corrected and hybrid functionals. I. Structure and energetics.

The structural and energetic properties of purely siliceous, proton-, and Cu- and Co-exchanged chabazite have been studied using periodic density-functional (DFT) calculations with both conventional gradient-corrected exchange-correlation functionals and hybrid functionals mixing exact (i.e., Hartree-Fock) and DFT exchange.

Conserved MHC class I-presented dengue virus epitopes identified by immunoproteomics analysis are targets for cross-serotype reactive T-cell response.

Dengue fever and dengue hemorrhagic fever are significant global public health problems, and understanding the overall immune response to infection will contribute to appropriate management of the disease and its potentially severe complications. Live attenuated and subunit vaccine candidates, which are under clinical evaluation, induce primarily an antibody response to the virus and minimal cross-reactive T-cell responses. Currently, there are no available tools to assess protective T-cell responses during infection or after vaccination.

Definition and measurement of rider-intrinsic physical attributes influencing all-terrain vehicle safety.

Object: All-terrain vehicle (ATV) usage has grown tremendously over the years, reaching 9.5 million vehicles in use in 2007. Accompanying this growth has been a concomitant increase in rider morbidity (including traumatic brain and spine injuries) and death, especially in children.

Outcome measures for emergency medicine residency graduates: do measures of academic and clinical performance during residency training correlate with American Board of Emergency Medicine test performance?

Objectives: Emergency medicine (EM) residency programs are increasingly asked to have measurable outcomes of residents' performance. Successful completion of the written and oral American Board of Emergency Medicine (ABEM) examinations is one key outcome. In the clinical practice of EM, emergency physicians (EPs) are often measured by their clinical productivity (patients per hour).

All-atom modeling of anisotropic atomic fluctuations in protein crystal structures.

The accurate modeling of protein dynamics in crystalline states is essential for the development of computational techniques for simulating protein dynamics under physiological conditions. Following a previous coarse-grained modeling study of atomic fluctuations in protein crystal structures, we have refined our modeling with all-atom representation and force field. We have calculated the anisotropic atomic fluctuations of a protein structure interacting with its crystalline environment either explicitly (by including neighboring proteins into modeling) or implicitly (by adding harmonic restraints to surface atoms involved in crystal contacts).

A tunable plasmon resonance in gold nanobelts.

Plasmonic nanowires with sub-100-nm rectangular cross sections were found to exhibit a strong transverse plasmon peak at visible wavelengths. By correlating atomic force microscopy measurements of individual nanobelts with their dark-field scattering spectra, it is seen that the transverse peak tunes with cross-sectional aspect ratio. Simulations revealed that the scattering plasmonic modes are transverse antisymmetric excitations across the nanobelt width.

Structural transition in the surfactant layer that surrounds gold nanorods as observed by analytical surface-enhanced Raman spectroscopy.

Surface-enhanced Raman spectroscopy (SERS) of gold nanorods in cetyltrimethylammonium bromide solution has been used to analyze the interfacial surfactant structure based on the distance-dependent electromagnetic enhancement. The spectra were consistent with a surfactant bilayer oriented normal to the surface. As the surfactant concentration was reduced, a structural transition in the surfactant layer was observed through a sudden increase in the signal from the alkane chains.

Development of recombinant Aleuria aurantia lectins with altered binding specificities to fucosylated glycans.

Changes in glycosylation have long been associated with disease. While there are many methods to detect changes in glycosylation, plant derived lectins are often used to determine changes on specific proteins or molecules of interest. One change in glycosylation that has been observed by us and by others is a disease or antigen associated increase in fucosylation on N-linked glycans.

Mammalian target of rapamycin (mTOR) inhibitors slow skin carcinogenesis, but impair wound healing.

Background: Recent studies suggest that patients on mammalian target of rapamycin (mTOR) inhibitors experience a reduction in cutaneous carcinogenesis by an estimated 50% or more compared with calcineurin inhibitors. While randomized trials are running, organ transplant recipients are frequently switched from calcineurin inhibitors to mTOR inhibitors when cutaneous carcinogenesis increases.

Objectives: To slow carcinogenesis in our patient, a heart transplant recipient with a neuropathic diabetic foot syndrome who had developed cutaneous carcinogenesis at a rate of more than 20 squamous cell carcinomas (SCC) annually.

Methylaminolaevulinic acid photodynamic therapy in the treatment of erythroplasia of Queyrat.

Background: Erythroplasia of Queyrat (EQ) is an intra-epithelial carcinoma of the penis. Progression to invasive carcinoma may occur. Its cause is unknown but some evidence suggests infection with human papillomavirus in the pathogenesis of EQ; however, recent data do not confirm this.

The perceived impact of public reporting hospital performance data: interviews with hospital staff.

Objective: To assess perceptions about the value and impact of publicly reporting hospital performance measure data.

Design: Qualitative research.

Setting And Participants: Administrators, physicians, nurses and other front-line staff from 29 randomly selected Joint Commission-accredited hospitals reporting core performance measure data.