Multiple introductions of the same pathogen into a country are be

Multiple introductions of the same pathogen into a country are being ignored because researchers know fast-evolving plant viruses can accumulate substantial sequence divergence over time, even from a single SB273005 manufacturer introduction. An increased use of phylogenetic methods in short-form publications could speed our understanding of these cryptic second introductions and aid in control of epidemics.”
“Introduction and objectives: Sprint Fidelis defibrillation leads are prone to early failure. Most of the reported series come from a single institution. This paper

describes the clinical experience in nine Spanish hospitals.

Methods: Clinical, implant, and follow-up data of all patients with a Sprint Fidelis lead were analyzed. All cases of lead failure were identified, medium-term lead survival was calculated, and possible predictors for lead failure were determined.

Results: In total, 378 leads in 376 patients were studied. The mean age (male 85.7%) was 64.9 +/- 13.6 years. The majority of patients (59.8%) had ischemic heart disease. Mean left ventricular ejection fraction was 33.4% +/- 14.5%. Left subclavian vein puncture was used in 74.8%. During a mean follow-up of 30.9 +/- 14 months, 16 lead failures have

occurred, with a lead survival of 96.1% at 36 months after implantation. Eleven of 16 lead failures were caused by failure of pace/sense conductors, 3 by defects in the high-voltage conductor, and 2 by defects in both types of conductors. A less depressed left ventricular ejection fraction was associated with an increased probability of lead failure (42.4% +/- 16% vs. 33% +/- 14.3%;

P=.011). Three hospitals presented a rate of lead failure higher than 10%; the rate was less than 5% in the remaining 6 hospitals.

Conclusions: In this multicenter series of 378 leads, the 3-year estimated survival was higher than that reported in prior series. Clinical presentation of lead failures was similar to that reported previously. Left ventricular ejection fraction and hospital of MK0683 implantation were variables associated to lead failure. (C) 2010 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S. L. All rights reserved.”
“Polymer blends typically are the most economical means to develop new resins for specific applications with the best cost/performance balance. In this paper, the mechanical properties, melting, glass transition, and crystallization behavoir of 80 phr polypropylene (PP) with varying weights of linear low density polyethylene (LLDPE) at 10, 20/20 wt % CaCO(3), 30, 40, and 50 phr were studied. A variety of physical properties such as tensile strength, impact strength, and flexural strength of these blends were evaluated.

The surface morphology, surface roughness of fissure cavities, an

The surface morphology, surface roughness of fissure cavities, and the degree of microleakage after laser treatment were compared with those after bristle brush treatment in vitro. Sixty extracted human teeth were used in this study. The teeth were

randomly divided into two groups of 30 each. Artificial fissures were prepared in all teeth into which artificial organic debris was placed. The debris in 30 teeth of one group was removed by means of Er:YAG laser system and the remaining 30 teeth were cleaned using a bristle brush with prophylaxis paste. Surface morphology and surface roughness of were analyzed in ten samples PCI-32765 ic50 from each group by color laser three-dimensional (3D) microscopy and by scanning electron microscopic examination. The remaining samples were then filled with sealant and subjected to a microleakage test

under thermocycling. Statistical analysis was performed using the Mann-Whitney U test; a value of p < 0.05 was considered significant. Morphologically, most of the debris was click here removed by Er:YAG laser treatment, whereas some fissures were not cleaned by bristle brush. However, microleakage test of both laser and etched brush methods showed similar results. Laser technique might facilitate good adaptation of resin sealant to enamel, because of an increase in surface roughness and favorable surface characteristics.”
“The incidence of pleural infection continues to rise worldwide. Identifying the causative organism(s) is important to guide antimicrobial therapy. The bacteriology of pleural infection is complex and has changed over time. Recent data suggest that the bacterial causes of empyema are significantly different between adult and paediatric patients, between community-acquired and nosocomial empyemas and can vary among geographical regions of the world. Since the introduction of pneumococcal vaccines, a change has been observed in the distribution of the Cyclopamine cost serotypes of Streptococcus pneumoniae in empyema. These observations have implications on therapy and vaccine strategies. Clinicians need to

be aware of the local bacteriology of empyema in order to guide antibiotic treatment.”
“The use of prosthetic material to prevent incisional hernia in clean-contaminated procedures as bariatric surgery remains controversial. We present our experience on 45 consecutive morbidly obese patients undergoing biliopancreatic diversion that was closed using a polypropylene mesh. Moreover, we reviewed the outcome of the 50 previous consecutive obese patients who underwent biliopancreatic diversion and conventional closure of the abdomen in order to compare the outcome between the two groups after a minimum follow-up of 2 years. Between January 2006 and February 2010, 95 morbidly obese patients underwent open biliopancreatic diversion at our department.

Malaria prevention for children should be a responsibility of hea

Malaria prevention for children should be a responsibility of healthcare providers and should be subsidized for low-income travelers to high-risk areas.”
“Background: Many malaria-related studies depend on infected red blood cells (iRBCs) as fundamental material; however, infected blood samples from human or animal models include leukocytes (white blood cells or WBCs), especially difficult to separate from iRBCs in cases involving Plasmodium vivax. These host WBCs are a source of contamination in biology, check details immunology and molecular biology studies, requiring their removal. Non woven fabric

(NWF) has the ability to adsorb leukocytes and is already used as filtration material to deplete WBCs for blood transfusion and surgery. The present study describes the development and evaluation of a prototype NWF filter designed

for purifying iRBCs from malaria-infected blood.

Methods: Blood samples of P. vivax patients were processed separately by NWF filter and CF11 column methods. WBCs and RBCs were counted, parasite Autophagy signaling inhibitors density, morphology and developing stage was checked by microscopy, and compared before and after treatment. The viability of filtrated P. vivax parasites was examined by in vitro short-term cultivation.

Results: A total of 15 P. vivax-infected blood samples were treated by both NWF filter and CF11 methods. The WBC removal rate of the NWF filter method was 99.03%, significantly higher than the CF11 methods (98.41%, P < 0.01). The RBC recovery rate of the NWF filter method was 95.48%, also significantly higher than the CF11 method (87.05%, P < 0.01). Fourteen in vitro short-term culture

results showed that after filter treatment, P. vivax parasite could develop as normal as CF11 method, and no obvious density, developing stage difference were fund between two methods.

Conclusions: NWF filter filtration removed most leukocytes from malaria-infected blood, and the recovery rate of RBCs was higher than with CF11 PFTα manufacturer column method. Filtrated P. vivax parasites were morphologically normal, viable, and suitable for short-term in vitro culture. NWF filter filtration is simple, fast and robust, and is ideal for purification of malaria-infected blood.”
“Background: Epidermal hyperinnervation in atopic dermatitis (AD) is activated directly by various external stimuli, causing enhanced itching. Nerve density is regulated by the nerve repulsion factor semaphorin 3A (Sema3A), along with nerve elongation factors.

Objective: To investigate the effects of Sema3A ointment in the NC/Nga mouse model of AD.

Methods: An AD-like phenotype was induced by repeated application of Dermatophagoides farinae body (Dfb) ointment to the dorsal skin of NC/Nga mice. Vaseline, heparinoid, betamethasone, tacrolimus and recombinant Sema3A ointments were applied to the lesional skin once a day for 4 days. Transepidermal water loss (TEWL) was measured before and after each treatment.

“Background: Recent advances in the treatment of cancer ha

“Background: Recent advances in the treatment of cancer have focused on targeting genomic aberrations with selective therapeutic agents. In rare tumors, where large-scale

clinical trials are daunting, this targeted genomic approach offers a PXD101 new perspective and hope for improved treatments. Cancers of the ampulla of Vater are rare tumors that comprise only about 0.2% of gastrointestinal cancers. Consequently, they are often treated as either distal common bile duct or pancreatic cancers.

Methods: We analyzed DNA from a resected cancer of the ampulla of Vater and whole blood DNA from a 63 year-old man who underwent a pancreaticoduodenectomy by whole genome sequencing, achieving 37x and 40x coverage, respectively. We determined somatic mutations and structural alterations.

Results: We identified relevant aberrations, including deleterious mutations of KRAS and SMAD4 as well as a homozygous focal deletion of the PTEN tumor suppressor gene. These findings suggest that these tumors have a distinct oncogenesis from either common bile duct cancer or pancreatic cancer. Furthermore, this combination of genomic aberrations suggests a therapeutic context

for dual mTOR/PI3K inhibition.

Conclusions: Whole genome sequencing can elucidate an oncogenic context and expose potential therapeutic vulnerabilities in rare cancers.”
“Crambe is an important biofuel crop and its oil has unique traits such as high erucic acid content which can be used as industrial lubricant, corrosion inhibitor

drug discovery as well as ingredient in synthetic rubber manufacturing. Genetic diversity among 70 progenies of Crambe abyssinica Hochst selected from a population of FMS Brilhante cultivar was quantified by multivariate analysis for traits related to germination, thousand grain weight and oil content. There were significant differences among progenies for all traits studied. Estimation of genetic variance and heritability coefficients showed that the variability found in the find protocol progeny is more genetic than environmental which enables genetic gains with selection. Heritability coefficient varied from 68 to 79%, except for oil content and number of dead seedlings. Simple correlation analysis showed that germination and vigor were positively correlated, and thousand grain weight and oil content were not correlated with any of the seed traits. Based on multivariate analysis, the progenies could be grouped into 26 clusters. Clusters 1,2 and 3 had the highest number of progeny with 7, 8 and 6 lineages, respectively. Clusters 21-26 had higher dissimilarity within the cluster with one in each progeny. The trait that most contributed to the cluster was the germination (36.2%) and less contributed was the number of seedlings killed (1.1%). The progenies indicate genetic diversity for seed traits and the selection of superior progenies is possible considering the studied traits. (C) 2013 Published by Elsevier B.V.

We measured the migration directedness and speed of different lun

We measured the migration directedness and speed of different lung cancer cell lines, CL1-0, CL1-5, and A549, and compared with those examined in 2D gelatin-coated and bare substrates. The migration direction is the same for all conditions but there are clear differences in cell AZD6094 in vitro morphology, directedness, and migration speed under EF. Our results demonstrate cell migration under EF is different in 2D and 3D environments and possibly due to different cell morphology and/or substrate stiffness. (C) 2012 American Institute

of Physics. [doi:10.1063/1.3671399]“
“The anhedonia-like behaviors following about 1-week withdrawal from morphine were examined in the present study. Male rats were pretreated with either a binge-like morphine paradigm or daily saline injection for 5 days. Three types of natural reward were used, food reward (2.5, 4, 15, 30, 40, and 60% sucrose solutions), social reward (male rat) and sexual reward (estrous female

rat). For each type of natural stimulus, consummatory behavior and motivational behaviors under varied testing conditions were investigated. The results showed that the morphine-treated rats significantly reduced their consumption of 2.5% sucrose solution during the 1-h consumption testing and their operant responding for 15, 30, and 40% sucrose solutions under a fixed ratio 1 (FR1) schedule. However, performance click here under a progressive ratio (PR) schedule increased in morphine-treated rats reinforced with 60% sucrose solution, but not in those reinforced with sucrose concentrations lower than 60%. Pretreatment PXD101 with morphine significantly decreased the male rats’ ejaculation frequency (EF) during the 1-h copulation testing, and impaired the maintenance of appetitive motivations to sexual and social stimuli under a free-approach condition. Moreover, the morphine-treated rats demonstrated a diminished motivation to approach social stimulus in the

effort-based appetitive behavior test but showed a remarkable increase in motivation to approach sexual stimulus in the risky appetitive behavior test. These results demonstrated some complex motivated behaviors following about 1 week of morphine withdrawal: (1) The anhedonia-like behavior was consistently found in animals withdrawn from morphine. However, for a given reward, there was often a dissociation of the consummatory behaviors from the motivational behaviors, and whether the consummatory or the motivational anhedonia-like behaviors could be discovered heavily depended on the type and magnitude of the reward and the type of testing task; (2) These anhedonia-like behaviors coexisted with a craving for the high-incentive reward which was evidenced by the increased PR performance for the 60% sucrose solution and the heightened risky appetitive behavior for the sexual stimulus.

The higher salt tolerance of Jerba plants was associated with low

The higher salt tolerance of Jerba plants was associated with low levels of malondialdehyde and of electrolyte leakage mainly at 600 mM NaCl. Besides, antioxidant activities of Jerba provenance, were more efficient than Bizerte. In addition, avicularin was the major phenolic

in both provenances. This compound concentration increased with salinity in Jerba shoots, while it was reduced in Bizerte especially at 600 mM NaCl. Overall, the higher salt tolerance of plants from Jerba provenance, and to a lower extent of those from Bizerte, may be partly related to their better capacity to limit oxidative damage when salt-challenged, and this is likely the result of redistribution in phenolic composition. Besides, abiotic factors such BMN 673 in vitro as salinity could be determinant

in antioxidant potentiality of this medicinal plant. (C) 2011 Elsevier Masson SAS. All rights reserved.”
“Highly efficient raw starch digesting alpha-amylase was produced after 24 h of batch fermentation of Bacillus licheniformis Navitoclax mw ATCC 9945a in laboratory bioreactor at 37 degrees C. The enzyme was purified by gel filtration chromatographies with 6-fold increase of specific activity and 38% recovery and showed a molecular mass of 31 kDa by SDS-PAGE. The purified enzyme had an optimum pH of 6.5 and optimum temperature of 90 degrees C. The purified alpha-amylase in the presence of CaCl(2) retained 55% of its activity after 6 h of incubation at 70 degrees C. Co(2+), Ni(2+) and Ca(2+) slightly stimulated, while Hg(2+) completely inhibited alpha-amylase activity. Hydrolysis rates of raw triticale, wheat, potato, horseradish and corn starches, at 1% concentration were 63, 60, 59, 52 and 37%, respectively, in a period of 4 h. The properties of the purified enzyme proved its high efficacy for digesting diverse raw starches below gelatinization temperature and, hence, its potential commercial value to use as an industrial enzyme. (C) 2010 Elsevier B.V.

All rights reserved.”
“Primary lymphoma of bone (PLB) is an extremely rare condition that is usually confused with other primary injuries of the bone. It is characterized by the involvement of one or more bone locations, with or without involvement of regional lymph Evofosfamide order nodes and viscera. PLB constitutes 3-7 of all malignant bone tumors and approximately 3 of all extranodal lymphomas. It is found at all ages, being most frequently seen in adult life. Any part of the skeleton can be involved, but a trend exists in favor of bones with persistent bone marrow. We report a case of PLB with an unusual presentation: involvement of the proximal phalanx of the thumb. Treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus etoposide established complete remission. Consolidation with radiotherapy of the femur and phalanx was performed. There was no evidence of recurrence at the 14 (th) month follow-up.

PLL-affected dogs from some breeds (most notably the Shar pei and

PLL-affected dogs from some breeds (most notably the Shar pei and the Brittany spaniel) did not carry the G1473+1A ADAMTS17 mutation, indicating they must suffer from a genetically distinct form of the condition. We also estimated the frequency of this ADAMTS17 mutation in some of the breeds. Our findings indicate the mutation segregates in a large INCB018424 solubility dmso number of different breeds

of dog, many of which are terriers or breeds with terrier co-ancestry, but some of which have more diverse origins. Our results also indicate that the mutation is present at high frequency within most of the breeds in which it segregates. In the miniature bull terrier breed estimates of mutation frequency ranged from 0.27 to 0.39, corresponding to 7.3-15.2% PLL-affected dogs in this breed. We also identified an increased risk

of PLL associated with heterozygosity at ADAMTS17, suggesting that carriers carry a low risk of developing PLL.”
“The present study examine the in vivo effects of Dorstenia Picta (D. picta) on urinary volume and sodium excretion in streptozotocin-induced diabetic rats, and determine a possible mechanism by which the extract increased sodium transport in A6 cells monolayers. Administration of the plant extract at the dose of 150 mg/kg during two weeks decreased urinary volume and sodium excretion. In CT99021 ic50 vitro study showed that, apical application of the plant extract at the dose of 100 mu g/mL does not significantly increase sodium transport, whereas basolateral administration provoked a significant (P<0.05) increase of sodium transport in a concentration-dependent manner. The plant extract increases the sodium transport by 69.93% versus 55.41% for insulin and 78.44% for adenosine after 30 min. Preincubation of A6 cells monolayers with inhibitor of all adenosine receptors completely suppressed adenosine and plant extract stimulated sodium transport. Interesting is that, the A(1) inhibitor receptor (DPCPX), at 100 nM completely abolished the effect of plant extract. The plant extract increased sodium transport by increase

PI3-kinase activity and this effect is strongly inhibited by LY-294002. These data also suggest that, the twigs methanol fraction from Dorstenia picta increase sodium transport via PI 3-kinase pathway and Adavosertib requires A(1) adenosine receptor.”
“Background: Clinical practice guidelines have been defined as systematically developed statements to assist practitioner and patient decision-making about appropriate health care for specific clinical circumstances. They play an important role in guiding evidence based clinical practice. The Australian National Health and Medical Research Council has developed and pilot-tested a new framework for guideline development, the FORM approach, the role of which has yet to be further defined.

Results: There were no significant differences in mean ENO levels

Results: There were no significant differences in mean ENO levels before and after SPM or before and after SPM plus 2 puffs of inhaled salbutamol in adults or children (asthmatic or healthy). Conclusions: Levels of ENO are not significantly affected by SPM or salbutamol inhalation. Copyright (C) 2011 S. Karger AG, Basel”
“Noncompaction click here of the

ventricular myocardium is a rare cardiomyopathy characterized by a pattern of prominent trabecular meshwork and deep intertrabecular recesses. The prevalence of left ventricular noncompaction is 0.01% in adults and 0.14% in pediatric patients. Although the usual site of involvement is the left ventricle, the right ventricle and septum can be affected as well. Previously, right ventricular

noncompaction has been described only in a few cases of newborns with congenital heart defects and in adult patients. This report presents a newborn with isolated right ventricular noncompaction. To the authors’ knowledge, this is the first newborn patient with isolated right ventricular noncompaction but no congenital heart defect involving only the right ventricle.”
“Objective: Parents of children Selleckchem Cyclopamine with cancer must cope with multiple challenges over time. As most research on parental coping has been conducted in Western countries, little information is available on the parental experience of coping in non-Western countries. Using a new cultural sample of Korean mothers, this study describes their coping strategies. In addition, the association of particular coping patterns with mothers’ report of psychosocial adjustment is investigated.

Methods: A total of 200 Korean mothers of children with cancer participated in the study. Coping strategies were measured by the learn more Coping Health Inventory for Parents in the following three categories: Maintaining Family Integration and an Optimistic Outlook for the Situation, Seeking Social Support, and Seeking Information. Maternal psychosocial adjustment was measured by psychological distress, family relationship, and social relationship subscales from the Psychosocial

Adjustment to Illness Scale.

Results: Korean mothers reported coping strategies related to Maintaining Family Integration and an Optimistic Outlook for the Situation as being most helpful. More frequent use of coping pattern, Maintaining Family Integration and an Optimistic Outlook for the Situation, and less frequent use of coping pattern, Information-Seeking were significantly associated with lower psychological distress and better family relationship after children’s medical and maternal characteristics were controlled for. Coping pattern, Seeking Social Support was only predictive of social relationships.

Conclusions: This study suggests that culture may play a significant role in the report of coping among Korean m others. Future studies should consider culturally preferred coping methods and available resources as they relate to different adjustment outcomes.

Combined magnetic and physical characterizations suggest that the

Combined magnetic and physical characterizations suggest that the dead

layer thickness saturates at the initial stage of the plasma etching and magnetic property remained unchanged with increasing etching duration upon formation of the dead layer. (C) 2010 American Institute of Physics. [doi:10.1063/1.3356231]“
“Background: Influenza causes a great disease burden on children especially in the outpatient setting. The signs and symptoms of influenza in unselected children learn more treated as outpatients have not been previously published.

Methods: We assessed the clinical presentation of influenza in a prospective study of respiratory infections in preenrolled cohorts of children <= 13 years of age during 2 consecutive respiratory seasons

(2231 child-seasons of follow-up). We examined the children and obtained a nasal swab for the detection of influenza during every episode of illness, regardless of the presence or absence of fever or the severity of the symptoms.

Results: Influenza was virologically confirmed in 372 children, of whom 353 (95%) providing Buparlisib molecular weight complete data on the signs and symptoms were included in the analyses. A total of 95% of these children were febrile, and 50% had fever >= 39.0 degrees C. Among children <3 years of age, 20% had fever >= 40.0 degrees C. Seventy-seven percent of the children had cough and 78% had rhinitis. In children CAL-101 manufacturer 7 to 13 years of age, only 39% had headache and 13% had myalgia.

Conclusions: High fever is a prominent sign of influenza in children, and the clinical presentation of influenza is most severe in children <3 years of age. Headache and myalgia are not typical features of influenza in outpatient

children. Most children with influenza have rhinitis during the early phase of the illness, which makes the clinical diagnosis of influenza difficult especially in the youngest children.”
“P>Paracetamol overdose (POD) is a major cause of acute liver failure (ALF) requiring liver transplantation in the United Kingdom. To characterize the early and late outcome after orthotopic liver transplantation (OLT) for POD in the Scottish Liver Transplant Unit over a 14-year period (1992-2006). Data were obtained from a prospective database combined with case-note review. Of 127 liver transplants performed for ALF, 44 were for POD. The median age was 30 (range 18-51). In 18 patients (63.7%), POD was associated with alcohol/other drugs, nine (20.5%) had a staggered overdose and four patients (9.1%) accidentally overdosed. Nineteen patients (43.2%) had a history of previous overdose/psychiatric illness. Post-transplant mortality during the index admission was 30% (13 patients), whilst five patients died during follow-up. The actuarial 5-year patient survival was 54.

cinerea (3,500 U/L) surpassed the enzyme production by free T ve

cinerea (3,500 U/L) surpassed the enzyme production by free T. versicolor (800 U/L). When the

conditions that gave the best laccase production to each fungus were employed in a stirred tank bioreactor, very low laccase production was observed for both the cases, suggesting that shear stress and mycelia damage caused by the agitation impellers negatively affected the enzyme production.”
“Backgroud: Bone marrow derived cells (BMDC) and mesenchymal stem cells (MSC) are necessary for healing of injured tissues. Intravenous granulocyte-colony stimulating factor (G-CSF) is known to induce mobilization of BMDC to peripheral blood and the tissue levels of the stromal ABT-737 cell derived factor-1 (SDF-1) to be key in their homing to sites of injury. We hypothesized that injection of SDF-1 to the site of injury and/or systemic administration of G-CSF increases homing of BMDC and improves healing of traumatic injury. We also postulated that increased homing of MSC alone to sites of injury would also improve tissue healing.

Methods: Male Sprague-Dawley rats were subjected to unilateral lung contusion (LC) and assigned to the following groups: LC + injection of SDF-1 (LC 3-MA mouse + SDF-1) in the contused lung, pretreatment with systemic G-CSF for 5 days followed by either LC alone (LC + G-CSF) or by LC + injection of SDF-1 (LC + SDF-1/G-CSF). Rats in the MSC group were subjected to LC followed

by systemic injection of MSC (LC + MSC). Unmanipulated controls and LC + local injection of saline (LC + saline) served as controls. Lung

injury was assessed on days 1 and 5 postinjury using a histologic Lapatinib Lung Injury Score. BMDC and MSC homing were assessed on day 1 by hematopoietic progenitor cell (CFU-GEMM, BFU-E, and CFU-E) colony growth and immunofluorescence tracking of tagged MSC in the injured lung, respectively.

Results: Both LC + SDF-1 and LC + G-CSF had increased hematopoietic progenitor cell colony growth in the injured lung, and their combination (LC + SDF-1/G-CSF) was additive when compared with LC + saline (18 +/- 3, 24 +/- 3, 32 +/- 3; 21 +/- 3, 36 +/- 10, 36 +/- 3; 31 +/- 4, 44 +/- 10, 53 +/- 5 vs. 6 +/- 2, 11 +/- 3, 17 +/- 4; * p < 0.05). Tagged MSC were tracked predominantly in the contused lung versus the non-contused lung (7 +/- 3 vs. 3 +/- 2, N degrees MSC/HPF; * p < 0.05). Lung Injury Score on day 5 after injury was significantly lower in the LC + SDF-1, LC + G-CSF, LC + SDF-1/G-CSF and LC + MSC groups versus LC + saline (1 +/- 0.6, 0.7 +/- 0.5, 1 +/- 0.9, 1.1 +/- 0.9 vs. 3.1 +/- 0.8; * p < 0.05).

Conclusion: Local SDF-1 and/or systemic G-CSF can effectively increase BMDC homing to sites of traumatic injury in an additive way and improve wound healing. This process appears to be mediated predominantly through MSC. Additional investigations are needed to identify the optimal adjuncts to improve wound healing following severe traumatic injury.