REDCap is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: 1) a brief description of the REDCap metadata-driven software toolset; 2) detail concerning the capture and use of study-related metadata from scientific research teams; 3) measures of impact for REDCap; 4) details concerning a consortium network of domestic and international institutions collaborating on the project; and 5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.

Recent scientific studies evaluating laser energy for tissue welding and thermokeratoplasty have demonstrated that the application of laser energy at non-ablative levels can alter collagen's structural and biochemical properties. A recent pilot study has demonstrated that the non-ablative application of holmium: yttrium-aluminum-garnet (Ho:YAG) laser energy to the joint capsule of patients with glenohumeral instability shrank the joint capsule, stabilizing the shoulder in the majority of the patients treated. Based on the collective findings of these studies, we hypothesized that thermal modification of dense collagenous tissues such as joint capsule, ligament, and tendon can be achieved by applying non-ablative laser energy. The purpose of this study was to evaluate the effect of laser energy at non-ablative levels on joint capsular mechanical, biochemical, histological, and ultrastructural properties in an in vitro rabbit model. Joint capsular tissues harvested from rabbit femoropatellar joints were treated by one of three power settings (5 watts (SW), 10 watts (lOW), 15 watts (15W)) or served as control in a randomized block design. Laser energy was applied using a Ho:YAG laser in 4 transverse passes across the tissue at a velocity of 2 mm/sec with the handpiece set at 1 .5 mm from the synovial surface in a 3TC tissue bath. Forty-eight specimens (n=12) were mechanically tested to determine tissue shrinkage, stiffness and viscoelastic properties. Twenty-four specimens (n=6) were processed for biochemical analysis to evaluate type I collagen content and non-reducible crosslinks. Twenty-four specimens (n=6) were processed for histological examination and transmission electron microscopy for ultrastructural analysis.Laser treatment significantly shortened the tissue by 9% (SW), 26% (lOW), and 38% (15W). Joint capsular stiffness decreased significantly in the lOW (77% decrease) and 15W (90% decrease) groups. Laser energy application did not significantly alter the viscoelastic properties of the tissue and the biochemical parameters evaluated, including type I collagen content and non-reducible crosslinks. Histological analysis revealed thermal alteration of collagen (fusion) and fibroblasts (pyknosis), with each subsequently higher laser energy causing significantly greater morphologic change over a larger area. Transmission electron microscopy revealed alteration of collagen ultrastructure, with significantly increased fibril crosssections for each of the treated groups compared to control. The fibrils began to lose their distinct edges and their periodical cross-striations at subsequently higher energy densities. This study demonstrated that laser energy at non-ablative levels can significantly alter joint capsular length and its structural properties. Ultrastructurally, laser energy caused disruption of the regular collagen organization. The results of this study suggested that the effects of laser energy were secondary to thermal denaturation of collagen with heat stable crosslinks maintained. To further clarif...

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The purpose of this study is to describe interstitial fluid flow in axisymmetric soft connective tissue (ligaments or tendons) when they are loaded in tension. Soft hydrated tissue was modelled as a porous medium (using Darcy's Law), and the finite element method was used to solve the resulting equations governing fluid flow. A commercially available computer program (FiDAP) was used to create an axisymmetric model of a biomechanically tested rat ligament. The unknown variables at element nodes were pressure and velocity of the interstitial fluid (Newtonian and incompressible). The effect of variations in fluid viscosity and permeability of the solid matrix was parametrically explored. A transient loading state mimicking a rat ligament mechanical experiment was used in all simulations. The magnitude and distribution of pressure, stream lines, shear (stress) rate, vorticity and velocity showed regular patterns consistent with extension flow. Parametric changes of permeability and viscosity strongly affected fluid flow behaviour. When the radial permeability was 1000 times less than the axial permeability, shear rate and vorticity increased (approximately 5-fold). These effects (especially shear stress and pressure) suggested a strong interaction with the solid matrix. Computed levels of fluid flow suggested a possible load transduction mechanism for cells in the tissue.

This is the first systematic report of perceptual voice assessment in subglottic stenosis. SGS patients have notable degrees of dysphonia with identifiable risk factors.