Long-Term Functional Outcomes in Military Service Members and Veterans After Traumatic Brain Injury/Polytrauma Inpatient Rehabilitation.

OBJECTIVE: To determine the effect of the established polytrauma/traumatic brain injury (TBI) infrastructure on immediate posttreatment functional gains, the long-term sustainability of any gains, and participation-related community reintegration outcomes in a baseline cohort of patients 8 years postadmission. DESIGN: Retrospective review and prospective repeated measures of an inception cohort. SETTING: Polytrauma rehabilitation center (PRC). PARTICIPANTS: Patients consecutively admitted to the PRC inpatient rehabilitation unit during its first full fiscal year, 2006 (N=44). INTERVENTIONS: The PRC infrastructure and formalized rehabilitation for polytrauma/TBI. MAIN OUTCOME MEASURES: FIM scores at admission, discharge, 3 months, and 8 years postdischarge; participation-related socioeconomic factors reflecting community reintegration 8 years after admission. RESULTS: Functional gains were statistically significantly increased from admission to discharge. Improvements were maintained at both 3 months postdischarge and 8 years postdischarge. The socioeconomic data collected at 8-year follow-up showed >50% either competitively employed or continuing their education and 100% living in a noninstitutionalized setting. CONCLUSIONS: This study addresses a concern regarding the long-term functional outcomes of rehabilitation patients treated by the established infrastructure of the Polytrauma System of Care inpatient rehabilitation centers. The results suggest that polytrauma/TBI rehabilitation care using a comprehensive, integrated approach is effective and durable in achieving functional gains and successful community reintegration within our initial PRC cohort. Follow-up of subsequent fiscal year cohorts would add to the validity of these outcome findings.

Proton affinities of deoxyribonucleosides via the ONIOM-ccCA methodology.

Utilizing the recently developed ONIOM-ccCA methodology, the proton affinities (PAs) of small biomolecules (∼15 nonhydrogen atoms) were determined. The ONIOM-ccCA method was used to predict the PAs of eight amine-containing molecules and these predictions were then compared with experiment. In these comparisons, a protocol for the determination of the model system size was established, and the low level method and basis set for the real system component of ONIOM-ccCA were considered. Several possible density functionals were investigated for description of the real system (low layer), including B3LYP, B97-1, B97-2, B98, BMK, M06, and M06-2X. The resulting proton affinities were compared both to experiment and to theoretical values that were calculated using the correlation consistent Composite Approach (ccCA). The impact of the choice of augmented correlation consistent basis sets in the ONIOM-ccCA low level calculation was also examined, and PAs calculated with augmented and non-augmented basis sets were compared to those extrapolated to the complete basis set (CBS) limit. ONIOM(ccCA:B3LYP/aug-cc-pVDZ) was then applied to deoxyribonucleosides to determine the PAs at possible sites of protonation.

A QM/QM multilayer composite methodology: The ONIOM correlation consistent composite approach (ONIOM-ccCA).

A QM/QM approach incorporating the correlation consistent composite approach (ccCA) into the ONIOM multilayer methodology has been implemented. This new multilayer composite scheme, ONIOM-ccCA, enables the accurate prediction of thermochemical properties for systems containing dozens-and potentially hundreds-of atoms. ONIOM-ccCA is used to predict the C-H bond dissociation energies of 18 anthracene and fluorene analogues, containing up to 43 atoms, to within 1.2 kcal mol(-1) of experimental values. Several density functional and basis set combinations are evaluated for use as the low level QM layer. The mean absolute deviation (1.2 kcal mol(-1)) using the most accurate ONIOM-ccCA method, ccCA:B3LYP/cc-pVTZ, is significantly lower than that of an earlier reported multilayer composite scheme [2.4 kcal mol(-1), Li, M.-J.; Liu, L.; Fu, Y.; Guo, Q.-X. J. Phys. Chem. B, 2005, 109, 13818]. Thus, through use of ONIOM-ccCA, accurate thermochemical calculations are now feasible for sizable molecular systems of chemical or biological interest.

Performance of density functional theory for 3d transition metal-containing complexes: utilization of the correlation consistent basis sets.

The performance of 44 density functionals used in conjunction with the correlation consistent basis sets (cc-pVnZ where n = T and Q) has been assessed for the gas-phase enthalpies of formation at 298.15 K of 3d transition metal (TM) containing systems. Nineteen molecules were examined: ScS, VO, VO(2), Cr(CO)(6), MnS, MnCl(2), Mn(CO)(5)Cl, FeCl(3), Fe(CO)(5), CoH(CO)(4), NiCl(2), Ni(CO)(4), CuH, CuF, CuCl, ZnH, ZnO, ZnCl, and Zn(CH(3))(2). Of the functionals examined, the functionals that resulted in the smallest mean absolute deviation (MAD, in parentheses, kcal mol(-1)) from experiment were B97-1 (6.9), PBE1KCIS (8.1), TPSS1KCIS (9.6), B97-2 (9.7), and B98 (10.7). All five of these functionals include some degree of Hartree-Fock (HF) exchange. The impact of increasing the basis set from cc-pVTZ to cc-pVQZ was found to be slight for the generalized gradient approximation (GGA) and meta-GGA (MGGA) functionals studied, indicating basis set saturation at the triple-zeta level. By contrast, for most of the generalized gradient exchange (GGE), hybrid GGA (HGGA), and hybrid meta-GGA (HMGGA) functionals considered, improvements in the average MAD of 2-3 kcal mol(-1) were seen upon progressing to a quadruple-zeta level basis set. Overall, it was found that the functionals that include Hartree-Fock exchange performed best overall, but those with greater than 40% HF exchange exhibit significantly poor performance for the prediction of enthalpies of formation for 3d TM complexes. Carbonyl-containing complexes, a mainstay in organometallic TM chemistry, are demonstrated to be exceedingly difficult to describe accurately with all but 2 of the 44 functionals considered. The most accurate functional, for both CO-containing and CO-free compounds, is B97-1/cc-pVQZ, which is shown to be capable of yielding results within 1 kcal mol(-1) of high-level ab initio composite methodologies.

Accurate thermochemistry for transition metal complexes from first-principles calculations.

The "correlation consistent Composite Approach" or ccCA is an ab initio model chemistry based on the single reference MP2 level of theory. By adjusting the basis set and level of theory of the core valence additive correction, ccCA is capable of reliable thermochemical predictions of inorganic and organometallic transition metal-containing molecules, as well as achieving chemical accuracy on main group species, with a mean absolute deviation of 0.89 kcal mol(-1) against the 147 enthalpies of formation in the G2/97 test set. For a set of 52 complexes containing elements Sc-Zn, ranging in size from diatomics to Ni(PF(3))(4) and Fe(C(5)H(2))(2), ccCA on average predicts enthalpies of formation to within +/-3 kcal mol(-1) of the experimental result with a mean absolute deviation of 2.85 kcal mol(-1) and a root mean square deviation of 3.77 kcal mol(-1). The ccCA methodology is a significant step toward quantitative theoretical modeling of transition metal thermodynamics.

Computation of potential energy surfaces with the multireference correlation consistent composite approach.

A multireference composite method that is based on the correlation consistent Composite Approach (ccCA) is introduced. The developed approach, multireference ccCA, has been utilized to compute the potential energy surfaces (PESs) of N(2) and C(2), which provide rigorous tests for multireference composite methods due to the large multireference character that must be correctly described as the molecules dissociate. As well, PESs provide a stringent test of a composite method because all components of the method must work in harmony for an appropriate, smooth representation across the entire surface.

Activation of Carbon-Hydrogen and Hydrogen-Hydrogen Bonds by Copper-Nitrenes: A Comparison of Density Functional Theory with Single- and Multireference Correlation Consistent Composite Approaches.

The kinetics and thermodynamics of copper-mediated nitrene insertion into C-H and H-H bonds (the former of methane) have been studied using several levels of theory: B3LYP/6-311++G(d,p), B97-1/cc-pVTZ, PBE1KCIS/cc-pVTZ, and ccCA (correlation consistent Composite Approach). The results show no significant difference among the DFT methods. All three DFT methods predict the ground state of the copper-nitrene model complex, L'Cu(NH), to be a triplet, while single reference ccCA predicts the singlet to be the ground state. The contributions to the total ccCA energy indicate that the singlet state is favored at the MP2/CBS level of theory, while electron correlation beyond this level (CCSD(T)) favors a triplet state, resulting in a close energetic balance between the two states. A multireference ccCA method is applied to the nitrene active species and supports the assignment of a singlet ground state. In general, the largest difference in the model reaction cycles between DFT and ccCA methods is for processes involving radicals and bond dissociation.

Hartree-Fock complete basis set limit properties for transition metal diatomics.

Numerical Hartree-Fock (HF) energies accurate to at least 1 microhartree are reported for 27 diatomic transition-metal-containing species. The convergence of HF energies toward this numerical limit upon increasing the basis set size has been investigated, where standard nonrelativistic all-electron correlation consistent basis sets and augmented basis sets, developed by Balabanov and Peterson [J. Chem. Phys. 123, 064107 (2005)], were employed. Several schemes which enable the complete basis set (CBS) limit to be determined have been investigated, and the resulting energies have been compared to the numerical Hartree-Fock energies. When comparing basis set extrapolation schemes, those in the form of exponential functions perform well for our test set, with mean absolute deviations from numerical HF energies of 234 and 153 microE(h), when the CBS limit has been determined using a two-point fit as proposed by Halkier et al. [Chem. Phys. Lett. 302, 437 (1999)] on calculations of triple- and quadruple-zeta basis set qualities and calculations of quadruple- and quintuple-zeta basis set qualities, respectively. Overall, extrapolation schemes in the form of a power series are not recommended for the extrapolation of transition metal HF energies. The impact of basis set superposition error has also been examined.