The importance of geriatrics to family medicine: a position paper by the Group on Geriatric Education of the Society of Teachers of Family Medicine

The role of geriatrics and geriatricians in family medicine remains unsettled. Despite a rapidly aging population, a tremendous shortage now exists of faculty with interest and expertise in geriatrics. Relatively few family practice residents choose to enter geriatric fellowship programs, and federal funding for such programs has been reduced. Despite accreditation requirements, residency programs are not always able to provide the range of geriatric experiences needed to properly prepare graduates to provide care for the broad range of older patients. Medical students' exposure to geriatrics remains limited. The Group on Geriatric Education of the Society of Teachers of Family Medicine believes that family medicine faculty must recognize and be committed to the notion that geriatrics is integral to family medicine. Both undergraduate and residency training programs should emphasize experience with geriatric patients in multiple settings. In particular, the nursing home should not be the main focus of geriatric training. The small number of certified geriatric faculty will be able to provide leadership, but a broad range of faculty must become involved in teaching geriatrics. Faculty development activities and continuing education programs to foster the necessary expertise will be essential to the accomplishment of this task.     

MQW wavelength-tunable DBR lasers with monolithically integrated external cavity electroabsorption modulators with low-driving voltages fabricated by selective-area MOCVD

The design and operation of multiple-quantum-well (MQW) wavelength-tunable distributed Bragg reflector (DBR) InGaAs QW lasers with nonabsorbing gratings and monolithically integrated external cavity electroabsorption modulators fabricated by selective-area MOCVD are presented. Uncoated devices exhibit CW threshold currents as low as 10.5 mA with slope efficiencies of 0.21 W/A from the laser facet. Wavelength tuning of 7 nm is obtained by injection current heating of the DBR section. These devices also exhibit extinction ratios of 18 dB from the modulator facet at a low modulator bias of 1 V, when measured with a broad-area detector. When coupled to a singlemode fiber, these devices exhibited high extinction ratios of 40 dB at a modulator bias of 1.25 V.     

Using principal-components regression to stabilize EMG-muscle forceparameter estimates of torso muscles

Models for estimating muscle force from surface electromyographic (EMG) recordings require parameter estimates with low intertrial variability. The inclusion of multiple muscles in multivariate statistical models can lead to multicollinearity, especially when there are significant correlations between synergist muscles. One result of multicollinearity is that parameter estimates are very sensitive to changes in the independent variables. This study compared the parameter variability of multiple regression and principal-components regression techniques when applied to a six muscle EMG analysis of the lumbar region of the torso. Nine subjects participated, Twenty-three percent of the traditional multiple-regression parameters had incorrect signs, but none of the principal-components regression parameters did. The principal components regression technique also produced parameter estimates having an order of magnitude smaller parameter variability. It was concluded that principal-components regression is an effective method of mitigating the effect of multicollinearity in torso EMG models     

Dynamic analysis and drilling degrees of freedom

Finite element methods for dynamic analysis employing elements with drilling degrees of freedom are presented. The formulation is based on a variational principle in which displacements and rotations are interpolated independently. The issue of zero masses corresponding to rotational degrees of freedom is addressed and techniques for defining consistent and lumped rotational mass matrices are presented.     

Production of the 19-kDa antigen of Mycobacterium tuberculosis in Escherichia coli and its purification

The 19-kDa antigen (19Ag) of Mycobacterium tuberculosis (Mt) is a lipoprotein which is released from the organism during growth. In order to study the possible involvement of this antigen in the host protective response against Mt infection, it would be helpful to obtain high-level production of 19Ag from a recombinant organism. We have found that overexpression of the native 19Ag gene in Escherichia coli or yeast leads to products which are aggregated and insoluble. By site-directed mutagenesis of the 19Ag lipoprotein leader sequence, we have generated a mutant gene which directs the production of 19Ag into the periplasmic space of E. coli, from where it can be easily purified in high yield. 19Ag obtained from this mutant construct lacks the lipid-modified N-terminal Cys residue found in the native 19Ag, and is not glycosylated, but is otherwise indistinguishable from 19Ag isolated from Mt culture supernatant.