Using a cost-construction model to assess the cost of educating undergraduate medical students at the University of Texas--Houston Medical School

Spontaneous resolution of deformities after excision of facial skin lesions has been known and used for a long time by plastic surgeons. The resorption mechanism of deformity is based on natural skin expansion, and seems to be directly related to the action of the muscles of facial expression and their skin relations. Natural expansion has been shown to be effective in children. Between 1990 and 1994 excision of skin lesions, including congenital nevi, leading to postoperative deformity of the cheek, labial commissure, nose, eyelid and forehead, was performed on 35 patients, aged from 3 month to 12 years. The average follow-up is 24 months. For 26 patients (74%), natural resorption was observed 4 or 6 weeks later with good aesthetic results. For 6 patients (17%), the deformity persisted 3 or 6 months later, but did not require any further surgery. For 3 patients (9%), a second operation was necessary. Using the skins natural capacity for expansion in the treatment of facial skin defects in children is a method of reconstruction which has already been used for excision in enforced position. The platysma and muscles of facial expression by their action on skin mobilisation, allow natural expansion. A better knowledge of cutaneous biomechanical properties enables plastic surgeons to find an alternative to other classical methods.     

Epidemiological study of hypertension and its determinants in an urban population of North India

OBJECTIVES: To determine age-specific prevalence of hypertension and blood pressure (BP) levels in relation to diet and lifestyle factors in North Indians. DESIGN AND SETTING: Cross-sectional survey in 20 randomly selected streets in Moradabad, North India. SUBJECTS AND METHODS: A total of 1806 subjects from North India (904 males and 902 females) age range 25-64 years. The survey methods were as follows: dietary diaries for 7 days food intake record; BP measurements; physician administered questionnaire and anthropometric measurements. Diagnosis of hypertension was based on new World Health Organization/International Society of Hypertension (WHO/ISH) criteria. Risk factors were assessed based on WHO guidelines. RESULTS: The prevalence of hypertension according to WHO/ISH criteria was 23.7% and by old WHO criteria 13.3%. In the WHO/ISH hypertensive group, isolated diastolic hypertension was present in 47.3% males and 40.6% females. Males have a slightly higher prevalence than females in the young age group, however, the prevalence rates are comparable in the older age groups. In both sexes, the prevalence rates and BP level increased with older age. Multivariate analysis revealed that age, higher body mass index, central obesity and higher socioeconomic status were independently and strongly associated with hypertension in both sexes. Higher dietary fat and salt intake and lower physical activity were weakly but significantly associated with hypertension. CONCLUSION: Association of higher socioeconmic status, higher body mass index and central obesity in North Indian adults with higher fat intake, lower physical activity and higher prevalence and level of hypertension indicate that these populations may benefit by decreasing the dietary fat intake and increasing physical activity, with an aim to decrease central obesity for decreasing hypertension in North Indians.     

Evaluating generalized predictive control for a brushless DC drive

This paper proposes a new control approach for a brushless DC motor drive using the generalized predictive control (GPC) algorithm. Based on the same least-squares framework as in the controller design, we further develop the method to design an observer. The GPC algorithm uses the receding horizon approach whereby the control signals are determined by minimizing a quadratic cost function. Our study shows that the rise time and settling time of the servo system have an approximate linear relationship with the prediction horizon. Thus, it is used to tune the controller of the drive. Moreover, the control weighting factor can be used to smooth the controller output. The proposed algorithm has been implemented using a digital signal processor (DSP) and tested in real time with a prototype system. The performance and robustness of the algorithms have been evaluated both in simulation and experiment. The results show that the drive performs reasonably well despite load changes and step changes in the position setpoint. Furthermore, it is fairly robust against motor parameters change     

Protein analysis of human von Ebner saliva and a method for its collection from the foliate papillae

The lingual serous glands of von Ebner are located close to the foliate and circumvallate papillae. Saliva secreted by these glands provides the immediate environment of the taste buds, and it has been hypothesized that it modulates taste perception. The purpose of this study was to develop a technique for collection of unstimulated and stimulated saliva from human von Ebner glands. Saliva was collected under resting conditions and after application of various gustatory stimuli (sweet, sour, salt, and bitter) by insertion of periostrips into the folds of the foliate papillae of healthy human volunteers. Stimulated saliva was also collected in glass microcapillaries or micropipettes. The flow-rates of unstimulated von Ebner saliva were 2.3 +/- 0.6 (S.E.) microL/min and 4.5 +/- 1.2 (S.E.) microL/min with 1% citric acid stimulation. The protein content was 2.5 +/- 0.5 (S.E.) mg/mL. The SDS gel electrophoretic profile of von Ebner saliva revealed two protein bands of Mr 18,000 that were identified on Western blots as von Ebner gland (VEG) proteins. Although lingual lipase activity was detected at very low levels by enzyme assay, this protein was not detected on Western blots. This collection technique should prove useful for analysis of specific functions associated with secretion from von Ebner glands.     

Off-Site Exposure to Respirable Aerosols Produced during the Disk-Incorporation of Class B Biosolids

Field experiments were conducted at a Class B biosolids land application site in central Arizona to measure, model, and source-track the off-site transport of aerosols emitted when biosolids were disk-incorporated into soils. Real-time PM10 monitoring provided time-resolved aerosol information sufficient for verifying both off-site concentration and off-site exposure time model results. Under the conditions considered and at a distance of 165?m from the aerosol source, biosolids disk-incorporation resulted in an intermittent exposure to biosolids-derived aerosol concentration between 15 and 40?μg/m3 and an inhalable biosolids dose between 2 and 8?μg. Transport modeling predicted that these doses will decrease with increasing wind speed. In addition, three DNA sequence-based biosolids source tracking methods were applied to aerosol samples and confirmed the presence of biosolids in aerosols at 5, 65, and 165?m from the aerosol source. Field measurements and modeling indicate that the nature of biosolids-derived aerosol exposure is a series of intermittent high concentration puffs, rather than a continuous low concentration.     

Efficient Spreadsheet Algorithm for First-Order Reliability Method

A new spreadsheet-cell-object-oriented algorithm for the first-order reliability method is proposed and illustrated for cases with correlated nonnormals and explicit and implicit performance functions. The new approach differs from the writers earlier algorithm by obviating the need for computations of equivalent normal means and equivalent normal standard deviations. It obtains the solution faster and is more efficient, robust, and succinct. Other advantages include ease of initialization prior to constrained optimization, ease of randomization of initial values for checking robustness, and fewer required optimization constraints during spreadsheet-automated search for the design point. Two cases with implicit performance functions, namely an asymmetrically loaded beam on Winkler medium and a strut with complex supports are analyzed using the new approach and discussed. Comparisons are also made between the proposed approach and that based on Rosenblatt transformation.     

An efficient algorithm for the minimum cost min-max load terminal assignment problem

One of the main issues to be addressed in topological design of centralized networks is that of assigning terminals to concentrators in such a way that each terminal is assigned to one (and only one) concentrator and the total number of terminals assigned to any concentrator (which is referred to as load in this paper) does not overload that concentrator, i.e. is within the concentrator's capacity. Under these constraints, an assignment with the lowest possible cost is sought. An assignment of terminals to concentrators which minimizes the maximum load among the concentrators (which qualitatively represents congestion at some hot spots in a network service area) is referred to as a min-max load assignment. In this paper, we consider the problem of finding a min-max load assignment with the-lowest cost. We call this problem the Minimum Cost Min-Max Load Terminal Assignment Problem (MCMLTAP). We present an algorithm for MCMLTAP and prove that the problem is optimally solvable in polynomial time using our proposed algorithm.     

P300 latency: abnormal in sleep apnea with somnolence and idiopathic hypersomnia, but normal in narcolepsy

To evaluate cognitive abnormalities in excessive daytime sleepiness (EDS) using cognitive evoked potentials (P300), and to evaluate if P300 measures differentiate among disorders of EDS, a series of EDS subjects were administered a polysomnogram, auditory and visual P300 testing using 31 scalp electrodes, and a multiple sleep latency test. P300 variables were compared with those of normal subjects. Forty normal subjects ages 16 to 65 years, and 69 EDS patients ages 16 to 65 years were used. Of these, 39 had profound obstructive sleep apnea (OSA, Respiratory Disturbance Index or RDI > 80/h sleep) with severe somnolence (Mean Sleep Latency < 5 min). Twenty-two had idiopathic hypersomnia (IH). Eight had narcolepsy. The normals and the three EDS groups did not differ in age. IH and profound OSA patients had longer visual P300 latency than normals or narcolepsy patients (p < 0.05). (p < 0.05). IH and profound OSA patients had longer auditory P300 latency than normals. They had smaller auditory P300 amplitude than narcolepsy patients. There were visual P300 latency topographic differences between normals and profound OSA patients. In conclusion, IH and profound OSA patients show cognitive evoked potential evidence of cognitive dysfunction. Narcolepsy patients do not show such evidence. Visual P300 latency differentiates among disorders of EDS.