Skin thickness of the anterior, anteromedial, and anterolateral thigh: a cadaveric study for split-skin graft donor sites

Background: The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site. Methods: Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias. Results: Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness (60±3.2 µm). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured 1,032±435 µm in the anteromedial region compared to 1,220±257 µm in the anterolateral region. Conclusions: Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh

Analysis of the Malaysian Toll Road Public-Private Partnership Program and Recommendations for Policy Improvements

Malaysia has relied on toll road public-private partnerships (PPPs) for over twenty years to provide important highway infrastructure. The program has been active with nearly 1800 kilometers either constructed or concessions agreed to. The public has been less supportive of the program due to low transparency and little public involvement. Public protests are common, which may lead to long-term program instability. The CLIOS Process, developed at MIT, is applied to Malaysia’s toll road PPP program to develop new policies that can better meet these public concerns while maintaining the financial viability of the sector. With increases in transparency and public involvement, the political risks of the program should be reduced and long-term stability for the government and concessionaires improved. We argue that the focus should be at the regional transportation planning level where toll road PPPs can be compared with alternatives for meeting transportation needs rather than at the national level where Malaysian toll road PPPs are currently handled

After Regions: what next for local enterprise partnerships?

Standing out as an oddity in comparison to the convergence of policy across EU nations whereby the merits of regional apparatus – however defined – for administering development support appear to be accepted, the UK Government has abandoned England’s experiment with regionalism. Under the banner of localism, providing the thinnest of masks for swingeing public expenditure cuts, sub-national development activity (encompassing planning, regeneration, infrastructure development, enterprise support and spatial leadership) is in the throes of considerable economic shifts, policy flux and institutional upheaval (Ward & Hardy, 2012). This article attempts to address some of the questions posed in The regional lacuna: a preliminary map of the transition from Regional Development Agencies to Local Economic Partnerships (Pugalis, 2011) and helps to advance some of the points relating to the emerging sub-national development landscape published in recent issues of Regions (e.g. Bailey, 2011). The purpose is to take stock of policy developments underway by means of a post-regional sub-national review in order to outline the future development trajectory of Local Enterprise Partnerships

High-resolution measurements of surface topography with airborne laser altimetry and the global positioning system

Recently, an airborne lidar system that measures laser pulse time-of-flight and the distortion of the pulse waveform upon reflection from earth surface terrain features was developed and is now operational. This instrument is combined with Global Positioning System (GPS) receivers and a two-axis gyroscope for accurate recovery of aircraft position and pointing attitude. The laser altimeter system is mounted on a high-altitude aircraft platform and operated in a repetitively-pulsed mode for measurements of surface elevation profiles at nadir. The laser transmitter makes use of recently developed short-pulse diode-pumped solid-state laser technology in Q-switched Nd:YAG operating at its fundamental wavelength of 1064 nm. A reflector telescope and silicon avalanche photodiode are the basis of the optical receiver. A high-speed time-interval unit and a separate high-bandwidth waveform digitizer under microcomputer control are used to process the backscattered pulses for measurements of terrain. Other aspects of the lidar system are briefly discussed

NASA airborne satellite instrumentation calibrator (NASIC) technical reference

The NASA Satellite Instrumentation Calibrator (NASIC) is a visible and near-infrared spectrometer used to calibrate various satellite instruments by underflying those instruments in a NASA ER-2 aircraft. The calibration instrument's hardware and software are documented. The design, operation, and function of an Ebert-Fastie monochronomator, which by means of a moveable diffraction grating, becomes a visible and near-infrared spectrometer used to calibrate satellite-borne instruments by high altitude underflights in the NASA ER-2

Quality of Neonatal Health Care: Learning From Health Workers’ Experiences in Critical Care in Kilimanjaro Region, Northeast Tanzania

Neonatal deaths are generally attributed to suboptimal standards of health care. Health care worker motivation and adherence to existing guidelines are rarely studied. To assess the performance of health workers for neonatal health care in the hospitals of Kilimanjaro region. A descriptive study using a semi-structured interview for health care workers at a tertiary referral hospital and peripheral health facilities (regional referral, district hospitals and health centres).was used. Health Care Workers (HCW) were asked to recall a scenario of a critically ill neonate admitted in the wards and the treatment that was provided. The WHO Emergency Triage Assessment and Treatment (ETAT) guidelines were used as a standard reference for knowledge of critical care. Birth asphyxia was the most recalled health problem requiring critical care, reported by 27.5% of 120 HCW at both peripheral hospitals and by 46.4% of 28 health workers in tertiary referral centres. Half of the HCW commented on their own performance (47.5%, n=140). HCW presented with low to moderate levels of knowledge for critical care were at 92%. Supplementary training was associated with a higher levels of knowledge of neonatal critical care (p value = 0.05). HCW in peripheral hospital had lower levels of knowledge (only 44.7% at peripheral hospitals had sufficient ratings compared to 82.1% at the referral centre). [Pearson χ2 (2) = 12.10, p value = 0.002]. Guided Practical-Competence Diagnostic Specific neonatal health care training is highly needed in the peripheral facilities of rural Kilimanjaro region

Eagle Lake Homecoming

A 2000 color print titled Eagle Lake Homecoming by John L. Ward.https://scholarworks.moreheadstate.edu/university_art_collection/1046/thumbnail.jp