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Objective Preeclampsia is a major obstetric disorder that can lead to severe maternal, fetal and infant outcomes. In women with suspected preeclampsia, measurement of the soluble fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF) ratio has been shown to have a high negative predictive value (>97%). Our aim was to estimate the value to the US healthcare system of adopting this test into clinical practice. Study design: An economic model was developed for the evaluation of suspected preeclampsia from a US payer perspective using data from a US observational study of 459 women evaluated between 23 and 34.6 weeks. Test results were not available to clinicians. The model compares two strategies for managing suspected preeclampsia: standard care versus a biomarker-informed pathway utilizing the sFlt1/PlGF ratio. Results Utilization of the sFlt1/PlGF ratio test reduced the number of women admitted for suspected preeclampsia by 34–49%. Despite fewer admissions, a higher proportion of women admitted to hospital subsequently developed preeclampsia, and the proportion of women not admitted who would subsequently develop preeclampsia remained low (3.2%–6.7%). Cost savings arising from a reduction in admissions are estimated to be $1050 in the base case; varying the hospitalization cost ±25% would lead to savings in the range $771 to $1330 per patient at 2020 prices. Conclusion Adopting the sFlt1/PlGF ratio test as an adjunct to clinical criteria improves the assessment of risk in women presenting with suspicion of preeclampsia and has the potential to safely reduce unnecessary admissions and save costs.

Background: Here we compare the performance of the high-throughput BD COR System (COR) to the Viper LT System (Viper) using the BD Onclarity HPV assay. Research Design and Methods: Remnant clinical specimens, contrived specimens in SurePath (BD) and PreservCyt (Hologic) media, and prospective clinical specimens in BD Cervical Brush Diluent (CBD) were tested. Outcomes included intra-laboratory agreement of Onclarity results on COR and inter-system agreement between COR and Viper. Results: Onclarity reproducibility on COR resulted in standard deviation and correlation of variation of Ct values ranging from 0.14 to 1.98 and 0.49% to 2.15%, respectively, for contrived specimens, and 0.9–3.08 and 2.89–9.21%, respectively, for clinical specimens. In the COR and Viper clinical agreement study, OPA for Onclarity ranged from 97.1%-98.9%, depending on the collection media type. PPA values for pooled, HPV(+) specimens at low positive (C95), and moderate positive (3XC95) target concentrations were ≥95.0% and 100%, respectively; PPA values associated with HPV 16, 18, 31, 45, 33/58, 52, 35/39/68, 51, and 56/59/66, individually, ranged from 93.8%-100%. Conclusions: Onclarity performance on COR is equivalent to Viper, and is accurate and reproducible for detection of all high-risk HPV genotypes, with a throughput of 330 results from a single 8-hour shift.

Purpose To provide the first report of effective use of bilateral XEN Gel Stent implantation using an ab externo open-conjunctival approach designed to improve bleb function and meet the uniquely low intraocular pressure requirements of a Japanese patient with normal-tension glaucoma refractory to topical medical therapy. Observations A 54-year-old phakic Japanese woman with severe normal-tension glaucoma on maximally tolerated medical therapy of four topical agents presented with above-goal intraocular pressures and new medication intolerances. She underwent bilateral ab externo open-conjunctival XEN Gel Stent implantation with tenectomy and sub-Tenon's injection of 40μg of mitomycin-C, which resulted in reduction of intraocular pressures by 41.2 and 28.6% to 10 and 10 mmHg in the right and left eyes, respectively at the most recent visit. Postoperatively, a diffuse filtering bleb with good morphology developed in both eyes. The procedure has so far allowed for complete cessation of all four topical medications for up to eight months following surgery without any serious complications. Conclusions This case illustrates the potential of Xen Gel Stent implantation through an ab externo, open-conjunctival approach to be an effective, simple alternative to trabeculectomy to meet the unique low-pressure requirements of normal-tension glaucoma patients with practical and safety benefits of a micro-invasive approach.

The objective of this study was to determine the result reproducibility and performance of the BD Onclarity human papillomavirus (HPV) assay (Onclarity) on the BD Viper LT platform using both contrived and clinical specimens. Reproducibility was assessed in BD SurePath liquid-based cytology (LBC) medium (SurePath) using contrived panels (HPV genotype 16 [HPV16] positive, HPV18 positive, or HPV45 positive) or clinical specimens (HPV16, -18, -31, -33/58, -45, or -52 positive or HPV negative). In addition, specimens from 3,879 individuals from the Onclarity trial were aliquoted prior to or following cytology processing and tested for HPV., The objective of this study was to determine the result reproducibility and performance of the BD Onclarity human papillomavirus (HPV) assay (Onclarity) on the BD Viper LT platform using both contrived and clinical specimens. Reproducibility was assessed in BD SurePath liquid-based cytology (LBC) medium (SurePath) using contrived panels (HPV genotype 16 [HPV16] positive, HPV18 positive, or HPV45 positive) or clinical specimens (HPV16, -18, -31, -33/58, -45, or -52 positive or HPV negative). In addition, specimens from 3,879 individuals from the Onclarity trial were aliquoted prior to or following cytology processing and tested for HPV. Finally, specimens were collected using either the Cervex-Brush or Cytobrush (or Cytobrush/spatula) for comparison of HPV results. Contrived specimens showed >95% concordance with the expected results, and pooled clinical specimens had standard deviations and coefficients of variation ranging from 0.87 to 1.86 and 2.9% to 5.6%, respectively. For precytology and postcytology aliquot analyses, specimens showed >98.0% overall agreement and mean differences in cycle threshold (CT) scores for HPV ranging from −0.07 to 0.31. Positivity rates were close between the Cervex-Brush and Cytobrush/spatula for all age groups tested. Onclarity results are reproducible and reliable, regardless of sample collection before or after cytology aliquoting. Onclarity performs well regardless of the method of specimen collection (Cervex-Brush or Cytobrush/spatula) for cervical cancer screening.

Everyone will be impacted by oral disease at some point in life. Dental caries (tooth decay) is the most widespread chronic disease worldwide, impacting nearly 100% of adults and 60–90% of school children. In addition, about 30% of people aged 65–74 have no natural teeth, and severe periodontal disease impacts 15–20% of middle-aged (35–44 years) adults globally. These staggering statistics demonstrate evidence of significant oral health neglect across the general population. This chapter discusses the challenges and solutions to improving oral health in low- and middle-income countries.

Purpose To report a patient with post-operative gas migration into the optic nerve and lateral ventricles after retinal detachment repair. Observations A 78-year-old pseudophakic man developed a temporal visual field cut in his non-operative, right eye 3 weeks after repair of a recurrent, shallow, macula-involving retinal detachment with perfluoropropane intraocular gas in the left eye. Visual acuity in the right eye measured 20/40, and static perimetry demonstrated temporal visual field loss that respected the vertical midline. Dilated fundus examination of the right eye was unrevealing for any retinal cause, raising suspicion for an intracranial etiology. An urgent CT scan of the brain demonstrated gas in all segments of the left optic nerve and lateral ventricles, consistent with intracranial gas migration along the optic nerve. Given the absence of systemic neurologic symptoms, cautious observation was advised on consultation with neuroradiology and neurosurgery, and follow-up CT scan 1 week later showed resolution of the intracranial gas. By 10-weeks post-operatively, vision returned to 20/20 in the right eye with persistent temporal field loss, and the left eye was hand motions (20/70 pre-operatively) with evidence of optic nerve atrophy and severe cupping. Conclusions Intracranial gas migration is a rare complication of retinaldetachment repair with intraocular gas and may occur in the setting of structural defects of the optic nerve and high post-operative intraocular pressure. Clinicians should be alert to this rare but serious complication, which can cause neurologic symptoms and result in vision loss in both the operative and non-operative eyes.

Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) worldwide. The prolyl hydroxylase domain (PHD)-hypoxia inducible factor (HIF) pathway is a key mammalian oxygen sensing pathway and is frequently perturbed by pathological states including infection and inflammation. We discovered a significant upregulation of hypoxia regulated gene transcripts in patients with chronic hepatitis B (CHB) in the absence of liver cirrhosis. We used state-of-the-art in vitro and in vivo HBV infection models to evaluate a role for HBV infection and the viral regulatory protein HBx to drive HIF-signalling. HBx had no significant impact on HIF expression or associated transcriptional activity under normoxic or hypoxic conditions. Furthermore, we found no evidence of hypoxia gene expression in HBV de novo infection, HBV infected human liver chimeric mice or transgenic mice with integrated HBV genome. Collectively, our data show clear evidence of hypoxia gene induction in CHB that is not recapitulated in existing models for acute HBV infection, suggesting a role for inflammatory mediators in promoting hypoxia gene expression.

Objectives: To compare the performance of the BD Onclarity HPV Assay (BD Diagnostics, Sparks, MD) in BD SurePath liquid-based cytology media with that of Hybrid Capture 2 (HC2, Qiagen, Germantown, MD) samples co-collected in specimen transport medium in an adjudicated patient cohort. Methods: The performance of the BD Onclarity HPV Assay using BD SurePath media was compared with that of HC2 samples co-collected in specimen transport medium using 541 archived samples from a multicenter US clinical trial with histologically adjudicated cervical biopsy specimens. Results: The sensitivity for cervical intraepithelial neoplasia (CIN) 2 positivity (n - 104) was 90.4% (95% confidence interval [CI], 83–95) and 93.3% (95% CI, 87–97) and specificity was 76.9% (95% CI, 73–81) and 77.8% (95% CI, 74–82) for the BD assay and HC2, respectively. Nine cases of CIN 2+ had results discordant with the high-risk HPV assay. All were found to have been correctly classified with the BD assay using a novel WAVE denaturing high-performance liquid chromatography double-stranded DNA sequencing method. Conclusions: The clinical performance of The BD Onclarity HPV Assay with respect to histology end points was similar to HC2. Moreover, discordant analysis revealed improved performance of the BD assay with respect to ability to provide extended genotyping information and lack of cross-reactivity with low-risk HPV types associated with cellular abnormalities. The relative risks for CIN 3 disease for HPV 31 and HPV 33/58 (combined) were comparable to that of HPV 18 in this population, suggesting that these genotypes may warrant monitoring in future studies.

Cervical cancer screening has been one of the most impactful human interventions in medical history, saving the lives of countless thousands of women since the introduction of organized cytology screening programs. Today, we stand at a crossroads in the fight against cervical cancer, with several countries actively engaged in introducing primary human papillomavirus (HPV) testing and vaccination as more effective means of prevention. This chapter discusses the history of organized screening and how this led to HPV test methods to detect cervical cancer. We go on to examine the technologies used to screen for high-risk HPV types and how they affect clinical performance. We examine the evidence for primary HPV screening and review recent self-collection initiatives to reach underserved women, including the use of urine as novel sample type. In addition, we critically examine the evolution of HPV test methods and make the case for the use of extended genotyping as an improved risk stratification tool for guiding clinical management. Finally, we look to the future of cervical cancer screening and consider options for future management programs.

This document contains the Data Model generated from the model contained in Rational Software Architect.

This System Requirements Document (SRD) defines waveform data processing requirements for the International Data Centre (IDC) of the Comprehensive Nuclear Test Ban Treaty Organization (CTBTO). The IDC applies, on a routine basis, automatic processing methods and interactive analysis to raw International Monitoring System (IMS) data in order to produce, archive, and distribute standard IDC products on behalf of all States Parties. The routine processing includes characterization of events with the objective of screening out events considered to be consistent with natural phenomena or non-nuclear, man-made phenomena. This document does not address requirements concerning acquisition, processing and analysis of radionuclide data but includes requirements for the dissemination of radionuclide data and products.

This document contains the brief descriptions for the actors and use cases contained in the IDC Use Case Model. REVISIONS Version Date Author/Team Revision Description Authorized by V1.0 12/2014 SNL IDC Reengineering Project Team Initial delivery M. Harris V1.1 2/2015 SNL IDC Reengineering Project Team Iteration I2 Review Comments M. Harris

This document contains the system specifications derived to satisfy the system requirements found in the IDC System Requirements Document for the IDC Reengineering Phase 2 project. Revisions Version Date Author/Team Revision Description Authorized by V1.0 12/2014 IDC Reengineering Project Team Initial delivery M. Harris V1.1 2/2015 IDC Reengineering Project Team Iteration I2 Review Comments M. Harris

This report provides a brief description of the scope of the IDC Reengineering Phase 2 project. It describes the goals and objectives of reengineering, the system definition, and the technical scope of the system. REVISIONS Version Date Author/Team Revision Description Authorized by 1.0 9/25/2014 SNL IDC Reengineering Team Unlimited Release for I2 M. Harris 1.1 28/01/2015 IDC Reengineering Team Align with previous IDC scope document E. Tomuta

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, using a commercial software cost estimation tool calibrated to US industry performance parameters. This is not a cost estimate for Sandia to perform the project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can more » neither commence nor continue unless adequate funding has been accepted and certified by DOE. « less

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, based on leveraging a fully funded, Sandia executed NDC Modernization project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.

Wrestling with pathology as our only activity will lead to rapid burn-out. Enhancing one's practice with client education and care, sharing with colleagues, making consultation room time easier, having equipment available that increases professional service and the enjoyment of the profession, and serving our patients and clients well improve our practices and ourselves.

The advent of MEMS (microelectromechanical systems) will enable dramatic changes in semiconductor processing. MEMS-based devices offer opportunities to achieve higher performance and functionality, at lower cost, with decreased size and increased reliability. In this work, we describe the achievement of several important devices for use in the semiconductor equipment industry. They include a low-flow mass flow controller, a high-precision pressure regulator, and an integrated gas panel. Compared to current technology, the devices are ultra-small in size, thus minimizing dead volumes and gas contact surface areas. With wettable surfaces comprised of ceramic and silicon (or, silicon coated with Si/sub 3/N/sub 4/ or SiC), they are resistant to corrosion, and generate virtually no particles. The devices are created from modular components. The science and technology of these components will be detailed. The modules examined are: normally-open proportional valves; normally-closed, low leak-rate shut-off valves; critical orifices (to extract information of flow rate); flow models (to extract flow rate from pressure and temperature information); silicon-based pressure sensors; and, the precision ceramic-based packages which integrate these modules into useful devices for semiconductor processing. The work finishes with a detailed description of the low-flow mass flow controller.

We live in a time in which society is very prone to litigation. People sue people. Government sues people. It is estimated that 50% of all the attorneys on this planet are in the United States. It has been suggested that that is the reason the United States is such a litigious society. The numbers seem to be a response to the need. When litigation occurs, evidence is presented by both parties. In court, this evidence is examined and cross-examined by both sides. Because objects, animals, laboratory results, photographs, and other inanimate objects cannot be examined and cross-examined, expert witnesses are called in to serve in this capacity.

This study uses Data Envelopment Analysis to examine the technical efficiencies of 573 Turkish acute general hospitals. Inputs of number of beds, number of primary care physicians, and number of specialists, and how they are used to produce outputs of inpatient discharges, outpatient visits, and surgical operations, are examined. Results illustrate that less than ten percent of Turkish acute general hospitals operate efficiently compared to their counterparts. Inefficient, compared to efficient hospitals, on average utilize 32% more specialists, 47% more primary care physicians, and have 119% more staffed bed capacity. They also produce on average less output. Particularly, 13% less outpatient visits, 16% inpatient hospitalization, and 57% less surgical procedures. Additionally, the validity of DEA is illustrated by comparing it to the ratio analysis methods no discernible differences in the results are found.

There are so many issues in the news every day that it is hard to keep up. As veterinarians, we try especially hard to pay attention to issues that relate to animals, but, with all the obligations we face every day in our jobs and with our families, some issues slip through the cracks. One issue, H.R. 669, the Non-native Wildlife Invasion Prevention Act, should not. It is too important. For those of you who have not heard about this proposed legislation, the underlying intent of this bill is, according to the American Veterinary Medical Association (AVMA) (and as published in The AVMA Advocate, 2009), to “establish a risk-assessment process to prevent the introduction into, and establishment in, the United States of non-native wildlife species that will cause or are likely to cause economic or environmental harm or harm to other animal species' health or human health.” This legislation would create 2 species lists for the United States: approved species and unapproved species. As the AVMA notes, “For species not already included on these 2 lists, H.R. 669 tries to account for this by providing a method to submit proposals for importation of a species. Upon submission of this request, the Secretary of the Interior, through the Fish and Wildlife Service, is required to determine if the species is (1) approved for importation and placed on the approved species list, (2) not approved for importation and placed on the unapproved species list, or (3) the Secretary has insufficient scientific and commercial information to make a determination.” Once species are classified, the breeding, sale, trade, and interstate transport of any species on the unapproved list would be prohibited. As the AVMA notes, what is unclear is what happens if there is insufficient scientific evidence to make a determination about a particular species. In addition, “H.R. 669 fails to take into consideration variations in climate, geology, hydrology and native species of a particular geographical region of the United States. With states as diverse as Hawaii, Alaska, Indiana and New Hampshire, it is difficult, if not impossible to legislate a one size fits all approach.”H.R. 669 has ramifications for all exotic species and for all those who work with exotic species. Although the bill was defeated in the House of Representatives, the AVMA recently commented, “It is our understanding that H.R. 669 will be re-written to more appropriately address the issue of invasive species.” Consequently, it is something we should all be thinking about. To this end, I have invited 5 participants knowledgeable about H.R. 669 to share their thoughts about this potential legislation. The participants are Susan Clubb, DVM, Dipl ABVP (Avian Practice), Rainforest Clinic For Birds & Exotics, Inc, Loxahatchee, FL, USA; Robert Groskin, DVM, Englewood Animal Hospital, Englewood, NJ, USA; Tarah Hadley, DVM, Dipl ABVP (Avian Practice), Atlanta Hospital for Birds and Exotics Inc, Lithonia, GA, USA; James M. Harris, DVM, Mayfair Veterinary Clinic, Sandy Bay, Tasmania, Australia; and Bruce Nixon, DVM, Animal Emergency Hospital of North Texas, Grapevine, TX, USA. I hope that their comments will be enlightening, thought provoking, and motivating to each of us to voice our own opinions about this daunting issue.

Numerous diseases are shared by birds and humans. Many of them are true zoonosis. Chlamydiosis, salmonellosis, and tuberculosis are the primary infectious diseases. Allergic alveolitis in humans, induced by exposure to bird dander and protein, is also of great significance. The other diseases are of less common occurrence or represent oddities. [Editor's note: However, the increased incidence of AIDS and the increased use of immune system-compromising medications in humans have resulted in a drastic increase in the zoonotic diseases. Formerly rare diseases are becoming more common.]

Sandia National Laboratories has tested, evaluated and reported on the Geotech Smart24 data acquisition system with active Fortezza crypto card data signing and authentication in SAND2008-. One test, Input Terminated Noise, allows us to characterize the self-noise of the Smart24 system. By computing the power spectral density (PSD) of the input terminated noise time series data set and correcting for the instrument response of different seismometers, the resulting spectrum can be compared to the USGS new low noise model (NLNM) of Peterson (1996), and determine the ability of the matched system of seismometer and Smart24 to be quiet enough for any general deployment location. Four seismometer models were evaluated: the Streckeisen STS2-Low and High Gain, Guralp CMG3T and Geotech GS13 models. Each has a unique pass-band as defined by the frequency band of the instrument corrected noise spectrum that falls below the new low-noise model.

Most test methodologies referenced in this Test Definition and Test Procedures were designed by Sandia specifically for geophysical instrumentation evaluation. When appropriate, test instrumentation calibration is traceable to the National Institute for Standards Technology (NIST). The objectives are to evaluate the overall technical performance of the infrasound sensor. The results of these evaluations can be compared to the manufacturer's specifications and any relevant application requirements or specifications.

Most test methodologies referenced in this Test Definition and Test Procedures were designed by Sandia specifically for geophysical instrumentation evaluation. When appropriate, test instrumentation calibration is traceable to the National Institute for Standards Technology (NIST).

This Test Definition for the Evaluation of Digitizing Waveform Recorders (DWR) defines the process that can be performed as part of the evaluation and testing of geophysical sensors, digitizers, sensor subsystems and geophysical station/array systems. The objectives are to (1) evaluate the overall technical performance of the DWR, measure the distortions introduced by the high resolution digitizers and provide a performance check of the internal calibrator if provided and (2) evaluate the technical performance of the DWR for a specific sensor application. The results of these evaluations can be compared to the manufacturer's specifications and any relevant application requirements or specifications.

The process of developing the National Nuclear Security Administration (NNSA) Knowledge Base (KB) must result in high-quality Information Products in order to support activities for monitoring nuclear explosions consistent with United States treaty and testing moratoria monitoring missions. The validation, verification, and management of the Information Products is critical to successful scientific integration, and hence, will enable high-quality deliveries to be made to the United States National Data Center (USNDC) at the Air Force Technical Applications Center (AFTAC). As an Information Product passes through the steps necessary to become part of a delivery to AFTAC, domain experts (including technical KB Working Groups that comprise NNSA and DOE laboratory staff and the customer) will provide coordination and validation, where validation is the determination of relevance and scientific quality. Verification is the check for completeness and correctness, and will be performed by both the Knowledge Base Integrator and the Scientific Integrator with support from the Contributor providing two levels of testing to assure content integrity and performance. The Information Products and their contained data sets will be systematically tracked through the integration portion of their life cycle. The integration process, based on lessons learned during its initial implementations, is presented in this report.

Previously, we have reported the science and technology of micromachiend valves and orifices, and their integration to form high-performance mass-flow controllers (MFCs), and vacuum leak rate shut-off devices (SOVs). In this work, we expand the science and technology base of these devices, to include not only performance, but more practical aspects of their behavior. Specifically, for MFCs we have studied long-term drift, mean time tofail, particle generation, dry down after moisture contamination, gas replacement, effects of gravitational orientation, and sensitivity to inlet pressure and ambient temperature. For SOVs, we have studied mean time to fail, particle generation, dry down after moisture contamination, vacuum leak rate, and sensitivity to inlet pressure and ambient temperature.© (2000) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

The advent of microelectromechanical systems has enabled dramatic changes in diverse technological areas. In terms of control and distribution of liquids and gases (microfluidics), MEMS-based devices offer opportunities to achieve increased performance, and higher levels of functional integration, at lower cost, with decreased size and increased reliability. This work focuses on recent research and development of high-purity gags distribution and control systems for semiconductor processing. These systems include the following components, based upon both normally-open and normally-closed microvalves: pressure- based mass flow controllers; vacuum leak-rate shut-off valves; and pressure regulators. Advanced packaging techniques enable these components to be integrated into gas sticks and panels which have small size, corrosion-resistant wetted materials, small dead volumes, and minimal particle generation. Principles of operation of components and panels, and performance data at both the component and system level, will be presented. The potential for 10X size reduction (linear dimension), 2X product yield improvement (through increased reliability, improved flow accuracy and repeatability, and contamination reduction), and 5X reduction in process gas consumption, will also be addressed. Particular emphasis on characterization and verification of flow measurements in mass flow controllers (versus NIST standards), and the flow models used in designing and characterizing these systems, will be made.

We are reporting the preliminary results of a nonrandomized trial using a low-level gallium- aluminum-arsenide (GaAlAs) laser at a wavelength of 830 nm (Microlight 830, Lasermedics, Inc., Stafford, TX) to treat patients with symptomatic Peyronie's disease. All patients entered into the study had disease consisting of a well-defined fibrous plaque causing pain and/or curvature of the penile shaft on erection that interfered with satisfactory sexual intercourse. Treatment has consisted of 30 mW administered over a duty cycle of 100 seconds (3 J) beginning at the base of the penis and extending to the coronal sulcus over the dorsum of the penis at 0.5 cm intervals. An additional duty cycle of 100 seconds was delivered to each 0.5 cm of palpable plaque. The ability of the therapy to reduce the size of the fibrous plaque, the severity of the penile curvature, and the severity of pain associated with penile erection and the treatment's effect on the patient's quality of life were assessed for each patient at completion of therapy and 6 weeks later.