Prepare a report that will inform the committee on current issues in the investment environment, ... more Prepare a report that will inform the committee on current issues in the investment environment, present alternatives for plausible strategic and tactical asset allocations, and deliver recommendations for the actions the fund should take. Your report should also consider to what extent the fund should use ‘active’ versus ‘passive’ investment approaches in the different asset classes, with recommendations for the investment management styles.
Morbid obesity represents a challenge to healthcare as the underlying source of numerous risks an... more Morbid obesity represents a challenge to healthcare as the underlying source of numerous risks and significant expenditure. Gastric bypass surgery has been validated as a means of significant and reproducible reduction in weight. In the laparoscopic era, the minimally invasive approach has been applied to this procedure with promising results. In our technique, we divide the stomach to create a small gastric pouch drained by a retrocolic, retrogastric Roux-en-Y alimentary jejunal limb. The gastrojejunostomy is performed in 2 layers, an inner stapled layer and an outer sutured layer. We, like other groups, have found that laparoscopic gastric bypass provides similar efficacy to open gastric bypass, but offers improved patient acceptance, quality of life, and significantly less wound complications.
The scope of general surgery practice has evolved tremendously in the last 20 years. However, cli... more The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90 000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.
IEEE Journal of Selected Topics in Quantum Electronics, 1997
Page 1. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS, VOL. 3, NO. 4, AUGUST 1997 1027 A... more Page 1. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS, VOL. 3, NO. 4, AUGUST 1997 1027 A Theoretical Investigation of Dynamic All-Optical Automatic Gain Control in Multichannel EDFA's and EDFA Cascades ...
Laminar natural convection heat transfer from uniformly heated horizontal cylinders of a triangul... more Laminar natural convection heat transfer from uniformly heated horizontal cylinders of a triangular cross-section is investigated numerically in air. Different cylinder cross-section dimensions and orientations are examined under laminar conditions. The computational procedure is based on the finite volume technique (using the commercial software FLOWORKS). Results are presented in the form of streamline and temperature contour plots around the perimeter of the cylinders. Some representations of thermal layers around the side of the cylinders are obtained for different modified Rayleigh numbers. General correlations of Nusselt numbers verse the modified Rayleigh numbers are obtained. Symmetric, transition, and asymmetric plumes are obtained and characterized for both positions of the cylinders.
Prepare a report that will inform the committee on current issues in the investment environment, ... more Prepare a report that will inform the committee on current issues in the investment environment, present alternatives for plausible strategic and tactical asset allocations, and deliver recommendations for the actions the fund should take. Your report should also consider to what extent the fund should use ‘active’ versus ‘passive’ investment approaches in the different asset classes, with recommendations for the investment management styles.
Morbid obesity represents a challenge to healthcare as the underlying source of numerous risks an... more Morbid obesity represents a challenge to healthcare as the underlying source of numerous risks and significant expenditure. Gastric bypass surgery has been validated as a means of significant and reproducible reduction in weight. In the laparoscopic era, the minimally invasive approach has been applied to this procedure with promising results. In our technique, we divide the stomach to create a small gastric pouch drained by a retrocolic, retrogastric Roux-en-Y alimentary jejunal limb. The gastrojejunostomy is performed in 2 layers, an inner stapled layer and an outer sutured layer. We, like other groups, have found that laparoscopic gastric bypass provides similar efficacy to open gastric bypass, but offers improved patient acceptance, quality of life, and significantly less wound complications.
The scope of general surgery practice has evolved tremendously in the last 20 years. However, cli... more The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90 000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.
IEEE Journal of Selected Topics in Quantum Electronics, 1997
Page 1. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS, VOL. 3, NO. 4, AUGUST 1997 1027 A... more Page 1. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS, VOL. 3, NO. 4, AUGUST 1997 1027 A Theoretical Investigation of Dynamic All-Optical Automatic Gain Control in Multichannel EDFA's and EDFA Cascades ...
Laminar natural convection heat transfer from uniformly heated horizontal cylinders of a triangul... more Laminar natural convection heat transfer from uniformly heated horizontal cylinders of a triangular cross-section is investigated numerically in air. Different cylinder cross-section dimensions and orientations are examined under laminar conditions. The computational procedure is based on the finite volume technique (using the commercial software FLOWORKS). Results are presented in the form of streamline and temperature contour plots around the perimeter of the cylinders. Some representations of thermal layers around the side of the cylinders are obtained for different modified Rayleigh numbers. General correlations of Nusselt numbers verse the modified Rayleigh numbers are obtained. Symmetric, transition, and asymmetric plumes are obtained and characterized for both positions of the cylinders.
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