Hypothesis: A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in soft tissue infections presents a treatment challenge. Design: Retrospective analysis.

The QoS-based Resource Allocation Model (Q-RAM) proposed in [20] presented an analytical approach for satisfying multiple quality-of-service dimensions in a resource-constrained environment. Using this model, available system resources can be apportioned across multiple applications such that the net utility that accrues to the end-users of those applications is maximized. In this paper, we present several practical solutions to allocation problems that were beyond the limited scope of [20]. First, we show that the Q-RAM problem of finding the optimal resource allocation to satisfy multiple QoS dimensions (at least one of which is dependent on another) is NP-hard. We then present a polynomial solution for this resource allocation problem which yields a solution within a provably fixed and short distance from the optimal allocation. Secondly, [20] dealt mainly with the problem of apportioning a single resource to satisfy multiple QoS dimensions. In this paper, we study the converse problem of apportioning multiple resources to satisfy a single QoS dimension. In practice, this problem becomes complicated, since a single QoS dimension perceived by the user can be satisfied using different combinations of available resources. We show that this problem can be formulated as a mixed integer programming problem that can be solved efficiently to yield an optimal resource allocation. Finally, we also present the run-times of these optimizations to illustrate how these solutions can be applied in practice. We expect that a good understanding of these solutions will yield insights into the general problem of apportioning multiple resources to satisfy simultaneously multiple QoS dimensions of multiple concurrent applications.

By providing direct data transfer between storage and client, network-attached storage devices have the potential to improve scalability for existing distributed file systems (by removing the server as a bottleneck) and bandwidth for new parallel and distributed file systems (through network striping and more efficient data paths). Together, these advantages influence a large enough fraction of the storage market to make commodity network-attached storage feasible. Realizing the technology's full potential requires careful consideration across a wide range of file system, networking and security issues. This paper contrasts two network-attached storage architectures-(l)Networked SCSI disks (NetSCSI) are networkattached storage devices with minimal changes from the familiar SCSI interface, while (2) Network-Attached Secure Disks (NASD) are drives that support independent client access to drive object services. To estimate the potential performance benefits of these architectures, we develop an analytic model and perform tracedriven replay experiments based on AFS and NFS traces. Our results suggest that NetSCSI can reduce tile server load during a burst of NFS or AFS activity by about 30%. With the NASD architecture, server load (during burst activity) can be reduced by a factor of up to five for AFS and up to ten for NFS.

Several authors have demonstrated the safety and effectiveness of titanium in orbital reconstruction. One question posed by clinicians is what happens to large pieces of titanium in communication with the paranasal sinuses or nasal-oral-pharyngeal area. This question becomes increasingly relevant as titanium is used to reconstruct extensive defects for which the destruction of bony architecture requires the placement of mesh in proximity to these areas. The objective of this study was to examine the gross and histologic soft-tissue response to large segments of titanium mesh in the setting of orbital and midface reconstruction, particularly when exposed to the nasal-oral-pharyngeal area and paranasal sinuses. In this study, large segments of titanium mesh were used in eight patients to reconstruct orbital and midface defects, with direct communication between the mesh and nasal-oral-pharyngeal area and paranasal sinuses. Four patients had suffered self-inflicted gunshot wounds; as a result, much of their midface was missing, including the inferior and medial orbital floor, maxilla, nose, naso-orbital-ethmoid complex, and hard palate. Extensive sheets of titanium mesh were used to reconstruct their medial and inferior orbital walls, nasal bridge, and maxilla. In the fifth patient, titanium mesh was used to reconstruct the maxilla after resection of a squamous cell carcinoma of the nasolacrimal duct. In the sixth and seventh patients, mesh was used to reconstruct the nasal bridge after severely comminuted nasal fractures resulted in the loss of bone and mucosa. Finally, the eighth patient had titanium mesh used to replace cocaine-induced bone loss involving the left medial orbital floor and wall and part of the maxilla. On gross examination by either endoscopy or direct inspection, all eight patients had rapid soft-tissue incorporation of the titanium mesh. Initial examination typically revealed budding of soft tissue through mesh interstices, followed by progressive incorporation. One patient's mesh was covered in only 15 days. Two patients underwent biopsies of this newly formed soft tissue. One had biopsies performed at 3, 15, and 31 months after the original operation. Biopsy examination at 3 months revealed incorporation of the titanium with fibrous soft tissue covered by ciliated respiratory epithelium, goblet cells, and squamous epithelium with metaplasia. In addition, the dense, acute inflammation present at 3 months evolved into mild, chronic inflammation at 31 months. The second patient had a single biopsy 4 months after secondary orbital reconstruction for delayed enophthalmos. Biopsy examination revealed a fibrous soft-tissue sheath lined by squamous epithelium with metaplasia. Again, mild chronic inflammation was present within the soft tissue. This study provides evidence of titanium's compatibility with soft tissue. The mesh underwent progressive incorporation with soft tissue that was then resurfaced by indigenous cells, including respiratory epithelia and goblet cells. This phenomenon occurred desp...