Prospective Clinical Trial Comparing Outcome Measures Between Furlow and von Langenbeck Palatoplasties for UCLP

The goal of this prospective randomized clinical trial was to compare 2 cohorts of standardized cleft patients with regard to functional speech outcome and the presence or absence of palatal fistulae. The 2 cohorts are randomized to undergo either a conventional von Langenbeck repair with intravelar velarplasty or the double-opposing Z-plasty Furlow procedure. A prospective 2 x 2 x 2 factorial clinical trial was used in which each subject was randomly assigned to 1 of 8 different groups: 1 of 2 different lip repairs (Spina vs. Millard), 1 of 2 different palatal repair (von Langenbeck vs. Furlow), and 1 of 2 different ages at time of palatal surgery (9-12 months vs. 15-18 months). All surgeries were performed by the same 4 surgeons. A cul-de-sac test of hypernasality and a mirror test of nasal air emission were selected as primary outcome measures for velopharyngeal function. Both a surgeon and speech pathologist examined patients for the presence of palatal fistulae. In this study, the Furlow double-opposing Z-palatoplasty resulted in significantly better velopharyngeal function for speech than the von Langenbeck procedure as determined by the perceptual cul-de-sac test of hypernasality. Fistula occurrence was significantly higher for the Furlow procedure than for the von Langenbeck. Fistulas were more likely to occur in patients with wider clefts and when relaxing incisions were not used.

Fenda cervical mediana

The midline cervical cleft is an unusual congenital anomaly of the ventral neck and fewer than 100 cases have been reported overall and the first described by Bailey in 1924. This anomaly is report in association with median cleft of lower lip, cleft mandible and tongue, and hypoplasia of other midline neck structures. Its considered an anomaly originated from the two first branchial arches. The treatment of this cleft is a vertical complete excision and a closure with multiple Z-plasty. Many authors recommend avoid linear closure and prefer multiple Z-plasty for evicted fibrosis and local retraction. In this paper we report 2 case of this anomaly and the literature is reviewed.

Encyclopedia contributions : entries S-Z in Oxford Companion to Australian Gardens

Shelton, E.M. (p.548); Sherwood Arboretum (p.550); Soutter, William (pp.563-4); Styles (pp.575-6); Summer-House (579-580); Trapnell, W.G. (p.602); Tropical Gardens (pp.604-5);Verandah Gardening (p.614); Wickham Park (p.642); Wijaya, Made (p.642); Williams, George (p.644); Williams Keith A (p.644).

Book review: ‘Anterior Eye Disease and Therapeutics A-Z' [2nd ed.] Edition, by A. Bruce and M. Loughnan. Churchill Livingstone (Elsevier), Edinburgh 2011

With the ever-increasing emphasis on ocular disease recognition in the practice of optometry and especially anterior eye disease management and therapeutics, any book addressing such issues is bound to have a captive audience. This second edition of Anterior Eye Disease and Therapeutics A–Z provides a succinct yet comprehensive coverage of this topic.

Using pulse transit delay in Z-scan to discriminate between excited-state absorption and other nonlinear processes in ZnO nanocones

We report a new approach that uses the single beam Z-scan technique, to discriminate between excited state absorption (ESA) and two and three photon nonlinear absorption. By measuring the apparent delay or advance of the pulse in reaching the detector, the nonlinear absorption can be unambiguously identified as either instantaneous or transient. The simple method does not require a large range of input fluences or sophisticated pulse-probe experimental apparatus. The technique is easily extended to any absorption process dependent on pulse width and to nonlinear refraction measurements. We demonstrate in particular, that the large nonlinear absorption in ZnO nanocones when exposed to nanosecond 532 nm pulses, is due mostly to ESA, not pure two-photon absorption.

Five-level Z-source diode-clamped inverter

This study proposes a five-level Z-source diode-clamped inverter designed with two intermediate Z-source networks connected between the dc input sources and rear-end inverter circuitry. By partially shorting the Z-source networks, new operating states not previously reported for two-level Z-source inverter are introduced here for operating the proposed inverter with voltage buck-boost energy conversion ability and five-level phase voltage switching. These characteristic features are in fact always ensured at the inverter terminal output by simply adopting a properly designed carrier modulation scheme, which always inserts two partial shoot-through states per half carrier cycle for smooth balanced operation. Theoretical findings and practical issues identified are eventually verified by constructing a scaled down laboratory prototype for testing.

Z-source-inverter-based flexible distributed generation system solution for grid power quality improvement

Distributed generation (DG) systems are usually connected to the grid using power electronic converters. Power delivered from such DG sources depends on factors like energy availability and load demand. The converters used in power conversion do not operate with their full capacity all the time. The unused or remaining capacity of the converters could be used to provide some ancillary functions like harmonic and unbalance mitigation of the power distribution system. As some of these DG sources have wide operating ranges, they need special power converters for grid interfacing. Being a single-stage buck-boost inverter, recently proposed Z-source inverter (ZSI) is a good candidate for future DG systems. This paper presents a controller design for a ZSI-based DG system to improve power quality of distribution systems. The proposed control method is tested with simulation results obtained using Matlab/Simulink/PLECS and subsequently it is experimentally validated using a laboratory prototype.

Performance evaluation of three-level Z-source inverters under semiconductor-failure conditions

This paper evaluates and proposes various compensation methods for three-level Z-source inverters under semiconductor-failure conditions. Unlike the fault-tolerant techniques used in traditional three-level inverters, where either an extra phase-leg or collective switching states are used, the proposed methods for three-level Z-source inverters simply reconfigure their relevant gating signals so as to ride-through the failed semiconductor conditions smoothly without any significant decrease in their ac-output quality and amplitude. These features are partly attributed to the inherent boost characteristics of a Z-source inverter, in addition to its usual voltage-buck operation. By focusing on specific types of three-level Z-source inverters, it can also be shown that, for the dual Z-source inverters, a unique feature accompanying it is its extra ability to force common-mode voltage to zero even under semiconductor-failure conditions. For verifying these described performance features, PLECS simulation and experimental testing were performed with some results captured and shown in a later section for visual confirmation.

Modulation and control of three-phase paralleled Z-source inverters for distributed generation applications

This paper presents a modulation and controller design method for paralleled Z-source inverter systems applicable for alternative energy sources like solar cells, fuel cells, or variablespeed wind turbines with front-end diode rectifiers. A modulation scheme is designed based on simple shoot-through principle with interleaved carriers to give enhanced ripple reduction in the system. Subsequently, a control method is proposed to equalize the amount of power injected by the inverters in the grid-connected mode and also to provide reliable supply to sensitive loads onsite in the islanding mode. The modulation and controlling methods are proposed to have modular independence so that redundancy, maintainability, and improved reliability of supply can be achieved. The performance of the proposed paralleled Z-source inverter configuration is validated with simulations carried out using Matlab/Simulink/Powersim. Moreover, a prototype is built in the laboratory to obtain the experimental verifications.

Evaluation of resonant damping techniques for Z-source current-type inverter

For the renewable energy sources whose outputs vary continuously, a Z-source current-type inverter has been proposed as a possible buck-boost alternative for grid-interfacing. With a unique X-shaped LC network connected between its dc power source and inverter topology, Z-source current-type inverter is however expected to suffer from compounded resonant complications in addition to those associated with its second-order output filter. To improve its damping performance, this paper proposes the careful integration of Posicast or three-step compensators before the inverter pulse-width modulator for damping triggered resonant oscillations. In total, two compensators are needed for wave-shaping the inverter boost factor and modulation ratio, and they can conveniently be implemented using first-in first-out stacks and embedded timers of modern digital signal processors widely used in motion control applications. Both techniques are found to damp resonance of ac filter well, but for cases of transiting from current-buck to boost state, three-step technique is less effective due to the sudden intermediate discharging interval introduced by its non-monotonic stepping (unlike the monotonic stepping of Posicast damping). These findings have been confirmed both in simulations and experiments using an implemented laboratory prototype.

Dual Z-source inverter with three-level reduced common mode switching

This paper presents the design of a dual Z-source inverter that can be used with either a single dc source or two isolated dc sources. Unlike traditional inverters, the integration of a properly designed Z-source network and semiconductor switches to the proposed dual inverter allows buck-boost power conversion to be performed over a wide modulation range with three-level output waveforms generated. The connection of an additional transformer to the inverter ac output also allows all generic wye- or delta-connected loads with three-wire or four-wire configuration to be supplied by the inverter. Modulation-wise, the dual inverter can be controlled using a carefully designed carrier-based pulse-width modulation (PWM) scheme that always will ensure balanced voltage boosting of the Z-source network, while simultaneously achieving reduced common-mode switching. Because of the omission of dead-time delays in the dual inverter PWM scheme, its switched common-mode voltage can be completely eliminated, unlike in traditional inverters where narrow common-mode spikes are still generated. Under semiconductor failure conditions, the presented PWM schemes can easily be modified to allow the inverter to operate without interruption and for cases where two isolated sources are used, zero common-mode voltage can still be ensured. These theoretical findings together with the inverter practicality have been confirmed both in simulations using PSIM with Matlab/Simulink coupler and experimentally using a laboratory implemented inverter prototype.