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One of the most ambitious efforts in value-centric design of a military aerospace system undertaken to date has been the parallel development by four performer teams, headlined by major space industry primes, of design tools for fractionated space architectures under DARPA's System F6 program. The goal of the System F6 program is to replace traditional, highly-integrated, monolithic satellites with wirelessly-networked clusters of heterogeneous modules incorporating the various payload and infrastructure functions. Such fractionated architectures can deliver a comparable or greater mission capability than monolithic satellites, but with significantly enhanced flexibility and robustness. In order to design an optimal fractionated architecture, the potential cost penalties due to the overhead of such a design must be balanced against the value enhancement due to improved flexibility and robustness. The first, preliminary design phase of the System F6 program, simultaneously awarded to four competing industry teams led by Boeing, Lockheed Martin, Northrop Grumman, and Orbital Sciences, commenced in February 2008 and included a significant effort for the development, validation, and demonstration of a Value-Centric Design methodology and associated tool suite that can support the design of optimized fractionated satellite systems based on a net lifecycle value metric and a probabilistic distribution thereof. This phase concluded in February 2009 and the Value-Centric Design methodology development to date is documented in a series of papers by the industry performer teams. This paper, from the System F6 Program Office, summarizes the overarching objectives of the Value-Centric Design effort, details and rationalizes the requirements for the methodology, discusses the relationship between Value-Centric Design and the traditional industry-standard systems engineering process, and fills any gaps in the performers' own presentations of their efforts, tools, and results. 1 The views expressed herein are the authors' own and do not necessarily represent those of the Defense Advanced Research Projects Agency, the Department of Defense, or the United States Government. Approved for public release. Distribution unlimited.

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Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

We have tried to clarify this confusing area by demonstrating the common relationships of these abnormalities. The development of the craniovertebral junction was present in order to understand the formation of the anomalies discussed. The radiologic lines and measurements that have been described are actually to measure the degree of compromise of the functional size of the foramen magnum. This mechanical compromise, either from direct neural compression and/or from a secondary vascular impairment (arterial or venous), leads to the signs and symptoms of cervicomedullary compression.

Background: Infection following implant-based breast reconstruction (IBBR) results in increased rates of hospital readmission, reoperation, patient and hospital expenses, and reconstructive failure. IBBR is a complex, multistep procedure, and there is a relative lack of high-quality plastic surgery evidence regarding "best practices" in the prevention of implant infections. In the absence of strong data, standardizing procedures based on available evidence can reduce error and improve efficacy and outcomes. Methods: We performed a focused literature review of the available evidence supporting specific interventions for infection prevention in the preoperative, intraoperative, and postoperative phases of care that are applicable to IBBR. In addition, we examined previously published standardized perioperative protocols for implant reconstruction. Results: Preoperative, intraoperative, and postoperative planning and organization is crucial in IBBR. Preoperative planning involves skin decolonization in advance of surgery with either chlorhexidine gluconate or mupirocin. Intraoperative methods that have shown potential benefit include double-gloving, breast pocket irrigation, separate closing instruments, and the utilization of "no-touch" techniques. In the postoperative period, the duration of drain removal and postoperative antibiotic administration play an important role in the prevention of surgical site infection. Conclusions: There is a crucial need to establish an evidence-based set of "best practices" for IBBR, and there exists a paucity of evidence in the breast literature. These data can be utilized to develop a standardized protocol as part of a rigorous quality improvement methodology.

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