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PubMed2006

Effect of farmyard manure application on boron adsorption-desorption characteristics of some soils.

Boron (B) availability to crop plants depends on soil properties as well as management practices like liming, fertilization and use of organic manures. To assess the effect of farmyard manure (FYM) application on availability of added B, adsorption-desorption of B was investigated in five different soils receiving varying doses of FYM (0, 5 and 10 g FYM kg(-1) soil). Two surfaces Freundlich model was found best to account for B adsorption-desorption data of all soils. Application of FYM increased B adsorption capacities pertaining to low (K1) and high (K2) concentration ranges in all soils, except Soil C (Alfisol) having a pH of 9.8, in which the higher rate of FYM decreased the value of K2. Application of FYM did not change B desorption capacities of soils corresponding to low B concentration range (K(1)(1)) significantly, however, it increased B desorption capacity pertaining to high B concentration (K(1)(2)) in all soils, except Soils C (Alfisol) and E (Entisol) having pH of 9.8 and 5.1, respectively. Application of FYM increased the desorption slope factor applicable to low concentration range (1/n(1)(1)) in Soil A (Inceptisol), but decreased it in Soil E (Entisol). The 1/n(1)(2) (desorption slope factor applicable to high concentration range) decreased with FYM application in all soils except Soil E (Entisol), where it was increased. Boron desorption index (slope(ads)/slope(des)) decreased with FYM application in low B concentration range, but increased in high concentration range for all soils except soil E (Entisol, pH 5.1), in which a reverse trend was observed. Application of FYM increased the retention of added B in soils and may help reducing the leaching losses.

Adsorption↗

PubMed2005

Evaluating the clinical safety of three vaginal applicators: a pilot study conducted in the Dominican Republic.

BACKGROUND: Targeted research on applicator safety has not been conducted as part of microbicide clinical trials and was considered necessary for ensuring safe and effective product use. Colposcopy, regarded as a standard method for assessing the safety of vaginal products, including microbicides, was used in this study to assess the external genitalia, vaginal epithelium and cervical epithelium after a single applicator use. OBJECTIVES: The objectives of this study were to assess and compare the effects of three vaginal applicators on symptoms and signs of irritation of the external genitalia, vagina and cervix as seen by colposcopy after applicator use. METHODS: Twenty women used three different vaginal applicators over three separate clinic visits 7-14 days apart and underwent a colposcopic examination before and after each applicator use. In total, the safety of each applicator was assessed over 20 product uses. RESULTS: No severe colposcopic finding was reported. Four minor colposcopic findings (petechiae) were considered possibly related to product use. No difference was found between applicators. CONCLUSIONS: This study provides reassuring data on the safety of the three applicator products from the perspective of causing vaginal trauma or irritation. Epithelial changes that could be more important for risk of disease transmission were not observed.

Administration, Intravaginal↗

PubMed2005

The ALPHA Project: an architecture for leveraging public health applications.

OBJECTIVE: Public health surveillance applications are central to the collection, analysis and dissemination of disease and health information. As these applications evolve and mature, it is evident that many of these applications must address similar requirements, such as policies, security and flexibility. It is important a software architecture is created to meet these requirements. METHODS: We outline the requirements for a public health surveillance application, and define a set of common components to address these requirements. These components are configured to produce services used in the development of public health applications. RESULTS: A layered software architecture, the ALPHA architecture, has been developed to support the development of public health applications. The architecture has been used to build eleven surveillance applications for the Public Health Agency of Canada in the areas of disease surveillance, survey, distributed data collection and inventory management. CONCLUSIONS: We have found that a software architecture that addresses requirements on policies, security and flexibility facilitates the development of configurable public health applications. By creating this architecture, key success factors, such as reducing cost and time-to-market of applications, adapting to changing surveillance targets and increasing user efficiency are achieved.

Canada↗

PubMed2005

A dosimetric study of Leipzig applicators.

PURPOSE: To obtain the absolute dose-rate distribution in liquid water for all six cup-shaped Leipzig applicators by means of an experimentally validated Monte Carlo (MC) code. These six applicators were used in high-dose-rate (HDR) afterloaders with the "classic" and v2 (192)Ir sources. The applicators have an inner diameter of 1, 2, and 3 cm, with the source traveling parallel or perpendicular to the contact surface. METHODS AND MATERIALS: The MC GEANT4 code was used to obtain the dose-rate distribution in liquid water for the six applicators and the two HDR source models. To normalize the applicator output factors, a MC simulation for the "classic" and v2 sources in air was performed to estimate the air-kerma strength. To validate this specific application and to guarantee that realistic source-applicator geometry was considered, an experimental verification procedure was implemented in this study, in accordance with the TG43U1 recommendations. Thermolumniscent dosimeter chips and a parallel plate ionization chamber in a polymethyl methacrylate (PMMA) phantom were used to verify the MC results for the six applicators in a microSelectronHDR afterloader with the "classic" source. Dose-rate distributions dependence on phantom size has been evaluated using two different phantom sizes. RESULTS: Percentage depth dose and off-axis profiles were obtained normalized at a depth of 3 mm along the central axis for both phantom sizes. A table of output factors, normalized to 1 U of source kerma strength at this depth, is presented. The dose measured in the PMMA phantom agrees within experimental uncertainties with the dose obtained by the MC GEANT4 code calculations. The phantom size influence on dose-rate distributions becomes significant at depths greater than 5 cm. CONCLUSIONS: MC-detailed simulation was performed for the Nucletron Leipzig HDR applicators. The matrix data obtained, with a grid separation of 0.5 mm, can be used to build a dataset in a convenient format to model these distributions for routine use with a brachytherapy treatment planning system.

Brachytherapy↗

PubMed2005

Effect of double-application of all-in-one adhesives on dentin bonding.

OBJECTIVES: To evaluate the effect of double-application of all-in-one adhesives using the micro-shear bond test. METHODS: The occlusal surfaces of extracted human third molars were ground perpendicular to the long axis of each tooth to expose a flat dentin surface. Three commercially available and one experimental bonding system were used in this study: Adper Prompt L-Pop (APL, 3M ESPE), REACTMER BOND (RB, Shofu), XENO III (Xeno, Dentsply-Sankin) and newly developed OBF-2 (OB2, Tokuyama Dental). These adhesives were applied on the dentin surfaces by either the manufacturers' instructions or by an experimental method (single-application or double-application). Resin composite was then placed and light-cured for 40s. After 24h immersion in water, a micro-shear bond test was carried out and the fractured dentin surfaces were observed microscopically. The data were analyzed by one-way ANOVA and Tukey's HSD tests (p<0.05). RESULTS: The mean bond strengths of APL, RB, Xeno and OB2 with single-application were 22.7, 28.3, 30.3 and 34.6MPa, respectively. The mean bond strengths of APL, RB, Xeno and OB2 with double-application were 29.5, 27.2, 29.6 and 32.5MPa, respectively. There were no statistically significant differences in micro-shear bond strengths between the single- and double-application methods for each adhesive system (p>0.05). The morphological observation of the fractured dentin surfaces revealed differences between the single- and double-application groups especially for APL and OB2. CONCLUSIONS: Micro-shear bond strengths of all-in-one adhesives in this study showed no statistically significant differences between the single-application and the double-application method.

Analysis of Variance↗

PubMed2004

Immunisation against plague by transcutaneous and intradermal application of subunit antigens.

We have investigated immunological responses in BALB/c mice following transcutaneous (TC) delivery of fraction 1 (F1) and V subunits from Yersinia pestis in conjunction with an enterotoxin-derived adjuvant (cholera toxin, CT). It was found that two or more TC applications of F1 and V subunits (admixed with cholera toxin) served to elicit significant levels of anti-F1 and V antibodies in the serum of immunised mice. IL-6 secretion from cultured splenocytes derived from immunised mice indicated that a single TC application of F1 and V subunits (admixed with cholera toxin) conferred a cell-mediated response. As compared with intranasal or direct intradermal injection of F1 and V, the numbers of F1/V-specific antibody-forming cells in the spleens of animals immunised by TC application of F1 and V (admixed with CT) was relatively low. It was noted that TC application of F1 and V admixed with CT was very effective for priming responses that were boosted by intranasal or intradermal routes. Similarly, it was found that TC application of F1 and V admixed with CT could be used to efficiently boost pre-existing responses engendered by intradermal injection or intranasal instillation of F1 and V. In order to assess if TC application of F1 and V admixed with CT could protect experimental animals from plague, immunised mice were injected with a virulent strain of Y. pestis. It was found that two TC applications of F1 and V admixed with CT conferred only limited protection against 10(2) MLDs. However, three TC applications of F1 and V admixed with CT conferred solid protection against 10(2) MLDs. Hence we have shown, for the first time, that TC application of F1 and V admixed with CT can protect animals against challenge with a virulent strain of plague causing bacteria. These data suggest that transcutaneous immunisation may be a simple and non-invasive method for immunising individuals against plague.

Adjuvants, Immunologic↗

PubMed1998

Single radiofrequency application to cure atrioventricular nodal reentry: arguments for the slow pathway origin of the high-low frequency slow potentials.

BACKGROUND: High-low frequency slow potentials are thought to be related to the slow AV pathway conduction. Their use was proposed to guide radiofrequency (RF) ablation of atrioventricular nodal reentrant tachycardia (AVNRT). The present study was designed to determine the prospective value of these high-low frequency slow potentials to guide AVNRT ablation using a single RF application. Single RF application could indeed reduce the size of the lesion created in the viciny of the specialized AV conduction system and shorten the radiation exposure and the overall duration of the procedure. RESULTS: Forty-one patients (14 men, 27 women, 45 +/- 16 years old) with AVNRT underwent slow pathway RF ablation guided by high-low frequency slow potentials. High-low frequency slow potentials were found in all patients along the tricuspid annulus and above the coronary sinus. Ablation was always performed in the posterior part of Koch's triangle. The mean A/V amplitude ratio of the successful site was 0.43 +/- 0.59. In 32 patients (78%) AVNRT was no longer inducible after a single RF application. Procedure and radiation times were 35 +/- 31 and 13 +/- 12 min respectively. Five patients required 2, 3 patients 3, and 1 patient 6 RF applications. The mean number of RF applications was 1.4 +/- 0.9 (median = 1). In the 32 patients who required only one RF application, 24 (75%) had an obvious dual AV nodal pathways with a jump before ablation, which completely disappeared in 18 of them (75%) after ablation. In the 6 remaining patients, who still had a jump after 1 RF application, there was no significant change in either conduction times or refractory periods concerning both the anterograde and retrograde AV conduction. No patient had PR interval purlongation. After a mean follow up of 11 +/- 5 months, recurrence was observed in a single patient who received 2 discontinued RF applications. CONCLUSION: Catheter-mediated ablation of AVNRT using high-low frequency slow potentials to localize the slow AV pathway is feasible and safe. Using this technique, a single RF application was successfull in 78% of patients, and slow pathway characteristics were completely eliminated in 75% of patients. The radiation time and the procedure duration were short. This suggest that, in patients with AVNRT, the choice of an appropriate RF target can reduce procedural duration.

Action Potentials↗

PubMed1992

Lower extremity applications of functional neuromuscular stimulation.

Functional electrical stimulation (FES) applications in the lower extremity are common in research laboratories, but clinical applications are minimal. This review summarizes current knowledge with respect to clinical application. When electrical stimulation is used in clinical applications for functional movement such as standing and walking, it is typically applied in an open-loop manner; a predetermined stimulus pattern is delivered regardless of the consequences of the actual movement. Few clinical applications of FES involve closed-loop control because of the numerous difficulties involved in its application. As with any volitional muscle contraction, electrically stimulated muscle contractions will exhibit fatigue. Although the dynamics of fatigue may differ, electrically stimulated muscle contractions cannot be continuously sustained, and if the duty cycle is too severe, even alternating periods of rest and contraction cannot be sustained at a constant force level. The exact nature of fatigue is highly specific to the past history of the individual muscle and to the individual subject. Despite their intricate detail, quantitative modeling studies have not yet been applied extensively to clinical applications. Present implantable systems are not yet a viable option for clinical application. It is not clear whether more success with surface or percutaneous systems must first be achieved to justify implantation or whether greater improvements in implantable technology and surgical protocols are needed before implantable systems will become practical. It is clear that almost any reasonably designed stimulation protocol will increase muscle bulk. The existence of other therapeutic benefits and their cost/benefit ratios remain to be fully established. It is possible to stand through bilateral stimulation of the quadriceps. Using surface electrodes, this technique is achievable in any physical therapy clinic having minimal expertise in neuromuscular stimulation. FES-aided standing must be conducted as a research project with a protocol approved by the local institutional review board, as there are currently no FDA-approved stimulation devices for standing. Multichannel FES systems are not currently available for clinical application in the United States. This may change if the "Parastep" system receives FDA approval. Percutaneous and implanted systems are years away from commercialization and clinical availability. Hybrid systems, based primarily on the reciprocating gait orthosis (RGO), are presently the only clinically available form of walking that includes some form of FES assistance. The costs and benefits of adding FES to the RGO and the long-term user acceptance rate for these systems remain to be determined.

Cerebrovascular Disorders↗

PubMed1983

The performance of a new 915-MHz direct contact applicator with reduced leakage.

The technical feasibility of commercially developing a safe and effective direct contact diathermy applicator operating at the industrial, scientific, medical (ISM) frequency of 915 MHz is demonstrated. The basic design consists of a circular waveguide which is internally loaded with two orthogonal pairs of forward ridges to obtain circular polarization and two rear ridges with a probe to excite the guide. Two prototype designs are considered: the small applicator (15 cm diameter) has one annular choke covered with a 2.5-cm thick microwave absorber, and the large applicator (25 cm diameter) has two additional concentric chokes to limit leakage radiation. The performance of the applicators was evaluated in terms of the requirements of a ORH microwave diathermy test protocol to control stray radiation and deliver a thermally effective absorbed dose rate to simulated muscle tissue of a phantom with a 1-cm or 2-cm fat layer. The net power required to deliver a thermally effective 235-W/kg specific absorption rate (SAR) to such a planar phantom was determined. For this net power, leakage levels considerably less than 5 mW/cm2 (at 5 cm from applicator-phantom boundary) were obtained for the applicators in direct contact with the phantom. If a small spacing (1 cm) between these applicators and planar phantoms is introduced, the net power required to deliver an effective SAR to a phantom and the associated leakage can become excessive. For the small applicator, the required net power for inducing an SAR of 235 W/kg in muscle tissue of a 1-cm fat layer phantom is about 330 W and the leakage is about 120 mW/cm2. For a 2-cm fat layer phantom, these values are somewhat higher. For the large applicator, using a 1-cm fat layer phantom, the values are about 200 W and about 17 mW/cm2. Again, for a 2-cm fat layer phantom, these values are somewhat higher.

Diathermy↗

PubMed1989

Multidisciplinary assessment of applicants for sheltered housing.

Three hundred applicants for sheltered housing underwent multidisciplinary geriatric assessment for suitability as a part of a joint assessment scheme with Local Authority Housing and Social Services Departments. Ninety-four applicants sought a move for health reasons while 206 applicants quoted housing and social reasons and denied medical problems. The assessment showed no significant disability necessitating sheltered housing facilities for 41 (44%) of the 94 people applying on health grounds. Severe disability made sheltered housing placement inappropriate for ten (10%) of the applicants with health problems. In the 206 applicants denying medical problems, the assessment revealed significant unreported physical illness in 46 (22%) and undiagnosed dementia in a further 26 (13%). Allocation of sheltered housing was affected in 99 (33%) of the 300 applicants. Eighty-two applicants were considered unsuitable, whereas 17 applicants originally thought to be unsuitable were recommended for sheltered housing. Multidisciplinary geriatric assessment is of considerable benefit in determining suitability of applicants for sheltered housing and will help in achieving better placement by avoiding inappropriate moves.

Aged↗

PubMed2002

Can medical school admission committee members predict which applicants will choose primary care careers?

PURPOSE: To determine the accuracy of admission committee members' predictions regarding which applicants are likely to become generalists, and to determine which applicant characteristics are used and should be used in making these predictions. METHOD: Thirteen characteristics of each applicant who entered medical school in 1990-1993 and graduated in 1994-1997 were obtained from their applications. Committee members reviewed these characteristics and assigned a probability of each applicant's choosing a generalist career. Just before their graduation, the students were surveyed to ascertain their career plans. The relationships between the characteristics and career predictions were analyzed using regression models. A secondary analysis examined the relationship between the students' stated career preferences at matriculation and career plans at graduation. RESULTS: The accuracy of the committee members' predictions was low. Predictions of generalist careers were significantly related to seven applicant characteristics: rural legal residence, gender (women), lower science grades, lower MCAT science scores, lower levels of parents' education, no reported research activity, and higher levels of community service. In contrast, the students' actual generalist career plans at graduation were significantly related only to gender (women) and higher levels of community service. In the secondary analysis, applicants' stated career preferences at matriculation were the strongest predictor of their having generalist career plans at graduation. CONCLUSIONS: Admission committee members often made inaccurate predictions about applicants' career plans. This may be because they based their judgments on applicants' characteristics that were not significantly related to the students' career plans at graduation.

Adult↗

PubMed2003

Communication between programs and applicants during residency selection: effects of the match on medical students' professional development.

PURPOSE: Communication between programs and applicants during the Match has raised concern among medical educators. This study explores the patterns of such communication and its effect on the ethical and professional development of medical students. METHOD: In March and April 2001, the authors made a secure, anonymous questionnaire available online to 1,362 medical students who were graduating from ten U.S. medical schools and who participated in the 2001 Match. Data analysis included chi square, ANOVA, and correlation tests as appropriate. RESULTS: A total of 740 students (54.3%) completed the questionnaire. Patterns of communication between programs and applicants varied significantly by medical school and specialty. Communication initiated by applicants came predominantly from those from less highly ranked medical schools (p =.000), and those applying to specialties with lower fill rates (p =.000). Programs initiated significantly more communication with applicants from more highly ranked schools (p =.006), and with those applying to specialties with higher fill rates (p =.000). The amount of pressure felt by applicants was related to the level of communication, whether initiated by applicants (p =.028) or programs (p =.000). Applicants who felt more pressure were significantly more likely to make misleading statements to programs (p =.000). CONCLUSIONS: Communication between applicants and programs during the Match varies and may have adverse effects on the ethical and professional development of medical students. This study provides support for proposals to limit communication between programs and applicants during the residency selection process.

Analysis of Variance↗

PubMed2001

Acceptability and feasibility of Micralax applicators and of methyl cellulose gel placebo for large-scale clinical trials of vaginal microbicides.

OBJECTIVE(S): To evaluate the feasibility and acceptability of the Micralax applicator and of methyl cellulose placebo gel for use in vaginal microbicide clinical trials. DESIGN: A two-centre prospective study following women for 2 months. SETTING: Two primary health care clinics in South Africa. PATIENTS, PARTICIPANTS: Female volunteers (n = 28) 18 years or older who were HIV negative and had no clinically detectable genital tract abnormalities or reproductive tract infections. INTERVENTIONS: Participants used pre-filled Micralax applicators to apply methyl cellulose gel every other day, as well as up to 1 h before to every episode of vaginal sex. MAIN OUTCOME MEASURE(S): Consistency in the weight of gel dispensed per application; side-effects attributed to applicator or gel use; and acceptability of the applicator and of the gel. RESULTS: Over a 2 month follow-up period the 22 women completing the study reported no adverse events related to gel or applicator use. The Micralax applicator proved acceptable. The gel was not too messy and did not reduce sexual frequency or pleasure. On average, the applicator dispensed 4.7 ml per use (close to the 4 ml planned). CONCLUSIONS: The Micralax applicator performs well as a delivery system for potential vaginal microbicides; and methyl cellulose is an appropriate placebo for future microbicide trials.

Administration, Intravaginal↗

PubMed2003

HIV-1 infection among civilian applicants for US military service, 1985 to 2000: epidemiology and geography.

OBJECTIVES: This study examined demographic and geographic correlates of HIV-1 prevalence among civilian applicants for US military service. METHODS: HIV-1 test results and demographic and geographic data were available for 5.3 million applicants. RESULTS: Between October 1985 and December 2000, a total of 5,340,694 individuals applied to join one of the armed service branches of the US military. Overall, HIV-1 prevalence was 0.80 per 1000 applicants (95% CI: 0.78-0.82), with 4276 applicants testing positive for HIV-1 infection. Prevalence declined over the 16-year period from a high of 2.89 per 1000 applicants in 1985 to 0.36 per 1000 applicants in 2000. The majority of applicants (82.7%) were male, and the majority of HIV-1 cases (89.4%) occurred in men. HIV-1 prevalence was higher among African Americans (2.47/1000) and Hispanics (0.90/1000) than among white applicants (0.36/1000). HIV-1 prevalence was lowest in the West North Central region of the United States (0.33/1000) and highest in the Middle Atlantic region (1.61/1000) and Puerto Rico (3.56/1000). CONCLUSIONS: Civilian applicants for US military service comprise a unique cohort for following trends in the evolving HIV-1 epidemic.

Adolescent↗

PubMed1997

Steady-state pharmacokinetics of oestradiol gel in post-menopausal women: effects of application area and washing.

OBJECTIVE: To investigate the effect of cutaneous application area on oestradiol absorption using an oestradiol gel for transdermal use. Furthermore, the effect of washing of the application site on oestradiol pharmacokinetics was studied. DESIGN: Open-label, randomised, three-way cross-over study. SETTING: A clinical pharmacokinetic research unit. SUBJECTS: Sixteen healthy postmenopausal volunteers. INTERVENTIONS: During three treatment periods, subjects were treated with 1 mg oestradiol (1.0 g Divigel/Sandrena 0.1% gel), applied on the thigh to a skin area of 200 cm2, 400 cm2, or on an area 'as large as possible'. Blood samples were drawn during steady-state (on days 14-15) immediately before application and at regular time intervals thereafter. MAIN OUTCOME MEASURES: Serum oestradiol levels were measured for determination of peak concentration (Cmax), time to peak concentration (tmax) and bioavailability using the area under the time concentration curve (AUC0-24). RESULTS: Bioavailability from a 200 cm2 area was 2-fold higher than that from the largest possible area (P < 0.05). Oestradiol peak plasma concentration from a 200 cm2 area was higher than from the two larger areas (P < 0.05), which did not differ significantly from each other. Washing of the application site 30 min after application reduced the bioavailability from both the 200 cm2 and 400 cm2 application areas (P < 0.01), but peak plasma concentration from the 200 cm2 area only (P < 0.01). Time to reach peak plasma concentrations was significantly reduced with all three application areas by washing. CONCLUSION: A higher oestradiol absorption was achieved from a smaller application area. No marked differences were observed in the pharmacokinetics between 200 cm2 and 400 cm2 application areas, which are those recommended for this oestradiol gel preparation.

Administration, Cutaneous↗

PubMed2003

The effect of undergraduate GPA selectivity adjustment on pre-interview ranking of rural medical school applicants.

CONTEXT: The ongoing need to attract more physicians into rural practice is well documented, and medical school admission practices are a critical component of a multistep effort to produce rural practitioners. PURPOSE: This study was completed to evaluate whether the practice of adjusting for the selectivity of the undergraduate school attended by medical school applicants has a detrimental effect on the pre-interview rankings of rural applicants. METHODS: Applicants to the Medical University of South Carolina from 1996 through 1999 were the subjects. Applicant pre-interview scores were calculated with and without the adjustment to grade point average (GPA) for selectivity. FINDINGS: There were 2033 in-state applicants in 1996 through 1999, and 8.5% to 9.7% were from rural areas. The selectivity adjustment resulted in 1 less rural applicant gaining an admission interview in 2 cohorts, 1 additional rural applicant gaining an admission interview in 1 cohort, and no difference in the other cohort. CONCLUSION: Adjusting undergraduate GPAs of medical school applicants based on undergraduate selectivity did not adversely affect the number of rural applicants offered admission interviews.

Education, Medical, Undergraduate↗

PubMed2006

Urban-rural differences in the availability of hospital information technology applications: a survey of Georgia hospitals.

CONTEXT: Information technology (IT) has been identified as a potential tool for improving the safety of health care delivery. PURPOSE: To determine if there are significant differences between urban and rural community hospitals in the availability of selected IT functional applications and technological devices. METHODS: A mailed survey of community hospitals in Georgia assessing the current availability of IT applications (54.6% response rate). FINDINGS: Georgia hospitals reported having 63.6% of 56 possible functional applications computerized but only 52.9% of 41 technological devices. Compared to rural hospitals, urban hospitals had significantly more functional applications computerized (38.0 vs 31.8, P = .031) and technological devices available (23.9 vs 18.2, P = .016). Urban hospitals had significantly (P < .05) more IT applications available in 4 areas: emergency room services (7 of 10), surgical/operating room (8 of 12), laboratory (7 of 12), and radiology (5 of 11). Overall, the availability of IT applications was bimodal in rural hospitals: over 40% of rural hospitals had adopted over 70% of all applications, while approximately 26% of rural hospitals had adopted less than 30%. CONCLUSIONS: Some of the observed urban/rural differences in availability of IT applications may be due to differences in the scope of services provided by rural hospitals, in particular laboratories, radiology departments, emergency rooms, and surgery/operating rooms. Nevertheless, the bimodal distribution of IT applications adopted in rural hospitals raises concerns about the ability of selected rural hospitals to take advantage of regional data-sharing initiatives and maintain quality of patient care in the future.

Georgia↗

PubMed2002

Vasodilatation in response to repeated anodal current application in the human skin relies on aspirin-sensitive mechanisms.

The vasodilatation resulting from prolonged square-wave monopolar current application as used in iontophoresis is assumed to rely on an axon reflex. Involvement of prostaglandins in the anodal current-induced vasodilatation remains unclear. We tested the hypothesis that prostaglandins participate in a sensitisation mechanism to current application rather than as direct vasodilators. In healthy volunteers, laser Doppler flowmetry (LDF) was recorded in the forearm during and following isolated or repeated 0.1 mA transcutaneous anodal current applications, using deionised water as a vehicle. Segmented current applications of 6 or 12 mC resulted in an LDF increase twice that observed following current applications of comparable total charge delivered all at once (P < 0.05). Following a 1 min anodal application, a slow and prolonged LDF drift occurred (slope: 0.3 +/- 0.5 arbitrary units min(-1)). When the same current application was repeated after intervals of 5 and 20 min, an abrupt vasodilatation occurred, with maximal LDF amplitude of 53.5 +/- 34.0 and 48.2 +/- 19.1 arbitrary units, respectively. Pretreatment with 1 g oral aspirin abolished the abrupt vasodilatation to repeated current application but not the initial slow drift. We suggest that vasodilatation occurs through two parallel pathways: (1) a slow progressive drift of LDF of limited amplitude insensitive to aspirin pretreatment, and (2) an abrupt vasodilatation probably resulting from afferent fibre activation, appearing if a preliminary sensitisation by current application is performed. Sensitisation lasts for at least 20 min, and is blocked by aspirin, suggesting participation of prostanoids.

Adult↗