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PubMed2006

A comprehensive overview of the applications of artificial life.

We review the applications of artificial life (ALife), the creation of synthetic life on computers to study, simulate, and understand living systems. The definition and features of ALife are shown by application studies. ALife application fields treated include robot control, robot manufacturing, practical robots, computer graphics, natural phenomenon modeling, entertainment, games, music, economics, Internet, information processing, industrial design, simulation software, electronics, security, data mining, and telecommunications. In order to show the status of ALife application research, this review primarily features a survey of about 180 ALife application articles rather than a selected representation of a few articles. Evolutionary computation is the most popular method for designing such applications, but recently swarm intelligence, artificial immune network, and agent-based modeling have also produced results. Applications were initially restricted to the robotics and computer graphics, but presently, many different applications in engineering areas are of interest.

Artificial Intelligence↗

PubMed2004

A web services choreography scenario for interoperating bioinformatics applications.

BACKGROUND: Very often genome-wide data analysis requires the interoperation of multiple databases and analytic tools. A large number of genome databases and bioinformatics applications are available through the web, but it is difficult to automate interoperation because: 1) the platforms on which the applications run are heterogeneous, 2) their web interface is not machine-friendly, 3) they use a non-standard format for data input and output, 4) they do not exploit standards to define application interface and message exchange, and 5) existing protocols for remote messaging are often not firewall-friendly. To overcome these issues, web services have emerged as a standard XML-based model for message exchange between heterogeneous applications. Web services engines have been developed to manage the configuration and execution of a web services workflow. RESULTS: To demonstrate the benefit of using web services over traditional web interfaces, we compare the two implementations of HAPI, a gene expression analysis utility developed by the University of California San Diego (UCSD) that allows visual characterization of groups or clusters of genes based on the biomedical literature. This utility takes a set of microarray spot IDs as input and outputs a hierarchy of MeSH Keywords that correlates to the input and is grouped by Medical Subject Heading (MeSH) category. While the HTML output is easy for humans to visualize, it is difficult for computer applications to interpret semantically. To facilitate the capability of machine processing, we have created a workflow of three web services that replicates the HAPI functionality. These web services use document-style messages, which means that messages are encoded in an XML-based format. We compared three approaches to the implementation of an XML-based workflow: a hard coded Java application, Collaxa BPEL Server and Taverna Workbench. The Java program functions as a web services engine and interoperates with these web services using a web services choreography language (BPEL4WS). CONCLUSION: While it is relatively straightforward to implement and publish web services, the use of web services choreography engines is still in its infancy. However, industry-wide support and push for web services standards is quickly increasing the chance of success in using web services to unify heterogeneous bioinformatics applications. Due to the immaturity of currently available web services engines, it is still most practical to implement a simple, ad-hoc XML-based workflow by hard coding the workflow as a Java application. For advanced web service users the Collaxa BPEL engine facilitates a configuration and management environment that can fully handle XML-based workflow.

Computational Biology↗

PubMed2000

Effect of l-menthol-ethanol-water system on the systemic absorption of flurbiprofen after repeated topical applications in rabbits.

The effect of the l-menthol-ethanol-water system (MEW system), a skin penetration enhancer, on the systemic absorption of flurbiprofen (FP) after repeated topical applications was investigated. FP (1%) gel containing ethanol (25%) and l-menthol (3%) as penetration enhancers was applied to rabbit dorsal skin and the in vivo absorption rate of FP was compared with the in vitro penetration rate through excised skin. In vivo absorption rate of FP was initially high and decreased with time to a value approximately equal to the in vitro rate. The remaining FP in the gel 6 h after the application was 60% of the initial loading and the systemic bioavailability over the 6 h application was about 10%, suggesting that the rest (30%) had accumulated in the skin tissues. The gel was applied for 6 h on the same site or on a new site after the first 6 h-application to learn the effect of repeated applications on FP absorption. The maximum FP concentration after the second application on the virgin skin was slightly higher than that after the first application, as expected in a typical pharmacokinetic process. In contrast, the same site application induced remarkably lower plasma concentration and area under the curve (AUC). A drug-free gel was also utilized to evaluate the effects of the enhancer system. Pretreatment of the drug-free gel on the same site also decreased the FP absorption, whereas post-treatment increased the plasma level of FP, in spite of the removal of the drug gel. These phenomena could be explained by ethanol in the MEW system acting a local irritant and a drug carrier.

Administration, Topical↗

PubMed2000

Topical application of 5-aminolevulinic acid hexyl ester and 5-aminolevulinic acid to normal nude mouse skin: differences in protoporphyrin IX fluorescence kinetics and the role of the stratum corneum.

An important limitation of topical 5-aminolevulinic acid (ALA)-based photodetection and photodynamic therapy is that the amount of the fluorescing and photosensitizing product protoporphyrin IX (PpIX) formed is limited. The reason for this is probably the limited diffusion of ALA through the stratum corneum. A solution to this problem might be found in the use of ALA derivatives, as these compounds are more lipophilic and therefore might have better penetration properties than ALA itself. Previous studies have shown that ALA hexyl ester (ALAHE) is more successful than ALA for photodetection of early (pre)malignant lesions in the bladder. However, ALA pentyl ester slightly increased the in vivo PpIX fluorescence in early (pre)malignant lesions in hairless mouse skin compared to ALA. The increased PpIX fluorescence is located in the stratum corneum and not in the dysplastic epidermal layer. In the present study, ALA- and ALAHE-induced PpIX fluorescence kinetics are compared in the normal nude mouse skin, of which the permeability properties differ from the bladder. Application times and ALA(HE) concentrations were varied, the effect of a penetration enhancer and the effect of tape stripping the skin before or after application were investigated. Only during application for 24 h, did ALAHE induce slightly more PpIX fluorescence than ALA. After application times ranging from 1 to 60 min, ALA-induced PpIX fluorescence was higher than ALAHE-induced PpIX fluorescence. ALA also induced higher PpIX production than ALAHE after 10 min of application with concentrations ranging from 0.5 to 40%. The results of experiments with the penetration enhancer and tape stripping indicated that the stratum corneum acts a barrier against ALA and ALAHE. Use of penetration enhancer or tape stripping enhanced the PpIX production more in the case of ALAHE application than in the case of ALA application. This, together with the results from the different application times and concentrations indicates that ALAHE diffuses more slowly across the stratum corneum than ALA.

Aminolevulinic Acid↗

PubMed2005

Evaluation of application technologies of entomopathogenic nematodes for control of the black vine weevil.

Black vine weevil, Otiorhynchus sulcatus (F.), is a severe pest of small fruit and nursery crops around the world. These studies were conducted to determine the efficacy of three species of entomopathogenic nematodes (Heterorhabditis marelatus, Heterorhabditis bacteriophora, and Steinernema riobrave) applied in infected host cadavers or as aqueous applications for black vine weevil larval control. Experiments were conducted in the greenhouse and outdoors. Application of three infected host cadavers or 40 infective juvenile nematodes (IJs) /cm2 were made to pots of Impatiens walleriana 5-7 d after larval infestation. Efficacy was assessed at 14 d in the greenhouse and at 14 and 28 d after nematode application in outdoor trials. In the greenhouse, all treatments with the exception the S. riobrave (cadaver and aqueous applications) provided nearly 100% efficacy after 14 d. The S. riobrave applications, although significantly better than the control, only provided 40-70% control and were not included in the outdoor trials. Nematode efficacy was slowed in the outdoor trials particularly in the cadaver applications. In the initial outdoor trial (soil temperatures < 12 degrees C), there were no significant differences between any nematode treatment and the control after 14 d. The nematode efficacy in the initial outdoor trial after 28 d was improved from the 14-d evaluation but not to the level seen in the second trial. In the second outdoor trial, in which soil temperatures were higher (> 12 degrees C), the aqueous applications of H. marelatus and H. bacteriophora provided nearly complete control after 14 d. The cadaver applications also provided nearly complete control in the second outdoor trial after 28 d. Even though the potential total number of IJs estimated per pot was higher in the cadaver-applied treatments, cool soil temperatures apparently delayed or potentially reduced IJ emergence from cadavers resulting in delayed control.

Animals↗

PubMed2006

Efficacy of broadcast and perimeter applications of S-methoprene bait on the red imported fire ant in grazed pastures.

The red imported fire ant, Solenopsis invicta (Buren), is a major pest in the United States because of its painful sting. Toxic bait has been an important management tool against fire ants, but site registrations prohibit applications of most baits on grazed pastures. Extinguish, containing the insect growth regulator methoprene, was selected for this study because it has a broad site registration that includes grazed pastures. The primary objective of this research was to evaluate the efficacy for control of red imported fire ants by using broadcast applications of methoprene bait at a label rate of 1,121 g/ha versus applications around the perimeter of a target area at the reduced rate of 280 g/ha. Grazed pastures in Lee County, Alabama, and Chambers County, Alabama, were selected for this study, with broadcast treatments, perimeter treatments, and controls replicated three times at each site. All mounds were counted and rated using the USDA population index before applications and then at 8 and 16 wk posttreatment. Perimeter applications did not significantly reduce S. invicta mound abundance, but bait treatments significantly reduced mound abundance at 16 wk posttreatment at site 1 where applications were conducted in early evening. However, broadcast applications were not effective at site 2 where treatments were conducted in early morning with warmer temperatures. Emergence of winged alates was observed at 12 wk posttreatment, followed by a high density of incipient mounds that may have masked the full treatment effect of methoprene applications at site 2. Methoprene bait was effective in reducing abundance of S. invicta only when full label rates were applied.

Agriculture↗

PubMed1994

Occupational impairment and disability among applicants for Social Security disability benefits in Pennsylvania.

OBJECTIVE: The study goal was to assess the extent of workplace-related disease and injury among Social Security Disability Insurance applicants. METHODS: A convenience sample of 240 consecutive applicants to the Pennsylvania Bureau of Disability Determination was studied to assess the prevalence of work-related disorders. An applicant had a work-related condition if there was a clear statement of a workplace illness or injury associated with the impairment, or if the applicant had worked at an occupation with a high likelihood of exposures known or suspected to contribute to the condition of interest. RESULTS: Of the 240 applicants, 166 (69%) were awarded disability insurance benefits; a total of 27 (11%) had work-related conditions, including 14 of the 166 (8%) who were found to be disabled. Forty percent of the 27 had a disorder that was musculoskeletal in origin. Of 59 applicants with cancer, 10.2% had some work-related etiological component. Of an estimated 71,680 adult disability insurance applicants in Pennsylvania in 1990, 5134 new insurance beneficiaries had a projected occupationally related disability. CONCLUSIONS: A substantial number of applicants for disability insurance benefits suffer from an impairment caused or exacerbated by prior workplace exposures. These individuals may serve as sentinel events for initiating follow-up surveillance and prevention activities.

Accidents, Occupational↗

PubMedDate not supplied

Application technique and slurry co-fermentation effects on ammonia, nitrous oxide, and methane emissions after spreading: II. Greenhouse gas emissions.

The aim of this study was to investigate the effect of different application techniques on greenhouse gas emission from co-fermented slurry. Ammonia (NH3), nitrous oxide (N2O), and methane (CH4) emissions were measured in two field experiments with four different application techniques on arable and grassland sites. To gather information about fermentation effects, unfermented slurry was also tested, but with trail hose application only. Co-fermented slurry was applied in April at a rate of 30 m3 ha(-1). Measurements were made every 4 h on the first day after application and were continued for 6 wk with gradually decreasing sampling frequency. Methane emissions were <150 g C ha(-1) from co-fermentation products and seemed to result from dissolved CH4. Only in the grassland experiment were emissions from unfermented slurry significantly higher, with wetter weather conditions probably promoting CH4 production. Nitrous oxide emission was significantly increased by injection on arable and grassland sites two- and threefold, respectively. Ammonia emissions were smallest after injection or trail shoe application and are discussed in the preceding paper. We evaluated the climatic relevance of the measured gas emissions from the different application techniques based on the comparison of CO2 equivalents. It was evident that NH3 emission reduction, which can be achieved by injection, is at least compensated by increased N2O emissions. Our results indicate that on arable land, trail hose application with immediate shallow incorporation, and on grassland, trail shoe application, bear the smallest risks of high greenhouse gas emissions when fertilizing with co-fermented slurry.

Ammonia↗

PubMedDate not supplied

Field dissipation of acetochlor in two New Zealand soils at two application rates.

The persistence of pesticides in soils has both economic and environmental significance and is often used as a key parameter in pesticide risk assessment. Persistence of acetochlor [2'-ethyl-6'-methyl-N-(ethoxymethyl)-2-chloroacetylanilide] in two New Zealand field soils was measured over two years and the data were used to identify models that adequately describe acetochlor persistence in the field. Acetochlor was sprayed onto six fallow plots (3 x 9 m each) at each site at the recommended rate (2.5 kg a.i. ha(-1)) and at twice that rate. Acetochlor concentrations were measured in soil cores. Simple first-order kinetics (Model 1) adequately described acetochlor persistence in Hamilton clay loam soil (Humic Hapludull, Illuvial Spadic) at the high application rate, but overestimated it at the low application rate. A quadratic model (Model 2), a first-order double-exponential model (Model 3), a first-order biphasic model (Model 4), or a two-compartment model (Model 5) better described acetochlor persistence at the low application rate. The time for 50% (DT50) and 90% (DT90) of initial acetochlor loss was approximately 9 and 56 d, and 18 and 63 d at low and high application rates, respectively. The more complex Models 2 through 5 also better described the biphasic dissipation of acetochlor in Horotiu sandy loam soil (Typic Orthic Allophanic) than Model 1, with Model 1 significantly underestimating acetochlor concentrations on the day of application at both application rates. The DT50 and DT90 values were 5 and 29 d and 7 and 31 d at low and high application rates, respectively. Overall, application rate significantly affected the DT50 and DT90 values in the Hamilton soil, but not in the Horotiu soil. Faster acetochlor loss in the Horotiu soil possibly resulted from the higher soil organic carbon content that retained more acetochlor near the soil surface where higher temperature and photolysis accelerated the loss.

Environmental Monitoring↗

PubMed2006

Poultry litter application to loblolly pine forests: growth and nutrient containment.

Forestland application of poultry manure offers an alternative to the conventional practice of pastureland application. Before such a practice is considered viable, however, it must be demonstrated that the forest ecosystem is capable of absorbing the nutrients contained in poultry manure, especially nitrogen (N) and phosphorus (P). From the forestry perspective, it must also be demonstrated that tree growth is not diminished. We investigated these questions using loblolly pine (Pinus taeda L.) stands growing in central Mississippi in an area of high poultry production. Stockpiled broiler litter was applied to newly thinned, 8-yr-old stands at 0, 4.6, and 18.6 dry Mg ha-1, supplying 0, 200, and 800 kg N ha-1 and 0, 92, and 370 kg P ha-1, respectively. Levels of nitrate in soil water, monitored at a 50-cm depth with porous cup tension lysimeters, exceeded 10 mg N L-1 during the first two years after application in the 18.6 Mg ha-1 rate but only on two occasions in the first year for the lower rate of application. Phosphate was largely absent from lysimeter water in all treatments. Other macronutrients (K, Ca, Mg, S) were elevated in lysimeter water in proportion to litter application rates. Soil extractable nitrate showed similar trends to lysimeter water, with substantial elevation during the first year following application for the 18.6 Mg ha-1 rate. Mehlich III-extractable phosphate peaked in excess of 100 microg P g-1 soil during the third year of the study for the 18.6 Mg ha-1 rate. The 4.6 Mg ha-1 rate did not affect extractable soil P. Tree growth was increased by the poultry litter. Total stem cross-sectional area, or basal area, was approximately 20% greater after 2 yr for both rates of litter application. Overall, the nutrients supplied by the 4.6 Mg ha-1 rate were contained by the pine forest and resulted in favorable increases in tree growth. The higher rate, by contrast, did pose some risk to water quality through the mobilization of nitrate. These results show that, under the conditions of this study, application of poultry litter at moderate rates of approximately 5 Mg ha-1 to young stands of loblolly pine offers an alternative disposal option with minimal impacts to water quality and potential increases in tree growth.

Animals↗

PubMed2006

Soil microbial communities and enzyme activities under various poultry litter application rates.

The potential excessive nutrient and/or microbial loading from mismanaged land application of organic fertilizers is forcing changes in animal waste management. Currently, it is not clear to what extent different rates of poultry litter impact soil microbial communities, which control nutrient availability, organic matter quality and quantity, and soil degradation potential. From 2002 to 2004, we investigated the microbial community and several enzyme activities in a Vertisol soil (fine, smectitic, thermic, Udic Haplustert) at 0 to 15 cm as affected by different rates of poultry litter application to pasture (0, 6.7, and 13.4 Mg ha(-1)) and cultivated sites (0, 4.5, 6.7, 9.0, 11.2, and 13.4 Mg ha(-1)) in Texas, USA. No differences in soil pH (average: 7.9), total N (pasture: 2.01-3.53, cultivated: 1.09-1.98 g kg(-1) soil) or organic C (pasture average: 25-26.7, cultivated average: 13.9-16.1 g kg(-1) soil) were observed following the first four years of litter application. Microbial biomass carbon (MBC) and nitrogen (MBN) increased at litter rates greater than 6.7 Mg ha(-1) (pasture: MBC = >863, MBN = >88 mg kg(-1) soil) compared to sites with no applied litter (MBC = 722, MBN = 69 mg kg(-1) soil). Enzyme activities of C (beta-glucosidase, alpha-galactosidase, beta-glucosaminidase) or N cycling (beta-glucosaminidase) were increased at litter rates greater than 6.7 Mg ha(-1). Enzyme activities of P (alkaline phosphatase) and S (arylsulfatase) mineralization showed the same response in pasture, but they were only increased at the highest (9.0, 11.2, and 13.4 Mg ha(-1)) litter application rates in cultivated sites. According to fatty acid methyl ester (FAME) analysis, the pasture soils experienced shifts to higher bacterial populations at litter rates of 6.7 Mg ha(-1), and shifts to higher fungal populations at the highest litter application rates in cultivated sites. While rates greater than 6.7 Mg ha(-1) provided rapid enhancement of the soil microbial populations and enzymatic activities, they result in P application in excess of crop needs. Thus, studies will continue to investigate whether litter application at rates below 6.7 Mg ha(-1), previously recommended to maintain water quality, will result in similar improved soil microbial and biochemical functioning with continued annual litter application.

Alkaline Phosphatase↗

PubMedDate not supplied

Intracavitary hyperthermia applicators for treating nasopharyngeal and cervical cancers.

Many intracavitary microwave applicators have been designed to heat tissues along the side of an antenna. For tumours in nearly closed-end cavities such as the nasopharynx and cervix, heating near the tip of the applicators is necessary for effective treatment. A nasopharyngeal applicator made of Micro Coax UT-250A and a cervical applicator made of RG-9/U cables were designed to provide heating at the tip. Return losses of 8-12 dB were obtained at 915 MHz by varying the size of two metal sleeves and adjusting the distance between these sleeves and the reflectors at the applicator tips. Heating patterns were evaluated on a muscle phantom with a thermograph. At 915 MHz, maximum heating rates of 1.3 and 0.85 degrees C/W-min, respectively, were observed near the tip of the nasopharyngeal applicator and at its first sleeve opening. When operated at 915 MHz the cervical applicator has a maximum heating rate of 0.25 degrees C/W-min at the tip. Clinically, both applicators require a maximum power of 30 W to provide effective heating. This makes it possible to provide intracavitary hyperthermia at rural hospitals and small clinics with a small portable system.

Biomedical Engineering↗

PubMedDate not supplied

Ultrasound applicators with integrated catheter-cooling for interstitial hyperthermia: theory and preliminary experiments.

Theoretical and experimental methods were used to evaluate a design of ultrasound applicators for interstitial hyperthermia. The basic schema consists of a multielement array of tubular piezoceramic radiators (1.5-1.6 mm diameter), each 5-10 mm long with separate power control, designed to be inserted within a 13-14 gauge closed-end brachytherapy implant catheter. Channels for circulating temperature-regulated water are integrated within the applicator to provide control of the catheter/tissue interface temperature. A quantitative theoretical analysis was undertaken to determine heating performance as a function of applicator spacing, blood perfusion, catheter material, frequency and required acoustic power output. Prototype multielement applicators were constructed and characterized in terms of acoustic pressure-squared distributions and acoustic power output capabilities. This study demonstrated distinct advantages of these catheter-cooled multielement ultrasound applicators within an implant, including higher T90's achievable within highly perfused tissues, dynamic control of the longitudinal power deposition, and no interaction between adjacent applicators or elements or sensitivity to applicator alignment. Preliminary measurements of prototype devices have indicated that implementation of these interstitial ultrasound applicators with integrated catheter-cooling is practicable, yet further development and in vivo verification of performance is warranted.

Acoustics↗

PubMed1976

A study of applicants to colleges of optometry in the U.S.

A statistical summary of numbers of applicants and applications to U.S. colleges of optometry, dentistry, and medicine is presented for the six academic years, 1969-70 through 1974-75. Attention is drawn to changes during the five-year interval in numbers of (a) professional schools, (b) total applicants, (c) total applications, (d) applicants accepted, (e) applicants per acceptance, (f) percent of applicants accepted, and (g) applications per individual. Absolute numbers are listed in tabular form and, to facilitate interdisciplinary comparison, in relative numbers in a series of figures. Concerns raised by the trends revealed are outlined.

Humans↗

PubMedDate not supplied

The effect of double adhesive application on the shear bond strength to dentin of compomers using three one-bottle adhesive systems.

The development of one-bottle dentin adhesive systems resulted in much optimism about providing simplified predictable esthetic dentistry. However, laboratory testing of these systems continues to provide significant variations between facilities. A potential effect of the number of applications was noted in this author's laboratory. This study evaluated the effect of doubling the manufacturer's recommended number of applications on shear bond strength to dentin. Ninety human molars were divided into groups of 15. The occlusal surfaces were finished to 600 grit SiC to provide a flat dentin bonding surface. Prime & Bond NT-Dyract, Optibond Solo-Elan and One Step-Dyract were evaluated. Each material was tested using: (1) the recommended number of adhesive applications and (2) twice the number of applications recommended. All adhesive applications were accomplished before light curing the adhesive. The specimens were thermocycled after one week of storage and tested in shear after two weeks. Specimens were also fabricated after adding Rhodamine D to the adhesive to allow for visualization using confocal microscopy. These teeth were sectioned and viewed 24 hours after fabrication. A t-test was used to compare differences within product groups. The results showed a significant effect (p < 0.001) when a double application of Prime & Bond NT was used. No difference was seen with Optibond Solo or One Step. All specimens appeared to have a uniform, glossy appearance of adhesive during fabrication. Therefore, the appearance of the adhesive after application may not be a reliable predictor of acceptable bonding. Confocal microscopy showed that single application Prime & Bond NT specimens did not exhibit a uniform thickness of adhesive across the entire interface. Tubule penetration and hybridization was apparent for all specimens.

Bisphenol A-Glycidyl Methacrylate↗

PubMed2001

Effect of papaverine applications on blood flow of the internal mammary artery.

The aim of this prospective study was to compare the effect of different papaverine applications on the free blood flow in the internal mammary artery (IMA) prepared for coronary artery bypass grafting (CABG). The patients were divided into three groups: group I (n=50; intraluminal papaverine application), group II (n=50; topical papaverine application), and group III (n=50; periarterial papaverine application). The free flow from the distal cut end of the IMA was measured under controlled hemodynamic conditions (Flow 1). Just before the establishment of cardiopulmonary bypass, the flows of the IMA were measured again (Flow 2). The mean blood flow in the IMA was 60.7+/-6.0 ml/min before papaverine application. After papaverine application, the mean blood flow in group I was 129.3+/-10.0 ml/min, in group II, it was 87.7+/-3.8 ml/min, and in group III, it was 130.6+/-9.2 ml/min (p<0.0001). Proportional increases in blood flow observed in group I (106.3%) and group III (116.2%) were higher than in group II (44.2%) (p<0.0001). Consequently, to relieve perioperative spasm of the IMA, application of papaverine injected into the periarterial tissues of its pedicle was considered to be a safe and effective alternative to topical or intraluminal application.

Adult↗

PubMed2001

Deception by applicants to family practice residencies.

BACKGROUND AND OBJECTIVES: Our residency program experienced applicants who actively misrepresented qualifications, background, or abilities. The experiences of other family practice residencies were unknown. This study 1) determined what information family practice residency directors required from applicants, 2) assessed whether this information was confirmed or verified, and 3) describes the deceptive application information discovered by program directors. METHODS: A questionnaire was sent to directors of all accredited family practice residencies. Information was collected about required information, data confirmation, and the deception and misrepresentation perceived. RESULTS: Thirty-two percent of the directors responded. Eight of 13 items on the Electronic Residency Application System were designated as required by more than half of responding directors. Only two of the items (licensure and certain facts in the personal statement) were confirmed by a majority of directors who required them. Deception was recognized by nearly half of respondents within the past 5 years. Most cases involved specialty choice or the personal statement of candidates and were recognized during the interview or by direct confirmation of data. CONCLUSIONS: Most directors appear to accept application information at face value. Recognition of deception about application information was reported. Misrepresentation by applicants may be a more common event than previously realized and may require more thorough verification of application credentials.

Clinical Competence↗

PubMed2001

Early detection of cervical cancer through acetic acid application--an aided visual inspection.

OBJECTIVE: To assess the sensitivity and specificity of visual inspection of cervix for detection of precancerous and early cancerous lesions of cervix. METHODS: In a Maternal and Child Health Care setting of New Delhi women underwent a detailed pelvic examination, visual inspection of cervix after 5% acetic acid application, cytology (pap smear), detailed colposcopic examination and colposcopic directed biopsy when indicated. RESULTS: Findings of aided visual inspection using 5% acetic acid and of cytology were evaluated among symptomatic 402 women against colposcopic findings and/or histologic reports. Seventy-three mild dysplasias, 50 moderate dysplasias, 45 severe dysplasias/Carcinoma in-situ and 40 early invasive cancerous cases were diagnosed histologically. The sensitivity of cytology (75.3%) was higher compared to that of acetic acid application (52.0%) for mild dysplasias. On the other hand, the sensitivity for detecting moderate dysplasias was 78% for cytology and 81.6% for acetic acid; for severe dysplasias/carcinoma in-situ it was 73.3% for cytology and 86.7% for acetic acid. For invasive cancers sensitivity for acetic acid application and cytology (95% for both modalities) was comparable. The specificity of cytology (99%) was higher compared to that of acetic acid application (94.3%). The false positive rate for cytology was 1.0% as against 5.7% for acetic acid application. The results of acetic acid application also showed a remarkable improvement in the sensitivity of unaided visual inspection for early cancerous lesion which was about 60% for early cancerous lesion and only 12% for mild dysplastic and 20% for moderate and severe dysplastic lesions in our earlier experience. It also reduced the false positive rates from 12% by unaided visual inspection to 5.7% by acetic acid application. Furthermore, cost of detection of one true lesion through acetic acid application (Rs.1689.00) was much lower as compared to the cost involved in cytology detected true lesions (Rs.2227.00). Visual inspection without acetic acid incurred Rs.6608.60 for detection of true lesion. CONCLUSION: Screening for cervical precancerous and cancerous lesions using visual inspection aided by acetic acid may be a suitable low-cost and a feasible alternative modality for control of cervical cancer in a resource poor setting.

Acetic Acid↗