By G. Eusebio. California State University, Fresno. 2017.
The image on the left depicts motion at a non-resonant frequency below the fundamental (first) resonance mode buy malegra fxt 140mg with amex, and the image on the right depicts motion at the fundamental resonance frequency 140mg malegra fxt with amex. A constant ampli- tude stimulus was applied to the vibrissa tip at frequencies from 0–600 Hz, and the relative change in vibrissa motion amplitude recorded using an optical sensor placed at the mid-point of the vibrissa length. The fundamental resonance frequency in this example occurred at ~160 Hz (grey vertical bar). The most famous proposal that resonance enhances frequency specific process- ing was made by Helmholtz, who suggested that the resonance properties of the cochlea generated a spatial segregation of frequency bands similar to the separation of frequencies on the strings of a piano, with low frequencies localized at one end of the cochlea and higher frequencies at the other. As such, the biomechanics of the cochlea form a spatial tonotopic map in which vibration, in response to a given frequency, is translated into increased © 2005 by Taylor & Francis Group. The spatial organization of these auditory fibers is preserved in an ascending system of neural tonotopic maps. This position-specific frequency amplification is believed to provide a place code in which the increased mean firing rate at a given position within a central auditory map is employed by an animal to make sound frequency judgments. While cochlear place coding is an important component of stimulus representation, several findings suggest that the fine timing of neural activity evoked by auditory stimuli may also play an essential role in stimulus representation and perception. The Vibrissa Resonance Hypothesis We and others have recently discovered that the biomechanical properties of vibrissae may play a central role in frequency transduction. The first prediction is that vibrissa resonance enhances the detection of small amplitude high frequency stimuli because mechan- ical amplification of these signals generates a detectable increase in the neural mean firing rate. The second prediction is that vibrissa resonance facilitates the discrimi- nation or identification of high frequency information in part through the tuning of individual vibrissae and their corresponding neural representation and in part through a place code provided by the systematic mapping of frequency preference across the face and in central somatic representations. The third prediction is that vibrissa resonance contribute to temporal coding of high frequency information by enabling the recruitment of precise temporal neural activity, most importantly in response to otherwise subthreshold small amplitude stimuli. Within this framework we predict that vibrissa resonance enhances the detection and discrimination of high frequency information generated in a variety of contexts, including airborne stimuli and tex- tured surfaces. VIBRISSA RESONANCE: RATE CODING AND PLACE CODING OF FREQUENCY-SPECIFIC TACTILE INFORMATION A. VIBRISSA RESONANCE Vibrissae resonance demonstrates oscillations of greater amplitude when stimulated at a narrow range of frequencies (Figure 2.
Meditative practices are increasingly offered in medical clinics and hospitals as a tool for improving health and Meditation can be used with other forms of medical quality of life malegra fxt 140mg overnight delivery. Meditation has been used as the primary treatment and is an important complementary therapy for therapy for treating certain diseases; as an additional both the treatment and prevention of many stress-related therapy in a comprehensive treatment plan; and as a conditions discount 140mg malegra fxt free shipping. Regular meditation can reduce the number of means of improving the quality of life of people with de- symptoms experienced by patients with a wide range of bilitating, chronic, or terminal illnesses. Based upon clinical evidence as well as theoretical understanding, meditation is consid- ered to be one of the better therapies for panic disorder, Benefits generalized anxiety disorder, substance dependence and Meditation benefits people with or without acute abuse, ulcers, colitis, chronic pain, psoriasis, and dys- medical illness or stress. It is considered to be a valuable adjunc- GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1307 MAHARISHI MAHESH YOGI 1911– Maharishi Mahesh Yogi is one of the most recog- nized spiritual leaders of the world. Almost single-hand- edly, the Maharishi (meaning great sage) brought Eastern culture into Western consciousness. He emerged in the late 1950s in London and the United States as a mission- ary in the cause of Hinduism, the philosophy of which is called Vedanta—a belief that “holds that God is to be found in every creature and object, that the purpose of human life is to realize the godliness in oneself and that religious truths are universal. These people, and many others, practiced Transcendental Meditation (TM), a Hindu-influenced procedure that en- dures in America to this day. The guru still had enough followers, though, to people the Maharishi International University, founded in 1971. Sid- has believe that group meditation can elicit the maharishi effect—a force strong enough to conjure world peace. Other times the eyes are be a valuable complementary therapy for allergies and open and gazing softly into the distance or at an object. Meditative practices have been reported to im- be concentrating on the sensation of the movement of the prove function or reduce symptoms in patients with breath, counting the breath, silently repeating a sound, some neurological disorders as well. Overall, a 1995 report to the National Institutes of Movement meditation can be spontaneous and free- Health on alternative medicine concluded that, “More form or involve highly structured, choreographed, repeti- than 30 years of research, as well as the experience of a tive patterns. Movement meditation is particularly help- large and growing number of individuals and health care ful for those people who find it difficult to remain still. These types are concentration meditation and professionals published in 2002 indicates that the major- mindfulness meditation. Concentration meditation prac- ity of physicians, nurses, and occupational therapists in tices involve focusing attention on a single object. Objects the United States accept meditation as a beneficial ad- of meditation can include the breath, an inner or external junct to conventional medical or surgical treatments.
Repeat once weekly for 6 wk; repeat 3 weekly doses 3 generic malegra fxt 140mg with mastercard, 6 purchase malegra fxt 140mg mastercard, 12, 18, and 24 mo after the initial therapy SUPPLIED: Inj 27 mg (3. BCG vaccine occasionally used in high risk-children who are negative on the PPD skin test and cannot be given isoniazid prophylaxis. Becaplermin (Regranex Gel) COMMON USES: Adjunct to local wound care in diabetic foot ulcers ACTIONS: Recombinant human PDGF, enhanced formation of granulation tissue DOSAGE: Based on size of lesion; 1¹ ₃-in. May be repeated 3 more × q6h for a max of 4 doses/48h SUPPLIED: Suspension 25 mg of phospholipid/mL NOTES: Administer via 4-quadrant method Betaxolol (Kerlone) COMMON USES: HTN ACTIONS: Competitively blocks β-adrenergic receptors (β1) DOSAGE: 10–20 mg/d SUPPLIED: Tabs 10, 20 mg Betaxolol, Ophthalmic (Betoptic) COMMON USES: Glaucoma ACTIONS: Competitively blocks β-adrenergic receptors (β1) DOSAGE: 1 gtt bid SUPPLIED: Soln 0. Lung toxicity likely when the total dose >400 mg (U) Bretylium COMMON USES: Acute Rx of VF or tachycardia unresponsive to conventional therapy ACTIONS: Class III antiarrhythmic DOSAGE: Adults. Same as adults, except the maintenance dose is 5 mg/kg/dose q6–8h SUPPLIED: Inj 50 mg/mL; premixed inf 1, 2, 4 mg/mL (limited availability) NOTES: Nausea and vomiting associated with rapid IV bolus; gradually ↓ dose and discontinue in 3–5 d; effects seen within the first 10–15 min; transient rise in BP seen initially; hypotension most frequent adverse effect and occurs within the first hours of treatment Brimonidine (Alphagan) COMMON USES: Open-angle glaucoma ACTIONS: α2-Adrenergic agonist DOSAGE: 1 gtt in eye(s) tid SUPPLIED: 0. Dose dependent on procedure, vascularity of tissues, depth of anesthesia, and degree of muscle relaxation required (see Chapter 17) SUPPLIED: Inj 0. Smoking cessation: 150 mg/d for 3 d, then 150 mg bid for 8–12 wk SUPPLIED: Tabs 75, 100 mg; SR tabs 100, 150 mg NOTES: Associated with seizures; avoid use of alcohol and other CNS depressants Buspirone (Buspar) COMMON USES: Short-term relief of anxiety ACTIONS: Antianxiety agent; selectively antagonizes CNS serotonin receptors DOSAGE: 5–10 mg PO tid. No physical or psychological dependence Busulfan (Myleran) COMMON USES: CML, preparative regimens for allogeneic and ABMT in high doses ACTIONS: Alkylating agent DOSAGE: 4–12 mg/d for several weeks; 16 mg/kg once or 4 mg/kg/d for 4 d in conjunction with an- other agent in transplant regimens. Refer to specific protocol SUPPLIED: Tabs 2 mg NOTES: Toxicity symptoms: Myelosuppression, pulmonary fibrosis, nausea (high-dose therapy), gy- necomastia, adrenal insufficiency, and hyperpigmentation of the skin Butorphanol (Stadol) [C] COMMON USES: Moderate to severe pain and headaches ACTIONS: Opiate agonist–antagonist with central analgesic actions DOSAGE: 1–4 mg IM or IV q 3–4 h PRN. Osteo- porosis salmon calcitonin: 100 U/d IM/SC; Intranasal 200 U = 1 nasal spray/d SUPPLIED: Spray, nasal 200 U/activation; inj, human (Cibacalcin) 0. Ca gluconate inj 10% = 100 mg/mL = Ca 9 mg/mL; tabs 500 mg = 45 mg Ca, 650 mg = 58. RDA for Ca: Adults = 800 mg/d, Peds = <6 mo 360 mg/d, 6 mo–1 y 540 mg/d, 1–10 y 800 mg/d; 10–18 y 1200 mg/d Calfactant (Infasurf) COMMON USES: Prevention and Rx of RSD in infants ACTIONS: Exogenous pulmonary surfactant DOSAGE: 3 mL/kg instilled into lungs. May be retreated for a total of 3 doses administered 12 h apart SUPPLIED: Intratracheal susp 35 mg/mL NOTES: Monitor for cyanosis and airway obstruction during administration Candesartan (Atacand) COMMON USES: HTN ACTIONS: Angiotensin II receptor antagonists DOSAGE: 2–32 mg/d, usual dose is 16 mg/d SUPPLIED: Tabs 4, 8, 16, 32 mg Capsaicin (Capsin, Zostrix, etc) [OTC] COMMON USES: Pain due to postherpetic neuralgia, chronic neuralgia, arthritis, diabetic neuropa- thy, postoperative pain psoriasis, intractable pruritus ACTIONS: Topical analgesic DOSAGE: Apply tid–qid SUPPLIED: OTC creams; gel; lotions; roll-ons Captopril (Capoten, Various) COMMON USES: HTN, CHF, LVD, and diabetic nephropathy ACTIONS: ACE inhibitor DOSAGE: Adults. HTN: Initially, 25 mg PO bid–tid; ↑ to a maintenance dose q 1–2 wk by 25-mg increments/dose (max 450 mg/d) to desired effect.
Patient referral by telemedicine: effectiveness and cost analysis of an Intranet system buy 140mg malegra fxt free shipping. Helsinki University of Technology buy cheap malegra fxt 140mg on-line, Department of Computer Science Reports 1994: TKO–A31. The impact of information and communication technology on optimal resource allocation in healthcare. Proceed- ings of the International Conference on TQM and Human Factors QERGO, Linköping, Sweden (pp. Evaluating computerised health informa- tion systems: hard lessons still to be learnt. Combating information overload: A six-month pilot evaluation of a knowledge management system in general practice. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Knowing and acting in medical practice: The epistemological politics of outcomes research. Visions of Health Care Information Systems in Finland by the year 2007 – At the point of intersection between different cultures. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. An Overview of Efforts to Bring Clinical Knowledge to the Point of Care 285 ChapterXVI An Overviewof Efforts to Bring Clinical Knowledgeto the Point of Care Dean F. Sittig, Medical Informatics Department, Kaiser Permanente Northwest, USA, Care Management Institute, Kaiser Permanente, USA and Oregon Health & Sciences University, USA Abstract By bringing people the right information in the right format at the right time and place, state of the art clinical information systems with imbedded clinical knowledge can help people make the right clinical decisions. This chapter provides an overview of the efforts to develop systems capable of delivering such information at the point of care. The first section focuses on “library-type” applications that enable a clinician to look- up information in an electronic document. The second section describes a myriad of “real-time clinical decision support systems.
The functions of blood Serum forms when fibrinogen separates from include the transport of various molecules (O cheap malegra fxt 140mg without a prescription,2 plasma in the process of blood clotting cheap 140 mg malegra fxt visa. CO, nutrients, metabolites, vitamins, electro-2 Theformationofbloodcellsoccursinthered lytes, etc. The suescontainpluripotentstemcells which,with blood consists of a fluid (plasma) formed el- the aid of hematopoietic growth factors (see ements: Red blood cells (RBCs) transport O2 below), develop into myeloid, erythroid and and play an important role in pH regulation. Since pluripotent White blood cells (WBCs) can be divided into stemcellsareautoreproductive,theirexistence neutrophilic, eosinophilic and basophilic is ensured throughout life. Hematocrit (Hct) is the volume ratio precursorcellsareproducedbymyelocytopoie- of red cells to whole blood (! Twohormones,er- tamins, hormones, gases, and proteins are dis- ythropoietinandthrombopoietin,areinvolved solved. Table) are involved in mainly in the liver) promotes the maturation humoral immune defense and maintain on- and development of megakaryocytes from cotic pressure, which helps to keep the blood which the platelets are split off. By binding to plasma pro- othergrowthfactorsaffectbloodcellformation teins, compounds insoluble in water can be in bone marrow via paracrine mechanisms. Itissecreted by Blood volume in liters relative to body weight (BW) the liver in the fetus, and chiefly by the kidney ( 0. Inresponsetoanoxy- Hematocrit (cell volume/ blood volume): gen deficiency (due to high altitudes, hemoly- ( 0. A), erythropoietin secretion in- Erythrocytes (1012/L of blood = 10 /6 µL of blood): creases, larger numbers of red blood cells are ( 4. Red MCH, MCV, MCHC—mean corpuscular (MC), hemo- blood cells regularly exit from arterioles in the globin (Hb), MC volume, MC Hb concentration! C splenic pulp and travel through small pores to Leukocytes (10 /L of blood = 10 /9 3 µL of blood): enter the splenic sinus (! B), where old red 3–11 (64% granulocytes, 31% lymphocytes, blood cells are sorted out and destroyed 6% monocytes) 9 3 (hemolysis). Macrophages in the spleen, liver, Platelets (10 /L of blood = 10 /µL of blood): bone marrow, etc.
