How much effort is needed to keep up with the literature relevant for primary care?

OBJECTIVES: Medicine must keep current with the research literature, and keeping current requires continuously updating the clinical knowledge base (i.e., references that provide answers to clinical questions). The authors estimated the volume of medical literature potentially relevant to primary care published in a month and the time required for physicians trained in medical epidemiology to evaluate it for updating a clinical knowledge base. METHODS: We included journals listed in five primary care journal review services (ACP Journal Club, DynaMed, Evidence-Based Practice, Journal Watch, and QuickScan Reviews). Finding little overlap, we added the 2001 "Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library." We counted articles (including letters, editorials, and other commentaries) published in March 2002, using bibliographic software where possible and hand counting when necessary. For journals not published in March 2002, we reviewed the nearest issue. Five primary care physicians independently evaluated fifty randomly selected articles and timed the process. RESULTS: The combined list contained 341 currently active journals with 8,265 articles. Adjusting for publication frequency, we estimate 7,287 articles are published monthly in this set of journals. Physicians trained in epidemiology would take an estimated 627.5 hours per month to evaluate these articles. CONCLUSIONS: To provide practicing clinicians with the best current evidence, more comprehensive and systematic literature surveillance efforts are needed.     

Electroosmotic flow hysteresis for dissimilar ionic solutions

Electroosmotic flow (EOF) with two or more fluids is commonly encountered in various microfluidics applications. However, no investigation has hitherto been conducted to investigate the hysteretic or flow direction-dependent behavior during the displacement flow of solutions with dissimilar ionic species. In this investigation, electroosmotic displacement flow involving dissimilar ionic solutions was studied experimentally through a current monitoring method and numerically through finite element simulations. The flow hysteresis can be characterized by the turning and displacement times; turning time refers to the abrupt gradient change of current-time curve while displacement time is the time for one solution to completely displace the other solution. Both experimental and simulation results illustrate that the turning and displacement times for a particular solution pair can be directional-dependent, indicating that the flow conditions in the microchannel are not the same in the two different flow directions. The mechanics of EOF hysteresis was elucidated through the theoretical model which includes the ionic mobility of each species, a major governing parameter. Two distinct mechanics have been identified as the causes for the EOF hysteresis involving dissimilar ionic solutions: the widening/sharpening effect of interfacial region between the two solutions and the difference in ion concentration distributions (and thus average zeta potentials) in different flow directions. The outcome of this investigation contributes to the fundamental understanding of flow behavior in microfluidic systems involving solution pair with dissimilar ionic species.