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Robotics: a way to link the "islands of automation".

This article looks at what the natural evolution of robots can do for the clinical testing industry, from performing simple functions to becoming the prime labor force of the clinical laboratory. Until now, robots have been applied to instrument processes as somewhat of an upgrade to accomplish a variety of laboratory tasks. Over the next 10 years, however, robotics development will respond to the internal and external influences expected to challenge the industry. A limited supply of human workers and the increased demands of testing volumes and cost-effectiveness will herald a new phase of robotics to link, as well as develop, technological capabilities. Since science fiction was invented, robots have teased the imagination-alternately as mindless automatons or as clones of their inventors endowed with minds of their own. The appeal in the first case was the seemingly infinite capacity for performing menial tasks too boring, complex, or dangerous for mankind. The appeal in the second was the fantasy of artificial intelligence. In both cases, the fictional concept has become reality--and, by the 21st century, should even be commonplace. Financial encouragement of robotics development might even be a mission for laboratories themselves, as they prepare for potential competition from even more complex technology.

Autoanalysis↗

Are foundations bearing fruit?

This is the second installment of a series on the impact of the growing number of sales of not-for-profit hospitals to investor-owned chains. Our March 13 issue reviewed whether communities benefit more from having inventor-owned hospitals that pay taxes or tax-exempt hospitals that provide more charity care. This week: Do tax-exempt foundations deliver on their promises? Also, an analysis of Columbia/HCA Healthcare Corp.'s strategy of acquiring not-for-profits through partnership agreements.

Charities↗

Technology transfer in the diagnostics industry.

Initiatives are underway to increase links between researchers and inventors working in the diagnostics sector and companies ready to commercialize the new technologies. This article describes the formation and aims of two groups working in this area, and reports on a review that has been made of the market requirements and opportunities for advanced sensors in the health care sector. The medical sensors market is predicted to expand during the next few years and the best opportunities for their development are outlined.

Diagnosis↗

Needed: a new system of intellectual property rights.

The world's current system of intellectual property rights has in recent years become unworkable and ineffective. Designed more than 100 years ago to meet the needs of an industrial era, it is inadequate to handle the ownership and distribution of intellectual property generated by the brainpower industries that have come to dominate the world's economy. The prevailing wisdom is that minor tweaking can remedy the problem. But MIT economist Lester Thurow challenges such thinking and calls instead for a new system--one redesigned from the ground up. In making his case for why the old system doesn't work anymore, Thurow lays out the challenges the new system must meet. It must offer incentives to inventors that are strong enough to offset the decline in publicly funded research. At the same time, it must protect the public interest by keeping some intellectual property--basic scientific knowledge, for example--in the public domain. The new system must be flexible enough to deal with the fact that new technologies have created new potential forms of intellectual property rights (Can pieces of a human being be patented?) and have made old rights unenforceable (When books can be downloaded from an electronic library, what does a copyright mean?). And in an increasingly global economy, a new system must meet the needs of both "catch-up" states and "keep-ahead" states. A system that ignores the lesson of history--that every country that has caught up has done so by copying--will be an unenforceable one.

Copyright↗

3D-brain 2.0--narrowing the gap between personal computers and high end workstations.

UNLABELLED: Recent advances in personal computer hardware and software have pushed the graphic capacity of these easier to use and, more importantly, cheaper computers to a level approximating the current standard of high end workstations. The interactivity and graphic complexity of a modern PC is rapidly approaching the current standard on Silicon Graphics (although with respect to texture mapping, the SGI is still ahead of the PCs). The modern medical student laboring under increasingly higher demands with respect to versatility, not only in basic science and traditional medical knowledge, is also faced with the requirement to learn and understand modern scientific visualization and analytical instruments. Furthermore, basic knowledge of information technology and computer literacy is expected of the next generation medical professionals. These demands forces medical schools to increasingly invest in computers and information technology for educational purposes. Due to common class sizes, these computers are most commonly Windows PCs or Apple Macintoshes. For distance education, telematics or studies at home, personal computer versions of the workstation graphics are a necessity. 3D-Brain 2.0 is an educational software package intended to run on basic personal computers and utilizing modern software technologies such as QuickTime VR 2.0 and VRML 2.0, to provide the students with insight into modern clinical and scientific visualization, focusing on the anatomy and functionality of the human brain. The aim of this paper to test the validity and usefulness of these new visualization techniques. METHODS: 3D-Brain is based on human brains sliced in 1 mm sections (NB. NOT based on NLMs Visual Human). Each slice was photographed, digitized, optimized and aligned using proprietary software. The datasets were then created by manual tracing followed by triangulation, smoothing and 3D visualization using Silicon Graphics computers. For the QuickTime VR project, 684 images with a 10 degrees angle were generated for each scene and ported to an Apple Macintosh computer for further manipulation. VRML code was generated directly from the original dataset. All interactivity was programmed on a Macintosh and subsequently ported to the Windows95 PC platform. The minimum requirements to run the software are either a PowerPC based Macintosh computer or a Pentium based Windows 95 computer with 16 Mb, 16 bit display and a 4 speed CD-ROM. RESULTS AND DISCUSSION: 3D-Brain 2.0 provides medical students at Goteborg University the means to complement traditional teaching using visualization techniques and three-dimensional models. These techniques also serve as an insight into the different clinical means of visualization the student will encounter throughout his/her continued education and professional career. For educational purposes, it has been established that among the tested new visualization techniques, CD-ROM based software utilizing QTVR is still the best methodology to use for pedagogical software. VRML shows promise in porting these software packages to the Web while Open Inventor is the preferred format for research purposes.

Brain↗

International biological standardization in historic and contemporary perspective.

Recounting the origination and development of the concepts and institutions to foster and control new and existing biological products is a fertile subject for historical review. It describes what was a necessary and functional activity that needed to be brought into being. The earliest examples of biologicals regulation were created by the eighteenth century inventors themselves and became progressively institutionalized by the creation of national control authorities which increased in number and sophistication during the past century. In 1948, the World Health Organization (WHO) was established and created biological standards and regulations as an advisory to member nations. This too has grown in sophistication and is now of central importance in the biologicals enterprise worldwide. The field of biological standardization and regulation can be viewed in its need and role to foster technological development and to assure that the products of that endeavour are worthy and are retained. In many respects, it is a tale of troubles, tragedies, and triumphs and this is recounted in the text.

Animals↗

Marshall H. Webb and extension for prevention: a literature review.

Dr Marshall Webb (1844-1883), author, lecturer, debater, clinician, inventor, and dentist extraordinaire, was a decade ahead of others in putting forth a concept of "extension for prevention." One hundred twenty years ago, he was one of the best known, most advanced, and highly regarded dentists in the world. His pioneering work in cardiology, preventive dentistry, ethics, and prevention of recurrent decay raised the standards of what we call operative or conservative dentistry, but he is almost unknown now. However, his concept of conservative tooth preparation could be applied today.

Dental Caries↗

Thomas Lea Buckingham, MD, DDS, (1816-1883).

Miller, farmer, mechanic, dry goods merchant, dentist, author, physician, teacher, inventor, and fourteenth president of the American Dental Association, take your pick, for Thomas Lea Buckingham without feigning, embraced that menu to the brim--the verge beyond which, only a pittance of dentists might succeed. Nevertheless, the facts lie untouched--a testament to one of dentistry's most brilliant, unassuming, and dedicated disciples. Loved by his students and respected by his peers, Thomas Lea Buckingham reached new heights in garnishing respect from his colleagues. Sharing his knowledge, Dr. Buckingham profusely wrote about his findings, being affirmed by at least 25 dental periodicals (many with multiple contributions), over a period of thirty-four years, from 1850 to 1884. His principal writings appeared in Dental Cosmos, Johnston's Dental Miscellany, New York Odontologic Society Transcripts, Odontologic Society of Pennsylvania, American Dental Association Transactions, Dental Items of Interest, Pennsylvania Journal of Dental Science, Dental News, Dental Jairus, Missouri Dental Journal, Dental Registrar, New England Journal of Dentistry, and the British Journal of Dental Science. Upon Buckingham's death, noted dentists of his era spoke with love and respect of this exceptional dentist. This paper highlights the maturation of a minimally educated miller, who, with determination and purpose, rose to the pinnacle of his selected professions and garnered the love and respect of his fellow men.

History, 19th Century↗

The historical impact of minimally invasive surgery.

At first there is an idea which asks for more comfort for the patient and equal results compared to conventional procedures. This means less pain and fatigue, quicker convalescence and shorter hospital stay. The new procedures requests an entirely new operative skill and a new technique with new instruments. Those were early developed in Germany. The roads on which this was performed will be described. In another chapter the history of this development is shown, especially the German, French and US inventors with a special view on their personal experiences and disappointments like in the German surgeon M_he and the gynecologist Semm from Kiel, Germany. But they all remained enthusiastic as a common personal quality. The new technique (MIC) was translated "Mickey-Mouse-Surgery" and medicolegal consequences like in M_he were usual events. Another example of misunderstanding of the impact of the new technique: the first publication of Semm about the laoaroscopically removed appendix has been withheld so long in Germany until it was published in the USA in the Journal "Obstetrics and Gynecology". Besides this it is reported about the life cycle of this innovation pointing out to the final promising report, the professional adoption and public acceptance and the randomized controlled trials. The last stage is characterized by "jumping on another train". Pictures are shown of those pioneers who had the idea, who understood what they were doing and who took the responsibility. The final chapter will deal with the consequences for the future generation of surgeons and their training and the unanswered questions as to further fields. Doubtlessly, the pioneer period did not come to an end yet. A glance into the future may be allowed.

Germany↗

Maitake extracts and their therapeutic potential.

Maitake (Grifola frondosa) is the Japanese name for an edible fungus with a large fruiting body characterized by overlapping caps. It is a premier culinary as well as medicinal mushroom. Maitake is increasingly being recognized as a potent source of polysaccharide compounds with dramatic health-promoting potential. The most recent development is the MD-fraction, a proprietary maitake extract its Japanese inventors consider to be a notable advance upon the preceding D-fraction. The D-fraction, the MD-fraction, and other extracts, often in combination with whole maitake powder, have shown particular promise as immunomodulating agents, and as an adjunct to cancer and HIV therapy. They may also provide some benefit in the treatment of hyperlipidemia, hypertension, and hepatitis.

Adjuvants, Immunologic↗

[Impact factor or do we have to choose between the impact factor and the Revue de Chirurgie Orthopédique?].

It is common practice to evaluate the scientific value of a candidate for a university or hospital position using the mean of the impact factors of the journals he/she has published in. This shows that the true composition and true meaning of the impact factor are not sufficiently understood. The impact factor was invented in the 60s to help librarians choose the most read journals. The impact factor provides an accurate definition of the distribution of a journal, but in no case the quality of its publications. Moreover, the impact factor has many technical limitations that are detailed in this article. This strongly limits the accuracy of the impact factor to compare between journals of different specialties. There is no correlation between the scientific value of a single author and the impact factor of the journals he/she has published in. Eugene Garfield, the inventor of the impact factor, has emphasized that it should not be used to judge the scientific value of a candidate.

Abstracting and Indexing↗

[Holter monitoring in 2000].

Ambulatory 24 hour monitoring was developed in the United States and bears the name of its inventor, Holter. It was introduced in France for the first time by the Lariboisière school, 25 years ago, and the end of the year 2000 is an appropriate time to review this tool. What are the new clinical indications, technical progress and prospects for the future? All the efforts of both cardiologists and engineers for the past 25 years have been focused on gathering information about the system of cardiac regulation which is more or less concealed in the ECG recordings. As far as arrhythmias are concerned, or the QRS or T wave morphology, or the circadian variations of sinus rate and depolarisation, the studies are numerous but not always easily applicable in clinical practice. However, the non-invasive analysis given by the Holter recording guarantees a promising future in terms of new discoveries and applications.

Arrhythmias, Cardiac↗

[EEG spatial organization and activation of creative processes].

Characteristic features of the spatino-temporal EEG organization of 24 right-handed children (aged from 8 to 13 years) were studied after stimulation of creative activity by the method of self-regulation of the brain functional state (Russian Inventor's Certificate no. 2157707, 01.06.1999). The multiparametric analysis of baseline recordings derived from 24 cortical points made it possible to find the most probable pattern of changes in the spatial synchronization of biopotentials, including increase in activity in the right anterior and left posterior cortical regions. These changes were accompanied by a rise in the information-energy parameter (the ratio between coherence and spectral power of potentials). This phenomenon may testify to a transition to the "economic" condition of information processing. Differences in EEG frequency characteristics corresponding to different levels of imagination and creative intuition were revealed.

Adolescent↗

In the eye of the storm: Dossa Dixon Evins and the neurocalometer debacle.

Dossa Dixon Evins, one of the lesser known figures in chiropractic history, played a prominent role in the 1920s, yet we know little about him. He was a vaudeville entertainer with his wife Billie, an inventor, electrical engineer, and a radio operator for the Secret Service during World War I. He is also the person who best weathered the hurricane which his most famous invention stirred in the chiropractic profession. What sort of man was he? The author seeks to answer that question in this paper as well as delving into the Neurocalometer Incident.

Chiropractic↗

[Contribution of Aleksander Sapieha (1773-1812) into European galvanization therapy].

For the development of the therapy using electricity as agent two tracks can be identified. On the one side, the indication for applying this therapy was handled more careful, simultaneously the technical equipment was improved. The Polish noble man Alexander Sapieha (1773-1812), the leading natural scientist of the Granddukedom of Warsaw, cooperated with excellent European scientists in order to improve the galvanic battery technologically. Among these scientists were Alexander Volta (1745-1827), the inventor of the battery, and Johann Bartholomaeus Trommsdorff (1770-1837), who is considered as one of the founders of scientific pharmacy in Europe. A. Sapieha supported the publication of galvanic experiences, e.g. in the case of Alexander of Humboldt (1769-1859) by publishing his paper about electric fishes. Sapiehas connections with the scientific centers in Turin and Bologna, Erfurt, Warszaw and Paris accelerated the exchange of information about galvanism. Later the resulting mini-batteries were employed in diathermie, in defibrillators and pacemakers. Details about these connections are presented in the lecture resp. full paper.

Electric Stimulation Therapy↗

[Producing the third dimension of flat radiographic images: analogue tomography - computer tomography].

The inventor of computer tomography, Godfrey N. Hounsfield, mentioned in his Nobel Foundation lecture the following three main problems of conventional radiography: 1. It depicts the sum of shadows from several tissue elements at the same spot of the film. 2. The sensitivity of the employed photographic medium does not allow to differentiate between various soft tissue densities. 3. It gives no exact measure characterizing tissue densities. The first part of this article is dealing with the solution of problem number one. Researchers within medical imaging from many countries developed independently of each other a variety of methods for body-sectional imaging methods, but he did not construct any equipment. Alessandro Vallebona constructed equipment and published the first clinical body-section imaging material ever in 1930, but his method was not ideal. The first clinical material employing an ideal method was published by Bernhard Ziedses des Plantes in 1932. Methods for transverse axial tomography was independently described by William Watson in 1937, Jean Kieffer in 1938, and Shinji Takahashi in 1947. The limitation in sensitivity of the photographic medium was revealed in parallel to this development. In 1963 Allan M. Cormack described the mathematical model for absorption of ionizing rays in inhomogenous tissue. Godfrey N. Hounsfield combined this knowledge of mathematics with the fast developing computer technology and the medical need for a more sensitive registration medium. In 1971 computer tomography was a reality. One of the greatest conquests in medicine of this century had been made. Recent developments within scanner technology predict still better and safer diagnostic possibilities.

History, 20th Century↗

[An overestimated technician - Leonardo da Vinci].

The reasons are discussed why Leonardo da Vinci is being overestimated as engineer and inventor, although the majority of his drawings concerning engineering are not beyond the level of contemporary engineering knowledge and he never attempted to carry out those which would have been novel in fact.

Engineering↗