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At least 19 recordsLinked to original sources
PubMed2016

DNA barcoding in diverse educational settings: five case studies.

Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5-18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future.This article is part of the themed issue 'From DNA barcodes to biomes'.

Biodiversity↗
PubMed2000

Enabling, empowering, inspiring: research and mentorship through the years.

The interrelationship between research and mentorship in an association such as the Medical Library Association (MLA) is revealed through the contributions of individuals and significant association activities in support of research. Research is vital to the well-being and ultimate survival of health sciences librarianship and is not an ivory tower academic activity. Mentorship plays a critical role in setting a standard and model for those individuals who want to be involved in research and, ultimately, for the preparation of the next generation of health sciences librarians. Research and mentorship are discussed in the context of personal experiences, scholarship, and problem solving in a practice environment. Through research and mentorship, we are enabled to enhance our services and programs, empowered to look beyond our own operations for information puzzles to be solved, and inspired to serve society by improving health.

Fellowships and Scholarships↗
PubMed1995

Investigative approach to frog gastrocnemius laboratory: potential impact on animal use in teaching laboratories.

With growing concern over the use of animal experimentation in the teaching of physiology, many biology departments are reassessing the use of animal experiments in the teaching lab. However, it may be just as important to assess how animal experimentation is used in the undergraduate teaching laboratory rather than simply assessing if animal experimentation should be used at all. In our study, sophomore-level life science students enrolled in a core organismal biology course undertook a laboratory exercise designed to elucidate properties of muscles and neuromuscular communication following two protocols: 1) a standard demonstrational model wherein students were told to undertake the exercise as a means to understand physiological processes that they had been exposed to previously in lecture or 2) an investigative model wherein the use of the gastrocnemius preparation was a logical next step in an ongoing investigation, the content of which was driven by student-generated hypotheses. We have observed a significant decrease in a number of the negative comments concerning the use of animals in experimentation (25.6 vs. 3.6%) since the implementation of the investigative approach to the laboratory, suggesting that curricular approaches to the use of animals in the teaching laboratory may have an impact on student attitudes concerning animal experimentation.

Animal Welfare↗
PubMed2026

Circulating Tumor DNA in Breast Cancer: A Liquid Biopsy Revolution for Non-Invasive Genomic Profiling and Clinical Decision-Making.

Breast cancer remains the most frequently diagnosed cancer and a leading cause of cancer-related mortality among women worldwide, underscoring the need for accurate, minimally invasive biomarkers to support precision oncology. Conventional tissue biopsy remains the standard for molecular characterization but is limited by its invasiveness, inability to capture spatial and temporal tumor heterogeneity, and challenges in serial monitoring. Circulating tumor DNA (ctDNA), a tumor-derived fraction of cell-free DNA, has emerged as a promising liquid biopsy biomarker capable of providing real-time genomic information throughout disease progression. This narrative review examines recent advances in ctDNA biology, analytical technologies, clinical applications, current limitations, and future directions in breast cancer management. A structured literature search of PubMed/MEDLINE, Scopus, Embase, Web of Science, and Google Scholar identified relevant English-language publications from 2015 to 2026. Current evidence indicates that highly sensitive platforms, including digital PCR, BEAMing, and next-generation sequencing, can detect clinically actionable alterations in genes such as PIK3CA, ESR1, TP53, ERBB2, AKT1, and BRCA1/2. ctDNA has demonstrated particular utility in identifying minimal residual disease, monitoring therapeutic response, detecting emerging resistance mechanisms, and guiding targeted treatment selection in advanced breast cancer. However, applications in early cancer detection, population screening, and artificial intelligence-assisted clinical decision-making remain investigational. Widespread clinical implementation is constrained by low ctDNA abundance in early-stage disease, analytical variability, limited assay standardization, and cost considerations. Continued technological innovation, prospective multicenter validation, standardized testing protocols, and evidence-based clinical guidelines are essential to fully integrate ctDNA into routine precision breast cancer care.

breast cancer↗
PubMed1998

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↗
PubMed1997

FDA perspective on specifications for biotechnology products--from IND to PLA.

Quality standards are obligatory throughout development, approval and post-marketing phases of biotechnology-derived products, thus assuring product identity, purity, and potency/strength. The process of developing and setting specifications should be based on sound science and should represent a logical progression of actions based on the use of experiential data spanning manufacturing process validation, consistency in production, and characterization of relevant product properties/attributes, by multiple analytical means. This interactive process occurs in phases, varying in rigour. It is best described as encompassing a framework which starts with the implementation of realistic/practical operational quality limits, progressing to the establishment/adoption of more stringent specifications. The historical database is generated from preclinical, toxicology and early clinical lots. This supports the clinical development programme which, as it progresses, allows for further assay method validation/refinement, adoption/addition due to relevant or newly recognized product attributes or rejection due to irrelevance. In the next phase, (licensing/approval) specifications are set through extended experience and validation of both the preparative and analytical processes, to include availability of suitable reference standards and extensive product characterization throughout its proposed dating period. Subsequent to product approval, the incremental database of test results serves as a natural continuum for further evolving/refining specifications. While there is considerable latitude in the kinds of testing modalities finally adopted to establish product quality on a routine basis, for both drugs and drug products, it is important that the selection takes into consideration relevant (significant) product characteristics that appropriately reflect on identity, purity and potency.

Antibodies, Monoclonal↗
PubMed2003

[Clinical prediction in medical oncology].

Predictive factors (PF) are variables that give information about survival, treatment response or toxicity and future complications on cancer patients. The foremost utility of PF takes root in the possibility to furnish an individualized treatment schedule with higher succeeding options. They include clinical characteristics of the patient, tumour features, treatment administrated, classical pathological and new molecular data obtained from patients clinical samples. Clinical parameters comprise age, sex, underlying diseases and performance status among others, and in concurrence with tumour pathology and clinical stage (TNM) usually define the best treatment options. Also, chemotherapy response can modify natural history of several tumours, and thus is a PF. Modifications in evolving PF typically induce a variation in patient outcome. Hence, surgical tumour size reduction or neoadjuvant down-staging improve survival in several cancers. In the other side, treatment adjustment to steady PF should offers better outcome than "standard therapies". Recent advances on cancer research have generated a great deal of biological data that help us to search new treatment and diagnostic modalities. Biotechnology offers a great amount of possibilities in the next future and probably a true individualized therapy. Conversely, there are a small amount of molecular evidences that imply a creal variation in current clinical practice. Hence, more scientific and financial efforts are necessary to exploit to the full knowledge spurting up from basic science. In summary, the prediction in oncology is a hard task derived from clinical observation, tumour behaviour, treatment schedules and biological evidences that must offer realistic predictions on a concrete cancer patient. Oncologists have a duty to know all these variables to accomplish this thorny assignment. This review will focus on classical and recent biological PF in cancer.

Age Factors↗
PubMed2001

Prostate cancer gene therapy.

Cancer-specific gene therapy is still in its infancy. Although the first gene therapy trials were initiated in the late 1980s, it was only more recently that the first successful treatment of a genetic disease was reported.3 The current problems with low efficiency of gene transfer coupled with the immunologic difficulties with certain vectors indicate that more effort needs to be directed at the basic science of gene transfer. Ultimately, successful cancer-specific gene therapy will require combinations of the lessons learned from the ex vivo and in vivo paradigms. The next generation of gene therapy trials likely will focus on combination therapy with conventional chemotherapeutic agents, differentiating agents, or radiation therapy. The obstacles to the development of gene-based human therapeutics (i.e., molecular medicine) are formidable, but the benefits are so great that eventually the technical issues of gene transfer methodology will be worked out, and ultimately this will become the standard of care, not only for inborn errors of metabolism, but also for cancer.

Adenocarcinoma↗
PubMed2005

Feeding people is easy: but we have to re-think the world from first principles.

OBJECTIVE: Agriculture designed to make best use of landscape and to be maximally sustainable would also provide food of the highest nutritional and gastronomic standards, and would inevitably employ a great many people. Thus it would solve the world's food problems, and its principal social problem, at a stroke. But agriculture in practice is designed for a quite different purpose--to generate wealth, in the cause of 'economic growth'. The pressing need is not for more science and technology, but to recognise the true cause of the problems and to re-think priorities. CONCLUSION: We could all be well fed. Indeed, everyone in the world who is ever likely to be born could be fed to the highest standards of gastronomy as well as of nutrition until humanity itself comes to an end. We already have most of the necessary technique--perhaps all that is needed. We could always do with more excellent science but we need not depend, as we are often told from on high, on the next technological fix. The methods that can provide excellent food would also create a beautiful environment, with plenty of scope for other creatures, and agreeable and stable agrarian economies with satisfying jobs for all. In reality, in absolute contrast, we have created a world in which almost a billion are chronically undernourished; another billion are horribly overnourished, so that obesity and diabetes are epidemic, and rising; a billion live on less than two dollars a day; and a billion live in urban slums--a figure set to increase and probably at least to double over the next half century; while other species are disappearing so fast that biologists speak of mass extinction.

Agriculture↗
PubMed1994

Expert fears doom if world population hits 12-15 billion.

Earth's land, water and cropland are disappearing so rapidly that the world population must be slashed to 2 billion or less by 2100 to provide prosperity for all in that year, says a study released yesterday. The alternative, if current trends continue, is a population of 12 billion to 15 billion people and an apocalyptic worldwide scene of "absolute misery, poverty, disease and starvation," said the study's author, David Pimentel, an ecologist at Cornell University. In the US, the population would climb to 500 million and the standard of living would decline to slightly better than in present-day China. Mr. Pimentel said at the annual meeting of the American Association for the Advancement of Science. Even now, the world population of 6 billion is at least 3 times what the Earth's battered natural resources and depleted energy reserves would be able to comfortably support in 2100, Mr. Pimentel said. Mr. Pimentel defines "comfortably support" as providing something close to the current American standard of living, but with wiser use of energy and natural resources. Although a decline to 1 billion or 2 billion people over the next century sounds nearly impossible, it could be done by limiting families around the world to an average of 1.5 children, Mr. Pimentel said. Currently, US women have an average of 2.1 children, while the average in Rwanda is 8.5.

Conservation of Natural Resources↗
PubMedDate not supplied

Use of transgenic mice in carcinogenicity hazard assessment.

Determining the carcinogenic potential of materials to which humans have significant exposure is an important, complex and imperfect exercise. Not only are the methods for such determinations protracted, expensive and utilize large numbers of animals, extrapolation of data from such studies to human risk is imprecise. Toxicologists have long recognized these shortcomings but the 2-year chronic rodent study has remained the gold standard. Recent developments in the field of molecular oncology and development of methods to insert or inactivate specific genes in animals have provided the tools with which to develop the next generation of carcinogenicity assays. With improved understanding of oncogene activation and tumor suppressor gene inactivation a number of animal models have been developed to dramatically reduce latency for chemically induced cancers. This has led to the development of shorter carcinogenicity assays. Also, because the spontaneous tumor frequencies in these animals are low during the in-life portion of the study, and studies are terminated well before the health complications of advanced aging are observed, it has been possible to reduce the group sizes and reduce animal usage. FDA's adoption of ICH S1B in 1997, (ICH, 1997) "Testing for the Carcinogenicity of Pharmaceuticals," opened the door for the use of such transgenic models in regulatory toxicology. This presentation reviews the current state of the science and its application to regulatory issues.

Animals↗
PubMed2026

AI In Leukemia Diagnostics: Complementing the Pathologist's Role.

Artificial intelligence (AI) is reshaping every stage of leukemia diagnostics, from digital morphology and multiparameter flow cytometry to next-generation sequencing, multi-omics analysis, and emerging computational frontiers such as quantum-inspired feature selection. This review outlines how contemporary AI tools can automate labor-intensive quantitation, flag diagnostically salient patterns, and standardize interpretation, while the pathologist or hematologist retains authority over validation, context-specific integration, and clinical decision-making. We present an illustrative "human-in-the-loop" workflow that embeds AI modules within current laboratory information systems, emphasizing points where expert oversight mitigates algorithmic bias and resolves discordant findings. We further map the validator-integrator role across morphology, flow cytometry, and genomic/multi-omic interpretation and provide practical training competencies and use cases for AI-assisted hematopathology. Beyond technical deployment, the article addresses the educational transformation required for sustainable adoption. Drawing on international competency frameworks, including the Digital Health Competencies in Medical Education Framework and recently proposed AI-specific Entrustable Professional Activities, we map core skills that future hematopathologists must master: data-science literacy, critical appraisal of AI outputs, and ethical governance. We highlight evaluated training models such as the Pathology Informatics Essentials for Residents curriculum, Stanford Artificial Intelligence in Machine and Imaging workshops, and College of American Pathologists bootcamps and propose integration strategies adaptable across resource settings. By pairing rigorous validation with targeted education, AI can elevate rather than eclipse the diagnostic role of the leukemia specialist, enabling more timely, reproducible, and personalized patient care.

Humans↗
PubMed2026

Beyond da Vinci: a systematic review of next-generation multiport robotic platforms in pediatric surgery.

As robotic surgery expands beyond the da Vinci platform, the relevance of new-generation systems to pediatric patients remains uncertain. This review examined the technical characteristics, applications, and perioperative outcomes of alternative multiport robotic platforms in children. PubMed/MEDLINE, Web of Science, Scopus, and the Cochrane Library were searched through 28 February 2026 in accordance with PRISMA 2020. Owing to clinical heterogeneity, findings were synthesized narratively, with Wilson 95% confidence intervals for key binary outcomes. Six studies reported 166 patients across 27 procedure types. Senhance accounted for 164 patients, while Hugo RAS and Hinotori were each represented by one patient. Ages ranged from 15 days to 17 years and weights from 3.8 to more than 100 kg. Senhance was the only platform used with 3-mm robotic instruments. Conversion or planned escalation occurred in 19 patients (11.4%; 95% CI, 7.5-17.2%). Four intraoperative complications were reported (2.4%; 95% CI, 0.9-6.0%). Across all reports, 20 patients experienced postoperative complications (12.0%; 95% CI, 7.9-17.9%). In the largest cohort, seven patients required reintervention (4.6%; 95% CI, 2.2-9.2%) and seven were readmitted (4.6%; 95% CI, 2.2-9.2%). No deaths or comparative pediatric studies were reported. Published experience remains sparse and is almost entirely limited to Senhance. Current evidence describes early clinical use without establishing comparative safety, effectiveness, or platform superiority. Prospective multicenter studies with standardized reporting are needed.

Humans↗
PubMed2003

The color of hamburger: slow steps toward the development of a science-based food safety system in the United States.

Concerns about food safety have played a key role in the emergence of the public health system in the United States. Unfortunately, the food safety regulatory system that was established in the early part of the 20th century in response to these concerns has not kept pace with our advancing scientific knowledge. In 1995, basic changes were made in the structure of the U.S. food safety regulatory structure, including implementation by USDA of the Pathogen Reduction: Hazard Analysis and Critical Control Point (HACCP) Systems; Final Rule for Meat and Poultry, from USDA's Food Safety and Inspection Service (FSIS); this was accompanied by creation of FoodNet, a sentinel surveillance system for active collection of foodborne disease surveillance data. The most recent FoodNet data show a 21% decline in the incidence of major bacterial foodborne diseases since implementation of the new regulations, a decrease paralleled by reductions in the frequency of contamination of meat and poultry with Salmonella. These data strongly support the public health importance of these regulatory changes. However, questions remain about the relative degree of responsibility of industry vs. the consumer in assuring safe food; the appropriateness of microbial standards for raw food products; and the directions that should be taken in the development of the "next generation" of food safety regulations.

Animals↗
PubMed2004

Anatomy: a must for teaching the next generation.

Teaching anatomy to both undergraduate medical students and medical graduates is in the midst of a downward spiral. The traditional anatomy education based on topographical structural anatomy taught by didactic lectures and complete dissection of the body with personal tuition, has been replaced by a multiple range of special study modules, problem-based workshops, computers, plastic models and many other teaching tools. In some centres, dissected cadaver-based anatomy is no longer taught. Changing the undergraduate medical curriculum in the UK has taken place without any research into the key aspects of knowledge necessary or comparing methods of teaching. There is no agreement on a common national core curriculum and as a result, numerous new curricula have been introduced. No external audit or validation is carried out, so medical schools have been free to teach and assess their own work themselves. There is a great divergence in medical schools across the UK and Ireland in teaching medicine in general and anatomy in particular. Published data on the impact of these changes is scant. The reduction in undergraduate teaching and knowledge of anatomy has caused great concern, not only for undergraduates but also to postgraduate students, especially in surgery. This, together with a change in basic surgical training, a marked reduction in demonstrator posts and a change in examination standards, has set up a system that is allowing young men and women with a poor knowledge of anatomy to become surgeons. There should be a full public debate at every level; the Royal Colleges, specialist associations, the Universities, Government, both health and education. This debate should highlight areas of concern, explore in depth and define a minimal core curriculum for anatomy. Teaching must be enhanced with a critical look at both teachers and methods. The dominance of research must be reassessed to establish an equitable cohabitation with teaching. The place of basic science, especially anatomy in basic surgical teaching, must be examined. A thorough knowledge of anatomy should be required in the new MRCS-UK. This should be mandatory as a preliminary to higher surgical training. The teaching of anatomy in surgical specialities must be improved. Does the dissecting room still have a place in educating our under- and postgraduate students? Yes--a sound knowledge of anatomy is essential if the medical practitioner is going to accurately define and successfully treat the problem presented by the patient. The dissected cadaver remains the most powerful means of presenting and learning anatomy as a dynamic basis for solving problems. The cadaver must not be dismissed as obsolete. Dissection has survived the most rigorous test of pedagological fitness--the test of time. The student--cadaver--patient encounter is paramount in medical education.

Anatomy↗
PubMed2006

Reversal of hepatic fibrosis -- fact or fantasy?

The prospect of reversing hepatic fibrosis has generated great interest now that basic science advances are being translated into promising new antifibrotic therapies. It is appropriate to recognize both the historical advances that created the framework for these successes, and the important role that Hepatology has played in disseminating them. A sense of urgency underlies this effort as the epidemics of HCV and NASH are becoming associated with advancing fibrosis. To maintain progress and minimize confusion among investigators and clinicians it is essential to standardize terms referring to fibrosis 'reversal' and 'regression.' There must also be rapid optimization of non-invasive markers of fibrosis to relieve this current bottleneck to conducting clinical trials. Progress in identifying genetic determinants of fibrosis could further refine patient selection for clinical trials and shorten their duration, as well as unearthing new directions of scientific inquiry. Realistic expectations for successful anti-fibrotic therapies reflect solid evidence of fibrosis regression in patients treated effectively for viral liver disease, as well as growing clarity in the understanding mechanisms of extracellular matrix production and degradation. The paradigms of stellate cell activation and apoptosis remain valuable frameworks for understanding pathways of hepatic fibrogenesis and fibrosis regression, respectively. Continued progress is essential in order to identify the determinants and dynamics of fibrosis reversibility, to discover additional targets for anti-fibrotic therapy, and to develop customized multi-drug regimens. These advances are sure to be captured in the next 25 years by Hepatology , and to profoundly impact the prognosis of patients with chronic liver disease.

Disease Progression↗
PubMed2004

Scalable fine-grained parallelization of plane-wave-based ab initio molecular dynamics for large supercomputers.

Many systems of great importance in material science, chemistry, solid-state physics, and biophysics require forces generated from an electronic structure calculation, as opposed to an empirically derived force law to describe their properties adequately. The use of such forces as input to Newton's equations of motion forms the basis of the ab initio molecular dynamics method, which is able to treat the dynamics of chemical bond-breaking and -forming events. However, a very large number of electronic structure calculations must be performed to compute an ab initio molecular dynamics trajectory, making the efficiency as well as the accuracy of the electronic structure representation critical issues. One efficient and accurate electronic structure method is the generalized gradient approximation to the Kohn-Sham density functional theory implemented using a plane-wave basis set and atomic pseudopotentials. The marriage of the gradient-corrected density functional approach with molecular dynamics, as pioneered by Car and Parrinello (R. Car and M. Parrinello, Phys Rev Lett 1985, 55, 2471), has been demonstrated to be capable of elucidating the atomic scale structure and dynamics underlying many complex systems at finite temperature. However, despite the relative efficiency of this approach, it has not been possible to obtain parallel scaling of the technique beyond several hundred processors on moderately sized systems using standard approaches. Consequently, the time scales that can be accessed and the degree of phase space sampling are severely limited. To take advantage of next generation computer platforms with thousands of processors such as IBM's BlueGene, a novel scalable parallelization strategy for Car-Parrinello molecular dynamics is developed using the concept of processor virtualization as embodied by the Charm++ parallel programming system. Charm++ allows the diverse elements of a Car-Parrinello molecular dynamics calculation to be interleaved with low latency such that unprecedented scaling is achieved. As a benchmark, a system of 32 water molecules, a common system size employed in the study of the aqueous solvation and chemistry of small molecules, is shown to scale on more than 1500 processors, which is impossible to achieve using standard approaches. This degree of parallel scaling is expected to open new opportunities for scientific inquiry.

Journal Article↗
PubMed1997

The cost management organization: the next step for materiel management.

With Materiel Management's transition over the last decade from simple logistics to analysis and cost management, it has gained recognition as a key part of the management team responsible for supplies, equipment, standards, and associated processes to identify, purchase, store, distribute, issue, and dispose of supplies and equipment. The materiel manager's job consists of putting the right product in the right place at the right time and in the right quantity at the best total delivered cost. In this context, Materiel Management has made powerful impacts to lower costs associated with: Distribution--costs have been lowered by actively adopting advanced supply channel management techniques such as primary suppliers, JIT, stockless programs, case cart/custom kit/procedure based delivery systems, modified stockless programs as well as margin management through cost plus, flat fee, or margins paid per activity. Cost of goods--lowered through aggregated purchasing in the forms of regional and national purchasing alliances and local capitation or other gain/risk share programs. Internal process costs--lowered by out-sourcing and/or integrating supplier processes and personnel into operations via partnership approaches. We have also reduced transactional costs through EDI transaction sets and the emerging use of the inter and intranet/electronic commerce, procurement cards, and evaluated receipt settlement processes. De-layering--We have lowered the operating costs of Materiel Management overhead by re-design/re-engineering, resulting in reduced management and greater front line authority. Quality--We have learned to identify and respond to customer and supplier needs by using quality improvement tools and ongoing measurement and monitoring techniques. Through this we have identified the waste of non-beneficial products and services. We have adopted supplier certification measurers to ensure quality is built into processes and outcomes. With so much already accomplished, it should be easy to rest on these laurels and simply operate. However, we believe that this is just a beginning. A new generation of highly educated leaders are emerging and taking advantage of the contributions of pioneers who laid the ground work. These new leaders will have advanced management, statistics, and behavioral sciences skills. They will be analysts and organizational motivators. Their goal will be to improve financial and clinical performance measured by real time process and performance data. The new leaders will have information at their fingertips thanks to significant leaps forward in data collection, automated continuous replenishment processes, and software designed for better management of clinical and cost outcomes. This article documents significant Materiel management accomplishments and conceptualizes cost management processes. The cost management organization is the logical evolution in our efforts for better outcomes in healthcare Materiel management.

Contract Services↗