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1.  Placebos in 19th century medicine: a quantitative analysis of the BMJ 
Objective To provide the first quantitative data on the use of the term “placebo” in the 19th century.
Design Computer search of BMJ’s archival database from January 1840 (the first issue) through December 1899 for uses of the words “placebo(s).” Grounded theory was used to categorise the implications of uses of the term.
Results 71 citations contained the term “placebo(s).” Of these, 22 (31%) used the term to mean “no effect” or as a general pejorative term, 18 (25%) portrayed placebo treatment as permitting the unfolding of the natural history (the normal waxing and waning of illness), 14 (20%) described placebo as important to satisfy patients, 7 (10%) described it as fulfilling a physician’s performance role, 3 (4%) described its use to buy time, 3 (4%) described its use for financial gain, 2 (3%) used it in a manner similar to a placebo control, and only one implied that placebo could have a clinical effect. Only one citation mentioned telling the patient about his placebo treatment.
Conclusion Nineteenth century physicians had diverse a priori assumptions about placebos. These findings remind us that contemporary medicine needs to use rigorous science to separate fact from its own beliefs concerning the “provision of care.” As in previous generations, ethical issues concerning placebos continue to challenge medicine.
doi:10.1136/bmj.e8326
PMCID: PMC3525309  PMID: 23249668
2.  The Ashtavaidya physicians of Kerala: A tradition in transition 
This paper presents what we have learned from the Ashtavaidya Ayurveda physicians of Kerala regarding the status of their unique medical tradition of Ayurveda in the contemporary context. We extensively interviewed several practicing Ashtavaidyas for the “Living History of Indian Scientific Traditions” archive, a new initiative at the NCBS, Bangalore to study the history of Indian sciences. As heirs of a tradition that has adapted and evolved over centuries without compromising its fundamental principles, their views on Ayurveda presented here represent an important contribution to the current debate on the role of traditional medicine in the Indian public health system.
doi:10.4103/0975-9476.74424
PMCID: PMC3117315  PMID: 21731370
Ashtavaidya; Gurukulam learning; Indian sciences; Kerala Ayurveda; Traditional medicine
3.  How to Search, Write, Prepare and Publish the Scientific Papers in the Biomedical Journals 
Acta Informatica Medica  2011;19(2):68-79.
This article describes the methodology of preparation, writing and publishing scientific papers in biomedical journals. given is a concise overview of the concept and structure of the System of biomedical scientific and technical information and the way of biomedical literature retreival from worldwide biomedical databases. Described are the scientific and professional medical journals that are currently published in Bosnia and Herzegovina. Also, given is the comparative review on the number and structure of papers published in indexed journals in Bosnia and Herzegovina, which are listed in the Medline database.
Analyzed are three B&H journals indexed in MEDLINE database: Medical Archives (Medicinski Arhiv), Bosnian Journal of Basic Medical Sciences and Medical Gazette (Medicinki Glasnik) in 2010. The largest number of original papers was published in the Medical Archives. There is a statistically significant difference in the number of papers published by local authors in relation to international journals in favor of the Medical Archives. True, the Journal Bosnian Journal of Basic Medical Sciences does not categorize the articles and we could not make comparisons. Journal Medical Archives and Bosnian Journal of Basic Medical Sciences by percentage published the largest number of articles by authors from Sarajevo and Tuzla, the two oldest and largest university medical centers in Bosnia and Herzegovina. The author believes that it is necessary to make qualitative changes in the reception and reviewing of papers for publication in biomedical journals published in Bosnia and Herzegovina which should be the responsibility of the separate scientific authority/ committee composed of experts in the field of medicine at the state level.
doi:10.5455/aim.2011.19.68-79
PMCID: PMC3621393  PMID: 23572850
System of biomedical scientific and research information; indexed medical journals in Bosnia and Herzegovina
4.  Basic Science Right, Not Basic Science Lite: Medical Education at a Crossroad 
Journal of General Internal Medicine  2009;24(11):1255-1258.
This perspective is a counterpoint to Dr. Brass’ article, Basic biomedical sciences and the future of medical education: implications for internal medicine. The authors review development of the US medical education system as an introduction to a discussion of Dr. Brass’ perspectives. The authors agree that sound scientific foundations and skill in critical thinking are important and that effective educational strategies to improve foundational science education should be implemented. Unfortunately, many students do not perceive the relevance of basic science education to clinical practice.
The authors cite areas of disagreement. They believe it is unlikely that the importance of basic sciences will be diminished by contemporary directions in medical education and planned modifications of USMLE. Graduates’ diminished interest in internal medicine is unlikely from changes in basic science education.
Thoughtful changes in education provide the opportunity to improve understanding of fundamental sciences, the process of scientific inquiry, and translation of that knowledge to clinical practice.
doi:10.1007/s11606-009-1109-3
PMCID: PMC2771241  PMID: 19774422
medical education; educational models; teaching; clinical care; research
5.  Conflicts of Interest at Medical Journals: The Influence of Industry-Supported Randomised Trials on Journal Impact Factors and Revenue – Cohort Study 
PLoS Medicine  2010;7(10):e1000354.
Andreas Lundh and colleagues investigated the effect of publication of large industry-supported trials on citations and journal income, through reprint sales, in six general medical journals
Background
Transparency in reporting of conflict of interest is an increasingly important aspect of publication in medical journals. Publication of large industry-supported trials may generate many citations and journal income through reprint sales and thereby be a source of conflicts of interest for journals. We investigated industry-supported trials' influence on journal impact factors and revenue.
Methods and Findings
We sampled six major medical journals (Annals of Internal Medicine, Archives of Internal Medicine, BMJ, JAMA, The Lancet, and New England Journal of Medicine [NEJM]). For each journal, we identified randomised trials published in 1996–1997 and 2005–2006 using PubMed, and categorized the type of financial support. Using Web of Science, we investigated citations of industry-supported trials and the influence on journal impact factors over a ten-year period. We contacted journal editors and retrieved tax information on income from industry sources. The proportion of trials with sole industry support varied between journals, from 7% in BMJ to 32% in NEJM in 2005–2006. Industry-supported trials were more frequently cited than trials with other types of support, and omitting them from the impact factor calculation decreased journal impact factors. The decrease varied considerably between journals, with 1% for BMJ to 15% for NEJM in 2007. For the two journals disclosing data, income from the sales of reprints contributed to 3% and 41% of the total income for BMJ and The Lancet in 2005–2006.
Conclusions
Publication of industry-supported trials was associated with an increase in journal impact factors. Sales of reprints may provide a substantial income. We suggest that journals disclose financial information in the same way that they require them from their authors, so that readers can assess the potential effect of different types of papers on journals' revenue and impact.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Medical journals publish many different types of papers that inform doctors about the latest research advances and the latest treatments for their patients. They publish articles that describe laboratory-based research into the causes of diseases and the identification of potential new drugs. They publish the results of early clinical trials in which a few patients are given a potential new drug to check its safety. Finally and most importantly, they publish the results of randomized controlled trials (RCTs). RCTs are studies in which large numbers of patients are randomly allocated to different treatments without the patient or the clinician knowing the allocation and the efficacy of the various treatments compared. RCTs are best way of determining whether a new drug is effective and have to be completed before a drug can be marketed. Because RCTs are very expensive, they are often supported by drug companies. That is, drug companies provide grants or drugs for the trial or assist with data analysis and/or article preparation.
Why Was This Study Done?
Whenever a medical journal publishes an article, the article's authors have to declare any conflicts of interest such as financial gain from the paper's publication. Conflict of interest statements help readers assess papers—an author who owns the patent for a drug, for example, might put an unduly positive spin on his/her results. The experts who review papers for journals before publication provide similar conflict of interest statements. But what about the journal editors who ultimately decide which papers get published? The International Committee of Medical Journal Editors (ICMJE), which produces medical publishing guidelines, states that: “Editors who make final decisions about manuscripts must have no personal, professional, or financial involvement in any of the issues that they might judge.” However, the publication of industry-supported RCTs might create “indirect” conflicts of interest for journals by boosting the journal's impact factor (a measure of a journal's importance based on how often its articles are cited) and its income through the sale of reprints to drug companies. In this study, the researchers investigate whether the publication of industry-supported RCTs influences the impact factors and finances of six major medical journals.
What Did the Researchers Do and Find?
The researchers determined which RCTs published in the New England Journal of Medicine (NEJM), the British Medical Journal (BMJ), The Lancet, and three other major medical journals in 1996–1997 and 2005–2006 were supported wholly, partly, or not at all by industry. They then used the online academic citation index Web of Science to calculate an approximate impact factor for each journal for 1998 and 2007 and calculated the effect of the published RCTs on the impact factor. The proportion of RCTs with sole industry support varied between journals. Thus, 32% of the RCTs published in the NEJM during both two-year periods had industry support whereas only 7% of the RCTs published in the BMJ in 2005–2006 had industry support. Industry-supported trials were more frequently cited than RCTs with other types of support and omitting industry-supported RCTs from impact factor calculations decreased all the approximate journal impact factors. For example, omitting all RCTs with industry or mixed support decreased the 2007 BMJ and NEJM impact factors by 1% and 15%, respectively. Finally, the researchers asked each journal's editor about their journal's income from industry sources. For the BMJ and The Lancet, the only journals that provided this information, income from reprint sales was 3% and 41%, respectively, of total income in 2005–2006.
What Do These Findings Mean?
These findings show that the publication of industry-supported RCTs was associated with an increase in the approximate impact factors of these six major medical journals. Because these journals publish numerous RCTs, this result may not be generalizable to other journals. These findings also indicate that income from reprint sales can be a substantial proportion of a journal's total income. Importantly, these findings do not imply that the decisions of editors are affected by the possibility that the publication of an industry-supported trial might improve their journal's impact factor or income. Nevertheless, the researchers suggest, journals should live up to the same principles related to conflicts of interest as those that they require from their authors and should routinely disclose information on the source and amount of income that they receive.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000354.
This study is further discussed in a PLoS Medicine Perspective by Harvey Marcovitch
The International Committee of Medical Journal Editors provides information about the publication of medical research, including conflicts of interest
The World Association of Medical Editors also provides information on conflicts of interest in medical journals
Information about impact factors is provided by Thomson Reuters, a provider of intelligent information for businesses and professionals; Thomson Reuters also runs Web of Science
doi:10.1371/journal.pmed.1000354
PMCID: PMC2964336  PMID: 21048986
6.  Launching the "Journal of Biomedical Discovery and Collaboration" 
The Journal of Biomedical Discovery and Collaboration was created to provide, for the first time, a unified forum to consider all factors that affect scientific practice and scientific discovery – with an emphasis on the changing face of contemporary biomedical science. In this endeavor we are bringing together three different groups of scholars: a) laboratory investigators, who make the discoveries that are the currency of the scientific enterprise; b) computer science and informatics investigators, who devise tools for data analysis, mining, visualization and integration; and c) social scientists, including sociologists, historians, and philosophers, who study scientific practice, collaboration, and information needs. We will publish original research articles, case studies, focus pieces, reviews, and software articles. All articles in the Journal of Biomedical Discovery and Collaboration will be peer reviewed, published immediately upon acceptance, freely available online via open access, and archived in PubMed Central and other international full-text repositories.
doi:10.1186/1747-5333-1-1
PMCID: PMC1440304
7.  Current Status of Biomedical Book Reviewing: Part I. Key Biomedical Reviewing Journals with Quantitative Significance 
This is the first part of a comprehensive, quantitative study of biomedical book reviewing. The data base of the total project was built from statistics taken from all 1970 issues of biomedical journals held in the Science Library of the Massachusetts Institute of Technology. Of 285 so-called “life sciences” journals held by that library, fifty-four English journals (excluding Science and Nature) were found to contain bona fide book reviews (as contrasted with mere author-title lists) and were therefore selected for close study. The statistical results reveal that there were 3,347 reviews of 2,067 biomedical books in these fifty-four selected journals in 1970. Part I of the study identifies key biomedical reviewing journals of quantitative significance. The top ten journals, British Medical Journal, Lancet, Annals of Internal Medicine, Journal of the American Medical Association, Archives of Internal Medicine, New England Journal of Medicine, Quarterly Review of Biology, Bioscience, Canadian Medical Association Journal,* and American Journal of the Medical Sciences, accounted for 63.03% of the total number of reviews in 1970.
PMCID: PMC198770  PMID: 4826479
8.  What's Out There Making Us Sick? 
Throughout the continuum of medical and scientific history, repeated evidence has confirmed that the main etiological determinants of disease are nutritional deficiency, toxicant exposures, genetic predisposition, infectious agents, and psychological dysfunction. Contemporary conventional medicine generally operates within a genetic predestination paradigm, attributing most chronic and degenerative illness to genomic factors, while incorporating pathogens and psychological disorder in specific situations. Toxicity and deficiency states often receive insufficient attention as common source causes of chronic disease in the developed world. Recent scientific evidence in health disciplines including molecular medicine, epigenetics, and environmental health sciences, however, reveal ineluctable evidence that deficiency and toxicity states feature prominently as common etiological determinants of contemporary ill-health. Incorporating evidence from historical and emerging science, it is evident that a reevaluation of conventional wisdom on the current construct of disease origins should be considered and that new knowledge should receive expeditious translation into clinical strategies for disease management and health promotion.
An analysis of almost any scientific problem leads automatically to a study of its history.—Ernst Mayr
doi:10.1155/2012/605137
PMCID: PMC3202108  PMID: 22262979
9.  Contribution of world health organization in the global acceptance of Ayurveda 
Amongst the mandates of United Nations, health of mankind is the thrust area of UN through World Health Organization (WHO). Planning and execution of policies for mainstreaming of traditional medicines (TRM) of respective countries along with conventional system of medicine (allopathy), first in the country of origin followed by the international arena, is the priority agenda of operations of WHO. Within Indian context, WHO accorded prime focus to Ayurveda in its activities related to TRM.Sponsorship and encouragement of studies substantiating parameters of standardization, safety and efficacy of herbal medicines of Ayurveda are under chief consideration of WHO. In this review, several guidelines of WHO are summarized. Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Central Council of Research in Ayurveda and Siddha and numerous other collaborative centers of WHO in India are assigned with several Appraisal Project Work (APW) and Direct Financial Cooperation (DFC) projects that will strengthen Ayurveda as evidence-based medicine for its global acceptance. Implementation of pharmacovigilance program in Ayurveda, publication of documents for rational use and initiatives to prepare consumer guidelines for appropriate use of Ayurvedic medicines are some other contributions of WHO toward advancement of Ayurveda at national as well as global level. Here, we suggest further exploration, interaction and interpretation of traditional knowledge in the light of contemporary core sciences and biomedical sciences that can pave the way for accreditation of Ayurveda worldwide as an established system of medicine.
doi:10.4103/0975-9476.90769
PMCID: PMC3255448  PMID: 22253507
Ayurveda; efficacy; standardization; safety; traditional medicine
10.  How Complementary and Alternative Medicine Practitioners Use PubMed 
Background
PubMed is the largest bibliographic index in the life sciences. It is freely available online and is used by professionals and the public to learn more about medical research. While primarily intended to serve researchers, PubMed provides an array of tools and services that can help a wider readership in the location, comprehension, evaluation, and utilization of medical research.
Objective
This study sought to establish the potential contributions made by a range of PubMed tools and services to the use of the database by complementary and alternative medicine practitioners.
Methods
In this study, 10 chiropractors, 7 registered massage therapists, and a homeopath (N = 18), 11 with prior research training and 7 without, were taken through a 2-hour introductory session with PubMed. The 10 PubMed tools and services considered in this study can be divided into three functions: (1) information retrieval (Boolean Search, Limits, Related Articles, Author Links, MeSH), (2) information access (Publisher Link, LinkOut, Bookshelf ), and (3) information management (History, Send To, Email Alert). Participants were introduced to between six and 10 of these tools and services. The participants were asked to provide feedback on the value of each tool or service in terms of their information needs, which was ranked as positive, positive with emphasis, negative, or indifferent.
Results
The participants in this study expressed an interest in the three types of PubMed tools and services (information retrieval, access, and management), with less well-regarded tools including MeSH Database and Bookshelf. In terms of their comprehension of the research, the tools and services led the participants to reflect on their understanding as well as their critical reading and use of the research. There was universal support among the participants for greater access to complete articles, beyond the approximately 15% that are currently open access. The abstracts provided by PubMed were felt to be necessary in selecting literature to read but entirely inadequate for both evaluating and learning from the research. Thus, the restrictions and fees the participants faced in accessing full-text articles were points of frustration.
Conclusions
The study found strong indications of PubMed’s potential value in the professional development of these complementary and alternative medicine practitioners in terms of engaging with and understanding research. It provides support for the various initiatives intended to increase access, including a recommendation that the National Library of Medicine tap into the published research that is being archived by authors in institutional archives and through other websites.
doi:10.2196/jmir.9.2.e19
PMCID: PMC1913941  PMID: 17613489
PubMed; research dissemination; complementary and alternative medicine; open access; professional development; information retrieval; information management; literacy
11.  Annals of General Psychiatry 
Our regular readers will notice that the title of our journal has changed from Annals of General Hospital Psychiatry (AGHP) to Annals of General Psychiatry (AGP) since January 1st, 2005. This was judged as necessary, in order to be able to serve better the aims of the journal. Our initial thoughts were that including the term 'General Hospital' in the journal's title would help us to launch a journal dedicated to the idea of Psychiatry as a medical specialty. But they were not justified; so, now the Annals of General Psychiatry (AGP) is born! It is still an Open Access, peer-reviewed, online journal covering the wider field of Psychiatry, Neurosciences and Psychological Medicine, and aims at publishing articles on all aspects of psychiatry. Primary research articles are the journal's priority, and both basic and clinical neuroscience contributions are encouraged. The AGP strongly supports and follows the principles of evidence-based medicine. AGP's articles are archived in PubMed Central, the US National Library of Medicine's full-text repository of life science literature, and also in repositories at the University of Potsdam in Germany, at INIST in France and in e-Depot, the National Library of the Netherlands' digital archive of all electronic publications. We hope that the change in the journal's name will cure the confusion caused by its previous title and help to achieve the journal's aims and scope, that is to help the world-wide promotion of research and publishing in the mental health area.
doi:10.1186/1744-859X-4-3
PMCID: PMC1088009  PMID: 15845139
12.  Debating Scientific Medicine: Homoeopathy and Allopathy in Late Nineteenth-century Medical Print in Bengal1 
Medical History  2012;56(4):463-480.
The historiography of medicine in South Asia often assumes the presence of preordained, homogenous, coherent and clearly-bound medical systems. They also tend to take the existence of a medical ‘mainstream’ for granted. This article argues that the idea of an ‘orthodox’, ‘mainstream’ named allopathy and one of its ‘alternatives’ homoeopathy were co-produced in Bengal. It emphasises the role of the supposed ‘fringe’, ie. homoeopathy, in identifying and organising the ‘orthodoxy’ of the time. The shared market for medicine and print provided a crucial platform where such binary identities such as ‘homoeopaths’ and ‘allopaths’ were constituted and reinforced. This article focuses on a range of polemical writings by physicians in the Bengali print market since the 1860s. Published mostly in late nineteenth-century popular medical journals, these concerned the nature, definition and scope of ‘scientific’ medicine. The article highlights these published disputes and critical correspondence among physicians as instrumental in simultaneously shaping the categories ‘allopathy’ and ‘homoeopathy’ in Bengali print. It unravels how contemporary understandings of race, culture and nationalism informed these medical discussions. It further explores the status of these medical contestations, often self-consciously termed ‘debates’, as an essential contemporary trope in discussing ‘science’ in the vernacular.
doi:10.1017/mdh.2012.28
PMCID: PMC3483755  PMID: 23112381
Scientific Medicine; Debate; Vernacular; Medical Correspondence; Medical System; Orthodoxy
13.  What do we know about who does and does not attend general health checks? Findings from a narrative scoping review 
BMC Public Health  2012;12:723.
Background
General and preventive health checks are a key feature of contemporary policies of anticipatory care. Ensuring high and equitable uptake of such general health checks is essential to ensuring health gain and preventing health inequalities. This literature review explores the socio-demographic, clinical and social cognitive characteristics of those who do and do not engage with general health checks or preventive health checks for cardiovascular disease.
Methods
An exploratory scoping study approach was employed. Databases searched included the British Nursing Index and Archive, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE), EMBASE, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI). Titles and abstracts of 17463 papers were screened; 1171 papers were then independently assessed by two researchers. A review of full text was carried out by two of the authors resulting in 39 being included in the final review.
Results
Those least likely to attend health checks were men on low incomes, low socio-economic status, unemployed or less well educated. In general, attenders were older than non-attenders. An individual’s marital status was found to affect attendance rates with non-attenders more likely to be single. In general, white individuals were more likely to engage with services than individuals from other ethnic backgrounds. Non-attenders had a greater proportion of cardiovascular risk factors than attenders, and smokers were less likely to attend than non-smokers. The relationship between health beliefs and health behaviours appeared complex. Non-attenders were shown to value health less strongly, have low self-efficacy, feel less in control of their health and be less likely to believe in the efficacy of health checks.
Conclusion
Routine health check-ups appear to be taken up inequitably, with gender, age, socio-demographic status and ethnicity all associated with differential service use. Furthermore, non-attenders appeared to have greater clinical need or risk factors suggesting that differential uptake may lead to sub-optimal health gain and contribute to inequalities via the inverse care law. Appropriate service redesign and interventions to encourage increased uptake among these groups is required.
doi:10.1186/1471-2458-12-723
PMCID: PMC3491052  PMID: 22938046
Health checks; Screening; Public health; Inequalities; Primary care
14.  Integrated radiology information system, picture archiving and communications system, and teleradiology—Workflow-driven and future-proof 
Journal of Digital Imaging  1999;12(Suppl 1):199-200.
The proliferation of integrated radiology information system/picture archiving and communication system (RIS/PACS) and teleradiology has been slow because of two concerns: usability and economic return. A major dissatisfaction on the usability issue is that contemporary systems are not intelligent enough to support the logical workflow of radiologists. We propose to better understand the algorithms underlying the radiologists′ reading process, and then embed this intelligence into the software program so that radiologists can interact with the system with less conscious effort. Regarding economic return issues, people are looking for insurance against obsolescence in order to protect their investments. We propose to future-proof a system by sticking to the following principles: compliance to industry standards, commercial off-the-shelf (COTS) components, and modularity. An integrated RIS/PACS and teleradiology system designed to be workflow-driven and future-proof is being developed at Texas Tech University Health Sciences Center
doi:10.1007/BF03168801
PMCID: PMC3452897  PMID: 10342212
15.  Contrasting selected reproductive challenges of today with those of antiquity—the past is prologue 
The Ulster Medical Journal  2013;82(3):150-156.
Viewing human history through a medical lens provides a renewed appreciation for today’s vexing reproductive challenges, as some modern dilemmas are actually continuations of similar challenges experienced long ago. Certainly there are many examples of assisted fertility therapy that were entirely theoretical only a generation ago, but have become commonplace in modern practice and society. In particular posthumous birth and infertility have, over time, been the focus of compelling social interest, occasionally even impacting national security and dynastic succession. While the concepts have remained static, the tools available to extend and improve reproductive success have changed radically. Appropriately regarded as confidential and private, an individual’s reproductive details are typically impervious to formal study. Yet, archival sources including ancient literature and formal court records can occasionally provide evidence of otherwise deeply personal concerns of a different era. Our assessment finds the issues, worries, and desires of patients of antiquity to align closely with contemporary reproductive challenges. Because children and family have always been central to the human experience, the consequences of reproduction (or the lack thereof) can make substantial imprints upon the cultural, economic, and political landscape—irrespective of civilization or century. In this article, selected motifs are described in a broad historical context to illustrate how challenges of human reproduction have remained essentially unchanged, despite a vast accumulation of knowledge made possible by gains in reproductive science and technology.
Plus ça change, plus c’est la même chose.
-Jean-Baptiste Alphonse Karr (1808–1890)
PMCID: PMC3913404  PMID: 24505149
16.  The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE) 
Emperor Shen-Nung was the second of China's mythical emperors (3500-2600 BCE). Widely considered the father of Chinese medicine, he catalogued over 365 species of medicinal plants which he personally tasted. Through his treatise ‘Shen Nung Benchau Jing’, we relive Emperor Shen-Nung's contribution to urology with reference to his management of erectile dysfunction. Time-related sources in medical and historical literature were reviewed, including the ‘Shen Nung Benchau Jing’ (The medicine book of Emperor Shen-Nung), archives and manuscripts at the Wellcome History of Medicine Collection, the Royal Society of Medicine, London, The Hong Kong Museum of Medical Sciences, and The Museum of Medical History, Shanghai, China. Chinese traditional herbal medicine began approximately 5000 years ago. Agricultural clan leader, Emperor Shen-Nung, was said to have a ‘crystal-like belly’ to watch the reactions in his own stomach of the herbs he collected. Ginseng was among of Shen Nung's contributions to herbal medicine. He experienced a warm and sexually pleasurable feeling after chewing the root. He advocated this as a treatment for erectile dysfunction and used it to stimulate sexual appetite. The reputation of ginseng as an aphrodisiac is based on the doctrine of signatures, since the adult root has a phallic shape. Shen-Nung believed that ginseng's resemblance to the human form is proof of its rejuvenative and aphrodisiac properties. It was believed that the closer the similarity to the human figure, the more potent the root. The use of ginseng for erectile dysfunction by Emperor Shen-Nung was unique for its time. It continues to hold parallels as a modern-day herbal aphrodisiac 5000 years on.
doi:10.4103/0970-1591.94946
PMCID: PMC3339779  PMID: 22557711
Ancient China; erectile dysfunction; ginseng; history of urology
17.  Osteopathic Medicine and Primary Care looks forward to 2009 
Osteopathic Medicine and Primary Care, which enters its third year of operation in 2009 under the umbrella of BioMed Central, continues to promote and advance open access publishing through universal online access without charge, indexing in PubMed and archiving in PubMed Central, retention of authors' copyright, and expeditious peer review. Notable accomplishments during 2008 included a median lag time of four months from initial manuscript submission to publication, designation of eight articles as "highly accessed," and achievement of a balanced proportion of publications in our core topic areas of osteopathic medicine and primary care. In October 2008, Springer Science+Business Media, a major publisher of journals in science, technology, and medicine, acquired the BioMed Central Group. Our 2009 Editorial Board is presented herein, as well as a new mechanism for posting book reviews on the Osteopathic Medicine and Primary Care website. We continue to encourage manuscript submissions and reader comments on our articles. Waivers or discounts of article processing charges are available via several mechanisms for eligible authors who submit qualified manuscripts.
doi:10.1186/1750-4732-3-2
PMCID: PMC2646741  PMID: 19193237
18.  The strategic and operational characteristics of a distributed phased archive for a multivendor incremental implementation of picture archiving and communications systems 
Journal of Digital Imaging  1999;12(Suppl 1):71-74.
The long-term (10 years) multimodality distributed phased archive for the Medical Information, Communication and Archive System (MICAS) is being implemented in three phases. The selection process took approximately 10 months. Based on the mandatory archive attributes and desirable features, Cemax-Icon (Fremont, CA) was selected as the vendor. The archive provides for an open-solution allowing incorporation of leading edge, “best of breed” hardware and software and provides maximum flexibility and automation of workflow both within and outside of radiology. The solution selected is media-independent, provides expandable storage capacity, and will provide redundancy and fault tolerance in phase II at minimum cost. Other attributes of the archive include scalable archive strategy, virtual image database with global query, and an object-oriented database. The archive is seamlessly integrated with the radiology information system (RIS) and provides automated fetching and routing, automated study reconciliation using modality worklist manager, clinical reports available at any Digital Imaging and Communications in Medicine (DICOM) workstation, and studies available for interpretation whether validated or not. Within 24 hours after a new study is acquired, four copies will reside within different components of the archive including a copy that can be stored off-site. Phase II of the archive will be installed during 1999 and will include a second Cemax-Icon archive and database using archive manager (AM) Version 4.0 in a second computer room.
doi:10.1007/BF03168760
PMCID: PMC3452876  PMID: 10342171
19.  Guide to the Internet. Logging in, fetching files, reading news. 
BMJ : British Medical Journal  1995;311(7020):1626-1630.
Aside from email and the world wide web, there are several other systems for distributing information on the Internet. Telnet is a system that allows you to log on to a remote computer from anywhere on the Internet and affords access to many useful biomedical sites on the Internet. File transfer protocol (FTP) is a method of transferring files from one computer to another over the Internet. It can be used to download files, including software, from numerous publiclly accessible "anonymous FTP archives" around the world. Such archives can be searched using a tool known as Archie. Network News is a system of electronic discussion groups covering almost every imaginable subject, including many areas of medicine and the biomedical sciences; MOOs are virtual environments that allow real time electronic conferencing and teaching over the Internet. It is difficult to predict the future of medicine on the Internet. However, the net opens up many possibilities not available through previous technologies. It is now up to medical practitioners to realise the Internet's full potential.
PMCID: PMC2551511  PMID: 8555810
20.  Integrative endeavor for renaissance in Ayurveda 
Currently western medicine has assumed the central position in mainstream global healthcare. Openness to learn from contemporary disciplines of basic sciences, application of modern technology and further adoption of the evidence-based approach has helped western medicine gain its currently acknowledged position as mainstream modern medicine. Modern medicine has further developed forms of integrative medicine by developing interfaces with other systems of medicine, including traditional, complementary and alternative medicine. However, these developments do not seem to address all the problems facing global health care caused by overemphasis on pharmaco-therapeutic drug developments. On the other hand, Ayurveda which is founded on genuine fundamentals, has the longest uninterrupted tradition of healthcare practice, and its holistic approach to healthcare management emphasizes disease prevention and health promotion; if it opens up to incorporate emerging new knowledge into mainstream Ayurveda, and maintains fidelity to Ayurveda fundamentals, it will certainly provide a broad-based opportunity to address the majority of the problems that have emerged from global healthcare requirements. To bring these solutions to bear, however, it will be necessary to progress from the present “utilitarian ethos” to a “unifying ethos” for realization of medical integration.
doi:10.4103/0975-9476.78179
PMCID: PMC3121253  PMID: 21731380
Ayurveda; global healthcare; integrative Ayurveda; integrative medicine
21.  Mortality in schizophrenia and related psychoses: data from two cohorts, 1875–1924 and 1994–2010 
BMJ Open  2012;2(5):e001810.
Objective
To investigate death rates in schizophrenia and related psychoses.
Design
Data from two epidemiologically complete cohorts of patients presenting for the first time to mental health services in North Wales for whom there are at least 1, and up to 10-year follow-up data have been used to calculate survival rates and standardised death rates for schizophrenia and related psychoses.
Setting
The North Wales Asylum Denbigh (archived patient case notes) and the North West Wales District General Hospital psychiatric unit.
Population
Cohort 1: The North Wales Asylum Denbigh (archived patient case notes). Of 3168 patients admitted to the North Wales Asylum Denbigh 1875–1924, 1074 had a schizophrenic or related psychosis. Cohort 2: Patients admitted between 1994 and 2010 to the North West Wales District General Hospital psychiatric unit, of whom 355 had first admissions for schizophrenia or related psychoses.
Results
We found a 10-year survival probability of 75% in the historical cohort and a 90% survival probability in the contemporary cohort with a fourfold increase in standardised death rates in schizophrenia and related psychoses in both historical and contemporary periods. Suicide is the commonest cause of death in schizophrenia in the contemporary period (SMR 35), while tuberculosis was the commonest cause historically (SMR 9). In the contemporary data, deaths from cardiovascular causes arise in the elderly and deaths from suicide in the young.
Conclusions
Contemporary death rates in schizophrenia and related psychoses are high but there are particular hazards and windows of risk that enable interventions. The data point to possible interventions in the incident year of treatment that could give patients with schizophrenia a normal life expectancy.
doi:10.1136/bmjopen-2012-001810
PMCID: PMC3488735  PMID: 23048063
22.  Highlights in asthma 2005 
Archives of Disease in Childhood  2006;91(5):422-425.
It is usual at the end of a year for top tens to feature large in our collective consciousness. These inevitably include the occasional controversial selection and without fail will overlook a number of gems, whether in the field of literature, art, or science. The approaches to such compilations include personal selections, convening expert committees through to letting the market decide. However, it is well recognised that experts can be wrong and markets distorted. A novel approach to identifying the key publications in the field of medicine, Faculty of 1000 Medicine (http://www.f1000medicine.com), uses faculty evaluations to assign ratings to published papers within topics and categories, bringing a flavour of the dynamism of post hoc peer review to biological sciences that exists in other fields of scholarship. Archives of Disease in Childhood has also developed a market led system of peer evaluation through its web based top ten most read articles feature.
doi:10.1136/adc.2006.094094
PMCID: PMC2082737  PMID: 16632671
airway inflammation; asthma; review; treatment
23.  Role of dermatomes in the determination of therapeutic characteristics of channel acupoints: a similarity-based analysis of data compiled from literature 
Chinese Medicine  2013;8:24.
Background
Analysis of the relationship between the nervous system anatomy and the therapeutic characteristics of all acupuncture points in the channel network may provide new insights on the physiological mechanisms underlying acupuncture stimulation for prevention, treatment, and rehabilitation purposes. This study investigates the association between the similarity of acupoints’ dermatomes, traditional actions, and contemporary indications.
Methods
Channel acupoints had their characteristics annotated from a literature review of four topographic atlases of Chinese medicine and one atlas of human anatomy: initials of the channel’s name (n = 14), sequential number in the channel (n = 67), acupoint’s name (n = 361), dermatomes related to perpendicular needle insertion (n = 31), traditional actions (n = 848), and contemporary indications (n = 1143). Jaccard’s similarity coefficient quantified the similarities between dual acupoints. All dual acupoints were evaluated to generate similarity matrices for each nominal variable. Cross-tables were generated by simultaneous classification of variables into levels of similarity with respect to: dermatomes versus traditional actions, dermatomes versus contemporary indications, and traditional actions versus contemporary indications. Goodman-Kruskal γ and Rousson γ*2 were calculated based on cross-tables, bootstrap and permutated samples to evaluate the association and determination coefficient between variables, respectively.
Results
Significant associations were observed between levels of similarities of dermatomes and traditional actions (γ = 0.542; P < 0.001), dermatomes and contemporary indications (γ = 0.657; P < 0.001), and traditional actions and contemporary indications (γ = 0.716; P < 0.001). Similarities of dermatomes explained 16% of the variance of traditional actions and 25% of contemporary indications. Traditional actions explained 30% of the variance of contemporary indications. The association between traditional actions and contemporary indications was the highest one (γ = 0.716, 95% confidence interval (95% CI) = [0.715; 0.719]), followed by the association between dermatomes and contemporary indications (γ = 0.622, 95% CI = [0.621; 0.623]), and between dermatomes and traditional actions (γ = 0.446, 95% CI = [0.444; 0.447]), all with P < 0.001.
Conclusions
The similarity of dermatomes between dual acupoints partially determined the similarity of traditional actions and contemporary indications, therefore dermatomes partially determine the therapeutic efficacy of acupuncture.
doi:10.1186/1749-8546-8-24
PMCID: PMC4129182  PMID: 24341704
24.  Computer hardware for radiologists: Part I 
Computers are an integral part of modern radiology practice. They are used in different radiology modalities to acquire, process, and postprocess imaging data. They have had a dramatic influence on contemporary radiology practice. Their impact has extended further with the emergence of Digital Imaging and Communications in Medicine (DICOM), Picture Archiving and Communication System (PACS), Radiology information system (RIS) technology, and Teleradiology. A basic overview of computer hardware relevant to radiology practice is presented here. The key hardware components in a computer are the motherboard, central processor unit (CPU), the chipset, the random access memory (RAM), the memory modules, bus, storage drives, and ports. The personnel computer (PC) has a rectangular case that contains important components called hardware, many of which are integrated circuits (ICs). The fiberglass motherboard is the main printed circuit board and has a variety of important hardware mounted on it, which are connected by electrical pathways called “buses”. The CPU is the largest IC on the motherboard and contains millions of transistors. Its principal function is to execute “programs”. A Pentium® 4 CPU has transistors that execute a billion instructions per second. The chipset is completely different from the CPU in design and function; it controls data and interaction of buses between the motherboard and the CPU. Memory (RAM) is fundamentally semiconductor chips storing data and instructions for access by a CPU. RAM is classified by storage capacity, access speed, data rate, and configuration.
doi:10.4103/0971-3026.69346
PMCID: PMC2963745  PMID: 21042437
Chipset; computers; console; CPU; CT; hardware; motherboard; MRI; RAM; workstations
25.  The Life of John Wishart (1850–1926): Study of an Academic Surgical Career Prior to the Flexner Report 
World Journal of Surgery  2012;36(3):684-688.
Background
The 1910 Flexner Report on Medical Education in the United States and Canada is often taken as the point when medical schools in North America took on their modern form. However, many fundamental advances in surgery, such as anesthesia and asepsis, predated the report by decades. To understand the contribution of educators in this earlier period, we investigated the forgotten career of John Wishart, founding Professor of Surgery at Western University, London Ontario.
Methods
Archives at the University of Western Ontario, University of Toronto, London City Library, and Wellington County Museum were searched for material about Wishart and his times.
Results
A fragmented biography can be assembled from family notes and obituaries with the help of contemporary documents compiled by early 20th century medical school historians. Wishart assisted Abraham Groves in the first reported operation for which aseptic technique was used (1874). He was considered locally to perform pioneering surgery, including an appendectomy in 1886. Wishart was a founding member of the medical faculty at Western University in 1881, initially as Demonstrator of Anatomy and subsequently as its first Professor of Clinical Surgery, which post he held until 1910. Comprehensive notes from his undergraduate lectures demonstrate his teaching style, which mixed organized didacticism with practical advice. The role of the Flexner review in the termination of his professorship is hinted at in minutes of Faculty of Medicine meetings. Wishart was a foundation fellow of the American College of Surgeons and a founding physician of London’s Catholic hospital, St. Joseph’s, despite his own Protestant background.
Conclusions
Wishart’s career comprised all the elements of modern academic surgery, including pioneering service, research, and teaching. Surgery at Western owes as much to Wishart as it does to university reorganization in response to the Flexner report.
doi:10.1007/s00268-011-1407-x
PMCID: PMC3279636  PMID: 22270978

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