This article presents a plethora of fragments from the medical notebooks found in the Cairo Genizah that comprise a unique source of historical data for scholarly study and for a better understanding of the ways in which medieval medical knowledge in Egypt was transferred from theory to practice and vice versa. These documents provide the most direct evidence we have for preferred practical medical recipes because they record the choices of medical practitioners in medieval Cairo. Since the language most commonly used in them was Judaeo-Arabic, they were evidently written by Jews. The medical genre in the notebooks was primarily pharmacopoeic, consisting of apparently original recipes for the treatment of various diseases. There are also a few notebooks on materia medica. The subject matter of the Genizah medical notebooks shows that they were mostly of an eclectic nature, i.e. the writers had probably learnt about these treatments and recipes from their teachers, applied them at the hospitals where they worked or copied them from the books they read. Foremost among the subjects dealt with were eye diseases, followed by skin diseases, coughs and colds, dentistry and oral hygiene, and gynaecological conditions. The writers of the Genizah notebooks apparently recorded the practical medical knowledge they wished to preserve for their future use as amateur physicians, students, traditional healers or professional practitioners.
Cairo Genizah; History of Medicine; Jewish; Medieval Middle East; Middle Ages; Notebook
The electronic laboratory notebook (ELN) has the potential to replace the paper notebook with a marked-up digital record that can be searched and shared. However, it is a challenge to achieve these benefits without losing the usability and flexibility of traditional paper notebooks. We investigate a blog-based platform that addresses the issues associated with the development of a flexible system for recording scientific research.
We chose a blog-based approach with the journal characteristics of traditional notebooks in mind, recognizing the potential for linking together procedures, materials, samples, observations, data, and analysis reports. We implemented the LabTrove blog system as a server process written in PHP, using a MySQL database to persist posts and other research objects. We incorporated a metadata framework that is both extensible and flexible while promoting consistency and structure where appropriate. Our experience thus far is that LabTrove is capable of providing a successful electronic laboratory recording system.
LabTrove implements a one-item one-post system, which enables us to uniquely identify each element of the research record, such as data, samples, and protocols. This unique association between a post and a research element affords advantages for monitoring the use of materials and samples and for inspecting research processes. The combination of the one-item one-post system, consistent metadata, and full-text search provides us with a much more effective record than a paper notebook. The LabTrove approach provides a route towards reconciling the tensions and challenges that lie ahead in working towards the long-term goals for ELNs. LabTrove, an electronic laboratory notebook (ELN) system from the Smart Research Framework, based on a blog-type framework with full access control, facilitates the scientific experimental recording requirements for reproducibility, reuse, repurposing, and redeployment.
Research in organic chemistry generates samples of novel chemicals together with their properties and other related data. The involved scientists must be able to store this data and search it by chemical structure. There are commercial solutions for common needs like chemical registration systems or electronic lab notebooks. However for specific requirements of in-house databases and processes no such solutions exist. Another issue is that commercial solutions have the risk of vendor lock-in and may require an expensive license of a proprietary relational database management system. To speed up and simplify the development for applications that require chemical structure search capabilities, I have developed Molecule Database Framework. The framework abstracts the storing and searching of chemical structures into method calls. Therefore software developers do not require extensive knowledge about chemistry and the underlying database cartridge. This decreases application development time.
Molecule Database Framework is written in Java and I created it by integrating existing free and open-source tools and frameworks. The core functionality includes:
• Support for multi-component compounds (mixtures)
• Import and export of SD-files
• Optional security (authorization)
For chemical structure searching Molecule Database Framework leverages the capabilities of the Bingo Cartridge for PostgreSQL and provides type-safe searching, caching, transactions and optional method level security. Molecule Database Framework supports multi-component chemical compounds (mixtures).
Furthermore the design of entity classes and the reasoning behind it are explained. By means of a simple web application I describe how the framework could be used. I then benchmarked this example application to create some basic performance expectations for chemical structure searches and import and export of SD-files.
By using a simple web application it was shown that Molecule Database Framework successfully abstracts chemical structure searches and SD-File import and export to simple method calls. The framework offers good search performance on a standard laptop without any database tuning. This is also due to the fact that chemical structure searches are paged and cached. Molecule Database Framework is available for download on the projects web page on bitbucket: https://bitbucket.org/kienerj/moleculedatabaseframework.
Chemical structure search; Database; Framework; Open-source
When Mary Cholmeley married Henry Fairfax in 1627, she carried to her new home in Yorkshire a leather-bound notebook filled with medical recipes. Over the next few decades, Mary and Henry, their children and various members of the Fairfax and Cholmeley families continually entered new medical and culinary information into this ‘treasury for health.’ Consequently, as it stands now, the manuscript can be read both as a repository of household medical knowledge and as a family archive. Focusing on two Fairfax ‘family books,’ this essay traces on the process through which early modern recipe books were created. In particular, it explores the role of the family collective in compiling books of knowledge. In contrast to past studies where household recipe books have largely been described as the products of exclusively female endeavors, I argue that the majority of early modern recipe collections were created by family collectives and that the members of these collectives worked in collaboration across spatial, geographical and temporal boundaries. This new reading of recipe books as testaments of the interests and needs of particular families encourages renewed examination of the role played by gender in the transmission and production of knowledge in early modern households.
Early modern medicine; gender history; household; informal science
The increasing complexity of medical curricula would benefit from adaptive computer supported collaborative learning systems that support study management using instructional design and learning object principles. However, to our knowledge, there are scarce reports regarding applications developed to meet this goal and encompass the complete medical curriculum. The aim of ths study was to develop and assess the usability of an adaptive computer supported collaborative learning system for medical students to manage study sessions.
A study platform named ALERT STUDENT was built as a free web application. Content chunks are represented as Flashcards that hold knowledge and open ended questions. These can be created in a collaborative fashion. Multiple Flashcards can be combined into custom stacks called Notebooks that can be accessed in study Groups that belong to the user institution. The system provides a Study Mode that features text markers, text notes, timers and color-coded content prioritization based on self-assessment of open ended questions presented in a Quiz Mode. Time spent studying and Perception of knowledge are displayed for each student and peers using charts. Computer supported collaborative learning is achieved by allowing for simultaneous creation of Notebooks and self-assessment questions by many users in a pre-defined Group. Past personal performance data is retrieved when studying new Notebooks containing previously studied Flashcards. Self-report surveys showed that students highly agreed that the system was useful and were willing to use it as a reference tool.
The platform employs various instructional design and learning object principles in a computer supported collaborative learning platform for medical students that allows for study management. The application broadens student insight over learning results and supports informed decisions based on past learning performance. It serves as a potential educational model for the medical education setting that has gathered strong positive feedback from students at our school.
This platform provides a case study on how effective blending of instructional design and learning object principles can be brought together to manage study, and takes an important step towards bringing information management tools to support study decisions and improving learning outcomes.
Medical education; Computer supported collaborative learning; E-learning; Information management; Memory retention; Computer-assisted instruction; Tailored learning; Student-centered learning; Spaced repetition
John Newsom-Davis was born in 1932 and died, aged 74, in 2007. After national service in the Royal Air Force, he read Natural Sciences at Cambridge. Following clinical studies at the Middlesex Hospital, he began research into respiratory neurophysiology with Tom Sears at the National Hospital, Queen Square, in London, and spent 1 year with Fred Plum at Cornell University in New York. After neurology specialist training at Queen Square, he became the director of the Batten Unit, continuing his interest in respiratory physiology. There he began to work on myasthenia gravis in collaboration with Ricardo Miledi at University College London and in 1978, after performing the first studies on plasma exchange in that disease, he established a myasthenia gravis research group at the Royal Free Hospital. There he investigated the role of the thymus in this disease and demonstrated an autoimmune basis for the Lambert Eaton myasthenic syndrome and ‘seronegative’ myasthenia. He was awarded the first Medical Research Council Clinical Research Professorship in 1979 but moved to Oxford in 1987 when he was elected Action Research Professor of Neurology. While at Oxford, he continued to run a very successful multidisciplinary group, researched further into the thymic abnormalities and cellular immunology of myasthenia, identified antibody-mediated mechanisms in acquired neuromyotonia, and began the molecular work that identified the genetic basis for many forms of congenital myasthenic syndrome. Meanwhile, he was also involved in university and college governance and contributed widely to the Medical Research Council, government committees, research charities and the Association of British Neurologists. Among many honours, he was elected Fellow of the Royal Society in 1991, appointed Commander of the British Empire in 1996 and made a Foreign Associate Member of the Institute of Medicine of the United States in 2001. Nearing and following retirement from Oxford, where he continued to see patients with myasthenia, he was the President of the Association of British Neurologists and Editor of Brain, and led a National Institutes of Health-funded international trial of thymectomy.
antibodies; myasthenia gravis; autoimmunity
G.F. Still's History of Paediatrics restricted the philosopher John Locke's (1632–1704) influence in paediatrics to pedagology and specifically his Some Thoughts Concerning Education (1693).1 This significantly limits Locke's immense ongoing influence on child health care and human rights. Locke was a physician and had a lifelong interest in medicine. His case records and journals relate some of his paediatric cases. His correspondence includes letters from Thomas Sydenham, the “English Hippocrates” (1624–89) when Locke has sought advice on a paediatric case as well as other correspondence from parents regarding child health care and management of learning disability. Locke assisted and influenced Thomas Sydenham with his writing, and Locke's own work, Two Treatises on Government, clearly stated the rights of children and limitation of parental authority. Furthermore, Locke's thoughts on Poor Law, making an economic case for a workhouse in every parish, were implemented from 1834.
children's rights; John Locke; learning disability; poor law
Elderly patients are more likely to ingest prescription medications concurrently with botanical supplements, therefore, they may be vulnerable to herb-drug interactions. Phytochemical-mediated modulation of cytochrome P-450 (CYP) activity may underlie many herb-drug interactions. Some evidence suggests that CYP activity may decrease in the elderly. If so, herb-mediated changes in CYP activity may take on greater clinical relevance in this population. Single time-point, phenotypic metabolic ratios were used to determine whether long-term supplementation of St. John’s wort, garlic oil, Panax ginseng, and Ginkgo biloba affected CYP1A2, CYP2D6, CYP2E1, or CYP3A4 activity in elderly subjects.
Twelve healthy volunteers between the ages of 60 and 76 (mean = 67 years) were randomly assigned to receive each supplement for 28 days followed by a 30-day washout period. Probe drug cocktails of midazolam, caffeine, chlorzoxazone, and debrisoquine were administered before and at the end of supplementation. Pre- and postsupplementation phenotypic ratios were determined for CYP3A4, CYP1A2, CYP2E1, and CYP2D6 using 1-hydroxymidazolam/midazolam serum ratios (1-hr), paraxanthine/caffeine serum ratios (6-hr), 6-hydroxychlorzoxazone/chlorzoxazone serum ratios (2-hr), and debrisoquine urinary recovery ratios (8-hr), respectively. The content of purported “active” phytochemicals was determined for each supplement.
Comparisons of pre- and post-St. John’s wort phenotypic ratios revealed significant induction of CYP3A4 (~140%) and CYP2E1 activity (~28%). Garlic oil inhibited CYP2E1 activity by approximately 22%. P. ginseng inhibition of CYP2D6 was statistically significant, but the magnitude of the effect (~7%) did not appear clinically relevant. None of the supplements tested in this study appeared to affect CYP1A2 activity.
Elderly subjects, like their younger counterparts, are susceptible to herb-mediated changes in CYP activity, especially those involving St. John’s wort. Pharmacokinetic herb-drug interactions stemming from alterations in CYP activity may adversely affect drug efficacy and/or toxicity. When compared to earlier studies that employed young subjects, the data suggest that some age-related changes in CYP responsivity to botanical supplementation may exist. Concomitant ingestion of botanical supplements with prescription medications, therefore, should be strongly discouraged in the elderly.
With massive amounts of data being generated in electronic format, there is a need in basic science laboratories to adopt new methods for tracking and analyzing data. An electronic laboratory notebook (ELN) is not just a replacement for a paper lab notebook, it is a new method of storing and organizing data while maintaining the data entry flexibility and legal recording functions of paper notebooks. Paper notebooks are regarded as highly flexible since the user can configure it to store almost anything that can be written or physically pasted onto the pages. However, data retrieval and data sharing from paper notebooks are labor intensive processes and notebooks can be misplaced, a single point of failure that loses all entries in the volume. Additional features provided by electronic notebooks include searchable indices, data sharing, automatic archiving for security against loss and ease of data duplication. Furthermore, ELNs can be tasked with additional functions not commonly found in paper notebooks such as inventory control. While ELNs have been on the market for some time now, adoption of an ELN in academic basic science laboratories has been lagging. Issues that have restrained development and adoption of ELN in research laboratories are the sheer variety and frequency of changes in protocols with a need for the user to control notebook configuration outside the framework of professional IT staff support. In this commentary, we will look at some of the issues and experiences in academic laboratories that have proved challenging in implementing an electronic lab notebook.
MeduMobile was a project to develop and evaluate learning scenarios for medical students and teachers by use of video communication and notebooks. Its core part was assigned to various medical routines, conferences or meetings such as doctor-patient bedside conversation. These were filmed by video teams and broadcasted live via the WLAN of the Charité campus to course participating students. One type of the learning arrangements was the autopsy conference as an on-call scenario.
Materials and methods
The MeduMobile project consisted of two main compartments: the regular seminar event which took place every week or month, and the on-call event. For an on-call event the students were informed two hours before the lesson's start. A mobile video team organised the video conference via a specific MeduMobile seminar system. This software offered the students to log. The MeduMobile seminar system is based on the Windows operating system and realises an extended video communication via WLAN. Thirteen access points were implemented at the Charité Campus Virchow Klinikum and Campus Mitte. A questionnaire was developed to investigate in the response and learning effect of the mobile seminar system.
During the MeduMobile project 42 video conferences with (cumulative) 145 participating students took place. Four autopsy conferences could be organised as on-call scenarios within this project. A prospective, not randomised follow-up study was included 25 students of the 1st – 6th clinical semester. According to the answers, professional reasoning, professional performance, sustainability, and the complexity were broadly accepted by the students.
In principle, the MeduMobile realised an interdisciplinary case presentation using video conference and web page. The evaluation indicates a high acception of such complex case presentation with multidisciplinary settings. The use of the notebooks in mobile learning enables an interconnective training and promotes a complex learning.
The traditional otorhinoendoscope is widely used in the diagnosis of a variety of ear and nose diseases, but only one doctor can use it at a time. It is also very difficult to share observations from one doctor with another doctor. With advances in electronic health technology, the extended potential application of smartphones to support medical practice or mobile health has grown steadily.
The first phase of the study discussed how smartphones may be used for otorhinoscopic imaging and image management via an innovative adaptor. The second phase of the study was to evaluate the diagnostic capability of the smartphone-based otorhinoendoscope, as compared to the traditional otorhinoendoscope, and its application in mobile health and teleotolaryngology.
We designed a unique adaptor to connect the otorhinoendoscope and smartphone in order to perform smartphone-based otorhinoendoscopy. The main aim was to transform the smartphone into an otorhinoendoscope. We devised a method that would allow us to use the smartphone’s camera to capture otorhinoscopic images. Using a freely available Web-based real-time communication application platform and the 3G (or WIFI) network, the smartphone-based otorhinoendoscope could synchronize the smartphone-based otorhinoscopic image with smartphones, tablet PCs, computer notebooks, or personal computers.
We investigated the feasibility of telemedicine using a smartphone, tablet PC, and computer notebook. Six types of clinical otorhinoscopic images were acquired via the smartphone-based otorhinoendoscope from six patients, which were examined in this study. Three teleconsultants (doctors A, B, and C) reviewed the six types of clinical otorhinoscopic images and made a telediagnosis. When compared to the face-to-face diagnosis, which was made in-person via a traditional otorhinoendoscope, the three teleconsultants obtained scores of a correct primary telediagnosis 83% (5/6), 100% (6/6), and 100% (6/6) of the time, respectively. When the clinical data were provided, the three teleconsultants obtained a correct secondary telediagnosis score of 100% (6/6), 100% (6/6), and 100% (6/6) of the time, respectively.
The use of previously available technologies in the absence of any additional expensive devices could significantly increase the quality of diagnostics while lowering extraneous costs. Furthermore, this could also increase the connectivity between most isolated family doctors and remote referral centers.
otorhinoendoscope; smartphone; mobile health; teleotolaryngology; telediagnosis
The need to train physicians committed to learning throughout their careers has prompted medical schools to encourage the development and practice of self-regulated learning by students. Longitudinal integrated clerkships (LICs) require students to exercise self-regulated learning skills. As mobile tools, tablets can potentially support self-regulation among LIC students.
We provided 15 LIC students with tablet computers with access to the electronic health record (EHR), to track their patient cohort, and a multiplatform online notebook, to support documentation and retrieval of self-identified clinical learning issues. Students received a 1-hour workshop on the relevant features of the tablet and online notebook. Two focus groups with the students were used to evaluate the program, one early and one late in the year and were coded by two raters.
Students used the tablet to support their self-regulated learning in ways that were unique to their learning styles and increased access to resources and utilization of down-time. Students who used the tablet to self-monitor and target learning demonstrated the utility of tablets as learning tools.
LICs are environments rich in opportunity for self-regulated learning. Tablets can enhance students’ ability to develop and employ self-regulatory skills in a clinical context.
mobile learning; self-regulated learning; clinical learning; longitudinal integrated clerkship; workplace learning
Professional working at computer notebooks is associated with high requirements on the body posture in the seated position. By the high continuous static muscle stress resulting from this position at notebooks, professionals frequently working at notebooks for long hours are exposed to an increased risk of musculoskeletal complaints. Especially in subjects with back pain, new notebooks should be evaluated with a focus on rehabilitative issues.
In a field study a new notebook design with adjustable screen was analyzed and compared to standard notebook position.
There are highly significant differences in the visual axis of individuals who are seated in the novel notebook position in comparison to the standard position. Also, differences are present between further alternative notebook positions. Testing of gender and glasses did not reveal influences.
This study demonstrates that notebooks with adjustable screen may be used to improve the posture. Future studies may focus on patients with musculoskeletal diseases.
John Locke speaks of personal identity and survival of consciousness after death. A criterion of personal identity through time is given. Such a criterion specifies, insofar as that is possible, the necessary and sufficient conditions for the survival of persons. John Locke holds that personal identity is a matter of psychological continuity. He considered personal identity (or the self) to be founded on consciousness (viz. memory), and not on the substance of either the soul or the body.
Personal Identity; Consciousness; Self; Memory; Survival after death
Research has shown that cultural competence training improves the attitudes, knowledge, and skills of clinicians related to caring for diverse populations. Social Justice in medicine is the idea that healthcare workers promote fair treatment in healthcare so that disparities are eliminated. Providing students with the opportunity to explore social issues in health is the first step toward decreasing discrimination. This concept is required for institutional accreditation and widely publicized as improving health care delivery in our society.
A literature review was performed searching for social justice training in medical curricula in North America.
Twenty-six articles were discovered addressing the topic or related to the concept of social justice or cultural humility. The concepts are in accordance with objectives supported by the Future of Medical Education in Canada Report (2010), the Carnegie Foundation Report (2010), and the LCME guidelines.
The authors have introduced into the elective curriculum of the John A. Burns School of Medicine a series of activities within a time span of four years to encourage medical students to further their knowledge and skills in social awareness and cultural competence as it relates to their future practice as physicians. At the completion of this adjunct curriculum, participants will earn the Dean's Certificate of Distinction in Social Justice, a novel program at the medical school. It is the hope of these efforts that medical students go beyond cultural competence and become fluent in the critical consciousness that will enable them to understand different health beliefs and practices, engage in meaningful discourse, perform collaborative problem-solving, conduct continuous self-reflection, and, as a result, deliver socially responsible, compassionate care to all members of society.
Participants read either a metaphorical prime sentence, such as That defense lawyer is a shark, or they read a baseline-prime sentence. The baseline-prime sentence was literally meaningful in Experiment 1 (e.g., That large hammerhead is a shark), nonsensical in Experiment 2 (e.g., His English notebook is a shark), and unrelated in Experiment 3 (e.g., That new student is a clown). After reading the prime sentence, participants verified a target property statement. Verification latencies for property statements relevant to the superordinate category (e.g., Sharks are tenacious) were faster after participants read the metaphor-prime sentence than after they read the baseline-prime sentence, producing an enhancement effect. In contrast, verification latencies for property statements relevant to only the basic-level meaning of the vehicle and not the superordinate (e.g., Sharks are good swimmers), were slower following the metaphor-versus the baseline-prime sentence, producing a suppression effect. As Glucksberg and Keysar’s (1990) class inclusion theory of metaphor predicts, the enhancement effect demonstrates that the vehicle of a metaphor stands for the superordinate category of the vehicle, and the suppression effect demonstrates that the metaphorical vehicle does not stand for its basic-level meaning.
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.
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.
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.
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.
John Peters and his committee had a few basic goals. One was that local, state, and federal governments needed to provide money to construct facilities, support medical research and education, and care for the poor. And they wanted experts to call the shots. Over time, Peters and the committee got what they wanted for the most part: Hill-Burton money for building the hospitals, the rise of the National Institutes of Health, Medicare, Medicaid, a Veterans Administration system, and new and expanded medical schools. The experts calling the shots included David Kessler at the Food and Drug Administration and Surgeon General C. Everett Koop. In the halcyon days of American health system reform, back in 1993, Yale's Paul Beeson wrote about the Committee of 430 Physicians and its goals in the Pharos of Alpha Omega Alpha. Beeson was optimistic and he quoted from my 1991 JAMA health system reform editorial as a sharp contrast to what Fishbein had written - although coincidentally, we both quote Lincoln. My editorial began, "'with malice toward none, with charity for all...' so spoke Abraham Lincoln in his second inaugural address recognizing that he had no political consensus regarding either the constitutionality of states seceding or the morality of slavery being abolished. Nonetheless, he knew what was right and was able, through persuasive, often inspiring rhetoric, to conclude a bloody and decisive Civil War and constitute the foundation for this great republic.... Yet access to basic medical care for all of our inhabitants is still not a reality in this country. There are many reasons for this, not the least of which is a long-standing, systematic, institutionalized racial discrimination.... An aura of inevitablitiy is upon us. It is not acceptable morally, ethically, or economically for so many of our people to be medically uninsured or seriously underinsured. We can solve this problem. We have the knowledge and the resources, the skills, the time, and the moral prescience. We need only clear-cut objectives and proper organization of existing resources. Have we now the national will and leadership?" Beeson's answer to that question in 1993 was, "Yes, but not by one comprehensive act." He quoted Peters from his 1938 Annals of Internal Medicine article: "a sweeping program suddenly imposed in this country as a whole out of the head of any Jove would undoubtedly create confusion if not chaos. Thoughtful investigation and experiment promises more than grandiose projects born of emotional preconceptions. The programs must be built of an evolutionary manner, step by step." Very wise, very valid. But how long must our people wait?
During his long career as a physician in Charlottetown, Dr. John Mackieson (1795-1885) compiled 4 medical manuscripts: 2 sets of case records, a synopsis of the medical conditions that were common in his day and a formulary. As primary sources, these documents provide information about medicine in 19th-century Canada and augment our knowledge of the problems of medical practice in that era. They illustrate aspects of the work of Dr. Mackieson, a generalist with interests in surgery and obstetrics, and they facilitate an understanding of the rationale underlying the treatments that he and his contemporaries used. Although 150 years old, the case records can be appreciated for their relevance to the art of medicine. Two excerpts from the case records, presented in this article, provide a sense of Dr. Mackieson's writings and introduce a discussion on the significance of these manuscripts in relation to the ideas on disease and treatment that governed medical practice, both in Prince Edward Island and elsewhere in Canada, in the 19th century.
Part diary, part scientific record, biological field notebooks often contain details necessary to understanding the location and environmental conditions existent during collecting events. Despite their clear value for (and recent use in) global change studies, the text-mining outputs from field notebooks have been idiosyncratic to specific research projects, and impossible to discover or re-use. Best practices and workflows for digitization, transcription, extraction, and integration with other sources are nascent or non-existent. In this paper, we demonstrate a workflow to generate structured outputs while also maintaining links to the original texts. The first step in this workflow was to place already digitized and transcribed field notebooks from the University of Colorado Museum of Natural History founder, Junius Henderson, on Wikisource, an open text transcription platform. Next, we created Wikisource templates to document places, dates, and taxa to facilitate annotation and wiki-linking. We then requested help from the public, through social media tools, to take advantage of volunteer efforts and energy. After three notebooks were fully annotated, content was converted into XML and annotations were extracted and cross-walked into Darwin Core compliant record sets. Finally, these recordsets were vetted, to provide valid taxon names, via a process we call “taxonomic referencing.” The result is identification and mobilization of 1,068 observations from three of Henderson’s thirteen notebooks and a publishable Darwin Core record set for use in other analyses. Although challenges remain, this work demonstrates a feasible approach to unlock observations from field notebooks that enhances their discovery and interoperability without losing the narrative context from which those observations are drawn.
“Compose your notes as if you were writing a letter to someone a century in the future.”
Perrine and Patton (2011)
Field notes; notebooks; crowd sourcing; digitization; biodiversity; transcription; text-mining; Darwin Core; Junius Henderson; annotation; taxonomic referencing; natural history; Wikisource; Colorado; species occurrence records
John Jones was a pioneer of American Surgery. Born in Long Island, New York in 1729, he received his medical degree in France from the University of Rheims. He returned to the colonies and helped to establish the medical school that would later become Columbia University’s College of Physicians and Surgeons where he was appointed the first Professor of Surgery in the New World. He used his position to assert that surgeons trained in America should be familiar with all facets of medicine and not be mere technicians. Before the outbreak of the American Revolution, he wrote a surgical field manual, which was the first medical text published in America. A believer in the principles of the American Revolution, he would go on to count Benjamin Franklin and George Washington as his patients. Despite achieving many firsts in American medicine, his influence on surgical training is his most enduring legacy.
Initial efforts to teach cultural competency at the University of Hawai‘i John A. Burns School of Medicine began in the late 1990s through the Native Hawaiian Center of Excellence. With the formation of the Department of Native Hawaiian Health in 2003, cultural competency training was added as a key area of focus for the department. A multidisciplinary team was formed to do the ground work. Physicians (Family Medicine and Internal Medicine) and an administrator (MBA now at Queens Medical Center) from the Department of Native Hawaiian Health were joined by a cultural anthropologist (Department of Family Medicine and Community Health), a social worker (UH Myron B. Thompson School of Social Work), and a retired DrPH/Registered Dietician from the State Department of Health to form the cultural competency curriculum team. All but one of the team members is Native Hawaiian.
As cultural competency training is a relatively new, rapidly developing field, there is no consensus on how to teach it. The department decided early on to focus on a variety of methodologies using Native Hawaiian health as the curriculum's foundation. Many different paths were taken toward the development of the present curriculum which utilized different components within the medical school's curriculum. This paper describes the process and development of a cultural competency training curriculum at the University of Hawai‘i medical school. Recent literature recommendations by experts in the field reinforce the current curricular content that resulted from this developmental process.
In 2002 the Australian National Competitive Grants System was opened to the Institute of Advanced Studies at the Australian National University as part of a commitment to transparency, competitiveness, and collaboration in national research funding.
The block grant to the John Curtin School of Medical Research had progressively eroded over many years. Access to the National Competitive Grants Schemes and associated infrastructure (through an agreed 'buy-in' price of 20% of block funding) has succeeded in its aims and in reversing this progressive effective decrease in funding.
Access to the National Competitive Grant Scheme has allowed the John Curtin School of Medical Research to contribute more broadly to Australia's health and medical research effort through increased collaboration, in a transparent and competitive funding environment.
To compare the efficacy of locking plates to non-locking plates in the osteosynthesis of mandibular fractures on the basis of clinical parameters.
Materials and Methods:
A prospective randomized clinical trial was conducted at the Faculty of Dental Science, CSMMU (formerly King Georges Medical College), Lucknow, to treat consecutive mandible fractures. The patients were randomly divided into two groups. The patients underwent osteosynthesis—group 1 with 2.4-mm locking titanium plates and group 2 with 2.7 mm non-locking titanium plates. The cause of trauma, the number of days from injury to surgery, average age, gender, and site distribution were all reviewed. The assessment of the patients was done at 1, 3, and 6 weeks and 3 months using the clinical parameters.
A total of 12 patients with mandibular fractures met the inclusion criteria. In our study, a statistically significant difference was not found in the clinical parameters such as infection, paraesthesia, hardware failure, and mobility between the fracture segments. A statistically significant difference was found between pain and swelling from the previous follow-up visit in groups 1 and 2. In locking group, pain decreases significantly at 3rd week, 6th week, 12th week from 1st week and pain was absent after 3 week. In non-locking group, pain decreases significantly at 3rd week, 6th week and 12th week from 1st week but pain was present till 12th week. Pre-operative swelling was present only in case of non-locking group. Swelling was present in 66.7% of non-locking group and 0% in locking group. After one week swelling was absent in 100% patients at 3rd, 6th and 12th week. Swelling was considerably decreased in locking group as compared to the non-locking group.
These findings show that the use of locking plates in mandibular fracture was efficacious enough to bear the masticatory loads during osteosynthesis of the fracture. The locking plates provide the advantage of a greater stability, with clinical results almost similar to those seen with non-locking plate osteosynthesis.
Locking; mandibular reconstruction; non-locking