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PubMedDate not supplied

What every surgical oncologist should know about digital mammography.

This article reviews the available information on digital mammography for surgeons who care for patients with breast cancer. The limitations of the current film-based technology and why digital mammography promises to improve breast cancer detection and breast lesion diagnosis are described. The basics of digital imaging technology are reviewed, including a description of image contrast and spatial resolution and its variance from currently available clinical digital mammography systems. The results of clinical trials completed to date are reported. An upcoming large screening trial for digital mammography, sponsored by the National Cancer Institute, is described. Future technological developments, including improvements in softcopy display, image processing, computer-aided detection and diagnosis (CADD), tomosynthesis, and digital subtraction mammography (DSM), are briefly discussed.

Breast Neoplasms↗

PubMed2001

Technology-driven triage of abdominal trauma: the emerging era of nonoperative management.

Selective nonoperative management of blunt or penetrating abdominal trauma is safe, has eliminated the complications associated with nontherapeutic laparotomies, and is cost-effective. Appropriately selected investigations, such as focused abdominal sonography for trauma, diagnostic peritoneal lavage, spiral computed tomography (CT) scan, diagnostic laparoscopy, or thoracoscopy and angiography, play a critical role in the triage of patients. Future technological advances, such as improvement of the ultrasonic hardware and software that provide automated interpretation and the availability of portable CT scan machines in the emergency room, may improve the speed and accuracy of the initial evaluation. Improvement of the optical system of minilaparoscopes may allow reliable bedside laparoscopy for suspected diaphragmatic injuries.

Abdominal Injuries↗

PubMed1998

Familial dysautonomia: a 47-year perspective. How technology confirms clinical acumen.

A historical perspective of familial dysautonomia is presented, highlighting the early contributions of Dr. Joseph Dancis. As further investigations proceeded, his original observations have withstood the test of time and may contribute to determining the molecular abnormality in this rare genetic disorder. Dr. Dancis's work in this area serves as a model of how observations based on clinical acumen and critical thinking can be verified by future technological advances.

Adult↗

PubMedDate not supplied

Little packages with big power. A micro-network to meet nursing information needs.

Installation and use of microcomputer LANs is on the rise in health care facilities. The microprocessor is becoming more powerful each day. The microcomputer is quite adept at handling textual and graphic information, which is a major requirement of any nursing patient information system. Microcomputer technology has now advanced to a level where a handful of hospitals have installed, and many hospitals actively plan to install, a complete nursing system based entirely upon a network of microcomputers. This paper discusses components of an order entry/results reporting/care management system based on a distributed, micro network architecture; the benefits of such a design; and the future technology to aid in system use and growth.

Computer Communication Networks↗

PubMed1988

Unresolved issues in the future of pharmacy.

The effect of the major forces shaping pharmacy's future--technology, economics, and social values--is discussed. Pharmacy can best respond to these forces by expanding the informational component of pharmacy practice and by returning to its fundamental relationship with society--that is, by accepting responsibility for drug-use control. To accomplish this, pharmacy must go through a process of occupational reconstruction and self-renewal. Technological forces shaping pharmacy practice include computers and robotics, communications, and therapeutics. Regarding economic changes, medical-care decisions are shifting away from individuals toward "third parties." This factor, combined with output-based payment systems, may lead to a consolidation of service providers. Marketing pharmaceutical services and organizing pharmacy's internal structure will become important. Some of the social forces affecting pharmacy's future include the aging population, the weakening of professional authority, and pharmacy's public image. Just as society goes through the "information revolution," pharmacy will need to undergo a "reprofessionalization." Pharmacy's societal function should involve "pharmaceutical care," a concept that includes both drug-product control and clinical pharmacy services. Pharmacy should return to its preindustrial origins in valued, complex, specific, and committed public service if it wishes a happy postindustrial future.

Pharmacy↗

PubMed2004

Sustainable sludge management--what are the challenges for the future?

Sewage sludge is a serious problem due to the high treatment costs and the risks to environment and human health. Future sludge treatment will be progressively focused on an improved efficiency and environmental sustainability of the process. In this context a survey is given of the most relevant sludge treatment options and separate treatment steps. Special attention is paid to those processes that are simultaneously focused on the elimination of the risks for environment and human health and on the recovery or beneficial use of the valuable compounds in the sludge such as organic carbon compounds, inorganic non-toxic substances, phosphorus and nitrogen containing compounds. Also, a brief assessment is given of the specific future technological developments regarding the various treatment steps. Furthermore, it is discussed how to assess the various pathways which can lead to the required developments. In such an assessment the technical and economic feasibility, the environmental sustainability, the societal acceptance and the implementation route are important factors. The optimal approach also strongly depends on the local and regional situation of concern and the relevant current and future boundary conditions.

Carbon↗

PubMedDate not supplied

Quantitative lingual, pharyngeal and laryngeal ultrasonography in swallowing research: a technical review.

Because of its distinct advantage in radiation-free soft tissue imaging, ultrasonography has been widely used to study lingual, pharyngeal, hyoid, laryngeal, and even esophageal action during swallowing in individuals of all ages. Qualitative ultrasonographic observations have made considerable contributions to our understanding of deglutition. Quantitative ultrasonographic swallowing research has also grown by leaps and bounds over the years with advances in imaging technologies and analytical methodologies. As a technical primer for new investigators, this paper reviews the modem methods for quantitative analysis in ultrasonographic swallowing research. The intended outcome is a basic understanding of the application of ultrasonography with various analysis options to the quantitative study of the deglutitive action of selected upper aerodigestive structures. Though proven useful for swallowing research, ultrasonography has inherent limitations and methodological issues. Future technological advancement and sophisticated image processing and analysis algorithms will resolve some of these issues.

Biomechanical Phenomena↗

PubMed1988

Knowledge-based automation.

Future technologic advances in microcomputer hardware will allow us to build complex interactive information systems that go far beyond conventional laboratory management functions to address the needs of laboratorians as well as physicians in patient care activities. These systems will use a "local-area network to transmit not only text but also images to workstations throughout a hospital. Unlike current systems driven from a central computer, future systems will decentralize much of the memory and processing to individual workstations." The expansion of software tools for modeling the decision-making process coupled with the development and testing of useful systems in relatively narrow problem domains will help the laboratory construct the necessary knowledge bases for future applications. Such systems will present complex medical data in a useful, informative manner, leading to a more rapid, consistent, and, it is hoped, cost effective decision making process. Utilizing these techniques, laboratory medicine can play a crucial role in fostering the appropriate and logical use of the laboratory.

Artificial Intelligence↗

PubMed1993

Technology assessment and cost management.

Endoscopic, less-invasive surgery has reshaped health care. The skill of correctly assessing purchases and leases is critical to a surgical service's success. Video technology changes rapidly, and systems become obsolete in months, not years. Each update presents new learning curves, thus additional educational costs. Choosing reusable instrumentation may include hidden costs not fully appreciated, whereas disposables may create waste management and environmental problems. Assessing and managing the costs related to less-invasive surgery require in-depth analyses of an institution's specific needs and of available and future technology.

Costs and Cost Analysis↗

PubMed2003

Intrathecal drug delivery 2002.

BACKGROUND: Intrathecal drug delivery has been used clinically since the 1970's. Significant clinical advances have been made combining new technology with pharmacology and surgery. Continuous infusion of medication for both analgesia and spasticity has become a part of the armamentarium for specialists in these areas. Significant recent advances in technology promise further enhancements and improvements for intrathecal therapy. METHODS: A review of the literature combined with 20 years personal experience with intrathecal drug delivery. FINDINGS/DISCUSSION: Intrathecal therapy has established a role in the treatment of malignant pain, benign pain and severe spasticity. Significant literature and the current state of practice in the United States are reviewed. Recent therapeutic enhancements are discussed, and a wish list of future technological enhancements presented.

Baclofen↗

PubMed2000

[Molecular biological approaches to lung cancer].

Advances in lung cancer research have come from modern technology, allowing the establishment of lung cancer cell lines and experimental model systems, recombinant DNA technology, robust biological and biochemical functional assays in addition to classical methods such as immunohistochemistry. Such work indicates that the aberrant activation of protooncogenes and inactivation of tumor suppressor genes are fundamental processes for lung carcinogenesis. Further improvements such as DNA array technology will continue to unravel the genetic and epigenetic defects in a far more rapid and comprehensive way that was previously possible. This knowledge will lead to a genetic characterization of lung cancer cells and its specific subtypes, which will hopefully translate to new diagnostic and therapeutic gene based strategies. This review focuses on molecular biological techniques that have been used on lung cancer research and discusses future technological approaches.

Animals↗

PubMed2006

Recent applications of affinity interactions in capillary electrophoresis.

Systems biology depends on a comprehensive assignment and characterization of the interactions of proteins and polypeptides (functional proteomics) and of other classes of biomolecules in a given organism. High-capacity screening methods are in place for ligand capture and interaction screening, but a detailed dynamic characterization of molecular interactions under physiological conditions in efficiently separated mixtures with minimal sample consumption is presently provided only by electrophoretic interaction analysis in capillaries, affinity CE (ACE). This has been realized in different fields of biology and analytical chemistry, and the resulting advances and uses of ACE during the last 2.5 years are covered in this review. Dealing with anything from small divalent metal ions to large supramolecular assemblies, the applications of ACE span from low-affinity binding of broad specificity being exploited in optimizing selectivity, e.g., in enantiomer analysis to miniaturized affinity technologies, e.g., for fast processing immunoassay. Also, approaches that provide detailed quantitative characterization of analyte-ligand interaction for drug, immunoassay, and aptamer development are increasingly important, but various approaches to ACE are more and more generally applied in biological research. In addition, the present overview emphasizes that distinct challenges regarding sensitivity, parallel processing, information-rich detection, interfacing with MS, analyte recovery, and preparative capabilities remain. This will be addressed by future technological improvements that will ensure continuing new applications of ACE in the years to come.

Animals↗

PubMed2006

Semiconductor nanowires: from self-organization to patterned growth.

The synthesis of semiconductor nanowires has been studied intensively worldwide for a wide spectrum of materials. Such low-dimensional nanostructures are not only interesting for fundamental research due to their unique structural and physical properties relative to their bulk counterparts, but also offer fascinating potential for future technological applications. Deeper understanding and sufficient control of the growth of nanowires are central to the current research interest. This Review discusses the various growth processes, with a focus on the vapor-liquid-solid process, which offers an opportunity for the control of spatial positioning of nanowires. Strategies for position-controlled and nanopatterned growth of nanowire arrays are reviewed and demonstrated by selected examples as well as discussed in terms of larger-scale realization and future prospects. Issues on building up nanowire-based electronic and photonic devices are addressed at the end of the Review, accompanied by a brief survey of recent progress demonstrated so far on the laboratory level.

Crystallization↗

PubMed2005

Elucidating mechanisms of drug-induced toxicity.

The early and high-throughput application of assays for non-genetic toxicity is of great interest to the pharmaceutical industry, although few systems have been validated as being of good predictive value. New technologies could enable toxicity to be studied in the context of systems biology. An important factor to be considered is the metabolism of drugs to reactive intermediates. Chemical reactions of these with cell and tissue nucleophiles are relatively well understood, but predicting how biological modifications will affect signalling and regulatory networks remains a challenge. Some of these pathways could be useful as sentinels for toxicity. This article will cover some examples of drug toxicity and the prospects for future technology development.

Animals↗

PubMed1998

On the horizon: minimally invasive cardiac surgery.

The landscape of cardiac surgery is changing. Advances in endoscopic and other instrumentation procedures such as port access, video instrumentation, and computer-assisted technology are opening new vistas for cardiac surgery. On the immediate horizon is minimally invasive cardiac surgery, also known as keyhole surgery. Imagine a patient not needing a median sternotomy incision or cardiopulmonary bypass. This new type of cardiac surgery is currently being explored at some cardiac surgical centers internationally. This article explores the current state-of-the-art related to minimally invasive direct coronary artery bypass surgery. The operative procedure, implications for perioperative nursing care, likely future technologies, and the research literature on outcomes are also discussed.

Cardiac Surgical Procedures↗

PubMed2005

[Techniques for functional tissue and organ replacement using postnatal stem cells].

Postnatal stem cells play a decisive role in cell-based therapies due to their high proliferation activity and functional plasticity. On the one hand, basic research in cell biological processes of adult stem cells is crucial in order to establish them as therapeutic tools. On the other hand, development and enhancements of appropriate techniques are required: we need to establish defined technologies for extraction and differentiation of stem cells and to develop adequate cell carrier devices, scaffolds, and bioreactors for in vitro purposes. Furthermore, it is an interdisciplinary challenge to consider logistical aspects concerning isolation, transport, and storage of stem cells in order to use them in a wide range of activities in regenerative medicine. In this review we present the current methods of work and research on adult stem cells. We explain their therapeutic use and define requirements for future technological developments for work with postnatal stem cells.

Bioreactors↗

PubMed2026

Scalable, generalizable and uncertainty-aware integration of spatial multiomics across diverse modalities and platforms with SCIGMA.

Recent advances in spatial omics technologies have enabled simultaneous profiling of transcriptomic, proteomic, epigenomic, metabolomic and imaging data at high spatial resolution, offering unprecedented opportunities to dissect tissue complexity. However, integrating these diverse and large-scale spatial multimodal datasets remains a major computational challenge. We present SCIGMA, a scalable and generalizable deep learning framework for spatial multiomics integration. SCIGMA introduces an uncertainty-aware contrastive learning objective and multiview graph neural networks to preserve modality-specific signals while learning biologically meaningful joint representations. Unlike previous methods, SCIGMA provides spatially resolved uncertainty estimates, interpretably identifying regions of biological or technical heterogeneity. SCIGMA supports integration of up to five modalities, and its modular framework is extensible to future technologies with even more modalities. It also scales to more than 1 million spatial locations, enabling analysis of high-resolution datasets such as Visium HD and Xenium Prime. We evaluated SCIGMA across 19 datasets spanning 8 modalities, 10 tissues and 9 platforms. On benchmarkable datasets, SCIGMA outperformed other methods in spatial domain detection, modality preservation, feature reconstruction and reproducibility. SCIGMA identifies biologically meaningful structures, refined spatial domains and modality-specific regulatory programs, providing a robust, flexible and future-ready solution for scalable spatial multimodal integration.

Multiomics↗

PubMed1985

Speech technology: present and future applications in the airborne environment.

Advanced speech technology systems, specifically voice recognition and voice synthesis systems are being considered as viable solutions to the problem of distributing pilot workload in today's increasingly complex airborne environment. The U.S. Air Force has funded various projects in this area over the past few years including studies defining and establishing priorities for candidate tasks to be accomplished by voice control, as well as a developmental hardware program which entered a flight test phase in December 1982. The applications of this technology are constrained only by the rate of its evolution. Certain tasks have already been identified as excellent candidates for control by a voice system and the present hardware is capable of being configured to perform these tasks. Other tasks have been identified as potential candidates. Although these candidates are tasks which would impact pilot workload, present technology is incapable fo supporting them.

Aviation↗