Differences and similarities in the regulation of medical practice between early modern Vienna and Osijek

This paper evaluates the regulation of medical practice from the sixteenth to the eighteenth centuries in two Habsburg cities, Vienna and Osijek, in the light of the spread of medical knowledge and practice from the centre to the periphery of the Habsburg Monarchy. Although both cities were part of the Habsburg Monarchy for much of the early modern period, there were more differences than similarities between them. This may be explained by appealing to a variety of factors, including geographical position, population structure, religion, government type, and professional organisations, all of which contributed to making medical practice very different in the two cities. The divergence occurred in spite of a central agenda for ensuring uniformity of medical practice throughout the Habsburg Monarchy. Although the legislation governing medical practice was the same in both cities, it was more strictly implemented in Vienna than in Osijek. In consequence, Osijek was the setting for some unique patterns of medical practice not to be found in the Habsburg capital.     

Introduction: Centre and periphery in the eighteenth-century Habsburg 'medical empire'

This paper introduces a collection of essays exploring different aspects of the relationship between medical knowledge and administration in the Habsburg Monarchy. The collection brings together a range of perspectives upon the confrontation between programmes for centralised medical bureaucracy emanating from Vienna, and their implementation in a variety of different cultural, linguistic, social and practical circumstances. Such confrontations raise issues about the nature and limits of enlightened universalism, the relationship between knowledge and government in the seventeenth and eighteenth centuries, and the similarities between the processes of centralisation and the issues addressed by historians of empire. The case of Gerard van Swieten, Catholic Dutch medical practitioner appointed as the chief physician to the Habsburg Imperial family, is used to illustrate some of the main issues involved.     

Virtual anthropology meets biomechanics

A meeting in Vienna in October 2010 brought together researchers using Virtual Anthropology (VA) and Finite Element Analysis (FEA) in order to explore the benefits and problems facing a collaboration between the two fields. FEA is used to test mechanical hypotheses in functional anatomy and VA complements and augments this process by virtue of its tools for acquiring data, for segmenting and preparing virtual specimens, and for generating reconstructions and artificial forms. This represents a critical methodological advance because geometry is one of the crucial inputs of FEA and is often the variable of interest in functional anatomy. However, we currently lack tools that quantitatively relate differences in geometry to differences in stress and strain, or that evaluate the impact on FEA of variation within and between biological samples. Thus, when comparing models of different geometry, we do not currently obtain sufficiently informative answers to questions such as “How different are these models, and in what manner are they different? Are they different in some anatomical regions but not others?" New methodologies must be developed in order to maximize the potential of FEA to address questions in comparative and evolutionary biology. In this paper we review these and other important issues that were raised during our Vienna meeting.     

Comparing parametric solid modelling/reconfiguration, global shape modelling and free-form deformation for the generation of 3D digital models of femurs from X-ray images

At present, computer assisted surgery systems help orthopaedic surgeons both plan and perform surgical procedures. To enable these systems to function, it is crucial to have at one's disposal 3D models of anatomical structures, surgical tools and prostheses (if required). This paper analyses and compares three methods for generating 3D digital models of anatomical structures starting from X-ray images: parametric solid modelling/reconfiguration, global shape modelling and free-form deformation. Seven experiences involving the generation of a femur model were conducted by software developers and different skilled users. These experiences are described in detail and compared at different stages and from different points of view.     

Comparing parametric solid modelling/reconfiguration,global shape modelling and free-form deformation for the generation of 3D digital models of femurs from X-ray images

At present, computer assisted surgery systems help orthopaedic surgeons both plan and perform surgical procedures. To enable these systems to function, it is crucial to have at one's disposal 3D models of anatomical structures, surgical tools and prostheses (if required). This paper analyses and compares three methods for generating 3D digital models of anatomical structures starting from X-ray images: parametric solid modelling/reconfiguration, global shape modelling and free-form deformation. Seven experiences involving the generation of a femur model were conducted by software developers and different skilled users. These experiences are described in detail and compared at different stages and from different points of view.     

‘A civilizing mission’? Austrian medicine and the reform of medical structures in the Ottoman Empire, 1838–1850

During the 1840s, physicians from the Habsburg Empire played a decisive role in the reform of medical structures in the Ottoman Empire. This paper discusses different aspects of this scientific and cultural encounter. It emphasizes the importance of Austrian health care structures as a model for the work of these physicians in the Ottoman Empire and studies the role of the medical school ran by the Austrians as a means of representing, on the one hand, the reformatory efforts of the Ottoman Empire and, on the other hand, the motivations of the Habsburg monarchy for an involvement in Ottoman health care affairs, strongly bound up with its own quarantine politics towards the Ottoman Empire.     

Vienna focus for Austrian ambitions

The Austrian Academy of Sciences has taken the bold step of closing a successful institute in Salzburg and opening two new ones in Vienna with the aim of creating an internationally attractive critical mass of biological research activity in the capital. Graham Tebb reports.     

Royal dynasties as human inbreeding laboratories: the Habsburgs

The European royal dynasties of the Early Modern Age provide a useful framework for human inbreeding research. In this article, consanguineous marriage, inbreeding depression and the purging of deleterious alleles within a consanguineous population are investigated in the Habsburgs, a royal dynasty with a long history of consanguinity over generations. Genealogical information from a number of historical sources was used to compute kinship and inbreeding coefficients for the Habsburgs. The marriages contracted by the Habsburgs from 1450 to 1750 presented an extremely high mean kinship (0.0628±0.009), which was the result of the matrimonial policy conducted by the dynasty to establish political alliances through marriage. A strong inbreeding depression for both infant and child survival was detected in the progeny of 71 Habsburg marriages in the period 1450–1800. The inbreeding load for child survival experienced a pronounced decrease from 3.98±0.87 in the period 1450–1600 to 0.93±0.62 in the period 1600–1800, but temporal changes in the inbreeding depression for infant survival were not detected. Such a reduction of inbreeding depression for child survival in a relatively small number of generations could be caused by elimination of deleterious alleles of a large effect according with predictions from purging models. The differential purging of the infant and child inbreeding loads suggest that the genetic basis of inbreeding depression was probably very different for infant and child survival in the Habsburg lineage. Our findings provide empirical support that human inbreeding depression for some fitness components might be purged by selection within consanguineous populations.     

The mobilization of the ethnic vote: A thesis with some Scottish and Welsh evidence*

This article provides a historical and comparative analysis of post‐imperial migrations of ethnic unmixing. It examines the post‐Soviet migration of ethnic Russians to Russia in the light of the migrations of other once‐dominant ‘new minorities’ engendered by transitions from multinational empire to incipient nation‐states: Balkan Muslims during and after the disintegration of the Ottoman Empire, Hungarians after the collapse of the Habsburg Empire, and Germans after the collapse of the Habsburg Empire and the German Kaiserreich.     

Three-dimensional printing: technologies,applications, and limitations in neurosurgery

Three-dimensional (3D) printers are a developing technology penetrating a variety of markets, including the medical sector. Since its introduction to the medical field in the late 1980s, 3D printers have constructed a range of devices, such as dentures, hearing aids, and prosthetics. With the ultimate goals of decreasing healthcare costs and improving patient care and outcomes, neurosurgeons are utilizing this dynamic technology, as well. Digital Imaging and Communication in Medicine (DICOM) can be translated into Stereolithography (STL) files, which are then read and methodically built by 3D Printers. Vessels, tumors, and skulls are just a few of the anatomical structures created in a variety of materials, which enable surgeons to conduct research, educate surgeons in training, and improve pre-operative planning without risk to patients. Due to the infancy of the field and a wide range of technologies with varying advantages and disadvantages, there is currently no standard 3D printing process for patient care and medical research. In an effort to enable clinicians to optimize the use of additive manufacturing (AM) technologies, we outline the most suitable 3D printing models and computer-aided design (CAD) software for 3D printing in neurosurgery, their applications, and the limitations that need to be overcome if 3D printers are to become common practice in the neurosurgical field.     

Stereoscopic virtual reality models for planning tumor resection in the sellar region

Background

It is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region.

Methods

To investigate the value of using a virtual reality system for planning resection of sellar region tumors. The study included 60 patients with sellar tumors. All patients underwent computed tomography angiography, MRI-T1W1, and contrast enhanced MRI-T1W1 image sequence scanning. The CT and MRI scanning data were collected and then imported into a Dextroscope imaging workstation, a virtual reality system that allows structures to be viewed stereoscopically. During preoperative assessment, typical images for each patient were chosen and printed out for use by the surgeons as references during surgery.

Results

All sellar tumor models clearly displayed bone, the internal carotid artery, circle of Willis and its branches, the optic nerve and chiasm, ventricular system, tumor, brain, soft tissue and adjacent structures. Depending on the location of the tumors, we simulated the transmononasal sphenoid sinus approach, transpterional approach, and other approaches. Eleven surgeons who used virtual reality models completed a survey questionnaire. Nine of the participants said that the virtual reality images were superior to other images but that other images needed to be used in combination with the virtual reality images.

Conclusions

The three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region. Virtual reality appears to be promising as a valuable tool for sellar region surgery in the future.

     

The new reconstructive ladder: modifications to the traditional model

The traditional reconstructive ladder has withstood the test of time, serving as a thought paradigm to guide surgeons in choosing their method of wound closure for an assortment of defects. Advances in anatomical understanding and technological innovations have improved our ability to achieve definitive closure in a wide variety of patients. In this article, the older construct is updated to reflect the use of negative-pressure wound therapy and dermal matrices. Perforator flap concepts are also discussed in terms of their inclusion as a rung on the ladder.     

Wall Street's growing influence on plastic surgery

The advent of managed care has unleashed market forces on the health care system. One result of these new pressures is a shift from nonprofit to Wall Street-based financing. This report quantifies these trends by comparing health organizations' financial structures in the 1980s and now. The reasons behind this shift and the function of the stock market are examined. A review of Wall Street's key financial measures confirms that health care has shifted to the stock market as its principal means of financing. The stock market works by assigning a current price to a company's stock based on estimates for future earnings. Thus, companies desire predictability in their costs, revenues, and profits. Plastic surgeons can master this system by meeting the challenges imposed by Wall Street financing. Important steps include continuously measuring costs and outcomes of procedures, demanding cost data from hospitals and payers, using these data to improve costs and outcomes, and taking advantage of the system's openness to innovation and easier access to capital. As they seek to protect their role as medical decision makers under the new free-market system, plastic surgeons can benefit from understanding the mechanisms of the stock market.     

Living with disabilities in Austria--with a special focus on the capital

Life expectancy, especially in the older age groups, is growing enormously due to better social and medical care. According to published data on disabled people (1997), about 30 % of the total population (7,119,000) in Austria suffer from at least one physical disability. In this study, data from a micro census as well as a report from the Federal Ministry for Social Security and Generations is analyzed to illuminate the situation of impaired people with a focus on the capital Vienna. Among other results, it is anticipated that a large number of disabled people receive no help at all. About every 7th person regularly receives care, every 10th receives daily support. Care intensity increases with age showing a clear progression from the age of 60 onwards. 88% of the main supporting individuals are related to the handicapped person being supported. Women generally exhibit a much higher participation in nursing. The socio-political developments are discussed.     

Newer concepts of anatomy of the lungs; advantages to surgeons,internists, bronchoscopist and radiologists

In the newer concept of the anatomical divisions of the lungs, the bronchopulmonary segment is the primary unit. Specific lung areas are identified by their relationship to the branch of the bronchus that serves them. The left upper lobe apical segment, for example, is that which is supplied by the left upper lobe apical bronchus. The boundaries of the segments are definitive; thin tissue surrounds each segment. Some diseases of the lungs tend to progress only "through channels"-reaching a segment via the specific airway serving it, and then frequently remaining within the segmental boundaries. The concept is of particular importance to surgeons because of the trend toward segmental resection and salvage of vital lung tissue. In addition, a more definitive nomenclature, useful to surgeons, internists, radiologists and bronchoscopists in designating the location of a lesion or a foreign body, is possible.     

Searching through functional space reveals distributed visual,auditory, and semantic coding in the human brain

The extent to which brain functions are localized or distributed is a foundational question in neuroscience. In the human brain, common fMRI methods such as cluster correction, atlas parcellation, and anatomical searchlight are biased by design toward finding localized representations. Here we introduce the functional searchlight approach as an alternative to anatomical searchlight analysis, the most commonly used exploratory multivariate fMRI technique. Functional searchlight removes any anatomical bias by grouping voxels based only on functional similarity and ignoring anatomical proximity. We report evidence that visual and auditory features from deep neural networks and semantic features from a natural language processing model, as well as object representations, are more widely distributed across the brain than previously acknowledged and that functional searchlight can improve model-based similarity and decoding accuracy. This approach provides a new way to evaluate and constrain computational models with brain activity and pushes our understanding of human brain function further along the spectrum from strict modularity toward distributed representation.     

Cluster-based upper body marker models for three-dimensional kinematic analysis: Comparison with an anatomical model and reliability analysis

Quantifying angular joint kinematics of the upper body is a useful method for assessing upper limb function. Joint angles are commonly obtained via motion capture, tracking markers placed on anatomical landmarks. This method is associated with limitations including administrative burden, soft tissue artifacts, and intra- and inter-tester variability. An alternative method involves the tracking of rigid marker clusters affixed to body segments, calibrated relative to anatomical landmarks or known joint angles. The accuracy and reliability of applying this cluster method to the upper body has, however, not been comprehensively explored. Our objective was to compare three different upper body cluster models with an anatomical model, with respect to joint angles and reliability. Non-disabled participants performed two standardized functional upper limb tasks with anatomical and cluster markers applied concurrently. Joint angle curves obtained via the marker clusters with three different calibration methods were compared to those from an anatomical model, and between-session reliability was assessed for all models. The cluster models produced joint angle curves which were comparable to and highly correlated with those from the anatomical model, but exhibited notable offsets and differences in sensitivity for some degrees of freedom. Between-session reliability was comparable between all models, and good for most degrees of freedom. Overall, the cluster models produced reliable joint angles that, however, cannot be used interchangeably with anatomical model outputs to calculate kinematic metrics. Cluster models appear to be an adequate, and possibly advantageous alternative to anatomical models when the objective is to assess trends in movement behavior.     

The frightening borderlands of Enlightenment: The vampire problem

Between 1724 and 1760, in the frontier area of the Habsburg empire waves of a hitherto unknown epidemic disease emerged: vampirism. In remote villages of southeastern Europe, cases of unusual deaths were reported. Corpses did not decay and, according to the villagers, corporeal ghosts were haunting their relatives and depriving them of their vital force. Death occurred by no later than three to four days. The colonial administration, alarmed by the threat of an epidemic illness, dispatched military officers and physicians to examine the occurrences. Soon several reports and newspaper articles circulated and made the untimely resurrection of the dead known to the perplexed public, Europe-wide. "Vampyrus Serviensis", the Serbian vampire, became an intensively discussed phenomenon within academe, and thereby gained factual standing. My paper depicts the geopolitical context of the vampire's origin within the Habsburg states. Secondly, it outlines the epistemological difficulties faced by observing physicians in the field. Thirdly, it delineates the scholarly debate on the apparent oxymoron of the living dead in the era of enlightened reason. Fourthly, the early history of vampirism shows that ghosts and encounters with the undead are not superstitious relics of a pre-modern past, or the Enlightenment's other, but intimate companions of Western modernity.     

The origin of the arteria sigmoidea ima]

The authors report the results of their observations on the lowest sigmoid artery, carried out on 92 anatomical specimens coming from surgical operations on the sigmoid and rectum. The specimens were injected and radiographed immediately after their removal . The observations were often preceded by pre-operative angiographies performed for diagnostic reasons. The AA. document all the variational patterns of this artery. They confirm the poor functional value of this artery more known by the old surgeons than by the anatomists.