Pierre Teilhard de Chardin: a visionary in controversy.

Teilhard de Chardin developed an evolutionary vision of our planetary future, currently developing from a sphere of life, or biosphere towards a sphere of mind, or noosphere. As a visionary, Teilhard was not only on the brink of formulating the internet, but he also anticipated current academic efforts to understand globalization, as well as human, cultural and technological evolution. However, his ideas are sources of enduring controversies in both scientific and theological circles. Here I uncover some of the core reasons why his ways of thinking and writing are often problematic, and propose a way forward. This note aims to introduce Teilhard's central article about the noosphere (The Formation of the Noosphere, 1947), but can also be read as an independent introduction to Teilhard's system of thought. A detailed exegesis of Teilhard's article is available as a supplementary document.

Cosmological immortality: how to eliminate aging on a universal scale.

The death of our universe is as certain as our individual death. Some cosmologists have elaborated models which would make the cosmos immortal. In this paper, I examine them as cosmological extrapolations of immortality narratives that civilizations have developed to face death anxiety. I first show why cosmological death should be a worry, then I briefly examine scenarios involving the notion of soul or resurrection on a cosmological scale. I discuss in how far an intelligent civilization could stay alive by engaging in stellar, galactic and universal rejuvenation. Finally, I argue that leaving a cosmological legacy via universe making is an inspiring and promising narrative to achieve cosmological immortality.

Modified robotic lightweight endoscope (ViKY) validation in vivo in a porcine model.

The added precision and steadiness of a robotically held camera enables the performance of more complex procedures laparoscopically. In contrast to typical laparoscope holders, the modified lightweight robotic endoscope, the ViKY system is particularly compact, simple to set up and use, and occupies no floor space. Ease and safety of setup was confirmed in a porcine model and several common general surgical procedures were performed. The sterilizable endoscope manipulator is sufficiently small to be placed directly on the operating room table without interfering with other handheld instruments during minimally invasive surgery. The endoscope manipulator and its user interface were tested and evaluated by several surgeons during a series of 5 minimally invasive surgical training procedures in a porcine model. The endoscope manipulator described has been shown to be a practical device with performance and functionality equivalent to those of commercially available models, yet with greatly reduced size, weight, and cost.

Ultrasonographic assessment of arterial cross-sectional area in the thoracic outlet on postural maneuvers measured with power Doppler ultrasonography in both asymptomatic and symptomatic populations.

OBJECTIVE: The purpose of this study was to evaluate the feasibility and potential usefulness of power Doppler ultrasonography (PDU) in the assessment of changes in arterial cross-sectional area in the thoracic outlet during upper limb elevation. METHODS: Forty-four volunteers and 28 patients with a clinical diagnosis of arterial thoracic outlet syndrome were evaluated by B-mode imaging and PDU. Arterial cross-sectional area was assessed in the 3 compartments of the thoracic outlet with the arm alongside the body and at 90 degrees, 130 degrees, and 170 degrees of abduction. The percentage of arterial stenosis was calculated for each of these arm positions. Nineteen of the 28 patients were also assessed by magnetic resonance (MR) imaging. RESULTS: No significant arterial stenosis was shown in the interscalene triangle and in the retropectoralis minor space of the volunteers and patients. A significant difference (P < .01) in stenosis between volunteers and patients was seen for all degrees of abduction in the costoclavicular space. The 130 degrees hyperabduction maneuver appeared to be the most discriminating postural maneuver. Seven patients assessed with MR imaging did not have any arterial stenosis on MR images, whereas an appreciable degree of arterial stenosis was shown with ultrasonography. CONCLUSIONS: Arterial compression inside the thoracic outlet can be detected and quantified with B-mode imaging in association with PDU.

The posterior lumbar ramus: CT-anatomic correlation and propositions of new sites of infiltration.

BACKGROUND AND PURPOSE: Lumbar zypapophyseal joints are innervated by the medial branch of the posterior lumbar ramus. The aim of this work was to describe the precise course of the medial ramus on axial CT scans and to define a precise location for its selective infiltration. METHODS: Lumbar spines of two cadavers were first dissected to assess the route of the L1-L5 posterior ramus. Thirty lumbar spinal nerves of three cadavers were injected in the epineural space with a mixture of iodine contrast and stain to perform a correlation between anatomic gross sections and CT sections in the axial plane. A histologic study was also performed to ensure the neurologic nature of the structure identified. RESULTS: The fibroosseous canal located between the mamillary and the accessory processes was a constant pathway for the medial branch of the L1-L4 posterior ramus. This former was always located closer to the accessory process. The L5 posterior ramus and its divisions could also be identified into a groove bounded laterally by the ala of the sacrum and medially by the base of the superior articular process of S1. CONCLUSION: The accessory process and the groove bounded laterally by the ala of the sacrum and medially by the base of the superior articular process of S1 can be easily depicted on CT images and may allow a precise and selective infiltration of the medial branch of the posterior lumbar ramus.

Análisis de la relación terapeuta-paciente en la práctica de la atención primaria / Analysis of physician-patient relation in primary health care

La capacitación de los equipos de atención primaria para el abordaje y resolución de los problemas de salud mental que contituyen una elevada proporción de su práctica, debe apoyarse de preferencia en un enfoque comprensivo de esos problemas, que supere el reduccionismo biomédico tradicional. El análisis de la relación terapeuta-paciente permite señalar dónde y cómo aparecen los aspectos psicológicos y socioculturales involucrados en esa práctica, los que a veces se traducen en situaciones conflictivas entre el terapeuta y su paciente. Se plantean las ventajas de trabajar la relación terapeuta-paciente como un primer paso dentro de un proceso de capacitación más amplio