124 results
Cost consequence analysis of Apathy in Dementia Methylphenidate Trial 2 (ADMET 2)
- Krista L. Lanctôt, Clara Chen, Ethan Mah, Alex Kiss, Abby Li, Dave Shade, Roberta W. Scherer, Danielle Vieira, Hamadou Coulibaly, Paul B. Rosenberg, Alan J. Lerner, Prasad R. Padala, Olga Brawman-Mintzer, Christopher H. van Dyck, Anton P. Porsteinsson, Suzanne Craft, Allan Levey, William J. Burke, Jacobo Mintzer, Nathan Herrmann
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue 11 / November 2023
- Published online by Cambridge University Press:
- 17 April 2023, pp. 664-672
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Background:
This paper used data from the Apathy in Dementia Methylphenidate Trial 2 (NCT02346201) to conduct a planned cost consequence analysis to investigate whether treatment of apathy with methylphenidate is economically attractive.
Methods:A total of 167 patients with clinically significant apathy randomized to either methylphenidate or placebo were included. The Resource Utilization in Dementia Lite instrument assessed resource utilization for the past 30 days and the EuroQol five dimension five level questionnaire assessed health utility at baseline, 3 months, and 6 months. Resources were converted to costs using standard sources and reported in 2021 USD. A repeated measures analysis of variance compared change in costs and utility over time between the treatment and placebo groups. A binary logistic regression was used to assess cost predictors.
Results:Costs were not significantly different between groups whether the cost of methylphenidate was excluded (F(2,330) = 0.626, ηp2 = 0.004, p = 0.535) or included (F(2,330) = 0.629, ηp2 = 0.004, p = 0.534). Utility improved with methylphenidate treatment as there was a group by time interaction (F(2,330) = 7.525, ηp2 = 0.044, p < 0.001).
Discussion:Results from this study indicated that there was no evidence for a difference in resource utilization costs between methylphenidate and placebo treatment. However, utility improved significantly over the 6-month follow-up period. These results can aid in decision-making to improve quality of life in patients with Alzheimer’s disease while considering the burden on the healthcare system.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Effect of methylphenidate on attention in apathetic AD patients in a randomized, placebo-controlled trial
- Krista L. Lanctôt, Sarah A. Chau, Nathan Herrmann, Lea T. Drye, Paul B. Rosenberg, Roberta W. Scherer, Sandra E. Black, Vijay Vaidya, David L. Bachman, Jacobo E. Mintzer,
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- Journal:
- International Psychogeriatrics / Volume 26 / Issue 2 / February 2014
- Published online by Cambridge University Press:
- 29 October 2013, pp. 239-246
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Background:
Little is known about the effect of methylphenidate (MPH) on attention in Alzheimer's disease (AD). MPH has shown to improve apathy in AD, and both apathy and attention have been related to dopaminergic function. The goal was to investigate MPH effects on attention in AD and assess the relationship between attention and apathy responses.
Methods:MPH (10 mg PO twice daily) or placebo was administered for six weeks in a randomized, double-blind trial in mild-to-moderate AD outpatients with apathy (Neuropsychiatric Inventory (NPI) Apathy ≥ 4). Attention was measured with the Wechsler Adult Intelligence Scale – Digit Span (DS) subtest (DS forward, selective attention) and apathy with the Apathy Evaluation Scale (AES). A mixed effects linear regression estimated the difference in change from baseline between treatment groups, defined as δ (MPH (DS week 6–DS baseline)) – (placebo (DS week 6–DS baseline)).
Results:In 60 patients (37 females, age = 76 ± 8, Mini-Mental State Examination (MMSE) = 20 ± 5, NPI Apathy = 7 ± 2), the change in DS forward (δ = 0.87 (95% CI: 0.06–1.68), p = 0.03) and DS total (δ = 1.01 (95% CI: 0.09–1.93), p = 0.03) favored MPH over placebo. Of 57 completers, 17 patients had improved apathy (≥3.3 points on the AES from baseline to end point) and 40 did not. There were no significant associations between AES and NPI Apathy with DS change scores in the MPH, placebo, AES responder, or non-responder groups. DS scores did not predict apathy response to MPH treatment.
Conclusion:These results suggest MPH can improve attention and apathy in AD; however, the effects appear independent in this population.
7 - Entrepreneurship at American Universities
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- By Nathan Rosenberg, Stanford University
- Edited by Zoltan J. Acs, David B. Audretsch, Indiana University, Bloomington, Robert J. Strom
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- Entrepreneurship, Growth, and Public Policy
- Published online:
- 05 June 2012
- Print publication:
- 02 February 2009, pp 146-175
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Summary
Innovations, almost by definition, are one of the least analyzed parts of economics, in spite of the verifiable fact that they have contributed more to per capita economic growth than any other factor.
Ken ArrowSome Historical Perspectives
My central concern in this chapter is with innovation in the American university community. I have chosen to begin with the term “innovation” rather than “entrepreneurship” because I propose to deal with issues that take us well beyond “entrepreneurship,” as that term is ordinarily used. I by no means ignore the traditional entrepreneur, but I also address larger themes such as the creation and the institutionalization of new academic disciplines and the roles that they have played, in turn, in the discovery and the diffusion of (potentially) useful knowledge.
The trajectory taken in the United States versus Europe owes a great deal to the political system in which it occurs. After the Napoleonic Wars, institutions of higher education in much of continental Europe became, overwhelmingly, public. In effect, they were nationalized, with extensive centralized control as the inevitable accompaniment of centralized funding. University faculty became civil servants.
Higher education in the United States was shaped by a very different set of political forces, the most distinguishing feature of which was an aversion to the centralization of power. The federalization of the country in the last two decades of the eighteenth century translated into the localization of decision making as well as financial support of the educational system.
A General-Purpose Technology at Work: The Corliss Steam Engine in the Late-Nineteenth-Century United States
- NATHAN ROSENBERG, MANUEL TRAJTENBERG
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- Journal:
- The Journal of Economic History / Volume 64 / Issue 1 / March 2004
- Published online by Cambridge University Press:
- 29 March 2004, pp. 61-99
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- March 2004
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The contribution to growth from the steam engine—Industrial Revolution icon and prime example of a “General Purpose Technology”—has remained unclear. This article examines the role that a particular design improvement in steam power, embodied in the Corliss engine, played in the growth of the U.S. economy in the late nineteenth century. Using detailed data on the location of Corliss engines and waterwheels and a two-stage estimation strategy, we show that the deployment of Corliss engines served as a catalyst for the industry's massive relocation into large urban centers, thus fueling agglomeration economies and further population growth.
6 - America's Entrepreneurial Universities
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- By Nathan Rosenberg, Professor of Economics, Stanford University
- Edited by David M. Hart, Harvard University, Massachusetts
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- The Emergence of Entrepreneurship Policy
- Published online:
- 18 December 2009
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- 27 October 2003, pp 113-138
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Summary
It is difficult to discuss American universities in the specific context of entrepreneurship without falling into a celebrationist (but not, one hopes, a complacent) mode. I say this because, from an international comparative perspective, one can hardly reject the conclusion that American universities have been uniquely successful in the scope and intensity of their contributions to entrepreneurship. This success stems largely from their own capacity for novelty and dynamism, which deserves the adjective “entrepreneurial” as well. The entrepreneurial perspective is only one of many possible perspectives from which one might examine the operation of American universities, and not necessarily the most important one. The European continent is endowed with numerous universities of great intellectual distinction, many of which have faculties who would look with deep disdain, if not total disbelief, at the idea that centers of learning should ever be judged by such a philistine standard. I have more than a little sympathy with that point of view. But in a world in which economic activity is becoming, indeed already has become, highly knowledge-intensive, it would be unrealistic, and perhaps even impolitic, to expect universities to remain withdrawn from the changing needs of their economic environments. The high degree of responsiveness to these changing needs has long been the most distinctive feature of American universities, at least as far back as the passage of the Morrill Act of 1862, which established the land grant college system.
14 - Twentieth-Century Technological Change
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- By David Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University
- Edited by Stanley L. Engerman, University of Rochester, New York, Robert E. Gallman, University of North Carolina, Chapel Hill
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- The Cambridge Economic History of the United States
- Published online:
- 28 March 2008
- Print publication:
- 28 August 2000, pp 803-926
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Summary
INTRODUCTION
An examination of technological innovation in the twentieth-century U.S. economy must naturally begin in the nineteenth century. An appropriate starting point is Alfred North Whitehead’s observation, in Science and the Modern World, that “The greatest invention of the nineteenth century was the invention of the method of invention” (98). The sentence just quoted is well known, but equally important is the less famous observation that immediately followed it:
It is a great mistake to think that the bare scientific idea is the required invention, so that it has only to be picked up and used. An intense period of imaginative design lies between. One element in the new method is just the discovery of how to set about bridging the gap between the scientific ideas, and the ultimate product. It is a process of disciplined attack upon one difficulty after another.
Whitehead’s statement serves as a valuable prolegomenon in at least two respects to much of this chapter’s discussion of technology in the twentieth century. First, a distinctive feature of the twentieth century was that the inventive process became powerfully institutionalized and far more systematic than it had been in the nineteenth century. This institutionalization of inventive activity meant that innovation proceeded in increasingly close proximity to organized research in the twentieth century. Of course, this research was not confined, as Whitehead appreciated, to the realm of science, much less to scientific research of a fundamental nature. But Whitehead’s observation is apposite in another respect as well. For all its reorganization and institutionalization, the realization of the economic impact of twentieth-century scientific and technological advances has required significant improvement and refinement of the products in which they are embodied.
6 - Dynamics of Comparative Advantage in the Chemical Industry
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- By Ashish Arora, Carnegie Mellon University, Ralph Landau, Stanford University, Nathan Rosenberg, Stanford University
- Edited by David C. Mowery, University of California, Berkeley, Richard R. Nelson, Columbia University, New York
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- Book:
- Sources of Industrial Leadership
- Published online:
- 05 June 2012
- Print publication:
- 13 October 1999, pp 217-266
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Summary
Introduction
The chemical industry is one the largest manufacturing industries in the world. In 1995, the sales of the U.S. chemical industry amounted to $372 billion, while those of Western Europe taken together amounted to $495 billion and the Japanese chemical industry, $252 billion. In terms of value added, chemicals and allied products account for about 10.4% of U.S. manufacturing output and 1.9% of the U.S. gross domestic product (GDP). Not only is the chemical industry very large, it is also very complex. In fact, the chemical processing industries (CPIs) group has been called the most miscellaneous of industries and the description is apt. The chemicals and allied products group (SIC 28) can be divided into three major subgroups: (1) basic chemicals such as acids, alkalis, salts, and organic chemicals; (2) intermediate chemical products such as synthetic fibers, plastic materials, and colors and pigments; (3) consumer chemical products such as drugs, cosmetics, soaps, as well as paint, fertilizers, and explosives. Even if one excludes closely related sectors such as refining, and paper and pulp, the CPI produce somewhere on the order of 50,000–70,000 products. Many of the products are new, the results of product innovation, but many older products survive, even if their relative importance has declined.
The most important class of chemicals are the organic compounds, which are much more pervasive and varied than the inorganic compounds, such as salt and minerals and products derived from them such as chlorine, bleach, caustic soda, and sulfuric acid.
8 - Diagnostic Devices: An Analysis of Comparative Advantages
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- By Annetine C. Gelijns, Columbia University, Nathan Rosenberg, Stanford University
- Edited by David C. Mowery, University of California, Berkeley, Richard R. Nelson, Columbia University, New York
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- Sources of Industrial Leadership
- Published online:
- 05 June 2012
- Print publication:
- 13 October 1999, pp 312-358
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Summary
Introduction
One of the most spectacular fields of medical device innovation since the end of the Second World War has been the field of diagnostics. Here we have seen the successive introduction of a wide range of sophisticated diagnostic devices, such as computed tomography (CT) scanners, magnetic resonance imaging (MRI) machines, and fiber-optic endoscopes. These devices have undoubtedly transformed modern medical practice, but have also resulted in significant changes in the industrial organization of the diagnostic medical devices sector. Unlike the rest of the medical device industry, which consists of a large number of small firms, the medical imaging sector is one that is dominated by a handful of very large firms. In the world imaging industry, technological breakthroughs, such as the CT scanner and MRI machine, were not introduced by established producers of X rays, but rather by a new breed of innovators. Yet, first-mover advantages do not seem to have been very significant and, as we will see, these new entrants failed to sustain themselves over time. In fact, established American and European X-ray companies have remained leaders in the imaging industry, with Japanese firms starting to play a more prominent role in the international arena only in recent years.
3 - The Internal Combustion Engine
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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- Paths of Innovation
- Published online:
- 05 June 2012
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- 28 September 1998, pp 47-70
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Summary
The internal combustion engine, which made the automobile and the airplane possible, is often regarded as the quintessential contribution of American technology to the first half of the 20th century. Nevertheless, the initial development of the gasoline-powered engine was almost entirely a European achievement, dominated by German and French contributors – Carl Benz (a German who operated the first vehicle to be run by an internal combustion engine in 1885), Gottlieb Daimler, Nikolaus Otto, Alphonse Beau de Rochas, Peugeot, Renault, and others.
The development and diffusion of the internal combustion engine illustrate a number of the broader themes that have characterized 20th-century U.S. innovation. The engine's rapid improvement and adoption within the United States were paced by the domestic abundance of low-cost petroleum-based fuels and the strong latent demand for low-cost automotive and air transportation among geographically dispersed U.S. population centers. In some contrast to the later development of new products and processes in the chemicals industry, or the post–World War II development of the electronics industry in the United States, the refinement of the internal combustion engine progressed during the early years of this century with little or no assistance from academic research.
The internal combustion engine also demonstrated the growing importance and often unexpected nature of intersectoral flows of technologies within the U.S. economy.
2 - The Institutionalization of Innovation, 1900–90
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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- Book:
- Paths of Innovation
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- 05 June 2012
- Print publication:
- 28 September 1998, pp 11-46
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Summary
As we noted in the introductory chapter, no account of technological innovation in the 20th-century U.S. economy can confine itself to a discussion of specific sectors or technologies. Another central element in the evolution of all industrial economies during this century was the transformation of the structure and organization of the innovation process. Like many other important technological advances in these economies, the development of organized industrial research was pioneered in Western Europe during the 1870s by German chemicals firms. U.S. industrial firms in chemicals and other industries quickly emulated this development, however, and by the 1920s, U.S. firms were, collectively, the leading industrial employers of scientists and engineers.
The U.S. R&D system that originated in the early 20th century has undergone profound structural change during this century. This structural change has two broad components. The first is the rapid exploitation by U.S. firms of the “invention of the art of invention” pioneered in Germany. A second, related feature of the evolution of the U.S. R&D system during this century is the shifting roles of industry, government, and universities as funders and performers of R&D. The magnitude of the shifts in importance among these three sectors within the 20th-century United States may well exceed that associated with any other industrial economy.
Index
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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- Book:
- Paths of Innovation
- Published online:
- 05 June 2012
- Print publication:
- 28 September 1998, pp 201-214
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4 - Chemicals
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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- Paths of Innovation
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- 05 June 2012
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- 28 September 1998, pp 71-102
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Summary
The u.s. chemicals industry, like the aircraft and automobile industries, has benefited throughout this century from scientific and technological advances originating elsewhere in the global economy. The primary contributors to fundamental knowledge of chemistry in the early decades of the century were virtually without exception Europeans. In the course of the century, however, the American scientific contribution grew, and since 1945 (in no small measure as a result of events connected with that war), the center of fundamental chemical research has been located in the United States. A comparison of trends in awards of the Nobel Prize in Chemistry to citizens of the United States and the major European powers before and after 1940 is revealing in this connection. Through 1939, German scientists received fifteen out of the thirty Nobel Prizes awarded in chemistry, U.S. scientists received only three, and French and British scientists each accounted for six. Between 1940 and 1994, U.S. scientists received thirty-six of the sixty-five chemistry Prizes awarded, German scientists received eleven, British scientists received seventeen, and French scientists received one (Encyclopaedia Britannica, 15th ed., pp. 740–747).
A central feature of technological change in chemicals during this century was undoubtedly the rise of the petrochemical industry, that is, the shift in organic chemicals away from a feedstock based on coal to one based on petroleum and natural gas.
Paths of Innovation
- Technological Change in 20th-Century America
- David C. Mowery, Nathan Rosenberg
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- Published online:
- 05 June 2012
- Print publication:
- 28 September 1998
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In 1903 the Wright brothers' airplane travelled a couple of hundred yards. Today fleets of streamlined jets transport millions of people each day to cities worldwide. Between discovery and application, between invention and widespread use, there is a world of innovation, of tinkering, improvement and adaptation. This is the world David Mowery and Nathan Rosenberg map out in Paths of Innovation, a tour of the intersecting routes of technological change. Throughout their book, Mowery and Rosenberg demonstrate that the simultaneous emergence of new engineering and applied science disciplines in the universities, in tandem with growth in the Research and Development industry and scientific research, has been a primary factor in the rapid rate of technological change. Innovation and incentives to develop new, viable processes have led to the creation of new economic resources - which will determine the future of technological innovation and economic growth.
5 - Electric Power
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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Summary
Central generation of electricity in the United States began with the opening of the Pearl Street Station in lower Manhattan in 1882. Although this technology eventually had enormous economic effects, by 1899 electric motors still accounted for less than 5% of total mechanical horsepower in American manufacturing establishments – electric power had not yet had a substantial impact on the American economy. Indeed, the gradual pace of early adoption of this epochal innovation is yet another example of the gradual realization of the economic impacts of truly major innovations, reflecting the need for numerous complementary innovations in technology, organization, and management to support widespread adoption. In addition, the first version of a new technology of this type inevitably must be substantially improved through a long series of incremental innovations and modifications. These modifications affect both the technology itself and the understanding, on the part of users, of its potential and operating requirements (“learning by using” – see Rosenberg [1982]).
The development of electric power generation technologies in the 20th-century United States resembled that of other technological clusters discussed in this volume in following a path of evolution that was sensitive to the U.S. natural-resource endowment, even as it transformed the definition of that endowment.
Frontmatter
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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Contents
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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6 - The Electronics Revolution, 1947–90
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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- 28 September 1998, pp 123-166
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Summary
Like most of the major technological advances considered in this volume, electricity and its associated innovations were complex systems of technologies, advances that frequently relied heavily on incremental improvements in individual components. Its complex and “systemic” nature meant that both adoption and realization of the productivity-enhancing effects of electrification took considerable time. An important characteristic of the evolution of electrical technologies, as well as chemicals and the internal combustion engine, is the frequent appearance of “technology bottlenecks,” often centered around individual components or the interconnections of components, within the system. Such bottlenecks also launched and guided the evolution of electronics technologies. The emergence of a critical bottleneck in telecommunications, as we note in this chapter, motivated Bell Telephone Laboratories to undertake the research program that produced the first transistors and ultimately launched the postwar electronics revolution. The subsequent development of electronics components and the computer systems into which they are incorporated has been influenced by the enduring need to resolve obstacles to further progress that are imposed by other elements of these complex systems – examples include excessive numbers of discrete components, complex software, and a lack of interchangeability in components.
Advances in electronics technology created three new industries – electronic computers, computer software, and semiconductor components – in the postwar U.S. economy. Electronics-based innovations supported the growth of new firms in these industries and revolutionized the operations and technologies of more mature industries, such as telecommunications, banking, and airline and railway transportation.
Bibliography
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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7 - Concluding Observations
- David C. Mowery, University of California, Berkeley, Nathan Rosenberg, Stanford University, California
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Summary
Technological change in the 20th-century United States is best understood in the context of a number of favorable and distinctive initial conditions. Among the most important of these was the rich natural-resource base of the U.S. economy. The direction and impact of technological change within this economy were shaped by the fact that the United States was well endowed by nature with the resources that were essential to modern industrialization.
This kindness of Providence to Americans is well known and has often been commented on, but this characterization is seriously incomplete in one sense. Although one may speak of resources as an endowment provided by nature, one must distinguish between natural resources as a geologist would think of them in surveying a new continent and resources in the much stricter sense of the economist. In 1900 oil that was thousands of feet below the sea floor off the coast of Louisiana would not have constituted a resource to the economist, even if the geologist was aware of its presence, simply because the technology required for its extraction did not yet exist.
The point is that natural resources do not intrinsically possess economic value. That value is a function of the availability of technological knowledge that allows those resources to be extracted and subsequently exploited in the fulfillment of human needs (Rosenberg 1972).