{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:45:34Z","timestamp":1759178734657,"version":"3.37.3"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Medical advances of great importance in improving diagnosis, treatment or prevention of disease are often called \u2018breakthroughs\u2019. The processes by which breakthroughs are achieved are multiple, but may include necessity (a problem which must be solved), opportunity (the time must be right), chance (the unexpected), curiosity (a desire to understand mechanisms) and ingenuity (ability to find a solution). Discovery can be the start of a chain reaction, so that the breakthrough at the end of the chain becomes \u201cinevitable\u201d. Two examples are given in which these attributes played a part (i) the development of a vaccine against the poliomyelitis virus and (ii) the harnessing of penicillin as a therapeutic agent to treat serious bacterial infections.<\/jats:p>","DOI":"10.1093\/qjmed\/hcaa257","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T20:07:46Z","timestamp":1597781266000},"page":"229-231","source":"Crossref","is-referenced-by-count":1,"title":["Medical breakthroughs: chance and opportunity"],"prefix":"10.1093","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8658-4208","authenticated-orcid":false,"given":"J M B","family":"Hughes","sequence":"first","affiliation":[{"name":"Institute, Faculty of Medicine, Imperial College, 4 Cedars Road, London SW13 0HP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"2021072910130903700_hcaa257-B1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.3181\/00379727-69-16638","article-title":"Production of hemagglutinin by mumps and influenza A viruses in suspended cell tissue culture","volume":"69","author":"Weller","year":"1948","journal-title":"Proc Soc Exp Biol Med"},{"key":"2021072910130903700_hcaa257-B2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1126\/science.109.2822.85","article-title":"Cultivation of the Lansing strain of poliomyelitis virus in cultures of various human embryonic tissues","volume":"109","author":"Enders","year":"1949","journal-title":"Science"},{"key":"2021072910130903700_hcaa257-B3","doi-asserted-by":"crossref","first-page":"673","DOI":"10.4049\/jimmunol.69.6.673","article-title":"Studies on the cultivation of poliomyelitis viruses in tissue culture. II. The propagation of the poliomyelitis viruses in roller\u2013tube cultures of various human tissues","volume":"69","author":"Robbins","year":"1952","journal-title":"J Immunol"},{"key":"2021072910130903700_hcaa257-B4","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1084\/jem.99.6.551","article-title":"Studies on variants of poliomyelitis virus. I. Experimental segregation and properties of a virulent variants of three immunologic types","volume":"99","author":"Sabin","year":"1954","journal-title":"J Exptl Med"},{"key":"2021072910130903700_hcaa257-B5","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1001\/jama.1953.13.1081","article-title":"Studies in human subjects on active immunization against poliomyelitis. I. A preliminary report of experiments in progress","volume":"151","author":"Salk","year":"1953","journal-title":"J Am Med Assoc"},{"volume-title":"Alexander Fleming: The Man and the Myth","year":"1985","author":"Macfarlane","key":"2021072910130903700_hcaa257-B6"},{"key":"2021072910130903700_hcaa257-B7","first-page":"306","article-title":"On a remarkable bacteriolytic element found in tissues and secretions","volume":"93","author":"Fleming","year":"1922","journal-title":"Proc Roy Soc B"},{"key":"2021072910130903700_hcaa257-B8","first-page":"226","article-title":"On the antibacterial action of cultures of a Penicillium, with special reference to their use in the isolation of B. influenza","volume":"10","author":"Fleming","year":"1929","journal-title":"Brit J Exp Path"},{"volume-title":"Howard Florey: The Making of a Great Scientist","year":"1979","author":"Macfarlane","key":"2021072910130903700_hcaa257-B9"},{"key":"2021072910130903700_hcaa257-B10","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S0140-6736(01)08728-1","article-title":"Penicillin as a therapeutic agent","volume":"236","author":"Chain","year":"1940","journal-title":"Lancet"},{"key":"2021072910130903700_hcaa257-B11","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0140-6736(00)72122-2","article-title":"Further observations on penicillin","volume":"238","author":"Abraham","year":"1941","journal-title":"Lancet"}],"container-title":["QJM: An International Journal of Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/qjmed\/advance-article-pdf\/doi\/10.1093\/qjmed\/hcaa257\/34130163\/hcaa257.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/qjmed\/article-pdf\/114\/4\/229\/39403085\/hcaa257.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/qjmed\/article-pdf\/114\/4\/229\/39403085\/hcaa257.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T23:03:59Z","timestamp":1696547039000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/qjmed\/article\/114\/4\/229\/5896989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,25]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,8,25]]},"published-print":{"date-parts":[[2021,7,28]]}},"URL":"https:\/\/doi.org\/10.1093\/qjmed\/hcaa257","relation":{},"ISSN":["1460-2725","1460-2393"],"issn-type":[{"type":"print","value":"1460-2725"},{"type":"electronic","value":"1460-2393"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2020,8,25]]}}}