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Saturday 29 November 2014

10 DEPRESSING TRUTHS ABOUT MODERN MEDICINE


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10 Depressing Truths About Modern Medicine
By B. J. Deming,
Listverse, 29 November 2014.

We expect our doctors to be competent, ethical, and up to date. What we don’t understand is that these qualities sometimes conflict. For example, does a new surgical technique really work, or does the patient just think it does? The only way to tell is with a clinical trial - somebody is going to secretly get a fake surgery as a test control. Is that ethical?

That’s just one of the many controversies the doctors are hotly debating (out of public sight, for the most part).

10. Doctors Can Be Deceived Or Make Mistakes

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Medical journals help physicians stay up to date. Unfortunately, they sometimes contain papers written by drug company ghostwriters. For instance: In 2000, a paper in the New England Journal of Medicine praised Vioxx, a new pain reliever. The writers - some of whom later turned out to be connected with the company that made Vioxx - played down cardiac side effects. Does Vioxx sound familiar? It was taken off the market in 2004 for - you guessed it - causing cardiac problems.

Most medical treatment goes through clinical trials to make sure that it works and is safe. However, experts recently went back through some of those studies and found that over a third of them had mistakes. These ranged from relatively small stuff all the way up to recommending treatment for the wrong group of people. And that’s not all. A second look at the studies that led governments to stockpile flu-fighting agents Tamiflu and Relenza showed that these drugs probably aren’t as effective as researchers once believed. They might shorten your bout of flu by half a day, but there’s no evidence that they will prevent complications or keep you out of the hospital.

9. Advance Directives Can Let Dementia Patients In For Risky Research

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Doctors won’t treat you without your informed consent. So what if you’re unconscious? Hopefully, you’ve filled out an advance directive. You might even have a research advance directive on file, if you don’t mind taking a chance and possibly helping others in the future. It’s pretty basic - unless you come down with dementia.

Alzheimer’s has been studied for over 100 years, but we still don’t know much about it. Research is a priority, and some scientists do it with the help of an advance directive. The special research consent has to be signed before the patient gets dementia, and this doesn’t happen often. Some believe that requiring this consent blocks valuable research. Others aren’t at all comfortable with the idea, and they’ve got a point, too. Terrible things have happened during human experiments.

The Alzheimer’s Association takes the middle ground. They suggest enrolling everybody in research if there’s little risk, obtaining the surrogate’s consent for risky research with potential benefits, and requiring research consent for any risky research without likely benefits.

8. Incidental Findings Can Ruin Your Life

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Modern medicine has the most powerful tools in history. However, sometimes it’s possible to see too much. Say you go to the ER because you’re feeling depressed, and routine tests show a mass on your adrenal gland. It’s such a common finding, doctors call it “incidentaloma.” These tumours are usually benign, but the doctors won’t know for sure that it’s not cancer unless they do a lot of tests.

Cancer? Do all the tests!

So they do all the tests, and those come back benign, because that’s what incidentalomas usually are. However, now you have huge medical bills and are feeling emotionally overwhelmed, maybe even suicidal. You could just ask the doctor not to tell you about incidental findings. However, if it involves gene sequencing, the doctor might ignore your request. The American College of Medical Genetics and Genomics tells its members to look for unrelated risky genes whenever they do genetic tests and to tell the patient about whatever they find. Medical technology can cause some expensive, heart-breaking problems. Nobody really knows how to handle the problem of incidental findings.

7. Unethical Co-Branding

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Co-branding can do wonderful things. For example, some credit card companies donate US$100 to a medical centre if new customers spend US$500 within six months of being approved. Businesses, including hospitals, link their names with other companies for greater public visibility. It usually works out well for everybody. However, problems can come up if the hospitals don’t do their homework on potential business partners.

Some genetic screening companies, for example, avoid regulation by describing their tests as “recreational.” Some direct-to-consumer companies that provide cardiac screening are under attack by consumer groups for pushing tests that these groups claim will do more harm than good.

It’s a mixed bag. Even experts who oppose direct marketing to patients have to admit that there’s no solid evidence so far that it’s harmful as an educational tool. Beyond that, there’s a lot of controversy. So don’t automatically assume the name of a respected medical institution on something guarantees it’s just what the doctor ordered - think it through and read the fine print.

6. You Could Wake Up During Surgery

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As depressing as modern medicine can be, at least there’s anaesthesia. Back in the day, surgery on a wide-awake patient was ghastly for everybody. Well, guess what? Today, one or two patients out of 1000 wake up while they’re being operated on. Not surprisingly, up to 70 percent of them develop PTSD.

It happens when the general anaesthesia is too light. The drugs are so powerful, that it’s a fine line between no pain and no vital signs. Anaesthesiologists want to keep you alive and comfortable. Sometimes, they just can’t tell how much is enough, especially toward the end of a case, when your body has used up most of the anaesthesia. Also, for certain high-risk surgeries, they have to go easy on the gas because you’re already in critical condition.

There can’t be any guarantees that you won’t wake up before they want you to. The good news is that, if you do, you’ll probably feel pressure, not pain. The pressure of instruments and strange hands deep inside your body, moving around - no wonder the PTSD rate is high.

5. Doctors May Have Conflicts Of Interest

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Everybody munches on freebies at the grocery store. Why shouldn’t doctors get free samples, too? Drug company reps offer them everything, from notepads to free pizza. Of course the physicians take some. Then they go on practicing medicine their own way. Probably. This isn’t a problem in itself - doctors have to eat and doodle just like the rest of us. Conflict of interest only gets serious when money and influence are at stake.

That happens a lot. Researchers say that 40 percent of the drug company directors they studied also held top posts at major academic medical centres. Those directors, on average, got well over US$250,000 dollars a year for their services. Then they went back to the medical centre and ran its health care, research, and school their own way. Probably.

It also turns out that your medical care may be different - and possibly more expensive - if your doctor owns any labs and equipment or is a partner in a specialty hospital. Federal and state laws restrict self-referrals. In spite of that, it’s been shown that patients have more tests and more surgeries in areas where physicians own a lot of the local medical infrastructure.

4. No One Really Knows What Your Health Care Costs

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When medical bills arrive, most people reach for their checkbook or maybe for the phone to call the insurance company (and possibly a bankruptcy lawyer). Would you believe the hospital might back off if you challenge the bill? Or that hospitals charge different prices depending on your insurance? They do this because nobody has a clue how much your visit actually costs. Don’t take our word for it. In 2004, the UC Davis Health System chief financial officer said, “There is no method to this madness. As we went through the years, we had these cockamamie formulas. We multiplied our costs to set our charges.”

Hospitals use a master price list called a “chargemaster.” Except in California, you don’t have the right to see one. Even if you do, it won’t make much sense. There’s no national standard for them, and everybody updates them differently. Your insurance company may get a discount of more than 50 percent off chargemaster prices. Uninsured? You’ll pay the full amount. Obamacare has caused a boom in medical billing specialists. But still no one is sure how to code your medical bill.

3. Electronic Health Record Errors

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Your medical records used to be stored on paper. Doctors and hospitals have saved time, space, and money by switching over to the electronic health records. These wonderful software packages save lives, too, but nothing is perfect. Computer and human errors are also present. Even worse, contracts with the software companies are silencing physicians who want to complain about the software.

Errors are common. Doctors miss important lab results because the screen is badly designed. Medication doses are mixed up. Notes disappear. And no one is tracking these errors. It’s even possible that this has contributed to the US Ebola crisis. Thomas Duncan caught the bug in Liberia. After coming home, he went to a Dallas ER for symptoms that could easily have been something like the flu. He did tell them where he’d been, and a nurse did enter that into his electronic record. What happened next isn’t clear, but it’s possible that the nurse’s note wasn’t immediately available to the ER doctor and other health care providers because of a software design flaw. In any case, they didn’t treat Mr. Duncan for Ebola, and he later died from the disease.

2. Hacked Medical Devices

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Medical equipment has NSA-level cybersecurity, right? No, not at all. Recently, a Midwestern US health care chain asked the IT department to hack equipment at its 100 facilities. It was horrifyingly easy for them to access medical records, reset medicine pumps, reprogram defibrillators, change refrigerator temperature settings, and to take down emergency and lab equipment. And that’s just what the company would publicly admit. Part of the problem were weak passwords, infected devices, and poor firewalling. However, the system’s best feature - feeding embedded information directly into medical records - also made it a hacker’s dream.

This isn’t a one-off problem. Malware shut down a New Jersey heart catheterization lab in 2010. The Conficker virus was found on 104 devices in a Tampa VA hospital. An antivirus program forced a third of Rhode Island’s hospitals to postpone everything but emergency surgeries and treatment because it mistakenly identified a critical Windows DLL as malicious.

No patients have been harmed yet, fortunately. The FDA just released cybersecurity guidelines. While they’re not federal law, good luck getting your new medical device approved if it’s not secure. And the guidelines are a heads-up to the health care world that now is the time to somehow secure all the vulnerable equipment out there.

1. Unfair Treatment Of Minorities Still Exists In The US

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Americans used to get different medical treatment based on their ethnic background. We’ve come a long way, but not as far as we think. In 2002, the Institute of Medicine found that minorities were routinely given lower quality health care and denied some drugs and medical procedures. They were also more likely to have an amputation for diabetes. Researchers called for system changes, as well as for more minority providers and more interpreters to overcome language barriers. Six years later, a different group found the same problems. This group put their findings in a book that people could use to improve things in their own communities.

In some ways, people are even worse off in 2014. Doctors say that it’s a very complex problem. Insurance plans and providers don’t serve poor communities. There are also cultural differences, communication barriers, and lack of information on how to access the system.

+ Faking Surgery For Science


Unfortunately, our example about secret placebo surgeries isn’t theoretical. It’s rare, but it has happened. In 2009, for example, a report was published in the New England Journal of Medicine that described how 63 patients with compression fractures from osteoporosis got “a simulated procedure without cement” as part of a study. This didn’t just happen at a single hospital, either. Several major medical centres were involved. Well, that sounds horrible, but the study proved that the real surgery probably wasn’t helping anybody. Was it worth it? When it comes to sham surgery, doctors are still trying to make up their minds.

[Source: Listverse. Edited.]

FONTUS: THE SELF-FILLING WATER BOTTLE THAT TURNS HUMIDITY INTO DRINKING WATER


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This Bottle Fills Itself With Water Automatically By Converting Humid Air Into Water
By
Wonderful Engineering, 27 November 2014.

A self-filling water bottle for your bike is the new thing in town. It makes water out of thin air. The new Fontus is powered by solar panels; it collects the moisture from your surrounding and stores it as safe drinking water after condensing it. It can produce 0.5 litres every hour, in the right climatic conditions.

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Designed by Kristof Retezar of the University of Applied Arts, the amazing invention is his entry for the James Dyson award competition. Fontus uses a Peltier Element for working; a solid-state active heat pump to transfer heat from one end of the device to other.

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The bottom side heats up while the upper side cools, during the time when it is powered by electricity. During pedalling, the air enters the lower chamber at high speeds; it cools the hot side down. When entering the upper chamber, perforated walls stop the air entering, reducing its speed and giving the air enough time to lose its water molecules, which then allows condensation which is collected in a water bottle.

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Rigorous tests have been performed on the prototype. According to Kristof, “After more than 30 experiments, I finally achieved a constant drop-flow of one drop of condensed water per minute. After developing a functioning inner system, I designed a compact and practical hull which can be easily attached to a bicycle, integrates the water bottle and can be comfortably handled.”

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The technology applied is not a new one and has been used in certain cultures in Asia and Central America for more than 2000 years. Kristof saw the opportunity to implement it for bikes. And for those thinking, “Why Bikes?” According to UN statistics, “More than 2 billion people in more than 40 countries live in regions where water is scarce.” Besides, the airflow produced during cycling is convenient for the process.

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This is a clever procedure to get water in those areas of the world where ground water is scarce but air humidity is high. Around 13,000km3 of mostly unexploited freshwater is contained within the Earth’s atmosphere in the form of moisture. Pretty cool invention for all cyclists, isn’t it?

[Source: Wonderful Engineering. Edited.]

10 INVENTIONS THAT ARE FAR OLDER THAN YOU WOULD EXPECT


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10 Inventions That Are Far Older Than You Would Expect
By Radu Alexander,
Listverse, 29 November 2014.

We associate items with cultures or eras because it helps our brains categorize information. We hear the word “pyramid,” and we instantly associate it with ancient Egypt, despite the numerous non-Egyptian pyramids in the world. Many of these associations are incorrect. Some things we strongly associate with the modern world are actually quite older.

10. Rap Battles

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Rappers in early 1980s New York might get most of the credit for this type of lyrical performance, but the practice is actually much older and comes from Scotland. It is called flyting and it was practiced by makaris (Scottish poets) during the 15th and 16th centuries. In this contest, two poets would engage in an exchange of verbal abuse, oftentimes in verse, and the winner was usually decided by the audience. The winner would then enjoy a large cup of mead or beer and more often than not would invite the loser to drink as well.

At one point, flyting was so popular in Scotland that the obscenities and vulgarities were overlooked, though they were otherwise not permitted in public. Flytes would usually take place in large rooms like feasting halls, but the most skilled poets would engage in flyting at the royal courts. King James IV was known to be a big fan of flyting, as well as James V.

Unfortunately, not many flytes from those times have survived. The most memorable one took place at the aforementioned court of James IV. It is known as “The Flyting of Dunbar and Kennedy” and took place between Walter Kennedy and William Dunbar.

9. Dentures

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Dentures’ long history is not particularly surprising. George Washington, for example, was a famous wearer of dentures (although none of his were made of wood, despite the myth). However, dentures go back much further than that. To the time of the Etruscan civilization, in fact, located in modern Italy between the eighth and fourth centuries B.C.

A lot of evidence suggests that the Etruscans were the first to create false teeth as early as 700 B.C. Ancient skulls have been discovered with gold bands inside them, and in Marzabotto, a skull was found with an artificial tooth still attached using gold wire. Apart from dentures, individual crowns have also been discovered, made for molars and canines.

Their dentistry skills were surprisingly advanced, and the dentures they made were quite similar to those still in use centuries later, even in the time of the aforementioned Washington. They were made using either animal or human teeth, which were fixed onto a gold band with metal pins and then secured in place inside the mouth.

8. Newspapers

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For a publication to classify as a newspaper, it must publish up-to-date information covering a range of topics at regular intervals and be reasonably accessible to the public. Some would say that a newspaper also has to be printed, which means that they couldn’t have existed prior to the printing press. However, if we overlook that small detail, then newspapers go back a lot farther. Ancient Rome and China both had handwritten news sheets presented to the public on a regular basis detailing current events and other important happenings.

In Rome, it was known as Acta Diurna and is considered to be the first daily gazette, even if it wasn’t even written on paper (it was carved in stone or metal). At first, it only covered legal proceedings and the results of trials. As its popularity grew, it expanded to also include politics, military campaigns, births, deaths, and executions.

In China, the earliest forms of newspapers were known as tipao (also Di Bao). They were imperial bulletins published during the Tang Dynasty. During the Kaiyuan era, they were replaced with Kaiyuan Za Bao, an official publication handwritten on silk and distributed mostly to imperial officials.

7. Toothbrushes

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Photo credit: Mrjohncummings/Wikimedia

Early dental techniques were of course a lot more primitive. In fact, the first “toothbrushes” were nothing but sticks with frayed ends that were rubbed against the teeth. While these weren’t particularly efficient, they at least gave the user refreshing breath. Such “chew sticks” were found in ancient China, Egypt, and even Babylonia, dating back to 3,000 B.C.

Something similar to a modern toothbrush didn’t appear until the 15th century in China. It was made out of bone or bamboo and had natural bristles made out of the hairs of a hog’s neck. Also around that time, China started trading with Europe, so the design was brought there before long. However, Europeans found the hog hairs too rigid and preferred to replace them with softer horse hairs.

While the design of the toothbrush would be updated from time to time, it really didn’t turn into the modern brush we know today until the beginning of the 20th century, when Wallace Carothers invented nylon for DuPont. Up until that point animal hairs kept being used for the bristles.

6. Welfare

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Photo credit: Francesco Z/Wikimedia

Ancient Rome had quite a few programs in place to provide its citizens with subsidized food. At first, this was not an obligation yet was still quite common when either the government or wealthy individuals wanted to gain favour with the public. They would make donations of corn to the people, known as frumentatio. In 123 B.C., however, a tribune by the name of Gaius Gracchus introduced Lex Frumentaria. Through this law, each citizen of Rome was entitled to an amount of wheat each month available at a reasonable price (somewhere around half the market price). This was only available to fathers of families but was not restricted only to poor Romans.

Roman emperors also had various approaches when it came to dealing with the poor. It was not uncommon for emperors back then to give money to each Roman to celebrate a certain event (usually a military victory). One emperor who instituted new welfare programs was Trajan. While he increased the number of citizens who could receive free grain from the state, he also introduced alimenta, a publicly funded institution that benefited poor children.

5. The Odometer

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The odometer is present in most modern vehicles, used to track travel distance. It has been around since the ancient Greeks. It is not certain who the inventor is. Vitruvius first talks of an ancient odometer in his book, and some believe that the device had been invented previously by Archimedes.

The concept of this early odometer was based around chariots having a standard wheel size. A wheel had to turn 400 times to complete a Roman mile. The axle’s pin engaged a 400-tooth cogwheel, itself attached to another gear. When a full revolution completed, the gear released a stone into a box. At the end of the trip, counting the stones determined the distance travelled.

We have no absolute evidence this device was built. However, during his travels, Alexander the Great had specialists called bematists who measured the distances of routes. Their measurements were later recorded by Pliny the Elder in his Natural History, and they are so accurate compared to modern measurements that a mechanical device was almost certainly employed.

It wasn’t long until another odometer was invented completely separately in ancient China. Created by prolific Chinese inventor Zhang Heng, the concept is similar, except that a drum was struck every half a kilometre.

4. High Heels

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We consider high heels a modern accessory used exclusively by women to enhance their beauty and create the illusion of long, slender legs. However, as popular as they might be today, they are definitely not modern. High heels date all the way back to the ninth century, when they were worn by men.

Ancient Persian ceramic bowls from over 1,000 years ago depict men wearing high-heeled shoes. Back then, the heels had a practical purpose rather than a cosmetic one. The men in question were archers, and the high heels allowed them to secure their feet in stirrups when shooting from horseback.

The heels remained in use for centuries, allowing Persia to assemble the fiercest archers on the planet. Eventually, Persian culture spread to Europe. By the 17th century, high heels became all the rage over there as well. Again, men wore them, but this time, it was the aristocracy, not the soldiers.

The shoes were status symbols. They were completely impractical - the higher the heel, the better. An impractical (and often uncomfortable) wardrobe was constantly used by the European elite to signify privilege. The heels were also dyed red because red dye was an expensive luxury item.

3. The Seismometer

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Photo credit: Kowloonese/Wikimedia

An earthquake can be incredibly devastating. Even though we can’t stop it, an instrument to warn us of seismic motions could prove to be invaluable. Nowadays, we have access to such instruments, and so did the ancient Chinese. The famed Chinese polymath Zhang Heng has the world’s first seismograph to add to his impressive list of achievements.

The invention known as Houfeng Didong Yi (“instrument for inquiring into the wind and the shaking of the earth”) was created in A.D. 132. It was later described in the History of the Later Han Dynasty as a giant bronze vessel. It had eight contact points in the form of bronze dragons with balls in their mouths on the outside of the vessel and a bronze column inside. When an earthquake approached, the column shifted in a particular direction, and a lever made that dragon drop the ball, thus revealing the quake’s direction.

2. Roller Skates

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We might associate the rise of the roller skates with the popularity of the roller discos of the ’60s and ’70s, but these inventions are far older. The first record of something we would call a pair of roller skates dates back to the 18th century. A Belgian inventor, John Joseph Merlin, created inline skates in the 1760s. They were ice skates with wheels instead of blades. He wanted to show off his new creations in style, and he wore them at a masquerade ball in the city of Huys, Belgium. However, the story goes that he couldn’t stop and crashed full-speed into a giant mirror.

The first inventor to patent a roller skate design was Frenchman M. Petitbled. His creation looked more like wooden sandals with three wheels attached to the sole. Like Merlin’s invention, the problem with the Petitbled skate was that it was incredibly different to turn, stop, or do practically anything other than go forward.

It wasn’t until James Leonard Plimpton invented the precursor to modern roller skates in 1863 that the concept really took off. His design with two pairs of wheels was the first of its kind and was a lot safer and easier to use. Plimpton then turned the office of his furniture business into a skating floor and later founded the New York Roller Skating Association to promote the sport.

1. Chewing Gum

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In one form or another, chewing gum has existed for a really long time - somewhere around 5,000 years, in fact. The oldest known chewing gum was discovered on a dig in Finland, and it dates back to the Neolithic age. It was a lump made out of birch bark tar, but it had clear tooth imprints in it. Even back then, chewing gum had a medical benefit. The birch bark contained phenols with antiseptic properties, so the chewing gum was likely used to treat gum infections.

Over the centuries, many other ancient cultures enjoyed their own types of gum. The Greeks made theirs from the resin of the mastic tree. Native Americans chewed resin from spruce trees. However, it is the Aztecs who helped launch the modern chewing gum craze.

They once chewed chicle, a natural gum derived from several species of South American trees. In the 1860s, Mexican general Antonio Lopez de Santa Anna brought chicle to America to inventor Thomas Adams, wanting to use it to manufacture rubber for tires. This failed, but Adams then thought of using chicle as the main ingredient for his Adams New York Chewing Gum. It was a big success, and two years later, Adams was mass-producing it. Chicle remained the core ingredient of gum for 100 years until it was replaced with synthetic rubbers that were cheaper to manufacture.

Top image: The oldest known chewing gum discovered in Finland, via Metro.

[Source: Listverse. Edited. Top image added.]

12 MOST SPECTACULAR MALLS IN THE WORLD


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Black Friday Special: The 12 Most Spectacular Malls in the World
By Matt Shaw,
Architizer, 28 November 2014.

The arrival of Black Friday presents the opportunity to experience shopping centres in their full glory. As a celebration of the form, we've gathered a showcase of some of the world's most notable malls.

1. Il Vulcano Buono - Nola, Italy

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Image via stroi.mos.ru

Nola, Italy, near Mount Vesuvius, boasts the Volcano Buono, which was designed by Renzo Piano to be part of the landscape (kind of). It opened in 2007 with over 150 shops, a movie theatre, and a hotel. The volcano-like shape is not only contextual, but also a spectacular space to shop in.

2. Mall of America - Bloomington, Minnesota, USA

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The Mall of America was one of the original megamalls, with over 4.3 miles of storefront. It includes the Nickelodeon Universe amusement park as well as an aquarium, mini-golf course, and a flight simulator. The mall attracts 40 million visitors each year. [Mall of America website]

3. Khan Shatyr - Astana, Kazakhstan

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Kazakhstan is known for its outrageous architecture, and this Foster + Partners' contribution doesn't disappoint. It is the largest tensile structure in the world, and its tent is designed in three layers to provide a comfortable atmosphere for stores, restaurants, an indoor green space, and a water park. [Khan Shatyr website]

4. GUM - Moscow, Russia

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Image via en.wikipedia.org

This huge mall is ironically located in Moscow's Red Square. Even before the structure was built, the area had been a shopping bazaar since the 16th century. The structure, completed in 1893, was one of the earliest modern steel, iron, and glass structures. After the Communist era, it was privatized in the early '90s. [GUM website]

5. Dubai Mall - Dubai, UAE

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Dubai has an abundance of indoor malls because of the extreme climate and the city's penchant for extravagance. The Dubai Mall complex has over 1,000 shops and a range of luxe amenities. These include access to the observation deck of the Burj Khalifa and the world's largest suspended aquarium; the latter's 33,000 aquatic animals includes the world's largest collection of sand tiger sharks. [Dubai Mall website]

6. Mall of the Emirates - Dubai, UAE

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Built in 2005, the Mall of the Emirates famously boasts Ski Dubai, the first indoor ski resort in the Middle East, which includes the world's first indoor black diamond run. [Mall of the Emirates website]

7. Galleria Vittorio Emmanuele II - Milan, Italy

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Image via en.wikipedia.org

Galleria Vittorio Emmanuele II is in the heart of Milan, and features the finest shops. It was constructed between 1865 and 1877, and is one of the earliest examples of modern architecture. Its iron and glass structure encloses a street lined with gorgeous classical architecture.

8. Canal City - Fukuoka, Japan

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Image via HugeinJapan

An 180-foot canal is the centrepiece of the Canal City, a mixed-use development that mixes traditional Japanese architecture with 20th century urbanism. The central "city theatre" gathers visitors along the canal and provides a lively setting to observe the diverse cityscape. It includes numerous shops, amusements, a movie theatre, two hotels, showrooms, and office space. [Canal City website]

9. Grand Canal Shoppes - Las Vegas, Nevada, USA

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The Grand Canal Shoppes are located at The Venetian Hotel & Casino in Las Vegas. The complex is famous for its series of indoor canals and gondolas that take shoppers around the mall. [Grand Canal Shoppes website]

10. ZÅ‚ote Tarasy - Warsaw, Poland

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The ZÅ‚ote Tarasy is a commercial, office, and entertainment complex located next to Warsaw's Central Railway Station. Its architecture is fantastic, with a bubble-like curving glass roof and interior volumes that make the indoor space come alive. [ZÅ‚ote Tarasy website]

11. Villaggio Mall - Doha, Qatar

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Image via www.panoramio.com

The ceilings and lighting at this huge mall simulate the sky, including day, night, and sunset. Street lamps add to the fun, as does a gondola that connects the shopping areas with entertainment such as a 13-screen IMAX 3D cinema and an ice-skating rink. [Villaggio Mall website]

12. Mall of the World - Dubai, UAE

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Image via The Guardian

The Mall of the World in Dubai is the logical conclusion of every other mall on this list, as well as any other shopping area in the history of shopping areas. It hasn't even been built yet, but it still makes it on to our list due to its sheer preposterousness. It includes replicas of streets in New York and London. [Dubai Holding Press Release]

Top image: The Khan Shatyr, via Most Beautiful Places.

[Source: Architizer. Edited. Top image and some links added.]