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Research on control of craniofacial morphogenesis: an NIDR State-of-the-Art Workshop.

To assess the wide clinical ramifications of control of craniofacial morphogenesis, a State-of-the-Art Workshop was conducted by the National Institute of Dental Research at the initiative of Richard L. Christiansen, Chief of the Craniofacial Anomalies Program. In conjunction with the authors listed above, the format for the workshop was developed and participants were selected. The workshop was designed to provide an in-depth review of present knowledge and to identify future goals and directions for research on guiding, altering, and thus controlling growth and development of the cranofacial skeleton. The agenda for discussion ranged from molecular biology to clinical arts such as orthopedics and surgery. It was evident during the workshop that the mechanisms and procedures for controlling craniofacial morphogenesis must be derived from many biologic, physical, and clinical fields of knowledge. It is hoped that there will evolve an interdisciplinary clinical art which is aimed at preventing and correcting craniofacial deformities. Substantial biologic information has already been accumulated on the craniofacial skeleton. The clinical art of correcting malocclusion through mechanical forces is now applicable to the entire skull. The outstanding technical accomplishments of radical surgery in the correction of congenital craniofacial anomalies show that the needed surgical skills are now available. When these resources are combined, an area of knowledge and a clinical discipline which might be called "orthocephalics" is already identifiable. The workshop was held at the National Institutes of Health in Bethesda, Maryland, on Feb. 12 and 13, 1974. The ideas exchanged were integrated and summarized by the planning committee to produce this report.

Animals↗

A Modified ART 1 Algorithm more Suitable for VLSI Implementations.

This paper presents a modification to the original ART 1 algorithm ([Carpenter and Grossberg, 1987a], A massively parallel architecture for a self-organizing neural pattern recognition machine, Computer Vision, Graphics, and Image Processing, 37, 54-115) that is conceptually similar, can be implemented in hardware with less sophisticated building blocks, and maintains the computational capabilities of the originally proposed algorithm. This modified ART 1 algorithm (which we will call here ART 1(m)) is the result of hardware motivated simplifications investigated during the design of an actual ART 1 chip [Serrano-Gotarredona et al., 1994, Proc. 1994 IEEE Int. Conf. Neural Networks (Vol. 3, pp. 1912-1916); [Serrano-Gotarredona and Linares-Barranco, 1996], IEEE Trans. VLSI Systems, (in press)]. The purpose of this paper is simply to justify theoretically that the modified algorithm preserves the computational properties of the original one and to study the difference in behavior between the two approaches. Copyright 1996 Elsevier Science Ltd.

Journal Article↗

Association of chronic kidney disease with clinical outcomes after coronary revascularization: the Arterial Revascularization Therapies Study (ARTS).

BACKGROUND: Chronic kidney disease (CKD) is associated with adverse outcomes after coronary artery bypass graft surgery (CABG) and percutaneous coronary interventions (PCI), but it is unclear which of these revascularization strategies is associated with lower risk for morbidity and mortality in this population. In the Arterial Revascularization Therapies Study (ARTS), we compared long-term clinical outcomes after CABG or PCI with multivessel stenting in patients with CKD. METHODS: The ARTS randomly assigned 1205 participants with and without CKD to CABG or PCI with multivessel stenting. We defined CKD as creatinine clearance < or =60 mL/min, estimated by the Cockroft-Gault equation. The primary outcome was the composite of death, myocardial infarction (MI), or stroke; and, a secondary outcome was repeat revascularization. Participants were followed for a mean of 3 years after their intervention. We evaluated whether randomization to CABG or PCI was associated with different outcomes among participants with CKD. RESULTS: Two hundred ninety participants (25%) had CKD at entry into ARTS. One hundred fifty-one received PCI, and 139 received CABG. No difference was observed in the primary endpoint with CABG or PCI among CKD participants (adjusted Hazard Ratio [HR] CABG vs PCI = 0.93; 95% CI 0.54-1.60; P = .97). However, CABG was associated with a reduced risk for repeat revascularization (HR = 0.28; 95% CI 0.14-0.54; P < .01). Compared with participants with normal renal function, CKD was associated with a nearly 2-fold risk for the primary outcome (unadjusted HR = 1.9; 95% CI 1.4-2.7; P < .01). After multivariate adjustment, this association remained significant (HR 1.6; 95% CI 1.1-2.4). CONCLUSIONS: In patients with multivessel CAD and CKD, treatment with CABG or PCI with multivessel stenting led to similar outcomes of death, MI, or stroke, but CABG was associated with decreased repeat revascularizations. When compared with ARTS participants with normal renal function, those with CKD had substantially elevated risk of adverse clinical outcomes after coronary revascularization.

Aged↗

Quality management systems in ART: are they really needed? An Australian clinic's experience.

As assisted reproductive technology (ART) expanded globally, several countries introduced prescribed requirements for treatment and monitoring of outcomes, as well as a licensing or accreditation requirement. While it is common for ART laboratories to be required to have an effective quality control system, the remainder of the clinic is often under less stringent regulation. Furthermore, when treatment conditions are prescribed, the standards tend to be conservative and clinics may choose to establish their own standards. Total quality management systems are now being used by an increasing number of ART clinics. In Australia and New Zealand, it is now a requirement to have a quality management system in order to be accredited and to help meet customer demand for improved delivery of ART services in these two countries.

Accreditation↗

The International Committee Monitoring Assisted Reproductive Technologies (ICMART) glossary on ART terminology.

The International Committee Monitoring Assisted Reproductive Technologies (ICMART) is an independent international nonprofit organization that has taken a leading role in the development, collection, and dissemination of worldwide data on assisted reproductive technology (ART). Information on availability, efficacy, and safety is provided to health professionals, health authorities, and the public. The glossary facilitates dissemination of ART data through a set of agreed-upon definitions, as seen in the most recent World Report on ART. It provides a conceptual framework for further international terminology and data development of ART.

Databases, Factual↗

Experiences with the Surgitek Art-1000 penile tumescence and rigidity monitor, and comparison with the RigiScan.

We compared real-time and nocturnal penile tumescence and rigidity monitoring with 2 different ambulatory rigidity and tumescence monitors: the Surgitek Art-1000 and the RigiScan devices. Real-time studies were performed in 5 patients with both devices used simultaneously. The results of the measurements with both monitors were rather identical, indicating that both devices are applicable in a satisfactory manner for real-time investigation. Within a short period 5 patients performed nocturnal monitoring at home with the Surgitek Art-1000 and RigiScan devices during 2 consecutive nights. The Surgitek Art-1000 device provided less reliable and less informative results when compared with the RigiScan monitor during these nocturnal measurements. It appears that problems with sizing and fixing of the passive sensing loops of the Surgitek Art-1000 device by the patient are the main cause of these disappointing results. We believe that when the loops are sized and fixed by the investigator, for example during nocturnal measurements in the hospital, the applicability will be more satisfying. This monitor seems not to be suitable for nocturnal measurements by the patient at home.

Equipment Design↗

Treatment of small cell lung cancer: the state of the art.

Many innovations have been tested to improve the power of chemotherapy for SCLC including: drug diversity enhancement, dose and dose-intensity escalation, incorporation of new agents, and resistance modification. Although superiority of combination chemotherapy over monotherapy has been shown, clinical trials have failed to demonstrate a clearly superior multiagent regimen. When dose and dose-intensity are diminished from standard levels, the effect is detrimental for both limited and extensive stage SCLC. Trials of dose and dose-intensity above standard levels have not yet shown advantages for patients with extensive stage SCLC. However, the only two randomized trials of chemotherapy dose escalation for limited SCLC show statistically significant survival benefits. The optimal intensity of chemotherapy for limited SCLC has not been defined. State-of-the-art chemotherapy for extensive SCLC could be CAV, EP, or CAV/EP but EP has generally been favored because it is associated with less myelotoxicity and four cycles are considered adequate rather than 6 cycles of the others. EP is widely regarded as state-of-the-art chemotherapy for limited SCLC particularly because this regimen can be integrated with concurrent thoracic irradiation with acceptable toxicity. Early thoracic irradiation with concurrent EP chemotherapy is state-of-the-art treatment for limited SCLC, however, it must be conceded that EP has never been shown to be superior to any other chemotherapy regimen in a phase III trial of either limited or extensive SCLC. Current state-of-the-art treatment for limited SCLC can result in actual 5-year survival rates of at least 20%; declaration of a statistically significant improvement will require sample sizes than most clinical trials performed to date.

Antineoplastic Combined Chemotherapy Protocols↗

The ECAT ART Scanner for Positron Emission Tomography. 2. Research and Clinical Applications.

The ECAT ART is a low-cost positron emission tomography (PET) scanner design for which increasing interest in the use of PET, and specifically (18)FDG PET for oncological studies, has stimulated a demand. Although targeted primarily for the clinical market, the performance of the ART scanner can also meet the demands of a research environment where, in addition to [(18)F], more challenging, shorter-lived isotopes such as [(11)C], [(13)N] and [(15)O] are used. The ART has been used successfully to perform quantitative (18)FDG studies, blood flow measurements with [(15)O]water, and brain mapping studies with [(15)O]water (activation). In the clinical arena, it has been used for a wide range of applications, including epilepsy, whole-body imaging in oncology, and for cardiac viability studies. This paper explores the capability of the ECAT ART scanner to meet the demands of PET studies in both a research and clinical arena.

Journal Article↗

The ECAT ART Scanner for Positron Emission Tomography. 1. Improvements in Performance Characteristics.

The widespread use of positron emission tomography (PET) has been to some extent limited by the cost and complexity of PET instrumentation. Recognition of the wider applicability of clinical PET imaging is reflected in the ECAT ART design, a low cost PET scanner targeted for clinical applications, particularly in oncology. The ART comprises two asymmetrically opposed arrays of BGO block detectors. Each array consists of 88 (transaxial) by 24 (axial) crystals, and the arrays rotate continuously at 30 rpm to acquire a full 3D projection data set. Sensitivity and count rate limitations are key performance parameters for any imaging device. This paper reports on improved performance characteristics of the ART, achieved by operating the scanner with a decreased block integration time, reduced coincidence time window, and collimated singles transmission sources. Compared to the standard ART configuration, these modifications result in both improved count rate performance and higher quality transmission scans.

Journal Article↗

Quality management in the ART laboratory.

Unlike most medical laboratories that play a diagnostic role, laboratories for assisted reproductive technologies, ART laboratories, are involved in the treatment of infertile couples. Handling human gametes and producing human embryos in order to achieve much-sought pregnancies form the key tasks of an ART laboratory. The impact of the activities and the possible risks makes it necessary to ensure the safety and reproducibility of all methods. To achieve and maintain the highest level of patient care and the highest success rates, a quality management system should be implemented. Several guidelines, compiled by professional associations of ART experts, official international standards and quality management models have been developed and issued and can be applied. Irrespective of the choice, establishing a quality management system in an ART laboratory leads to a huge amount of additional work and requires a lot of investment in all kind of areas. However, due to the increased standardization and efficiency of all procedures as well as the improved transparency and traceability of all actions performed, the quality of service provided by the laboratory will improve substantially and the effort will be worthwhile.

Humans↗

Atraumatic perspectives of ART: psychological and physiological aspects of treatment with and without rotary instruments.

Atraumatic Restorative Treatment, ART, is a method of minimal caries intervention that uses only hand instruments. The aim of the present study was to explore a possible difference between the extent of discomfort experienced during dental treatment according to the ART approach and a method using rotary instruments. The study was performed in Indonesia. A total of 403 children were randomly divided in two groups. In each child, one class II restoration in a deciduous molar was made. One group received treatment using rotary instruments (750 r.p.m.). The other group was treated according to the ART approach. Glass ionomer cement was used for restoration in both groups. Discomfort scores were determined using both physiological measurements (heart rate) and behavioral observations (Venham) on specific moments during the treatment. Venham scores showed a marked difference between the two groups at most time points. Heart rate measurements were different at deep excavation. Also, a clear relation between Venham scores and heart rate measurements could be found at all time points. Confounding could be shown for operating dentist, gender of the patient and initial anxiety, not for age. No effect modification could be shown. It can be concluded that children treated according to the ART approach using hand instruments alone experience less discomfort than those treated using rotary instruments.

Age Factors↗

A novel mitochondrial septin-like protein, ARTS, mediates apoptosis dependent on its P-loop motif.

Here we describe a protein product of the human septin H5/PNUTL2/CDCrel2b gene, which we call ARTS (for apoptosis-related protein in the TGF-beta signalling pathway). ARTS is expressed in many cells and acts to enhance cell death induced by TGF-beta or, to a lesser extent, by other apoptotic agents. Unlike related septin gene products, ARTS is localized to mitochondria and translocates to the nucleus when apoptosis occurs. Mutation of the P-loop of ARTS abrogates its competence to activate caspase 3 and to induce apoptosis. Taken together, these observations expand the functional attributes of septins previously described as having roles in cytokinesis and cellular morphogenesis.

Amino Acid Motifs↗

Palaeolithic paintings. Evolution of prehistoric cave art.

Sophisticated examples of European palaeolithic parietal art can be seen in the caves of Altamira, Lascaux and Niaux near the Pyrenees, which date to the Magdalenian period (12,000-17,000 years ago), but paintings of comparable skill and complexity were created much earlier, some possibly more than 30,000 years ago. We have derived new radiocarbon dates for the drawings that decorate the Chauvet cave in Vallon-Pont-d'Arc, Ardèche, France, which confirm that even 30,000 years ago Aurignacian artists, already known as accomplished carvers, could create masterpieces comparable to the best Magdalenian art. Prehistorians, who have traditionally interpreted the evolution of prehistoric art as a steady progression from simple to more complex representations, may have to reconsider existing theories of the origins of art.

Archaeology↗

The art of nursing: the experience of patients and nurses.

Historical and contemporary conceptualizations of nursing have not addressed the art of nursing from an experiential research approach. This study explores patients' and nurses' experiences of the art of nursing using a phenomenological-hermeneutic approach to enquiry that allows for exploration of the empirical experience. Explicating a paradigm of the art of nursing, five distinct metathemes express nursing as art and describe the complex artistic processes that are lived through the nurse and patient.

Caregivers↗

Challenges imposed by scientific development in ART.

The primary goal of ART is to produce a healthy baby which will develop into a healthy adult. There are a number of challenges which must be met in order to achieve this goal, with possibly two foremost at the present time. The first is to eliminate multiple pregnancy by transfer of a single embryo, and the second is to understand the risks involved in ART. In recent years spin-out technologies have also developed from ART, first the diagnosis of genetic disease in the embryo, and now the derivation of embryonic stem cell lines with the potential to treat a range of human health disorders. Current and future scientific developments can help achieve all of these aims, but present a number of challenges to the ART community and regulatory bodies.

Female↗

A projection access order for speedy convergence of ART (algebraic reconstruction technique): a multilevel scheme for computed tomography.

The practical performance of algebraic reconstruction techniques (ART) for computed tomography (CT) depends heavily on the order in which the projections are considered. Complete orthogonalization, notwithstanding its theoretical justification, is not feasible because the computational time is prohibitive. The authors report here a scheme that yields the most efficient reconstruction without orthogonalization: projections are organized and accessed in a nominally multilevel fashion. Each level makes the best use of the image information reconstructed in the preceding levels. If the number of projections is a power of two. Then the access orders are exactly that for the 1D FFT. The authors' scheme can be easily implemented. Using it, one iteration of ART yields a high-quality image. Experimental results of this algorithm are demonstrated and compared with the results from the conventional sequential method and also random ordering. Comparisons show that this scheme is superior. ART is better in image quality than the Fourier back-projection algorithm, at least for a smaller number of projections. Since the authors have made it much more efficient in computational speed, ART could now find widespread use in medical imaging.

Algorithms↗

ARTS: accurate recognition of transcription starts in human.

UNLABELLED: We develop new methods for finding transcription start sites (TSS) of RNA Polymerase II binding genes in genomic DNA sequences. Employing Support Vector Machines with advanced sequence kernels, we achieve drastically higher prediction accuracies than state-of-the-art methods. MOTIVATION: One of the most important features of genomic DNA are the protein-coding genes. While it is of great value to identify those genes and the encoded proteins, it is also crucial to understand how their transcription is regulated. To this end one has to identify the corresponding promoters and the contained transcription factor binding sites. TSS finders can be used to locate potential promoters. They may also be used in combination with other signal and content detectors to resolve entire gene structures. RESULTS: We have developed a novel kernel based method - called ARTS - that accurately recognizes transcription start sites in human. The application of otherwise too computationally expensive Support Vector Machines was made possible due to the use of efficient training and evaluation techniques using suffix tries. In a carefully designed experimental study, we compare our TSS finder to state-of-the-art methods from the literature: McPromoter, Eponine and FirstEF. For given false positive rates within a reasonable range, we consistently achieve considerably higher true positive rates. For instance, ARTS finds about 35% true positives at a false positive rate of 1/1000, where the other methods find about a half (18%). AVAILABILITY: Datasets, model selection results, whole genome predictions, and additional experimental results are available at http://www.fml.tuebingen.mpg.de/raetsch/projects/arts.

Algorithms↗

Epigenetic risks related to assisted reproductive technologies: epigenetics, imprinting, ART and icebergs?

Recently, a series of case reports and small studies has suggested that births involving assisted reproductive technology (ART) may have an increased risk of imprinting disorders such as Beckwith-Wiedemann syndrome and Angelman syndrome. Herein, the significance and implications of these findings are discussed. It is speculated that, although such imprinting disorders may be shown to be only rare complications of ART, epigenetic errors might account for a much wider spectrum of ART-related complications than is recognized currently. Addressing these questions should be a priority for research on cohorts of ART children.

Angelman Syndrome↗