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Statistical dynamic image reconstruction in state-of-the-art high-resolution PET.

Modern high-resolution PET is now more than ever in need of scrutiny into the nature and limitations of the imaging modality itself as well as image reconstruction techniques. In this work, we have reviewed, analysed and addressed the following three considerations within the particular context of state-of-the-art dynamic PET imaging: (i) the typical average numbers of events per line-of-response (LOR) are now (much) less than unity, (ii) due to the physical and biological decay of the activity distribution, one requires robust and efficient reconstruction algorithms applicable to a wide range of statistics and (iii) the computational considerations in dynamic imaging are much enhanced (i.e., more frames to be stored and reconstructed). Within the framework of statistical image reconstruction, we have argued theoretically and shown experimentally that the sinogram non-negativity constraint (when using the delayed-coincidence and/or scatter-subtraction techniques) is especially expected to result in an overestimation bias. Subsequently, two schemes are considered: (a) subtraction techniques in which an image non-negativity constraint has been imposed and (b) implementation of random and scatter estimates inside the reconstruction algorithms, thus enabling direct processing of Poisson-distributed prompts. Both techniques are able to remove the aforementioned bias, while the latter, being better conditioned theoretically, is able to exhibit superior noise characteristics. We have also elaborated upon and verified the applicability of the accelerated list-mode image reconstruction method as a powerful solution for accurate, robust and efficient dynamic reconstructions of high-resolution data (as well as a number of additional benefits in the context of state-of-the-art PET).

Algorithms↗

Promoting breast cancer screening in rural, African American communities: the "science and art" of community health promotion.

Implementing community health promotion programs can be a daunting task for social workers. Aside from the practical skills necessary for engaging diverse groups, it requires an understanding of the complex interplay of several theoretical constructs. Using an eight-year breast cancer prevention project, the North Carolina Breast Cancer Screening Program, as a case study, this article describes both the "science and art" of community health promotion. The article provides examples illustrating the "art" of generating participation by both lay and professional communities and concludes with guidelines for social workers who plan to conduct their own community health promotion programs.

Black or African American↗

Avoiding multiple pregnancies in ART: consideration of new strategies.

To maximize pregnancy rates, physicians who perform IVF, often transfer multiple embryos, which increases the multiple birth risk. Multiple birth infants are at significant risk for a number of adverse outcomes including preterm delivery, low birth weight, congenital malformations, fetal and infant deaths and long term morbidity and disability among survivors. Since the ultimate goal for an IVF treatment is the birth of a healthy infant, an important issue for all kinds of assisted reproductive technologies (ART) must be the reduction or elimination of multiple pregnancies. In this article, different strategies to avoid multiple births in ART are discussed.

Female↗

Endometrial cavity fluid is associated with poor ovarian response and increased cancellation rates in ART cycles.

BACKGROUND: Endometrial cavity fluid (ECF) is occasionally observed during assisted reproductive technology (ART) cycles. However, few reports have described its prevalence or significance. METHODS AND RESULTS: We examined the relationships between ECF, clinical pregnancy rate (CPR), tubal factor infertility and ultrasound-visible (USV) hydrosalpinges. In 843 ART cycles involving 721 patients, ECF was observed during stimulation in 57 cycles and after human chorionic gonadotrophin (HCG) administration in 12 cycles, with an overall incidence of 8.2% (69/843). When ECF was observed during stimulation, the cancellation rate due to poor ovarian response was significantly higher (29.8 versus 16.9%, P <0.05) and the CPR per started cycle was significantly lower (26.3 versus 42.4%, P <0.05) than cycles without ECF. When ECF developed after HCG administration, the CPR was similar compared with that of the group for which ECF was not observed. In the 327 cycles involving tubal factor infertility patients, USV hydrosalpinges were noted in 71 cycles (71/327; 21.7%), and ECF developed in five of those cycles (5/71; 7.0%). A total of 27 cycles during which ECF developed (27/57, 47.4%) involved non-tubal factor patients. CONCLUSIONS: ECF during stimulation was associated with increased cancellation rates and lower CPRs per started cycle, and was not associated with USV hydrosalpinges. Furthermore, ECF observed after HCG administration did not impact CPR and may represent a different clinical entity.

Adult↗

Safety issues in assisted reproductive technology: aetiology of health problems in singleton ART babies.

The frequency of health problems in singleton assisted reproductive technologies (ART) babies is higher than in singletons from spontaneous gestations. Any of the following factors may be involved: in-vitro technology, ovarian stimulatory drugs and infertility itself. A literature review on premature birth, low birth weight, perinatal mortality and major birth defects in children conceived from infertility treatments was conducted. Only publications comparing the outcome of pregnancy in an infertile group of patients to a matched control group were selected. The analysis of the outcome of singleton pregnancies resulting from IVF versus artificial insemination, obtained with or without the use of ovarian stimulatory agents and obtained with or without the use of a semen donor, suggests that female infertility is an important risk factor. Criteria for screening at-risk infertile women have not yet been identified. Prospective studies designed to identify precisely the aetiology of health problems in singletons ART babies will have to be conducted. The absence of criteria correlating at-risk infertile women to health problems in their children does not allow a gynaecologist the opportunity to offer infertility treatments to the least susceptible patients.

Congenital Abnormalities↗

PCR-detected hepatitis C virus RNA associated with human zona-intact oocytes collected from infected women for ART.

BACKGROUND: The aim of this study was to investigate the susceptibility of human oocytes from hepatitis C virus (HCV) RNA-positive women to HCV contamination during assisted reproductive technology (ART). METHODS: A reverse transcriptase-PCR assay was used to test for the presence of HCV RNA associated with 24 unfertilized oocytes 48 h after follicular fluid aspiration in 10 IVF attempts (seven conventional IVF and three ICSI). Negative and positive controls (10 unfertilized oocytes from HCV-negative women and 20 unfertilized oocytes artificially contaminated with HCV RNA-positive plasma; HCV RNA was also quantified in plasma and follicular fluid) were included. RESULTS: HCV RNA was associated with 17/24 (70.8%) oocytes (6/7 after ICSI and 11/17 after conventional IVF) and was found in 19/20 (95%) follicular fluid samples. A weak correlation was found between plasma and follicular fluid HCV RNA loads (r = 0.73, P < 0.001). CONCLUSIONS: HCV associated with unfertilized oocytes surrounded by their intact zona pellucida from anti-HCV antibody-positive and viraemic women undergoing ART raises questions concerning the safe management of medically assisted procreation for these women and good practice of oocyte/embryo cryopreservation and donation.

Adult↗

The effect of fibroids without cavity involvement on ART outcomes independent of ovarian age.

BACKGROUND: The effect of fibroids that do not distort the endometrial cavity on pregnancy rate (PR) and implantation rate (IR) is controversial. Use of oocyte donor-derived embryos offers an ideal patient population to study the effect of fibroids in patients utilizing assisted reproductive technologies (ARTs). METHODS: We conducted a retrospective cohort study of patients undergoing oocyte donor recipient (ODR) IVF cycles at two tertiary care fertility centres. We examined medical records for the presence of non-cavity-distorting fibroids and evaluated subsequent PR and IR. RESULTS: Three hundred and sixty-nine patients, 94 with fibroids, underwent oocyte donor recipient transfer cycles with fresh embryos. There was no statistical difference in IR (36 versus 38%) or clinical PR (47 versus 54%) between patients with or without fibroids. Neither the location (subserosal versus intramural) and the presence of multiple myomas nor the size of the myomas affected outcomes. Fibroids were more likely to be present in patients with increasing recipient age. CONCLUSIONS: Clinical PR and IR are not affected by the presence of non-cavity-distorting leiomyomata. This evidence does not support myomectomy before ART in patients with asymptomatic fibroids that do not significantly distort the endometrial cavity or cause abnormal uterine bleeding.

Adult↗

Preferences of elderly music listeners residing in nursing homes for art music, traditional jazz, popular music of today, and country music.

The purpose of this study was to investigate seniors' comparative music preference for four generic styles including art music, country music, popular music of today, and traditional jazz. The study also attempted to identify certain variables that have an effect on preference. Sixty-three subjects with a mean age of 82.5 from four nursing homes in the South Central Michigan area participated in the study. An interview and musical preference test were administered to the subjects individually. The listening test consisted of 16 music selections, four from each style. The seniors judged how much they liked the selections on a scale from 1 to 5, with 5 indicating greatest preference. Results indicated that country music style was preferred the most, followed by traditional jazz, art music, and lastly popular music. Variables that were found to affect preference were education level, community size in which the seniors grew up, and music training outside the school setting.

Aged↗

ARTS: a web-based tool for the set-up of high-throughput genome-wide mapping panels for the SNP genotyping of mouse mutants.

Genome-wide mapping in the identification of novel candidate genes has always been the standard method in genetics and genomics to correlate a clinically interesting phenotypic trait with a genotype. However, the performance of a mapping experiment using classical microsatellite approaches can be very time consuming. The high-throughput analysis of single-nucleotide polymorphisms (SNPs) has the potential of being the successor of microsatellite analysis routinely used for these mapping approaches, where one of the major obstacles is the design of the appropriate SNP marker set itself. Here we report on ARTS, an advanced retrieval tool for SNPs, which allows researchers to comb freely the public mouse dbSNP database for multiple reference and test strains. Several filters can be applied in order to improve the sensitivity and the specificity of the search results. By employing the panel generator function of this program, it is possible to abbreviate the extraction of reliable sequence data for a large marker panel including several different mouse strains from days to minutes. The concept of ARTS is easily adaptable to other species for which SNP databases are available, making it a versatile tool for the use of SNPs as markers for genotyping. The web interface is accessible at http://andromeda.gsf.de/arts.

Animals↗

The ARTS web server for aligning RNA tertiary structures.

RNA molecules with common structural features may share similar functional properties. Structural comparison of RNAs and detection of common substructures is, thus, a highly important task. Nevertheless, the current available tools in the RNA community provide only a partial solution, since they either work at the 2D level or are suitable for detecting predefined or local contiguous tertiary motifs only. Here, we describe a web server built around ARTS, a method for aligning tertiary structures of nucleic acids (both RNA and DNA). ARTS receives a pair of 3D nucleic acid structures and searches for a priori unknown common substructures. The search is truly 3D and irrespective of the order of the nucleotides on the chain. The identified common substructures can be large global folds with hundreds and even thousands of nucleotides as well as small local motifs with at least two successive base pairs. The method is highly efficient and has been used to conduct an all-against-all comparison of all the RNA structures in the Protein Data Bank. The web server together with a software package for download are freely accessible at http://bioinfo3d.cs.tau.ac.il/ARTS.

Internet↗

Can poetry make better doctors? Teaching the humanities and arts to medical students and residents at the University of California, Irvine, College of Medicine.

The Program in Medical Humanities & Arts at the University of California, Irvine, College of Medicine has been in existence for five years. The program was implemented to enhance aspects of professionalism including empathy, altruism, compassion, and caring toward patients, as well as to hone clinical communication and observational skills. It contains elective or required curriculum across all four years of medical school and required curriculum in two residency programs, organized according to structural principles of horizontal coherence, vertical complexity, and patient care applications. The program emphasizes small-group, interdisciplinary teaching and faculty development, and is notable for learners' use of creative projects to reflect on patients and themselves. Evaluation of the program indicates a positive response among learners. More systematic studies point to increases in empathy and positive attitudes toward the humanities as tools for professional development as a result of exposure to the program curriculum. Future directions include closer collaboration with the University of California, Irvine, Schools of the Arts and Humanities, involvement of local artists and writers, and development of a graduation with distinction in humanities for medical students.

California↗

State-of-the-art patient care. The impact of doctorally prepared clinical nurses.

Delivery of state-of-the-art patient care requires new models to foster the development of professional nurses and integrate practice, research, and education. The Chief Nursing Officer of University Hospital/Associate Dean of the College of Nursing at a tertiary health science center positioned doctorally prepared nurses in clinical practice settings to assist in actualizing a vision of state-of-the-art patient care. Strategic targets for performance improvement included building collaboration between the college and hospital, supporting advanced education for nurses, moving the nursing culture from one of co-dependence to one of professionalism, fostering research at the unit level, and capitalizing on the strengths of nurse leaders. Creating an environment where staff nurses use critical thinking skills and access their advanced practice nurse (APN) resources as they do their work has been a win-win-win situation for the patients, the hospital, and the college at the health science center.

Clinical Competence↗

Faculty practice in a small liberal arts college.

Small liberal arts colleges are challenged to find ways to participate in faculty practice. With limited access to large healthcare centers, small liberal arts colleges must create innovative faculty practice models. The author shares one college's experience in faculty practice that can be used by others, detailing practice development, funding, developmental challenges, and future goals.

Contract Services↗

The weighted-distance scheme: a globally optimizing projection ordering method for ART.

The order in which the projections are applied in the algebraic reconstruction technique (ART) has a great effect on speed of convergence, accuracy, and the amount of noise-like artifacts in the reconstructed image. In this paper, a new projection ordering scheme for ART is presented: the weighted-distance scheme (WDS). It heuristically optimizes the angular distance of a newly selected projection with respect to an extended sequence of previously applied projections. This sequence of influential projections may incorporate the complete set of all previously applied projections or any limited time interval subset thereof. The selection algorithm results in uniform sampling of the projection access space, minimizing correlation in the projection sequence. This produces more accurate images with less noise-like artifacts than previously suggested projection ordering schemes.

Algorithms↗

Multilevel category structure in the ART-2 network.

Multilevel categorization is investigated within the context of analog activity patterns on the output layer of an ART 2 network. The ART 2 network parameters are analyzed in terms of stable category formation and in terms of the number of nodes in the output layer that can become most active. The resulting activity patterns on the output layer demonstrate a multilevel category structure based on the relative differences between patterns that exist for many different values of the vigilance parameter. We have shown that the information contained in the output analog patterns can be interpreted in several different ways, which is not possible when the category is represented by a single winning node. Also, favorable comparisons are also demonstrated between the category structure emerging from the set of category patterns and principles of categorization in psychology and neurobiology.

Neural Networks, Computer↗

Art and science of photodynamic therapy.

1. Photodynamic therapy is an established modality for the treatment of solid tumours and other accessible lesions. Although the concept and practice of combining light with a photosensitizing agent for the treatment of disease states has been around for almost a century, the understanding of the art and science therein has been tremendously enhanced over the past few years. 2. Photosensitized reactions are dependent on the generation of reactive oxygen species, in particular singlet oxygen, which accounts for the damaging effects on biological macromolecules, such as membrane lipids and proteins. Therefore, compounds that give a good yield of (1)O(2) are used as photosensitizers. 3. The main photosensitizers used in the clinical setting belong to the photofrin family; however, newer and more effective sensitizers are being evaluated for their potential clinical effectiveness. 4. Light sources have moved from the use of white light with specific filters in the old days to the more recent use of monochromatic light sources, such as lasers, to more sophisticated light-emitting diodes. However, dosimetry remains a big issue mainly because of difficulties in establishing the optimum treatment conditions for an approach that requires the fine-tuning of several variables, such as sensitizer and light doses and drug-to-light interval, as well as the issues of skin photosensitivity and low selectivity. A newer development to circumvent these and provide a broader application for this concept has been the phenomenon of photo-activation, whereby photo-exposure of chromophores to generate novel, small biologically active compounds has been demonstrated successfully. 5. The aim of the present review was to provide a general overview of the art and science of photodynamic therapy and to highlight some of the issues and recent developments in further advancing this modality of treatment.

Angiogenesis Inhibitors↗

The art of comfort care.

Nursing art is defined and a template is presented for practicing one type of nursing art called comfort care. Propositions for comfort care are derived from a theory of comfort. Benefits are listed for integrating comfort care into practice. Testimony from a student who learned and applied comfort care provides support for its effectiveness as a learning tool. Comfort care is a holistic, individualistic, creative, and efficient model.

Holistic Nursing↗

A 2-year clinical study of two glass ionomer cements used in the atraumatic restorative treatment (ART) technique.

The purpose of the study was to evaluate, in a clinical study over 2 years, the deterioration of two glass ionomer cements used with the atraumatic restorative treatment (ART) technique or approach. Fifty-five Fuji IX and 45 ChemFil Superior restorations were placed randomly in 23 adult patients, mainly in small occlusal preparations in molar teeth. The restorations were placed in a dental hospital by one dentist using the ART technique. Photographs, radiographs and replicas were obtained at baseline and subsequent recalls. Both cements were easy to mix and place, but the radiolucency of ChemFil Superior was a disadvantage. Both cements also showed early high losses of sealant and restorative material. After 2 years, 34.5% of the sealants appeared to be completely lost, with caries recorded in 5.3% of the exposed fissures. In some instances, these small lesions may have been present, but not detected clinically, at the time of sealing. Restoration failures of 7.0% were from wear and fracture of the cements and recurrent caries. Mean cumulative wear was 83.1 microm for Fuji IX and 104.0 microm for ChemFil Superior, which was not statistically significant. The cements became darker after their placement to more closely match the restored teeth, but there were few exact matches. There was no surface staining and only minor marginal discrepancies and staining associated with the restorations. Although the short-term clinical performance of the two glass ionomer cements was reasonable, the materials require further improvements in their mechanical properties, to reduce sealant losses and wear. The cements evaluated appear suitable for restricted use only, in posterior teeth.

Adult↗