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Technology transfer in digital mammography. Report of the Joint National Cancer Institute-National Aeronautics and Space Administration workshop of May 19-20, 1993.

Digital mammography is one of the most promising novel technologies for further improvement of early detection of breast cancer, offering important potential advantages: 1) improved image quality; 2) digital image processing for improved lesion contrast; 3) computer-aided diagnosis for enhanced radiologic interpretation; and 4) teleradiology for facilitated radiologic consultation. The Diagnostic Imaging Research Branch of the National Cancer Institute (NCI) recently funded an international, multidisciplinary, multi-institutional Digital Mammography Development Group for collaborations between NCI, the academic community, and industry to facilitate the integrated development and implementation of digital mammographic systems. Currently, however, digital mammography faces a number of fundamental technological roadblocks: 1) cost-effective digital detectors and displays for imaging systems; 2) the need for novel algorithms for image processing and computer-aided diagnosis; and 3) high performance, low cost digital networks to provide an "information superhighway" for teleradiology. To solve some of these technological problems, the Diagnostic Imaging Research Branch of NCI joined efforts with the Technology Transfer Division of the National Aeronautics and Space Administration to pursue a federal technology transfer program in digital mammography. The authors discuss the findings and recommendations of the workshop entitled "Technology Transfer in Digital Mammography," which was organized and held jointly by the NCI and the National Aeronautics and Space Administration in May, 1993. Numerous innovative technologies of varying degree of promise for digital mammography were presented at the conference. In this article, specific technologies presented at the workshop by the federal and federally-supported laboratories are described, and critiques of these technologies by the leaders of the medical imaging community are presented.

Breast Neoplasms↗

Joint report of the Third International Workshop on Canine Immunogenetics. I. Analysis of homozygous typing cells.

The Third International Workshop on Canine Immunogenetics involved 80 potentially DLA-D homozygous typing cells obtained from dogs of various breeds and submitted from five laboratories in Europe and the United States. Mutual reactivity of all cells was studied in mixed leukocyte cultures, and stabilized relative responses were used for analysis. Intralaboratory and interlaboratory comparisons of results suggest that a stabilized relative response of 30% represents an acceptable parameter for "typing responses" indicating phenotypic DLA-D identity of stimulator and responder cells. Using this criterion, 10 clusters of homozygous typing cells were defined and accepted on an international level, and they were assigned the specificities Dw1 to Dw10. At least six additional (provisional) specificities were recognized that were well characterized within individual laboratories but require additional testing before workshop specificities can be assigned. These data show that DLA-D typing is feasible and represents a useful tool in the genetic analysis of the canine major histocompatibility complex. Much work is needed to confirm the present results in family studies, to determine gene frequencies, and to analyze at a molecular level the antigens responsible for mixed leukocyte culture reactivity.

Animals↗

Joint report of the Third International Workshop of Canine Immunogenetics. II. Analysis of the serological typing of cells.

Using a standardized microlymphocytotoxicity assay, seven international laboratories evaluated 144 anti-dog lymphocyte antigen (DLA) sera in 319 mixed breed and 152 Beagle dogs. The workshop confirmed the serological definitions for DLA-A2, A3, A9; DLA-B4, B5, B6, B13; DLA-C11(Cwl); and C12(Cw2). Two new specificities were assigned to the DLA-A locus (Aw14 and Aw15) in only the mixed breed dogs. A third specificity (Cw3), was assigned to the DLA-C locus. The antigen and gene frequencies of these alleles differed between the two groups of dogs, but the frequencies of the "blank" were similar in both groups. Future international collaborations will be necessary to definite more completely the polymorphisms of the major histocompatibility complex (MHC) of the dog. Those efforts will benefit from the standard serological test established in this workshop.

Alleles↗

Nonprimate animal models of menopause: workshop report.

OBJECTIVE: Menopause, an understudied, normal biological process in middle-aged women, is associated with loss of fertility and increased risk for osteoporosis and cardiovascular disease. Appropriate animal models allow in-depth investigation of biological mechanisms that underlie the increased risk for adverse health events in menopausal women. Although some species of older female nonhuman primates experience a menopause-like condition, with cessation of reproductive cycles, decreased bone density, and perhaps an increased risk for atherosclerosis, several factors restrict their usefulness for research (e.g., expense of purchase and care, relatively small numbers of animals available, risk for disease transmission to humans, limited facilities for experimentation). Thus, it may be useful to consider nonprimate animal species as potential models for pathophysiological changes associated with loss of reproductive function. DESIGN: A workshop was convened in June 1998 at the National Institutes of Health to explore the suitability of nonprimate animal species in this context. The focus of this workshop was on middle-aged, ovariectomized females of various laboratory animal species and the ability of exogenous estrogen to reverse pathophysiological changes in the skeleton, cardiovascular system, and thermoregulatory control mechanisms in these species. CONCLUSIONS: Of the species considered (mice, rats, dogs, rabbits, pigs, and sheep) and because of the limitations of relatively small amounts of research in ovariectomized, middle-aged animals for most of these species, mice (largely because of transgenic technology) have the potential to be good models for the effect of ovariectomy and estrogen replacement on associated bone and cardiovascular changes. Rats are an excellent model for bone but a poor model for the cardiovascular system changes associated with loss of reproductive function. Usefulness of the pig, which is usually considered to be a good model for the human cardiovascular system, is limited by the dearth of information available on ovariectomized mature pigs in cardiovascular and bone studies, sensitivity of bone density to dietary calcium, the difficult-to-manage size of regular pigs, and the relatively high cost of minipigs. Rabbits show good potential as a cardiovascular model despite the limited numbers of studies and the difference from primates in coronary artery structure. Although rabbits are the smallest species known to have Haversian bone remodeling processes, the limited number of bone studies in ovariectomized rabbits is confounded by effects of dietary calcium. Although there are virtually no studies on the cardiovascular system of the ovariectomized dog, bone studies that have been conducted suggest that it is a poor model for the menopausal human. Furthermore, the role of estrogen in bone and cardiovascular physiology is difficult to interpret because of the limitation of two estrus cycles per year in the dog. The sheep seems to be a promising large animal model for the bone and cardiovascular systems, but more research is needed. Of the species examined for estrogen effects on vasomotor symptoms (guinea pig, mouse, rat, and monkey), only rats and monkeys show evidence of hot flashes associated with loss of reproductive function.

Animals↗

Patient education workshop on CD-ROM: an innovative approach for staff education.

This article describes an innovative patient education workshop on CD-ROM for use by staff educators and patient education coordinators. The CD-ROM allows nurses to gain an in-depth understanding of patient education practice. With the interactive, computerized format, nurses can complete the workshop on their computers and at their convenience. The CD-ROM format uses streaming video clips, audio, thought questions, case studies, and interactive practice activities to enhance learning.

CD-ROM↗

The National Institutes of Health Workshop on Fetal Treatment: needs assessment and future directions.

The National Institute of Child Health and Human Development and Office of Rare Diseases convened a multidisciplinary group of experts on August 16-17, 2004, for a workshop entitled ''Fetal Treatment: Needs Assessment and Future Directions.'' The purpose of the workshop was to develop a plan for the surgical, obstetric, neonatal, and maternal-fetal fields for the evaluation and dissemination of maternal-fetal surgical innovations and to further the scientific evaluation of maternal-fetal surgery. This article highlights the discussions and outlines recommendations for the future. An overarching recommendation was for the formation of a cooperative group of investigators and clinicians to help set a national agenda for research and clinical progress, as well as emphasize ethical issues.

Animals↗

Incorporating first-trimester Down syndrome studies into prenatal screening: executive summary of the National Institute of Child Health and Human Development workshop.

The National Institute of Child Health and Human Development (NICHD), the Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists (ACOG), cosponsored a workshop on December 16-17, 2004, to discuss the evidence for first-trimester Down syndrome screening and to explore the effects of combining first- and second-trimester screening, given the results of recent U.S. trials. The experts evaluated the evidence for offering first-trimester screening to provide individual risk assessment for Down syndrome. First-trimester screening has been demonstrated to provide efficient Down syndrome risk assessment, with a detection rate of 84% (95% confidence interval 80-87%), which is clinically comparable to the second-trimester quadruple screen at a fixed false-positive rate of 5%. The participants at the workshop concluded that at this time there is sufficient evidence to support implementing first-trimester Down syndrome risk assessment in obstetric practice in the United States, provided that certain requirements can be met. These requirements include training and quality control standards for first-trimester nuchal translucency measurement and laboratory assays, access to chorionic villus sampling, and appropriate counseling regarding screening options.

Amniocentesis↗

Workshop on cancer biometrics: identifying biomarkers and surrogates of cancer in patients: a meeting held at the Masur Auditorium, National Institutes of Health.

The current excitement about molecular targeted therapies has driven much of the recent dialog in cancer diagnosis and treatment. Particularly in the biologic therapy of cancer, identifiable antigenic T-cell targets restricted by MHC molecules and the related novel stress molecules such as MICA/B and Letal allow a degree of precision previously unknown in cancer therapy. We have previously held workshops on immunologic monitoring and angiogenesis monitoring. This workshop was designed to discuss the state of the art in identification of biomarkers and surrogates of tumor in patients with cancer, with particular emphasis on assays within the blood and tumor. We distinguish this from immunologic monitoring in the sense that it is primarily a measure of the tumor burden as opposed to the immune response to it. Recommendations for intensive investigation and targeted funding to enable such strategies were developed in seven areas: genomic analysis; detection of molecular markers in peripheral blood and lymph node by tumor capture and RT-PCR; serum, plasma, and tumor proteomics; immune polymorphisms; high content screening using flow and imaging cytometry; immunohistochemistry and tissue microarrays; and assessment of immune infiltrate and necrosis in tumors. Concrete recommendations for current application and enabling further development in cancer biometrics are summarized. This will allow a more informed, rapid, and accurate assessment of novel cancer therapies.

Alternative Splicing↗

Report from the techa river dosimetry review workshop held on 8-10 December 2003 at The State Research Centre Institute of Biophysics, Moscow, Russia.

Large releases of fission products into the Techa River, in the Southern Urals, occurred in 1950 and 1951, during the early years of operation of the Mayak Production Association (Mayak PA), which produced plutonium for nuclear weapons. Increases of leukemia and of solid cancers with radiation dose have been noted in the population of about 30,000 people who lived in the settlements downstream of the site of the radioactive releases; that population has been studied for several decades by Russian scientists, notably in the framework of cooperation with American and European scientists. The radiation doses are currently estimated by means of the Techa River Dosimetry System-2000 (TRDS-2000). Recently, a scientist from Mayak PA has suggested in several publications that the doses calculated using TRDS-2000 might be underestimated substantially. A special international Workshop, held in Moscow on 8-10 December 2003, aimed to resolve some of the pressing issues related to the determination of the external and internal doses received by the Techa River population and to give recommendations on the further development of methodologies used for dose reconstruction. The authors of this article were selected by the organizers of the Workshop to draw the conclusions of the meeting. They express the view that, while the dose reconstruction system TRDS-2000 is basically sound, additional work is needed and the results of any epidemiological studies making use of TRDS-2000 should be qualified as preliminary, pending resolution of several issues. The most important of these issues is the re-evaluation of the activities released, using additional information that could be obtained with the help of Mayak experts. Other specific suggestions aiming to improve the dose reconstruction methodology for the Techa River cohort, i.e., continued measurements of accumulated dose in environmental samples and human tissues, validation of external dose estimates with thermoluminescence measurements of bricks and with electron paramagnetic resonance measurements of teeth, estimation of individual doses instead of group doses, detailed account of the contributions to dose of medical examinations and of other releases from the Mayak complex, and careful assessment of the uncertainties, were made by the meeting participants.

Dose-Response Relationship, Radiation↗

Toward development of imaging modalities for islets after transplantation: insights from the National Institutes of Health Workshop on Beta Cell Imaging.

BACKGROUND: Pancreatic islet transplantation can provide insulin independence and near normal glucose control in selected patients with type 1 diabetes mellitus. However, in most cases, achieving insulin independence necessitates the use of at least two donor pancreases per recipient and the rate of insulin independence may decline after transplantation. To better understand the fate of transplanted islets and the relationship between transplanted islet mass, graft function, and overall glucose homeostasis, an accurate and reproducible method of imaging islets in vivo is needed. METHODS: Recent advances in noninvasive imaging techniques such as magnetic resonance imaging, positron emission tomography, and other imaging modalities show great promise as potential tools to monitor islet number, mass, and function in the clinical setting. A recent international workshop, "Imaging the Pancreatic Beta Cell," sponsored by the National Institute of Biomedical Imaging and Bioengineering, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Juvenile Diabetes Research Foundation International focused on these emerging efforts to develop novel ways of imaging pancreatic beta cells in vivo. RESULTS: Potential clinically applicable techniques include the use of directed magnetic resonance contrast agents such as lanthanides (Ln(3+)) and manganese (Mn(2+)) or magnetic resonance imaging probes such as superparamagnetic iron oxide nanoparticles. Potential techniques for positron emission tomography imaging include the use of beta cell-specific antibodies, or pharmacologic agents such as glyburide analogs, or d-mannoheptulose. Optical imaging techniques are also being used to evaluate various aspects of beta cell metabolism including intracellular Ca(2+) flux, glucokinase activity, and insulin granular exocytosis. CONCLUSIONS: The consensus among investigators at the imaging workshop was that an accurate and reproducible in vivo measure of functional islet mass is critically needed to further the strides that have been made in both islet transplantation and diabetes research as a whole. Such measures would potentially allow the assessment of islet engraftment and the early recognition of graft loss, leading to greater improvements in islet graft survival and function.

Diagnostic Imaging↗

National Science Foundation-sponsored workshop report. Draft plan for soybean genomics.

Recent efforts to coordinate and define a research strategy for soybean (Glycine max) genomics began with the establishment of a Soybean Genetics Executive Committee, which will serve as a communication focal point between the soybean research community and granting agencies. Secondly, a workshop was held to define a strategy to incorporate existing tools into a framework for advancing soybean genomics research. This workshop identified and ranked research priorities essential to making more informed decisions as to how to proceed with large scale sequencing and other genomics efforts. Most critical among these was the need to finalize a physical map and to obtain a better understanding of genome microstructure. Addressing these research needs will require pilot work on new technologies to demonstrate an ability to discriminate between recently duplicated regions in the soybean genome and pilot projects to analyze an adequate amount of random genome sequence to identify and catalog common repeats. The development of additional markers, reverse genetics tools, and bioinformatics is also necessary. Successful implementation of these goals will require close coordination among various working groups.

Computational Biology↗

BCI Meeting 2005--workshop on signals and recording methods.

This paper describes the highlights of presentations and discussions during the Third International BCI Meeting in a workshop that evaluated potential brain-computer interface (BCI) signals and currently available recording methods. It defined the main potential user populations and their needs, addressed the relative advantages and disadvantages of noninvasive and implanted (i.e., invasive) methodologies, considered ethical issues, and focused on the challenges involved in translating BCI systems from the laboratory to widespread clinical use. The workshop stressed the critical importance of developing useful applications that establish the practical value of BCI technology.

Algorithms↗

Contemporary transference work and the analytic attitude: aims and methods--a clinical workshop.

There are various ways of working as an analyst, and there are various ways of utilizing the concept and the phenomena of transference-countertransference. I hope to draw an adequate picture of a way of working that is called 'working-in-the-transference' as distinct from ways of working that 'analyse transference'. The former has long been practiced by many Jungians as well as by many psychoanalysts. As method, it has aroused controversy in both groups, and is frequently both misunderstood and imitated. It can arouse strong anxiety. It can appear narrow and restrictive. It famously precludes a gamut of activities in which many analysts engage. Is working-in-the-transference old fashioned, or does it deserve to be increasingly appreciated? Can it offer support and validation whilst remaining true to its conception? It was hoped that these questions would be addressed in the clinical material brought to the workshop. The emphasis in the workshop was on active participation and it was hoped that those attending would bring their clinical concerns for discussion.

Adult↗

A discussion of findings and their possible implications from a workshop on bioterrorism threat assessment and risk management.

In November 2001, the Monterey Institute of International Studies convened a workshop on bioterrorism threat assessment and risk management. Risk assessment practitioners from various disciplines, but without specialized knowledge of terrorism, were brought together with security and intelligence threat analysts to stimulate an exchange that could be useful to both communities. This article, prepared by a subset of the participants, comments on the workshop's findings and their implications and makes three recommendations, two short term (use of threat assessment methodologies and vulnerability analysis) and one long term (application of quantitative risk assessment and modeling), regarding the practical application of risk assessment methods to bioterrorism issues.

Bioterrorism↗

Analysis of alloantisera against bovine lymphocytes. Joint report of the 1st International Bovine Lymphocyte Antigen (BoLA) workshop.

The results and agreements of the 1 international BoLA workshop, held in Edinburgh, Scotland in August 1978, are reported. Most of these concern the results from a comparison test of 249 alloantisera to bovine lymphocytes, the antisera being contributed by 9 laboratories. These sera were compared directly in Edinburgh on a panel of lymphocytes from 130 cattle of 21 breeds. In the microlymphocytotoxicity test used 75% of the sera reacted. Sixty eight of these sera were grouped into clusters according to their reaction patterns against the lymphocyte panel. Eleven of these clusters were clearly defined and were given workshop BoLA designations. In addition 22 sera were assigned to subgroups of the agreed clusters. There was no evidence that the method of production of the sera had any effect on their specificity. Although genetic data was not available, the phenotypes of the test panel of lymphocytes are consistent with the clusters detecting antigens controlled by multiple alleles at a single autosomal locus. It was agreed to name the genetic region where this putative locus is located BoLA (bovine lymphocyte antigen).

Animals↗

The Croydon workshop for parents of pre-school mentally handicapped children.

A multidisciplinary team of professionals met the parents of 25 pre-school handicapped children for a series of evening meetings to discuss how professionals and parents can help the development of the child. The workshop was exceptionally well-attended by parents who received practical advice from both the professionals and other parents. Multidisciplinary parents workshops appear to be an effective community service for the parents of handicapped children.

Child Behavior Disorders↗

The Croydon Workshop for the parents of severely handicapped school age children.

A multidisciplinary team of professionals met the parents of 18 severely handicapped children for a series of 10 evening sessions. All children were between 5 and 11 years of age and included six Downs, six non-communicating and six children with rare syndromes or no known diagnosis. The professionals provided practical advice and couselling. They did not adopt one exclusive approach such as behaviour modification, but employed a variety of ideas drawn from several theories of learning and from personal experience. The workshop as well received by both parents and professionals, with an average attendance of 80%. The paper also discusses some of the organizational problems of parent workshops.

Autistic Disorder↗

Update on extranodal lymphomas. Conclusions of the Workshop held by the EAHP and the SH in Thessaloniki, Greece.

Classification and proper treatment of extranodal lymphoma is hindered by the diversity of lymphoma types and the relative rarity of many of these tumour types. In order to review controversial issues in extranodal lymphoma diagnosis, a joint Workshop of the European Haematopathology Association (EAHP) and the Society for Hematopathology (SH) was held, where 99 selected cases were reviewed and discussed. This Workshop summary is focused on the most controversial aspect of cutaneous B-cell lymphoma, other extranodal B-cell lymphomas, plasmablastic lymphoma and anaplastic large-cell lymphoma in extranodal sites, and makes practical recommendations about diagnosis and therapeutic approaches.

Diagnosis, Differential↗