Advanced Computational Methods for Radiation Dose Optimization in CT.

BACKGROUND: In planning radiotherapy treatments, computed tomography (CT) has become a crucial tool. CT scans involve exposure to ionizing radiation, which can increase the risk of cancer and other adverse health effects in patients. Ionizing radiation doses for medical exposure must be kept "As Low As Reasonably Achievable". Very few articles on guidelines for radiotherapy-computed tomography scans are available. This paper reviews the current literature on radiation dose optimization based on the effective dose and diagnostic reference level (DRL) for head, neck, and pelvic CT procedures used in radiation therapy planning. This paper explores the strategies used to optimize radiation doses, and high-quality images for diagnosis and treatment planning. METHODS: A cross-sectional study was conducted on 300 patients with head, neck, and pelvic region cancer in our institution. The DRL, effective dose, volumetric CT dose index (CTDIvol), and dose-length product (DLP) for the present and optimized protocol were calculated. DRLs were proposed for the DLP using the 75th percentile of the distribution. The DLP is a measure of the radiation dose received by a patient during a CT scan and is calculated by multiplying the CT dose index (CTDI) by the scan length. To calculate a DRL from a DLP, a large dataset of DLP values obtained from a specific imaging procedure must be collected and can be used to determine the median or 75th-percentile DLP value for each imaging procedure. RESULTS: Significant variations were found in the DLP, CTDIvol, and effective dose when we compared both the standard protocol and the optimized protocol. Also, the optimized protocol was compared with other diagnostic and radiotherapy CT scan studies conducted by other centers. As a result, we found that our institution's DRL was significantly low. The optimized dose protocol showed a reduction in the CTDIvol (70% and 63%), DLP (60% and 61%), and effective dose (67% and 62%) for both head, neck, and pelvic scans. CONCLUSIONS: Optimized protocol DRLs were proposed for comparison purposes.

Evolving radiographic practice: Identifying possible skill requirements for future radiographers practicing in the United Arab Emirates (UAE).

AIM: This study aims to identify the prospective skill requirements for future radiographers practising in the United Arab Emirates (UAE). Such information will inform educational institutions, healthcare organisations, and policymakers in developing effective strategies. METHODS: A cross-sectional study was conducted involving currently practising radiographers, nuclear medicine technologists, sonographers, and radiation therapists in the UAE (n =74). A comprehensive survey questionnaire was developed and validated through piloting and expert consultations. Ethical approval was obtained, and data were collected through purposive sampling. Descriptive statistics, reliability analysis, Chi-square tests, and factor analysis were employed in the data analysis. RESULTS: The results showed that 73%, 47.3%, 43.2%, 40.5%, 39.2%, 33.8% interested in radiology safety, image interpretation, interprofessional and interpersonal skills, research and managerial skills, Picture Archiving and Communication System (PACS) administration and AI (Artificial Intelligence) and, clinical supervision and assessment, respectively. The factor analysis showed four factors factor considered for CPD training are training settings (15.12), training topics (1.88), CPD credits (1.72) and, presenter and expenses (1.49). CONCLUSION: This study sheds light on the CPD requirements and aspirations of radiographers in the UAE, offering insights into their preferences and challenges. These findings can inform strategies for improving CPD opportunities and ensuring that radiographers are equipped to meet the evolving healthcare demands in the UAE, including performing enhanced practice. IMPLICATIONS FOR PRACTICE: Development of flexible and comprehensive CPD programmes tailored to radiographers' career interests is required. Employers should provide financial support and flexibility in training options. Regulatory bodies should continue to mandate CPD, fostering a culture of lifelong learning. Supportive work environments, interdisciplinary collaboration, and technological fluency are crucial. Emphasising patient-centred care, research opportunities, and continuous assessment further enhances radiography practice.

CovMediScanX: A medical imaging solution for COVID-19 diagnosis from chest X-ray images.

INTRODUCTION: Radiologists have extensively employed the interpretation of chest X-rays (CXR) to identify visual markers indicative of COVID-19 infection, offering an alternative approach for the screening of infected individuals. This research article presents CovMediScanX, a deep learning-based framework designed for a rapid and automated diagnosis of COVID-19 from CXR scan images. METHODS: The proposed approach encompasses gathering and preprocessing CXR image datasets, training deep learning-based custom-made Convolutional Neural Network (CNN), pre-trained and hybrid transfer learning models, identifying the highest-performing model based on key evaluation metrics, and embedding this model into a web interface called CovMediScanX, designed for radiologists to detect the COVID-19 status in new CXR images. RESULTS: The custom-made CNN model obtained a remarkable testing accuracy of 94.32% outperforming other models. CovMediScanX, employing the custom-made CNN underwent evaluation with an independent dataset also. The images in the independent dataset are sourced from a scanning machine that is entirely different from those used for the training dataset, highlighting a clear distinction of datasets in their origins. The evaluation outcome highlighted the framework's capability to accurately detect COVID-19 cases, showcasing encouraging results with a precision of 73% and a recall of 84% for positive cases. However, the model requires further enhancement, particularly in improving its detection of normal cases, as evidenced by lower precision and recall rates. CONCLUSION: The research proposes CovMediScanX framework that demonstrates promising potential in automatically identifying COVID-19 cases from CXR images. While the model's overall performance on independent data needs improvement, it is evident that addressing bias through the inclusion of diverse data sources during training could further enhance accuracy and reliability.

Embedding patient safety in a scaffold of interprofessional education; a qualitative study with thematic analysis.

BACKGROUND: Regardless of a proliferation of interest in reducing unsafe practices in healthcare, threats to patient safety (PS) remain high. Moreover, little attention has been paid towards the role of interprofessional education (IPE) in enhancing PS. This qualitative study was conducted to unfold the insights of the senior medical, dental and health sciences students at the University of Sharjah (UoS) in the United Arab Emirates (UAE) about PS in an online IPE-based workshop. METHODS: This inductive thematic analysis study was conducted on senior medical and health students at the Colleges of Medicine, Dental Medicine, Health Sciences, and Pharmacy of UoS. During an online workshop, students discussed plausible solutions for four real practice-based clinical scenarios with elements of unsafe healthcare practices. During the breakout rooms, the students exhibited high level of articulation and proactively participated in discussions. The data from the online workshop were transcribed and then coding, categorizing, and labelling of recurrent themes were carried out. Multiple individual deliberations, consolidation, incorporation of the identified preliminary themes, and merging and reorganizing sub-themes led to a final thematic framework. RESULTS: This work delved into the perspectives of 248 students regarding teamwork, communication, problem-solving, and other aspects concerning PS in interprofessional settings in an online workshop. The iterative process of data transcription, curating and qualitative analysis surfaced 32 codes. Later, the inductive themaric analysis yielded five themes with distinct yet interconnected nested subthemes in the context of PS in IPE settings. These themes of information sharing and grounding (problem-solving, social skills), maintaining communication (clinical reasoning, shared mental model), executing interprofessional activities (collaborative practice, collaboration scripts), professional cognitive abilities (cognitive maturity, metacognition), and negotiating professional identities (systematic change, socio-economic scaffolding) emerged as fundamental pillars for enhancing PS in healthcare. CONCLUSION: Our study demonstrated the outcome of an innovative and team-based workshop which embedded PS within a scaffold of IPE environment. This research calls for incorporation of the emerging areas of clinical reasoning, problem solving, collaborative practice, and shared mental model into medical curricula for structured IPE in improving PS domains in medical education. These findings underscore the need for multifaceted dimensions of IPE imperatives for cultivating collaborative competence.

Systematic Review on Diagnostic Reference Levels for Computed Tomography Examinations in Radiation Therapy Planning.

Background: In August 2017, the European Commission awarded the "European Study on Clinical Diagnostic Reference Levels (DRL) for X-ray Medical Imaging" project to the European Society of Radiology to provide up-to-date Diagnostic Reference Levels based on clinical indications. This work aimed to conduct an extensive literature review by analyzing the most recent studies published and the data provided by the National Competent Authorities to understand the current situation regarding Diagnostic Reference Levels based on clinical indications for Radiation Therapy Computed Tomography. Objective: To review the literature on established DRLs and methodologies for establishing Diagnostic reference levels in radiation therapy planning computed tomography (RTCT). Methods: Eligibility criteria: A cohort study (observational design) reporting DRLs in adult patients undergoing computed tomography (CT) for radiation therapy for the region head and neck or pelvis were included. The comprehensive literature searches for the relevant studies published between 2000 and 2021 were performed using PubMed, Scopus, CINHAL, Web of Science, and ProQuest. Results: Three hundred fifty-six articles were identified through an extensive literature search. Sixty-eight duplicate reports were removed. The title and abstract of 288 studies were assessed and excluded if they did not meet the inclusion criteria. Sixteen of 288 articles were selected for full-text screening (studies conducted between 2000 and 2021). Five articles were included in the review after the full-text screening. Conclusions: A globally approved standard protocol that includes scanning techniques, dose measurement method, and DRL percentile needs to be established to make a valuable and accurate comparison with international DRLs.

Community and Policy Factors Influencing the Decision to Undergo Screening Mammography amongst Indian Women in the United Arab Emirates.

OBJECTIVE: This study explored the expectations, requirements, and recommendations and identifies the socio-ecological determinants for the informed uptake of screening mammography amongst expatriate women residing in the UAE. METHODOLOGY: A qualitative research approach was adopted using five focus group discussions. The study comprised two populations- those who had undergone screening mammography and those who had not. Thematic analysis- the six-phase model was adopted and modified for data analysis. RESULTS: The factors that influence the rate of uptake of screening mammography by the participants were multifactorial and reciprocal. The community determinants identified are cultural beliefs, medical professionals, breast cancer survivors, community organizations, and media. The health policies in an expatriate's home country and adopted country were found to have a considerable influence on the health behaviors of the participants. A comprehensive approach to change in health behavior is required to increase the informed uptake of screening mammography by expatriate women residing in the UAE. CONCLUSION: The study identified the need of developing migrant health units with community navigators, international health collaboration, migrant health directory, risk assessment team, automatic invitation system for screening, referral system, migrant cancer registry, and psychological support team in UAE. However, further studies are expected to give a wider perspective.

The impact of an online intervention on the medical, dental and health sciences students about interprofessional education; a quasi-experimental study.

BACKGROUND: Interprofessional education (IPE) encompasses integration, communication, mutual trust and shared decision-making with a common goal of improved patient care and safety. Despite its crucial role, IPE has not gained its anticipated popularity. This study aims to determine the impact of an online educational intervention about IPE on medical, dental and health sciences students in the University of Sharjah (UoS). METHODS: This quasi-experimental research was conducted in three phases; a pre-intervention phase where the Readiness for Interprofessional Learning Scale (RIPLS) inventory was administered online to the medical, dental and health sciences students of UoS; an intervention phase where an online workshop was organized via Microsoft Teams®; and a post-intervention phase where RIPLS was used to gather the students' attitudes towards IPE. The independent t test was used to compare the responses between genders and junior and senior students. A paired sample t test was used to determine the impact of the intervention on the students' understandings and attitudes about IPE. RESULTS: Out of 800 invited students, 530 students responded to the pre-intervention RIPLS survey. A comparison of the pre-post intervention for the RIPLS subscales of teamwork and collaboration, professional identification, and professional roles showed a significant improvement of students' attitudes with p-values 0.03, 0.00 and 0.00, respectively. All workshop moderators scored a median of 4 or 5 to the essential elements of IPE during intervention except for a median of 3 for group dynamics. CONCLUSION: The present data, derived from the application of a brief online educational intervention, underpins the readiness and positive attitudes of undergraduate medical students towards IPE. The positive impact of online intervention necessitates the development of a structured and unified IPE curriculum to enhance the receptiveness and application of IPE in the medical field.

Acceptability and potential impacts of innovative E-Portfolios implemented in E-Learning systems for clinical training.

OBJECTIVE: There is growing evidence that use of E-portfolios has a positive effect on learning experience. However, literature has not shown sufficient data about the effectiveness of E-portfolios in medical education. This study was conducted to assess the acceptability and potential impacts of E-portfolio use for undergraduate radiography students. METHODS: This cross-sectional quantitative study was conducted during the academic year 2016-2017 on students studying clinical courses. A self-administered questionnaire was distributed to the selected cohort of students. All participants completed the consent form before answering the questionnaire. RESULTS: Of 75 students, 66 completed the survey (response rate; 88%). Students' experience, students' learning support, and the challenges of E-portfolio use were identified. Forty-one (62%) students perceived that E-portfolios facilitated the effective organization of their work, and 40 (61%) agreed that E-portfolios enhanced their professional skills. In contrast, the students perceived a negative correlation between students' learning support and future utilization of E-portfolios (correlation coefficient -0.394, p = 0.05). Future utilization of E-portfolios was found to be positively correlated with challenges and commitment to deadlines, with correlation coefficients of 0.371 and 0.152, respectively. CONCLUSION: The study found that continuous technical support for E-portfolios throughout the course had a potential role in enhancing learning experience. Appropriate training for integrating E-portfolios into teaching and learning can potentially enrich the educational environment. Student and faculty feedback is the main cornerstone for E-portfolio success.