Evolving from Didactic to Dialogic: How to Improve Faculty Development and Support Faculty Developers by Using Action Research.

Problem: Since competency-based medical education has gained widespread acceptance to guide curricular reforms, faculty development has been regarded as an indispensable element to make these programs successful. Faculty developers have striven to design and deliver myriad of programs or workshops to better prepare faculty members for fulfilling their teaching roles. However, how faculty developers can improve workshop delivery by researching their teaching practices remains underexplored. Intervention: Action research aims to understand real world practices and advocates for formulation of doable plans through cycles of investigations, and ultimately contributes to claims of knowledge and a progression toward the goal of practice improvement. This methodology aligns with the aim of this study to understand how I could improve a faculty development workshop by researching my teaching practices. Context: In 2016, we conducted four cycles of action research in the context of mini-Clinical Evaluation Exercise (mini-CEX) workshops within a faculty development program aiming for developing teaching and assessment competence in faculty members. We collected multiple sources of qualitative data for thematic analysis, including my reflective journal, field notes taken by a researcher-observer, and post-workshop written reflection and feedback in portfolio from fourteen workshop attendees aiming to develop faculty teaching and assessment competence. Impact: By doing action research, I scrutinized each step as an opportunity for change, enacted adaptive practice and reflection on my teaching practices, and formulated action plans to transform a workshop design through each cycle. In so doing, my workshop evolved from didactic to dialogic with continuous improvement on enhanced engagement, focused discussion and participant empowerment through a collaborative inquiry into feedback practice. Moreover, these processes of action research also supported my growth as a faculty developer. Lessons Learned: The systematic approach of action research serves as a vehicle to enable faculty developers to investigate individual teaching practices as a self-reflective inquiry, to examine, rectify, and transform processes of program delivery, and ultimately introduce themselves as agents for change and improvement.

Specification of Self-Adaptive Privacy-Related Requirements within Cloud Computing Environments (CCE).

This paper presents a novel approach to address the challenges of self-adaptive privacy in cloud computing environments (CCE). Under the Cloud-InSPiRe project, the aim is to provide an interdisciplinary framework and a beta-version tool for self-adaptive privacy design, effectively focusing on the integration of technical measures with social needs. To address that, a pilot taxonomy that aligns technical, infrastructural, and social requirements is proposed after two supplementary surveys that have been conducted, focusing on users' privacy needs and developers' perspectives on self-adaptive privacy. Through the integration of users' social identity-based practices and developers' insights, the taxonomy aims to provide clear guidance for developers, ensuring compliance with regulatory standards and fostering a user-centric approach to self-adaptive privacy design tailored to diverse user groups, ultimately enhancing satisfaction and confidence in cloud services.

Food Thermal Labels are a Source of Dietary Exposure to Bisphenol S and Other Color Developers.

To test the hypothesis that migration from the thermal labels on plastic film packaging is a major source of exposure to bisphenols and alternative color developers in food, we analyzed 140 packaging materials from packaged fresh food purchased in North America. No bisphenol A (BPA) was detected in either the packaging samples or thermal labels. However, significant amounts of bisphenol S (BPS) and alternative color developers (up to 214 µg/cm2) were present in thermal labels; their relative occurrence varied among stores. In a controlled experiment, we wrapped fish in film with a thermal label for 5 days at 4 °C. The fish in contact with the label contained BPS (≤1140 ng/g wet weight [ww]), 4-hydroxyphenyl 4-isoprooxyphenylsulfone (D-8) (≤230 ng/g ww), bis(2-chloroethyl)ether-4,4'-dihydroxydiphenyl sulfone monomer (D-90) (≤3.41 ng/g ww), and/or Pergafast-201 (≤1.87 ng/g ww). The corresponding film samples were then tested using migration cells for 10 days; significantly higher BPS migration was observed systematically from the films with thermal labels compared to plain films. This study provides evidence, for the first time, that BPS and alternative thermal label color developers migrate from packaging materials into food. Further, BPS migration significantly exceeded the European Union Specific Migration Limit (50 ng/g ww), suggesting that further risk assessment studies are warranted.

A Novel, Expert-Endorsed, Neurocognitive Digital Assessment Tool for Addictive Disorders: Development and Validation Study.

BACKGROUND: Many people with harmful addictive behaviors may not meet formal diagnostic thresholds for a disorder. A dimensional approach, by contrast, including clinical and community samples, is potentially key to early detection, prevention, and intervention. Importantly, while neurocognitive dysfunction underpins addictive behaviors, established assessment tools for neurocognitive assessment are lengthy and unengaging, difficult to administer at scale, and not suited to clinical or community needs. The BrainPark Assessment of Cognition (BrainPAC) Project sought to develop and validate an engaging and user-friendly digital assessment tool purpose-built to comprehensively assess the main consensus-driven constructs underpinning addictive behaviors. OBJECTIVE: The purpose of this study was to psychometrically validate a gamified battery of consensus-based neurocognitive tasks against standard laboratory paradigms, ascertain test-retest reliability, and determine their sensitivity to addictive behaviors (eg, alcohol use) and other risk factors (eg, trait impulsivity). METHODS: Gold standard laboratory paradigms were selected to measure key neurocognitive constructs (Balloon Analogue Risk Task [BART], Stop Signal Task [SST], Delay Discounting Task [DDT], Value-Modulated Attentional Capture [VMAC] Task, and Sequential Decision-Making Task [SDT]), as endorsed by an international panel of addiction experts; namely, response selection and inhibition, reward valuation, action selection, reward learning, expectancy and reward prediction error, habit, and compulsivity. Working with game developers, BrainPAC tasks were developed and validated in 3 successive cohorts (total N=600) and a separate test-retest cohort (N=50) via Mechanical Turk using a cross-sectional design. RESULTS: BrainPAC tasks were significantly correlated with the original laboratory paradigms on most metrics (r=0.18-0.63, P<.05). With the exception of the DDT k function and VMAC total points, all other task metrics across the 5 tasks did not differ between the gamified and nongamified versions (P>.05). Out of 5 tasks, 4 demonstrated adequate to excellent test-retest reliability (intraclass correlation coefficient 0.72-0.91, P<.001; except SDT). Gamified metrics were significantly associated with addictive behaviors on behavioral inventories, though largely independent of trait-based scales known to predict addiction risk. CONCLUSIONS: A purpose-built battery of digitally gamified tasks is sufficiently valid for the scalable assessment of key neurocognitive processes underpinning addictive behaviors. This validation provides evidence that a novel approach, purported to enhance task engagement, in the assessment of addiction-related neurocognition is feasible and empirically defensible. These findings have significant implications for risk detection and the successful deployment of next-generation assessment tools for substance use or misuse and other mental disorders characterized by neurocognitive anomalies related to motivation and self-regulation. Future development and validation of the BrainPAC tool should consider further enhancing convergence with established measures as well as collecting population-representative data to use clinically as normative comparisons.

Automatic measurement of beam-positioning accuracy at off-isocenter positions.

PURPOSE: This study performed an automatic measurement of the off-axis beam-positioning accuracy at a single isocenter via the TrueBeam Developer mode and evaluated the beam-positioning accuracy considering the effect of couch rotational errors. METHODS: TrueBeam STx and the Winston-Lutz test-dedicated phantom, with a 3 mm diameter steel ball, were used in this study. The phantom was placed on the treatment couch, and the Winston-Lutz test was performed at the isocenter for four gantry angles (0°, 90°, 180°, and 270°) using an electronic portal imaging device. The phantom offset positions were at distances of 0, 25, 50, 75, and 100 mm from the isocenter along the superior-inferior, anterior-posterior, and left-right directions. Seventeen patterns of multileaf collimator-shaped square fields of 10 × 10 mm2 were created at the isocenter and off-axis positions for each gantry angle. The beam-positioning accuracy was evaluated with couch rotation along the yaw-axis (0°, ± 0.5°, and ± 1.0°). RESULTS: The mean beam-positioning errors at the isocenter and off-isocenter distances (from the isocenter to ±100 mm) were 0.46-0.60, 0.44-0.91, and 0.42-1.11 mm for the couch angles of 0°, ±0.5°, and ±1°, respectively. The beam-positioning errors increased as the distance from the isocenter and couch rotation increased. CONCLUSION: These findings suggest that the beam-positioning accuracy at the isocenter and off-isocenter positions can be evaluated quickly and automatically using the TrueBeam Developer mode. The proposed procedure is expected to contribute to an efficient evaluation of the beam-positioning accuracy at off-isocenter positions.

Gamification in software engineering: the mediating role of developer engagement and job satisfaction.

Gamification seeks to encourage behavior of participants by borrowing elements of games, such as scoring points. Few rigorous studies exist of gamification in software organizations, and several questions have remained unanswered, for example, what might drive developers to partake, and what are the consequences of developer engagement. This article seeks to provide some answers through a rigorous empirical study at one organization that created an internal gamification platform. We develop a theoretical model that seeks to explain why developers may participate, and develop the concept of developer engagement, which we link to job satisfaction. We collected data from two sources that were linked together: developer opinion data collected through a survey, and data from the organization's version control system. We test our theoretical model using structural equation modeling and moderation analysis, and find support for our model. These findings suggest that gamification can be an effective mechanism to engage developers within the organization, and that developer engagement is positively associated with job satisfaction, which is a key outcome that is of great interest to software organizations.

Analysing Time-Stamped Co-Editing Networks in Software Development Teams using git2net.

Data from software repositories have become an important foundation for the empirical study of software engineering processes. A recurring theme in the repository mining literature is the inference of developer networks capturing e.g. collaboration, coordination, or communication from the commit history of projects. Many works in this area studied networks of co-authorship of software artefacts, neglecting detailed information on code changes and code ownership available in software repositories. To address this issue, we introduce git2net, a scalable python software that facilitates the extraction of fine-grained co-editing networks in large git repositories. It uses text mining techniques to analyse the detailed history of textual modifications within files. We apply our tool in two case studies using GitHub repositories of multiple Open Source as well as a proprietary software project. Specifically, we use data on more than 1.2 million commits and more than 25,000 developers to test a hypothesis on the relation between developer productivity and co-editing patterns in software teams. We argue that git2net opens up an important new source of high-resolution data on human collaboration patterns that can be used to advance theory in empirical software engineering, computational social science, and organisational studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1007/s10664-020-09928-2).

Lumbar spine posture and spinopelvic parameters change in various standing and sitting postures.

PURPOSE: This study aimed to compare differences in lumbosacral and spinopelvic parameters between pain developers and non-pain developers as well as the effects of various posture changes. METHODS: A total of 38 consecutive participants, 20 standing-induced low back pain developers (mean age: 27.7 ± 5.3; mean BMI: 22.64 ± 2.95) and 18 non-pain developers (mean age: 29.0 ± 7.5; mean BMI: 24.2 ± 1.87) (p > 0.05), were prospectively evaluated. Six sagittal plane radiographs were taken. Upright standing posture was used as the reference posture. Lumbar lordosis, lumbosacral lordosis, L1/L2 and L5/S1 intervertebral (IV) joint angles, pelvic incidence, pelvic tilt and sacral slope were measured on each radiograph. RESULTS: There were no significant differences in terms of age, BMI, SF-36 score, or Oswestry Disability Index scores between pain developer and non-pain developer groups (p > 0.05). Pain developers had significantly larger lumbar lordosis, larger L1/L2 intervertebral angles, larger pelvic incidences and sacral slopes in all postures (p < 0.05). The contribution of L5/S1 intervertebral angle to lumbar flexion was higher than that of the L1/L2 intervertebral angle during stair descent, the sitting and the leaning forward while sitting postures (p < 0.05). CONCLUSION: The current study supports the assertion that increased lumbar lordosis is associated with increased pain. Lumbar spine angles change in various postures. The changes were more prominent in pain developers than in non-pain developers. Larger lumbar lordosis due to larger pelvic incidence may be a risk factor for the development of standing-induced low back pain. These slides can be retrieved under Electronic Supplementary Material.

Visualising the past - An evaluation of processes and sequences for fingermark recovery from old documents.

This study aimed to collect data on the effectiveness of most of the fingermark visualisation reagents currently used on porous surfaces on fingermarks aged for up to 90 years, significantly extending the timescales for which such information exists. A limited subset of the variables associated with processing of old fingermarks was explored, with a focus on the use of 1,8 diazafluoren-9-one (DFO), 1,2-indandione, ninhydrin, and physical developer. These techniques were used in sequence on batches of cheques between 11 and 32 years old, and on documents dating from the 1920s and 1940s. The potential for applying a physical developer enhancement process (blue toning) as the final step in the sequence was also explored. The benefits of using processing sequences on porous items were clearly demonstrated, with all processes in the sequence adding value in terms of additional marks found on the cheques up to 32 years old. In addition, physical developer was found to be capable of developing fingermarks up to 90 years old, whereas the amino acid reagents appear less effective on documents of 70 years and older. An experimental physical developer formulation with reduced environmental impact was found to be as effective as the existing process in these experiments. Blue toning was found to visualise an additional 10-25% of marks, and its wider use after silver-based deposition processes is recommended based on the evidence from this study.

Fluorometric determination of hydroquinone by using blue emitting N/S/P-codoped carbon dots.

N/S/P-codoped carbon dots (CDs) are shown to be a viable fluorescent probe in a turn-off-on fluorometric assay for hydroquinone (HQ). The preparation of CDs was carried out using a one-step hydrothermal reaction starting with glyoxal and isocarbophos. The method is based on the formation of ground state complexes between CD and Fe(III) which leads to quenching of blue fluorescence (with excitation/emission peaks at 363/448 nm). On addition of HQ, it will be oxidized by Fe(III) upon which fluorescence recovers. This turn-off-on system can be utilized to quantify HQ. A linear relationship exists between fluorescence recovery and HQ concentration in range between 0.56 and 375 µM. The limit of detection is 0.16 µM. The assay was successfully applied to the determination of HQ in spiked water samples and developer samples. Graphical abstract Fluorometric determination of hydroquinone (with good selectivity over catechol and resorcinol) by using blue-emitting N/S/P-codoped carbon dots and the quenching effect of Fe(III).

Compatibility of DNA IQ™, QIAamp® DNA Investigator, and QIAsymphony® DNA Investigator® with various fingerprint treatments.

Latent fingerprint and touch DNA are the two most important contact evidence for individualization in forensic science which provide complementary information that can lead to direct and unequivocal identification of the culprit. In order to retrieve useful information from both fingerprints and DNA, which are usually mingled together, one strategy is to perform fingerprint examination prior to DNA analysis since common DNA sampling technique such as swabbing could disturb or even destroy fingerprint details. Here, we describe the compatibility of three automatic DNA extraction systems, namely, DNA IQ™, QIAamp® DNA Investigator, and QIAsymphony® DNA Investigator®, with respective to the effects of various fingerprint detection techniques. Our results demonstrate that Super Glue fingerprint treatment followed by DNA IQ™ extraction shows better effectiveness in DNA profiling. Aluminum powder dusting offers the least interference to the three DNA extraction systems above. Magnetic powder dusting, on the other hand, strongly impedes DNA recovery. Physical Developer is the most intrusive, which yields profiles with poor quality, including lower peak heights, poor peak height ratios, and poor intra-color balance. In terms of the choice of extraction method, DNA IQ™ system is recommended for sampling after fingerprint treatments, but not the two DNA Investigator systems.

Trading certainty for speed - how much uncertainty are decisionmakers and guideline developers willing to accept when using rapid reviews: an international survey.

BACKGROUND: Decisionmakers and guideline developers demand rapid syntheses of the evidence when time sensitive evidence-informed decisions are required. A potential trade-off of such rapid reviews is that their results can have less reliability than results of systematic reviews that can lead to an increased risk of making incorrect decisions or recommendations. We sought to determine how much incremental uncertainty about the correctness of an answer guideline developers and health policy decisionmakers are willing to accept in exchange for a rapid evidence-synthesis. METHODS: Employing a purposive sample, we conducted an international web-based, anonymous survey of decisionmakers and guideline developers. Based on a clinical treatment, a public health, and a clinical prevention scenario, participants indicated the maximum risk of getting an incorrect answer from a rapid review that they would be willing to accept. We carefully reviewed data and performed descriptive statistical analyses. RESULTS: In total, 325 (58.5%) of 556 participants completed our survey and were eligible for analysis. The median acceptable incremental risk for getting an incorrect answer from a rapid review across all three scenarios was 10.0% (interquartile range [IQR] 5.0-15.0). Acceptable risks were similar for the clinical treatment (n = 313, median 10.0% [IQR 5.0-15.0]) and the public health scenarios (n = 320, median 10.0% [IQR 5.0-15.0]) and lower for the clinical prevention scenario (n = 312, median 6.5% [IQR 5.0-10.5]). CONCLUSIONS: Findings suggest that decisionmakers are willing to accept some trade-off in validity in exchange for a rapid review. Nevertheless, they expect the validity of rapid reviews to come close to that of systematic reviews.

THE EARLY BIRD CATCHES THE WORM: EARLY COST-EFFECTIVENESS ANALYSIS OF NEW MEDICAL TESTS.

OBJECTIVES: There is little specific guidance on performing an early cost-effectiveness analysis (CEA) of medical tests. We developed a framework with general steps and applied it to two cases. METHODS: Step 1 is to narrow down the scope of analysis by defining the test's application, target population, outcome measures, and investigating current test strategies and test strategies if the new test were available. Step 2 is to collect evidence on the current test strategy. Step 3 is to develop a conceptual model of the current and new test strategies. Step 4 is to conduct the early-CEA by evaluating the potential (cost-)effectiveness of the new test in clinical practice. Step 5 involves a decision about the further development of the test. RESULTS: The first case illustrated the impact of varying the test performance on the headroom (maximum possible price) of an add-on test for patients with an intermediate-risk of having rheumatoid arthritis. Analyses showed that the headroom is particularly dependent on test performance. The second case estimated the minimum performance of a confirmatory imaging test to predict individual stroke risk. Different combinations of sensitivity and specificity were found to be cost-effective; if these combinations are attainable, the medical test developer can feel more confident about the value of further development of the test. CONCLUSIONS: A well-designed early-CEA methodology can improve the ability to develop (cost-)effective medical tests in an efficient manner. Early-CEAs should continuously integrate insights and evidence that arise through feedback, which may convince developers to return to earlier steps.

Empirically testing some factors affecting HMS usage.

Purpose - Without use the expected benefits from healthcare management systems (HMS) cannot be derived. Thus, while use alone may not guarantee success, one can safely assume that the more use the better. HMS has been instrumental in facilitating care providers' work. However, many hospitals have encountered usage problems and some user-related factors have been recognized in the literature as potentially important to make HMS more successful. The purpose of this paper is to test the importance of the factors proposed in the literature as important determinants of HMS usage measured by the number of hours used and the frequency of use. Design/methodology/approach - Several user-related variables such as user participation, user expertise, and user training previously studied separately by different authors are brought together into an integrated model to be tested empirically. Data from 213 nurses using their hospital HMS have been used to test proposed relationships between the independent variables and HMS usage results. Findings - The results confirm the importance of these factors and provide the basis for managerial recommendations. Hospital managers can use the resources validated by this study to improve their own operations and improve the likelihood of success implementing HMS. Future research projects may identify other possible factors important for HMS implementation success to improve the model proposed here. Originality/value - HMS is a very widely used and an important system for hospitals, but has been neglected in research. This is one of the first rigorous studies of HMS, and the results provide new practical insights for hospital administrators.

Trends in COVID-19 Vaccine Development: Vaccine Platform, Developer, and Nationality.

Various vaccine platforms, including emerging platforms, have been applied in the development of COVID-19 vaccines. Biotechnology startups often lead the development of new medical technologies, whereas major pharmaceutical companies and public institutions have long contributed to vaccine development. In this study, vaccine platforms and developers involved in COVID-19 vaccine development were analyzed, elucidating the trends of vaccine platforms used, the country distribution of the developers, and differences in the profiles of developers by vaccine platform technologies and country. The analysis revealed that conventional, established, and emerging vaccine platforms have been widely used and that older platforms are more advanced in clinical development. It also demonstrated the emergence of China, in addition to the U.S., while many pharmerging countries have been engaged in development. Startups have significantly contributed to the development of viral vector and RNA-based vaccines, suggesting their important role in the application of novel technologies. The major developers differ by country and region. Alliances, including international collaborations, have progressed in late clinical development. Based on these results, future perspectives of pandemic vaccine development and implications for policy and corporate strategies are discussed.

West Nile Virus Infection in a Pekin Duck ( Anas platyrhynchos domesticus ) Developer Flock.

Developer ducks are ducks being reared for breeding. Like breeder candidate chickens, they are raised with appropriate light and feed programs. A commercial Pekin duck (Anas platyrhynchos domesticus) developer flock experienced an extraordinary, elevated mortality event at 6 wk of age. Weekly mortality rate that week was 162 ducklings out of a flock of 6420 (2.5%). Mortality jumped to 988 (15.4%) ducklings the next week. On first elevated mortality, six dead ducks from that flock were submitted for diagnostic investigation at Michigan State University Veterinary Diagnostic Laboratory. Myocarditis, pale striping or diffuse pallor of the epicardium, was grossly evident in five of the six submitted ducklings. All of the ducklings had hydropericardium, three had ascites, and three had congested meninges. Histology confirmed myocarditis with myocardial necrosis. Cerebrum and brainstem had lymphocytic vasculitis with rare neuronal necrosis in affected areas, as well as Purkinje cells in the cerebellum. West Nile virus was confirmed by PCR the day after submittal and by immunohistochemistry soon thereafter.

Reporte de caso- Infección por el virus del Nilo occidental en una parvada en desarrollo de patos Pekin (Anas platyrhynchos domesticus) reproductores. Los patos reproductores en desarrollo son patos que se crían para la reproducción. Al igual que los pollos candidatos para reproducción, se crían con programas de iluminación y alimentación adecuados. Una parvada comercial en desarrollo de pato Pekín (Anas platyrhynchos domesticus) experimentó un evento de mortalidad elevada y extraordinaria a las seis semanas de edad. La tasa de mortalidad semanal de esa semana fue de 162 patitos de una parvada de 6420 (2.5%). La mortalidad se elevó a 988 (15.4%) patitos la semana siguiente. En el primer aumento de mortalidad, seis patos muertos de esa bandada fueron enviados para una investigación de diagnóstico en el Laboratorio de Diagnóstico Veterinario de la Universidad Estatal de Michigan. La miocarditis, caracterizada por rayas pálidas o palidez difusa del epicardio, fue evidente en cinco de los seis patitos presentados. Todos los patitos mostraron hidropericardio, tres tenían ascitis y tres tenían meninges congestionadas. La histología confirmó miocarditis con necrosis miocárdica. El cerebro y el tronco del encéfalo tenían vasculitis linfocítica con rara necrosis neuronal en las áreas afectadas, así como de las células de Purkinje en el cerebelo. El virus del Nilo Occidental se confirmó mediante PCR el día después de la llegada al laboratorio y mediante inmunohistoquímica poco tiempo después.

Building a Veterinary Practice Team.

Building a successful veterinary team is foundational and a driving force to having an all-around accomplished veterinary practice, one that provides quality customer service and medical care while being financially healthy and creating an environment for team members to thrive and be happy, highly productive employees. This article focuses on new and innovative approaches to cultivating a practice personality and culture that is employee centered. This article provides a road map to assist in implementing and achieving the next big steps needed to have an employee-focused business. Taking care of employees, unlike ever before, is desperately needed in veterinary practices.

Leveraging Generative AI Tools to Support the Development of Digital Solutions in Health Care Research: Case Study.

BACKGROUND: Generative artificial intelligence has the potential to revolutionize health technology product development by improving coding quality, efficiency, documentation, quality assessment and review, and troubleshooting. OBJECTIVE: This paper explores the application of a commercially available generative artificial intelligence tool (ChatGPT) to the development of a digital health behavior change intervention designed to support patient engagement in a commercial digital diabetes prevention program. METHODS: We examined the capacity, advantages, and limitations of ChatGPT to support digital product idea conceptualization, intervention content development, and the software engineering process, including software requirement generation, software design, and code production. In total, 11 evaluators, each with at least 10 years of experience in fields of study ranging from medicine and implementation science to computer science, participated in the output review process (ChatGPT vs human-generated output). All had familiarity or prior exposure to the original personalized automatic messaging system intervention. The evaluators rated the ChatGPT-produced outputs in terms of understandability, usability, novelty, relevance, completeness, and efficiency. RESULTS: Most metrics received positive scores. We identified that ChatGPT can (1) support developers to achieve high-quality products faster and (2) facilitate nontechnical communication and system understanding between technical and nontechnical team members around the development goal of rapid and easy-to-build computational solutions for medical technologies. CONCLUSIONS: ChatGPT can serve as a usable facilitator for researchers engaging in the software development life cycle, from product conceptualization to feature identification and user story development to code generation. TRIAL REGISTRATION: ClinicalTrials.gov NCT04049500; https://clinicaltrials.gov/ct2/show/NCT04049500.

Perception of Current and Future Commitment of Medical Teachers to the Varied Roles of a Teacher: An Observational Study.

Background Medical education is gradually moving towards self-directed learning, thus the roles of a teacher have assumed wider dimensions than before. The awareness of these roles among medical teachers has been studied in several countries, but no study on the awareness of these roles among Indian medical faculty has been found. The aim of this research was to assess the current and future commitment perception of the roles of a teacher among Indian medical faculty. Methods A cross-sectional questionnaire-based survey regarding the 12 roles of a teacher, as defined by Harden and Crosby, was conducted among medical teachers in a tertiary-level hospital and medical college. The questionnaire consisted of three categories: importance in medical teaching, current commitment, and preferred future commitment to these roles, all measured on a five-point Likert scale. Results The highest mean scores were given to the roles of learning facilitator and on-the-job role model. In contrast, the lowest scores were designated to the production of study guides. Interestingly, the teachers' current commitment to roles such as curriculum planner and course organizer was found to be low. A significant difference was observed between the three categories for the majority of the roles. Younger faculties showed significant difference among categories, while the senior professors did not show significant variations across the roles. Conclusion This study of Indian medical teachers emphasizes the decreased importance attributed to roles like curriculum planning and course organization. Further studies in other developing countries are essential to understand this issue more comprehensively.

Patient specific evaluation of breathing motion induced interplay effects.

PURPOSE: In lung SABR, interplay between target motion and dynamically changing beam parameters can affect the target coverage. To identify the potential need for motion-management techniques, a comprehensive methodology for pre-treatment estimation of interplay effects has been implemented. METHODS: In conjunction with an alpha-version of VeriSoft and OCTAVIUS 4D (PTW-Freiburg, Germany), a method is presented to calculate a virtual, motion-simulated 3D dose distribution based on measurement data acquired in a stationary phantom and a subsequent correction with time-dependent target-motion patterns. In-house software has been developed to create user-defined motion patterns based on either simplistic or real patient-breathing patterns including the definition of the exact beam starting phase. The approach was validated by programmed couch and phantom motion during beam delivery. Five different breathing traces with extremely altered beam-on phases (0 % and 50 % respiratory phase) and a superior-inferior motion altitude of 25 mm were used to probe the influence of interplay effects for 14 lung SABR plans. Gamma analysis (2 %/2mm) was used for quantification. RESULTS: Validation measurements resulted in >98 % pass rates. Regarding the interplay effect evaluation, gamma pass rates of <92 % were observed for sinusoidal breathing patterns with <25 number of breaths per delivery time (NBs) and realistic patterns with <18 NBs. CONCLUSION: The potential influence of interplay effects on the target coverage is highly dependent on the patient's breathing behaviour. The presented moving-platform-free approach can be used for verification of ITV-based treatment plans to identify whether the clinical goals are achievable without explicit use of a respiratory management technique.