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.

Optimizing CT Abdomen-Pelvis Scan Radiation Dose: Examining the Role of Body Metrics (Waist Circumference, Hip Circumference, Abdominal Fat, and Body Mass Index) in Dose Efficiency.

Objective: This study investigates the correlation between patient body metrics and radiation dose in abdominopelvic CT scans, aiming to identify significant predictors of radiation exposure. Methods: Employing a cross-sectional analysis of patient data, including BMI, abdominal fat, waist, abdomen, and hip circumference, we analyzed their relationship with the following dose metrics: the CTDIvol, DLP, and SSDE. Results: Results from the analysis of various body measurements revealed that BMI, abdominal fat, and waist circumference are strongly correlated with increased radiation doses. Notably, the SSDE, as a more patient-centric dose metric, showed significant positive correlations, especially with waist circumference, suggesting its potential as a key predictor for optimizing radiation doses. Conclusions: The findings suggest that incorporating patient-specific body metrics into CT dosimetry could enhance personalized care and radiation safety. Conclusively, this study highlights the necessity for tailored imaging protocols based on individual body metrics to optimize radiation exposure, encouraging further research into predictive models and the integration of these metrics into clinical practice for improved patient management.

In-depth exploration of the radiation exposure to staff performing endoscopic retrograde cholangiopancreatography procedures (ERCP) through RANDO phantom and TLDs.

This study provides a comprehensive evaluation of the occupational radiation exposure faced by healthcare professionals during Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Utilizing an anthropomorphic RANDO phantom equipped with Thermoluminescent Dosimeters (TLDs), we replicated ERCP scenarios to measure radiation doses received by medical staff. The study meticulously assessed radiation exposure in various corresponding body regions typically occupied by medical staff during ERCP, with a focus on eyes, thyroid, hands, and reproductive corresponding organ regions. The findings revealed significant variations in radiation doses across different body parts, highlighting areas of higher exposure and underscoring the need for improved protective measures and procedural adjustments. The effective radiation doses were calculated using standard protocols, considering the varying levels of protection offered by lead aprons and thyroid shields. The results demonstrate the substantial radiation exposure experienced by healthcare staff, particularly in regions not adequately shielded. This study emphasizes the necessity for enhanced radiation safety protocols in clinical settings, advocating for advanced protective equipment, training in radiation safety, and the exploration of alternative imaging modalities. The findings have crucial implications for both patient and staff safety, ensuring the continued efficacy and safety of ERCP and similar interventional procedures. This research contributes significantly to the field of occupational health and safety in interventional radiology, providing vital data for the development of safer medical practices.

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.

Assessment of extremity dose for medical staff involved in positron emission tomography/computed tomography imaging: Retrospective study.

There has been an increase in positron emission tomography (PET)/computed tomography (CT) imaging procedures, and medical workers involved in PET/CT are at increased risk of occupational exposure. Data on extremity dose exposure are limited globally. The current study aimed to evaluate the occupational radiation dose for extremities for medical workers (nurses, radiographers/radiologic technologists, and nuclear medicine physicians) working in PET/CT scanners at 5 large hospitals in Turkey. Optically stimulated luminescence (OSL) and Thermoluminescent dosimeter (TLD) ring dosimeters were used to measure equivalent dose values. Hospitals 1, 2, and 5 used OSL, and 3 and 4 used TLD. A total of 502 readings were obtained from 55 workers. In millisievert (mSv), the average annual effective dose for all workers was 14.5 ±â€…17.7 (0.2-157.2). A radiography technologist received a maximum dose of 157.21. Nurses received the highest average annual effective dose (15.2 ±â€…19.46) (0.32-65.58), followed by radiography technologists (14.7 ±â€…18.03) (0.4-157.2), and nuclear medicine physicians demonstrated the least dose (8.6 ±â€…10.5) (1.2-24.4). The results show that the extremity dose is well below the annual dose limit of 500 mSv. However, there is a wide variation in dose among the workers, underlining a need for careful assessment of working conditions to ensure safe practices for all workers.

Exploring Radiographers' Engagement in Research: Motivation and Barriers in Five Arab Countries.

(1) Background: This study aims to comprehensively understand the motivations driving radiographers in five Arab countries to engage in research. (2) Methods: A cross-sectional study employing an anonymous online survey was conducted for 12 weeks from May to July 2023. The study sample consisted of 250 radiographers, with equal representation from Iraq, the Kingdom of Saudi Arabia, Palestine, Sudan, and the United Arab Emirates. (3) Results: Overall, the participants showed limited involvement in research-related activities in all five countries, particularly in presenting at conferences and publishing in peer-reviewed journals. Most participants believed research positively impacts their professional development (34.8%) and patient care and outcomes (40%). The participants perceived professional development (36.4%) as a key motivator for research engagement. A significant majority (81.6%) expressed motivation to start research in clinical practice. A total of 66.8% found research opportunities available during clinical practice. Barriers included time constraints (56%), limited resources (47.2%), and lack of support and skills (33.2% and 32%, respectively). (4) Conclusion: This study emphasises the need for targeted strategies to enhance research engagement among radiographers in the Arab region. Addressing barriers, such as time constraints and resource limitations, while leveraging intrinsic motivators, such as professional development, is crucial for fostering a culture of research-driven excellence in radiography.

A closer look at the current knowledge and prospects of artificial intelligence integration in dentistry practice: A cross-sectional study.

Background: Healthcare professionals have expressed worries about using AI, while others anticipate more work opportunities in the future and better patient care. Integrating AI into practice will directly impact dentistry practice. The purpose of the study is to evaluate organizational readiness, knowledge, attitude, and willingness to integrate AI into dentistry practice. Methods: a cross-sectional exploratory study of dentists, academic faculty and students who practice and study dentistry in UAE. Participants were invited to participate in a previously validated survey used to collect participants' demographics, knowledge, perceptions, and organizational readiness. Results: One hundred thirty-four responded to the survey with a response rate was 78% from the invited group. Results showed excitement to implement AI in practice accompanied by medium to high knowledge and a lack of education and training programs. As a result, organizations were not well prepared and had to ensure readiness for AI implementation. Conclusion: An effort to ensure professional and student readiness will improve AI integration in practice. In addition, dental professional societies and educational institutions must collaborate to develop proper training programs for dentists to close the knowledge gap.

A closer look at the utilized radiation doses during computed tomography pulmonary angiography (CTPA) for COVID-19 patients.

Introduction: CTPA stands for computed tomography pulmonary angiography. CTPA is an X-ray imaging that combines X-rays and computer technology to create detailed images of the pulmonary arteries and veins in the lungs. This test diagnoses and monitors conditions like pulmonary embolism, arterial blockages, and hypertension. Coronavirus (COVID-19) has threatened world health over the last three years. The number of (CT) scans increased and played a vital role in diagnosing COVID-19 patients, including life-threatening pulmonary embolism (PE). This study aimed to assess the radiation dose resulted from CTPA for COVID-19 patients. Methods: Data were collected retrospectively from CTPA examinations on a single scanner in 84 symptomatic patients. The data collected included the dose length product (DLP), volumetric computed tomography dose index (CTDIvol), and size-specific dose estimate (SSDE). The organ dose and effective dose were estimated using VirtualDose software. Results: The study population included 84 patients, 52% male and 48% female, with an average age of 62. The average DLP, CTDIvol, and SSDE were 404.2 mGy cm, 13.5 mGy, and 11.6 mGy\, respectively. The mean effective doses (mSv) for males and females were 3.01 and 3.29, respectively. The maximum to minimum organ doses (mGy) between patients was 0.8 for the male bladder and 7.33 for the female lung. Conclusions: The increase in CT scans during the COVID-19 pandemic required close dose monitoring and optimization. The protocol used during CTPA should guarantee a minimum radiation dose with maximum patient benefits.

Toward the strengthening of radioprotection during mammography examinations through transparent glass screens: A benchmarking between experimental and Monte Carlo simulation studies.

Introduction: A lead-acrylic protective screen is suggested to reduce radiation exposure to the unexposed breast during mammography. The presence of toxic lead in its structure may harm the tissues with which it comes in contact. This study aimed to design a CdO-rich quaternary tellurite glass screen (C40) and evaluate its efficiency compared to the Lead-Acrylic protective screen. Methods: A three-layer advanced heterogeneous breast phantom designed in MCNPX (version 2.7.0) general-purpose Monte Carlo code. Lead acrylic and C40 shielding screens were modeled in the MCNPX and installed between the right and left breast. The reliability of the absorption differences between the lead acrylic and C40 glass were assessed. Results and discussion: The results showed that C40 protective glass screen has much superior protection properties compared to the lead acrylic protective screen. The amount of total dose absorbed in the unexposed breast for C40 was found to be much less than that for lead-based acrylic. The protection provided by the C40 glass screen is 35-38% superior to that of the Lead-Acrylic screen. The C40 offer the opportunity to avoid the toxic Pb in the structure of Lead-Acrylic material and may be utilized for mammography to offer superior radioprotection to Lead-Acrylic and significantly lower the dose amount in the unexposed breast. It can be concluded that transparent glass screens may be utilized for radiation protection purposes in critical diagnostic radiology applications through mammography.

Utilization of three-layers heterogeneous mammographic phantom through MCNPX code for breast and chest radiation dose levels at different diagnostic X-ray energies: A Monte Carlo simulation study.

Introduction: We report the breast and chest radiation dose assessment for mammographic examinations using a three-layer heterogeneous breast phantom through the MCNPX Monte Carlo code. Methods: A three-layer heterogeneous phantom along with compression plates and X-ray source are modeled. The validation of the simulation code is obtained using the data of AAPM TG-195 report. Deposited energy amount as a function of increasing source energy is calculated over a wide energy range. The behavioral changes in X-ray absorption as well as transmission are examined using the F6 Tally Mesh extension of MCNPX code. Moreover, deposited energy amount is calculated for modeled body phantom in the same energy range. Results and discussions: The diverse distribution of glands has a significant impact on the quantity of energy received by the various breast layers. In layers with a low glandular ratio, low-energy primary X-ray penetrability is highest. In response to an increase in energy, the absorption in layers with a low glandular ratio decreased. This results in the X-rays releasing their energy in the bottom layers. Additionally, the increase in energy increases the quantity of energy absorbed by the tissues around the breast.

Exploring the Radioprotective Indium (III) Oxide Screens for Mammography Scans Using a Three-Layer Heterogeneous Breast Phantom and MCNPX: A Comparative Study Using Clinical Findings.

Background: During mammography, a lead-acrylic protective screen is recommended to reduce radiation exposure to the unexposed breast. Objectives: This research study aimed to construct an Indium-(III)-oxide-rich tellurite-glass screen (TZI8) and compare its performance to that of lead acrylic. Materials and Methods: A three-layer heterogeneous-breast phantom was developed, using the MCNPX (version 2.7.0) Monte Carlo code. An MCNPX-simulation geometry was designed and implemented, using the lead-acrylic and TZI8 shielding screens between the right and left breast. Next, the reliability of the phantom and the variations in absorption between the lead-acrylic and TZI8 glass were investigated. Results: The findings show that the TZI8-protective-glass screen offers significantly greater radioprotection than the lead-acrylic material. The quantity of total dose absorbed in the unexposed breast was much lower for TZI8 than for lead-based acrylic. The TZI8-glass screen gives about 60% more radioprotection than the lead-acrylic screen. Conclusion: Considering the toxic lead in the structure that may be hazardous to the human tissues, the TZI8-glass screen may be used in mammography examination to provide greater radioprotection than the lead-acrylic screen, in order to greatly reduce the dose to the unexposed breast.

Establishment of Diagnostic Reference Levels in Cone Beam Computed Tomography Scans in the United Arab Emirates.

This study aimed to address the knowledge gap in assessing the radiation doses from cone beam computed tomography (CBCT) procedures, establishing a typical value, and estimating effective and organ doses. A total of 340 patients aged 18-80 years were included in this study. Organ doses were estimated using VirtualDose IR software. The typical values were based on median values estimated as 1000 mGy cm2. The mean ED (µSv) per procedure was 149.5 ± 56, and the mean of the peak skin dose during the CBCT examination was 39.29 mGy. The highest organ dose was received by the salivary glands (2.71 mGy), the extrathoracic region (1.64 mGy), thyroid (1.24 mGy) and eyes (0.61 mGy). The patients' doses were higher than in previous studies. Staff awareness, education, training and dose optimisation are highly recommended. With the establishment of local DRLs, patient dosages can be reduced successfully without compromising image quality.

Infection control and radiation safety practices in the radiology department during the COVID-19 outbreak.

RATIONALE AND OBJECTIVES: Radiology personnel must have good knowledge, experience and adherence to radiation protection and infection control practices to ensure patient safety and prevent the further spread of the COVID-19 virus. This study analysed compliance and adherence to radiation protection and infection control during COVID-19 mobile radiography. METHODS: A cross-sectional using online survey was conducted from September to December 2021. Data on demographic characteristics, adherence to radiation protection and infection control practice were collected during mobile radiography for COVID-19 patients in the study. A random sample of the radiographers working in COVID-19 centres in the United Arab Emirates. RESULTS: Responses were received from 140 participants, with a response rate of 87.5%. Females were the predominant participants (n = 81; 58%). Participants aged ages between 18-25 years (n = 46; 33%) and 26-35 years (n = 42; 30%), (n = 57; 41%) had less than five years of experience, followed by participants who had more than 15 years (n = 38; 27%). Most participants (n = 81; 57.9%) stated that they performed approximately 1-5 suspected or confirmed COVID-19 cases daily. The participants had moderate to high adherence to radiation protection, with a mean and standard deviation of 42.3 ± 6.28. Additionally, infection control adherence was high, with 82% of the participants showing high adherence. CONCLUSION: Continuous guidance, training and follow-up are recommended to increase adherence and compliance to radiation protection and infection control compliance. Educational institutions and professional organisations must collaborate to provide structured training programmes for radiology practitioners to overcome the practice and knowledge gap.

Development of acceptable quality radiation dose levels for common computed tomography examinations: A focused multicenter study in United Arab Emirates.

Purpose: Diagnostic Reference Level (DRL) is a practical tool for radiation dose optimization, yet it does not indicate the patient size or image quality. The Acceptable Quality Dose (AQD) introduced to address the limitations of the DRLs and it is based on image quality, radiation dose, and patient weight. The aim of this study is to establish the AQD for adult patients' undergoing Computed Tomography (CT) examinations (Head, chest, abdomen). Methods: This study is conducted in the four main hospitals at the Ministry of Health and Prevention. Patient information and exposure parameters were extracted. All the acceptable images are scored for their quality assessments. Data is classified as seven weight groups, <50, 50-59, 60-69, 70-79, 80-89, 90-99, and ≥100 kg. The mean ± SD, median, and 75th are calculated for the CTDIvol and DLP for each weight group per examination. Results: Out of 392, 358 CT examinations are scored with acceptable quality. The median CTDIvol values for the weight groups are obtained as 24.6, 25.4, 25.4, 25.0, 26.0, 27.0, and 29.0 mGy. Moreover, median DLP values are obtained as 576.7, 601.0, 616.5, 636.1, 654.0, 650.0, 780.0, and 622.5 mGy.cm, respectively, for head CT without Contrast Media (CM). Similar calculation for head CT with (CM), chest without CM, abdomen without CM, and chest and abdomen (with and without CM) CTs are presented. Conclusion: Images with bad, unacceptable and higher than necessary qualities contribute to increasing patient dose and increasing the DRLs. The AQD for the selected examinations were lower than the proposed DRLs in the United Arab Emirates. The integration of image quality and patients size in the assessment of the AQD values provide effective model to compare radiation dose indices within facility and compare with others. The obtained results may be useful in terms of improving dose and the diagnostic quality in the national and international levels.

Integration of artificial intelligence into nursing practice.

Background: Artificial Intelligence (AI) is developing at a rapid pace and finding new applications across the health service team. Some professionals have voiced concerns over the implementation of AI, whilst others predict greater job opportunities in the future. Nursing practice will be directly affected and further information is required on the knowledge and perceptions of nurses regarding the integration of AI in practice. The study aims to assess the knowledge, attitude, willingness, and organizational readiness in integrating AI into nursing practice. Methods: An exploratory cross-sectional survey of nurses working in health organisations. A survey link was emailed to participants. Nurses working in the United Arab Emirates (UAE) health organisations were invited to participate. Eligibility criteria included registered nurses in government or private hospitals. The survey captured the nurses demographic, knoweldage, preceptions, orgianizational readinesss and challenges regarding implementation of AI into nursing practice. Results: 553 responses were returned from 650 invitation giving a response rate of 85%. 51% of respondents stated their knowledge on AI was obtained through self-taught measures for most of the participants, while 20% of them gained it through various courses. Only 8% stated they learned through postgraduate courses, while 9% stated they lack knowledge of AI. 75% of all respondents agreed that the nursing curriculum should include some basic knowledge of AI. Conclusions: There is a lack of understanding of the principles of AI across the nursing profession. Further education and training is required to enable a seamless and safe integration of AI into nursing practice.

Factors that affect student engagement in online learning in health professions education.

BACKGROUND: Student engagement is vital in achieving learning outcomes and improving students' motivation, involvement, and attitudes toward learning. The aim of this study was to identify the factors that affect student engagement in online learning in medical and health science colleges. METHODS: A cross-sectional study was conducted among medical and health science students and faculty in May 2020. The Online Engagement Strategies Questionnaire was e-mailed to 370 students and 102 faculty members. The SPSS statistical software was used for the statistical analysis. Exploratory factor analysis was performed to identify the factors that affected the students' engagement in online learning. Composite scores were calculated for factors, separately for the student and faculty responses. Descriptive statistical analysis was performed for the student and faculty responses. RESULTS: The response rates of the students and faculty were 85.1% and 74.1%, respectively. The mean ages of the students and faculty were 20.6 and 44.6 years, respectively. Eighty-five percent of the faculty (n = 51) and 88.3% (n = 278) of the students found that the use of technology in proper communication was an important strategy to engage students in online learning. The factor analysis revealed agreement between the students and faculty regarding the factors that support student engagement in online learning. Techno-pedagogical skills were considered very important for faculty and important for students. For both faculty and students, self-directed learning skills were important, and peer-assisted learning (PAL) was fair symmetry. Nevertheless, collaborative learning (CL) was fairly symmetry to students and important to faculty. CONCLUSION: To enhance student engagement in online learning, faculty members should consider improving their techno-pedagogical skills. Moreover, by incorporating self-directed learning, CL and PAL will support student engagement. Finally, faculty development, updating of course design, and institutional policies are all required to support online learning.

IMPACT OF RADIATION FIELD SIZE ON ABSORBED ORGAN DOSES IN NEONATES UNDERGOING CHEST RADIOGRAPHY IN AN ANTERIOR-POSTERIOR PROJECTION: A MONTE CARLO SIMULATION STUDY.

Electronic image cropping and poor collimation practices are used by some radiographers during paediatric radiography. Advantages of collimation should be investigated to disseminate convenient use among radiographers and create awareness. The aim of this study was to use Monte Carlo simulation to investigate the extent of the effect of collimation on the absorbed organ dose in neonates undergoing anterior-posterior chest examination. The minimum field size recommended by the European guidelines was calculated experimentally using a neonate phantom. A PCXMC version 2.0 simulation calculated the organ and effective doses at the minimum field size and at different field sizes. Increasing the field size by 1 cm in the head-to-feet direction increases the dose to the urinary bladder and prostate, whereas increasing the field size by 1 cm on all sides increases the dose to the upper limbs, ovaries, testicles and prostate. The use of an optimal field size reduces organ doses for neonates undergoing chest X-ray. Cropping X-ray images to reduce unnecessarily large field sizes results in unnecessary patient dosages and should be avoided. The primary beam should be restricted to expose only the area of interest, and image cropping should be discouraged.

Assessment of the Willingness of Radiologists and Radiographers to Accept the Integration of Artificial Intelligence Into Radiology Practice.

RATIONALE AND OBJECTIVES: This study aimed to investigate radiologists' and radiographers' knowledge, perception, readiness, and challenges regarding Artificial Intelligence (AI) integration into radiology practice. MATERIALS AND METHODS: An electronically distributed cross-sectional study was conducted among radiologists and radiographers in the United Arab Emirates. The questionnaire captured the participants' demographics, qualifications, professional experience, and postgraduate training. Their knowledge, perception, organisational readiness, and challenges regarding AI integration into radiology were examined. RESULTS: There was a significant lack of knowledge and appreciation of the integration of AI into radiology practice. Organisations are stepping toward building AI implementation strategies. The availability of appropriate training courses is the main challenge for both radiographers and radiologists. CONCLUSION: The excitement of AI implementation into radiology practise was accompanied by a lack of knowledge and effort required to improve the user's appreciation of AI. The knowledge gap requires collaboration between educational institutes and professional bodies to develop structured training programs for radiologists and radiographers.