Author Index: Volume 51, issues 1–6, (2022)

A Single Site Pilot Project Examining Radiation Oncology Nursing Education Needs And Nursing Confidence

The International Journal of Computer Engineering in Research Trends (IJCERT) is a peer-reviewed, open access journal that publishes high-quality research papers, reviews, short communications, and notes in the field of computer science engineering and its research trends. The journal covers a wide range of topics in computer science and engineering, including: Welcome to the International Journal of Computer Engineering in Research Trends (IJCERT), is a peer-reviewed, open access journal dedicated to publishing innovative research papers, reviews, short communications, and notes in the field of computer science engineering and related disciplines. IJCERT encourages conceptual, state-of-the-art, research, standard, implementation, experimental, application, and industrial case study discussions in various areas, including: computer architecture, computer networks, software engineering, information security, artificial intelligence, machine learning, data science, robotics, cyber-physical systems, the internet of things, and other areas of computer science engineering and Its Applications.

The International Journal of Computer Engineering in Research Trends (IJCERT) is a peer-reviewed, open access journal that publishes high-quality research papers, reviews, short communications, and notes in the field of computer science engineering and its research trends. The journal covers a wide range of topics in computer science and engineering, including: Welcome to the International Journal of Computer Engineering in Research Trends (IJCERT), is a peer-reviewed, open access journal dedicated to publishing innovative research papers, reviews, short communications, and notes in the field of computer science engineering and related disciplines. IJCERT encourages conceptual, state-of-the-art, research, standard, implementation, experimental, application, and industrial case study discussions in various areas, including: computer architecture, computer networks, software engineering, information security, artificial intelligence, machine learning, data science, robotics, cyber-physical systems, the internet of things, and other areas of computer science engineering and Its Applications.

The Current Trends in Biomedical Engineering & Biosciences is an Open Access journal publishing Original research articles, Reviews, Mini reviews, Short communications, Opinions and Letter to editors with high impact. This open access Journal is enthusiastic in the development and dissemination of knowledge concerning Biomedical Engineering & Biosciences: seeks to close the gap between engineering, medicine and scientific, coalesce the design and problem-solving skills of engineering with medical and biological sciences which helps in development of sophisticated instruments which are used for the advance health care treatment, including diagnosis, monitoring, and therapy.Biosciences cover the significant developments in the broad field of biology and biological aspects of living organisms. Current Trends in Biomedical Engineering & Biosciences is peer reviewed journal that includes the topics Animal Sciences, Cell Biology and Life Sciences.

The journal seeks high-quality research from all medical specialties encompassing basic, applied and translational research in order to support and disseminate the knowledge and evidence based practices in the field of medical sciences. The journal publishes various studies like basic studies including animal experiments, clinical and epidemiological studies in the form of original research articles, review articles (narrative as well as systematic), short communications, case studies and letter to the editor that meet the criteria of scientific and technical merits.

The Challenges of the Next 5 Years

New technologies are constantly being introduced in radiation oncology primarily because they are new and not because they are clearly better than the technologies they are replacing. Often there is a “belief” that the new technology “ought” to be better but many believe that they should be widely adopted in the clinic only after evidence has shown that they are at least as safe and efficacious as existing technologies, which are often less expensive. This is the concern debated in this month's Point/Counterpoint. Arguing for the Proposition is Christopher Njeh, Ph.D. Dr. Njeh obtained his Ph.D. degree in Medical Physics from Sheffield Hallam University, UK, and, after graduation, he worked at the Addenbrooke's Hospital in Cambridge and Queen Elizabeth's Hospital, Birmingham, UK. He then came to the United States as a Visiting Postdoctoral Fellow at the University of California, San Francisco, where he was subsequently appointed as an Assistant Professor of Radiology. He later completed a Medical Physics residency at Johns Hopkins University, Baltimore, and is currently Chief Medical Physicist at Texas Oncology in Tyler, TX, and holds an adjunct faculty position at the University of Texas at Tyler. Dr. Njeh is certified in Therapeutic Radiologic Physics by the ABR. His major research interests include image-guided radiation therapy and accelerated partial breast irradiation. He is author or coauthor of over 50 papers and 10 book chapters and is coeditor of two books. Arguing against the Proposition is Dr. Christian McDonald Langton. Dr. Langton obtained his M.Sc. degree in Medical Physics from the University of Aberdeen and his doctoral degrees from the University of Hull. After working in industry for two years, he returned to academia in the UK and ultimately attained the rank of Professor of Medical Physics at the University of Hull. In 2008, Dr. Langton was appointed Professor of Medical Physics at Queensland University of Technology in Brisbane, Australia, and Director of the Queensland Cancer Physics Collaborative. Dr. Langton's main research interest has been in quantitative bone imaging and characterization, and his work on the science, technology, and clinical utility of ultrasound assessment of cancellous bone and osteoporosis has resulted in over 1800 publication citations. He holds several related patents and there are seven commercial devices currently available adopting his broadband ultrasonic attenuation technique, with over 12 000 systems utilized worldwide. Medical technology encompasses all drugs, devices, and medical and surgical procedures used in medical care as well as the organizational supportive systems within which such care is provided.1 Radiation oncology has recently witnessed an explosion in innovation including but not limited to: proton therapy, CyberKnife, tomotherapy, IGRT, and IMRT. Efficacy, safety, and cost effectiveness, however, remains the focus in the provision of optimal care to patients. While some of these innovations offer unprecedented breakthroughs for some patients, they have the potential to also result in unintended harm if not used appropriately. It is, therefore, essential that adoption of these new technologies be evidence based. Evidence-based medicine can be perceived as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”2 Its practice presupposes the integration of individual clinical expertise with the best available external clinical evidence from systematic collection and synthesis of data, including patients’ values and expectations.3 The gold standard for the attainment of level 1 evidence is usually through randomized controlled trials (RCTs) and meta-analysis of such trials. There are many reported instances in the scientific literature where RCTs refuted evidence from theoretical, observational, physiologic studies or common sense. In the 1890s, Dr. William Halsted, for instance, developed radical mastectomy for breast cancer. His procedure was performed unchallenged for over 80 years. It was, however, not until an RCT was conducted in the late 1980s that it dawned upon the scientific community that radical mastectomy had no advantage over simpler forms of treatment for early-stage breast cancer.4 Another more recent example is vascular brachytherapy that was used to treat in-stent restenosis until an RCT showed that this therapy yielded comparatively inferior outcomes to polymer-based slow-release paclitaxel-eluting stents.5 Opponents of RCTs may be surprised to learn that not all new therapies amount to an improvement compared to the standard of therapy. For example, an analysis of outcome data from 58 RCTs, including a total of 12734 patients, conducted between 1968 and 2002 by the Radiation Therapy Oncology Group, found that, overall, experimental and standard arms were equally successful.6 They also found that treatment-related mortality and morbidity were, on average, higher in the innovative arm. In contemplating these facts, we are reminded of the economist who once said “…man's wants are numerous but his means are limited.” His view is applicable to national health care. Were one to place the cost of new technology into proper context it would be safe to assert that U.S. health care costs have risen faster than the gross domestic product (GDP), often by a substantial margin. While in 1960 approximately 5% of the GDP of the United States was spent on medical care,1 by 2004 it accounted for over 15% and is expected to be as much as 20% of GDP by 2015.7 According to a landmark study by The Kaiser Family Foundation,8 new technology has been identified as one of the causes of this exponential rise in health care cost. I submit, therefore, that new technology needs to fulfill the triple condition of efficacy, safety, and cost-effectiveness so that our limited resources can be put to the most judicious use. Evidence-based medicine is commonly defined as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”9 These are admirable words, but what do they really mean? Are they a realistic aspiration for adoption of new technologies in radiation oncology? A key factor is the validity of the evidence, so variable in reality that a number of category levels are widely utilized. For example, the U.S. Preventative Services Task Force10 lists three levels of “quality of evidence,” the highest level being “evidence obtained from at least one properly designed randomized controlled trial.” For the laudable randomized clinical trial, there has been a dramatic expansion in the number of publications associated with “radiation oncology” alone. Considering “Web of Science” publications per year using the topic search category of (“RCT” or “randomized clinical trial” or “randomized control trial”) and (“radiation oncology” or “radiotherapy”) yields: 1989 = 2, 1994 = 32, 1999 = 55, 2004 = 107, and 2009 = 228. How do we arrive at a consensus based upon such a wealth of information? Will a comparison be made against an untarnished “gold standard” or with current practice? The latter will inevitably necessitate large cohort numbers in each study arm, often impracticable from a recruitment perspective. Is there potential for a high attrition rate? Will it be difficult to assign and maintain inclusion and exclusion criteria? Will it be difficult to avoid bias? Very few cases are truly “equivalent.” Noting the understandable need to maintain a primary focus on patient welfare, as circumstances potentially change, will it be difficult to maintain a rigid protocol? Will the protocol be readily and reliably transferable multicenter and multinational? How long will it be before the technique could be routinely adopted? Technology developments appear at a fast time rate and may evolve during the course of an RCT such that they are used differently at the end of a trial than at the beginning and might even become outdated before the trial is over. How important are factors such as quality of life and secondary cancer risk? Other criticisms of adopting “evidence-based medicine” include stagnation, bland uniformity, and lowering of standards through deskilling practitioners. Instead of using clinical judgment, they will be encouraged to follow protocols that treat all patients as essentially interchangeable.9 There is also a threat to the adoption of new techniques in radiation oncology through a growing movement of “lack-of-evidence based medicine” that has been used to restrict access to a number of therapies,11 particularly by the UK's National Institute of Clinical Excellence. Perhaps the hottest “new technology in radiation oncology” debate relates to proton verses photon IMRT, with a question raised as to whether large randomized phase III comparative trials should be performed?; that would inherently encompass a significant number of scientific and ethical issues11,12 — I will end with that thought! The sheer volume of information available in the literature is more reason for a unified and systematic approach to synthesize them. Recruitment bias can be avoided by proper randomization.13 EBM makes decision making more thoughtful and more transparent, providing a stronger scientific backbone to medical practice. Not all studies are carried out with the same degree of rigor (quality, quantity, and consistency) hence a need to grade the quality of the research such as required by SORT,14 GRADE,15 or the Center for Evidence Based Medicine. The FDA is not thorough enough in its technology approval process. Recent studies have shown that the FDA premarket approval process is often based on weak studies.16 Ethical dilemmas in RCTs are eliminated by the acknowledgement of the equipoise principle which assumes that the two arms in a study have an equal chance of performing well.17 This principle has been validated by the fact that only 25%–50% of new technology is better than traditional technology.18 Another issue with pursuing RCTs has to do with the vested interests of three players if the RCT proves that the procedure is ineffective: the physician (new technology is accompanied by higher reimbursement), the hospital (need to pay for the equipment), and the manufacturer (need to make a profit).19 In conclusion, obtaining the relevant high quality evidence is a challenging, demanding, time-consuming, and costly pursuit. Nevertheless, it is a rigorous process, which we must demand of new technology so as to remain accountable to our patients. Having carefully considered my opponent's Opening Statement, I am confident that the arguments provided within my own Opening Statement remain valid and wholly intact. There are two primary components of my opposition to the proposition. First, it is impossible in reality to acquire irrefutable evidence as to whether a “new technology” will indeed improve individual patient care. Second, it is impossible to create a single unifying consensus based upon reported data. Allied to this, there has been a dramatic increase in the number of evidence-based medicine derived “clinical guidelines,” so much so that there has been a call for “guidelines for clinical guidelines” within a British Medical Journal Editorial.20 A fundamental question that we must address is whether so-called “evidence-based medicine” serves its purpose of helping clinicians make better decisions for the individual patient; related not only to the primary factors of diagnosis and treatment, but also encompassing prognosis, benefit, risk, and cost. Continuing this somewhat broader perspective, I wish to consider another component of the proposition's title, specifically, what do we really mean by “new technology in radiation oncology”? Are many so-called “new technologies” simply part of a fundamentally evolutionary advancement process? Noting the age-old tenet of “maximally treating the cancer by maximally sparing normal tissue,” are we in danger of being distracted away from aspects of radiation oncology that are of greater importance from an individual patient's perspective? For example, are we in need of true “new technologies” that better target regions of a particular tumor or organ that require, or maybe do not require, “treatment;” and to determine how these relate to both static and temporal anatomy? In summary, while appreciating the ideological paradigm that “the adoption of new technology in radiation oncology should rely on evidence-based medicine,” in reality, this cannot be achieved and we should concentrate on the primary role of helping clinicians make better decisions for the individual patient.

Building better oncology data systems and workforce models in a rapidly changing health care system.

Dissemination and Implementation-A Primer for Accelerating "Time to Translation" in Radiation Oncology.

Pilot Study Assessing Student Interest in Combined Residency Training Pathways With Radiation Oncology

The level of exposure of science undergraduate students to primary literature is varied, despite evidence that it is a useful tool to teach factual information and critical thinking skills1. Reading and interpreting primary literature is a skill that is required in many scientific careers and these skills which are developed when analyzing primary literature are transferable to many areas. In an undergraduate Human Anatomy and Physiology course we incorporated weekly discussions and presentations of primary research articles as a tool to accomplish our course goals. These course goals included exploring current research in the physiology of organ systems being studied as well as developing critical thinking on a topic. In our course students were required to read a total of five primary research articles selected by the course instructors. Students were then required to write a brief 100‐word synopsis of each article prior to class. Then each week in class, students took turns in small groups to be responsible for leading a class discussion of the article. Students were responsible for discussing articles five times during the semester and leading the article discussion once during the semester. Students perceptions of the complexity and usefulness of the exercise were surveyed at the beginning and at the end of the semester.We observed that at the start of the semester 50% of students felt confident in presenting and leading a discussion on a primary research article, compared with 67% at the end of the semester. Just 17% expected to enjoy the exercise, whereas at the end of the semester 32% reported having enjoyed it. At the start of the semester 85% of students believed that developing skills in reading primary research literature was important for their future careers. We found the level of understanding of primary literature and quality of discussion to vary greatly between students.In conclusion we propose that the development of skills in reading primary research literature in undergraduate students enrolled in a Human Anatomy and Physiology course are valuable. We found that the students felt that the skills developed during this exercise are useful for their intended future careers and they enjoyed the exercise more than they expected. Our future plans include finding ways to improve upon student satisfaction and enjoyment of the activity.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Artificial intelligence (AI) and machine learning (ML) are emerging as transformative tools in intensive care medicine. Nevertheless, despite the development of numerous AI/ML models, their integration into routine ICU practice remains limited. This concise review examines the role of AI and data science in critical care, with a focus on their contributions to safety and quality assurance, clinical processes improvements, and ICU management. By synthesizing current evidence, this review aims to highlight the opportunities and challenges associated with implementing AI-driven solutions in critical care settings. English-language articles were identified in PubMed using keywords related to AI, ML, ICU management, clinical decision support, and predictive analytics. Original research articles, reviews, letters, and commentaries relevant to AI/ML applications in ICU quality and performance assessment were included. Relevant literature was identified, key findings were synthesized into a structured narrative review. The integration of AI and ML into ICU management leverages vast clinical data to evaluate ICU performance, measure risk factors, optimize workflows, and predict adverse events. ML-driven models can improve clinical decision-making and ICU management. Despite the promising results, real-world implementation requires rigorous validation and clinician adoption. AI-driven successful implementation in ICU comes with significant challenges. AI and ML have the potential to transform ICU management. However, their success depends on validated methodologies, interoperable data frameworks, and interpretable models that clinicians can trust. Advancing AI use in the ICU demands a multidisciplinary effort to create adaptive, transparent, and clinically meaningful solutions that enhance patient care and improve workflow, while ensuring safety and efficiency.

The Journal of Sport and Exercise Science™ ISSN 2703-240X Our Journal: Aims and Scope The Journal of Sport and Exercise Science™ (JSES) is a peer-reviewed online journal that publishes original research articles, reviews, invited commentaries, and letters to the editor, in the broad context of sport and exercise science. This includes, but is not limited to, […]

International research has shown that in most countries, there are few women studying towards information technology (IT) careers (Galpin, 2002), and there is much research, particularly in the United States (U.S.), United Kingdom (UK) and Australia into why this is the case (Gürer & Camp, 2002). This article considers the situation in sub-Saharan Africa and focuses on women’s involvement in the generation and creation of information and communication technologies (ICTs) in sub-Saharan Africa, as opposed to ICT use in sub-Saharan Africa, which is considered elsewhere in this volume. There are a number of aspects to the generation and creation of ICTs: how women are involved in this process as IT professionals and how they are educated for these careers, as well how technology can be used appropriately within the specific conditions of sub-Saharan Africa. ICTs will be considered in the broadest sense of the word, covering all electronic technologies, from computers and networking to radio and television. Women’s participation is important: The World Summit on the Information Society (WSIS) Gender Caucus (www.genderwsis.org) has identified women’s involvement in the design and development of technology as well as technology management policy, as key principles for the information society. Marcelle (2001) emphasizes the necessity for African women to become involved in technological and scientific areas, including “computer science, software engineering, network design, network management and related disciplines” (Marcelle, 2001, para. 15) to create an information society appropriate for African women. The diversity of those involved in design leads to higher-quality and more appropriate technological solutions (Borg, 2002; Lazowska, 2002). Background Sub-Saharan Africa has a population of 641 million, young (almost half under 15) and rural (35% urban). Significant problems are undernourishment, poverty and HIV/AIDS (United Nations Development Programme (UNDP), 2004). All the countries in sub-Saharan Africa are classified as developing countries. Some countries are relatively wealthy, such as Mauritius, South Africa, and Nigeria, but have large wealth disparities within their populations. Women in sub-Saharan Africa are expected to focus on the home, they have less access to education and health, and their contribution to family and community is not valued (Huyer, 1997).

European Chemical Bulletin (ISSN 2063-5346) is a peer-reviewed journal that publishes original research papers, short communications, and review articles in all areas of chemistry. European Chemical Bulletin has eight sections, namely