A virtual laboratory system for physiology teaching

The problem of understanding physiological processes can be aided by visualization tools. Traditionally this has been achieved by the use of schematic paper diagrams. However, many physiological processes are quite complex, and in many instances students encounter difficulties in understanding the dynamics. This paper describes the rationale behind an alternative approach using interactive three‐dimensional computer‐graphics simulation to aid comprehension of scientific concepts

Imaging biomarker roadmap for cancer studies.

Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.Development of this roadmap received support from Cancer Research UK and the Engineering and Physical Sciences Research Council (grant references A/15267, A/16463, A/16464, A/16465, A/16466 and A/18097), the EORTC Cancer Research Fund, and the Innovative Medicines Initiative Joint Undertaking (grant agreement number 115151), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in kind contribution

Imaging biomarker roadmap for cancer studies.

Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.Development of this roadmap received support from Cancer Research UK and the Engineering and Physical Sciences Research Council (grant references A/15267, A/16463, A/16464, A/16465, A/16466 and A/18097), the EORTC Cancer Research Fund, and the Innovative Medicines Initiative Joint Undertaking (grant agreement number 115151), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in kind contribution

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes

Advances in Games Technology: Software, Models, and Intelligence Advances in Games Technology: Software, Models, and Intelligence

Abstract Games technology has undergone tremendous development. In this article, the authors report the rapid advancement that has been observed in the way games software is being developed, as well as in the development of games content using game engines. One area that has gained special attention is modeling the game environment such as terrain and buildings. This article presents the continuous level of detail terrain modeling techniques that can help generate and render realistic terrain in real time. Deployment of characters in the environment is increasingly common. This requires strategies to map scalable behavior characteristics for characters as well. The authors present two important aspects of crowd simulation: the realism of the crowd behavior and the computational overhead involved. A good simulation of crowd behavior requires delicate balance between these aspects. The focus in this article is on human behavior representation for crowd simulation. To enhance the player experience, the authors present the concept of player adaptive entertainment computing, which provides a personalized experience for each individual when interacting with the game. The current state of game development involves using very small percentage (typically 4% to 12%) of CPU time for game artificial intelligence (AI). Future game AI requires developing computational strategies that have little involvement of CPU for online play, while using CPU&apos;s idle capacity when the game is not being played, thereby emphasizing the construction of complex game AI models offline. A framework of such nonconventional game AI models is introduced. 753 Keywords artificial intelligence, behavior modeling, board game, character modeling, conversational avatars, environment modeling, game AI, game development, game editor, game engine, game software, gardening game, genetic algorithms, hybrid soft computing, memetic algorithms, neural network optimization, programmable tournament, racing game, small world models, terrain modeling This article is organized as follows. First, we present some simple and effective topics in software games engineering. Then we look at some of the state-of-the-art game engines available for game development. A survey of the major issues that have occupied game programmers, in relation to the problems of terrain generation, over the past 10 years, is presented, and then we present current trends as a prelude to the development of a general purpose reusable terrain function library. We then describe how to generate realistic human behaviors. This is a challenging and interesting problem in many applications such as computer games, military simulations, and crowd animation systems. First, we propose a generic behavior modeling framework that reflects the major observations on human behavior in daily-life situations. Next, we describe a case study to illustrate how this modeling framework can be used in various crowd simulations. Personalization in games can be in terms of difficulty levels, game resources, emotion, characters, and so forth. In game design, the first area can be easily identified and addressed. Normally, during this first stage, the genre of the game will be determined. However, the second area of personalization is sometimes difficult. This is because of the differences of players in terms of their personality, background, culture, skill, and learning ability. Currently, game artificial intelligence (AI) is used for modeling various aspects of nonplayer characters. Although such applications (e.g., behavior modeling) have been very successful, the deployment of game AI for serious games having learning as main component poses basic questions, such as the representation of an explanation capability as perceived by the human player. In this article, we propose a general framework for the development of such an explanation capability. Various soft-computing models have complementary capabilities. This motivates us to propose a framework for their integration. We identify the need for future game AI engines with such capabilities. Simple and Effective Topics in Software Games Engineering Over the past few years, we have introduced several simple but effective new topics into the teaching of software programming and other similar courses. These new topics are industry case study, open-source game editors, programmable tournament, and project-based development. The industry case study allows the students to understand the myriad factors in the technical and business sides of a real games company; the case study we use is id Software, a standout small company that is one of the true leaders in the games industry. The open-source game editor abstracts the programming at AJOU UNIV on March 1, 2010 http://sag.sagepub.com Downloaded from 754 Simulation &amp; Gaming 40 (6) details of the platform away from the game, and provides an easy and fast way of creating the domain and objectives of game. Thus, the students can focus their learning on the story line, game boarding, and psychologically manipulating the player. The programmable tournament allows the students to devise and build game strategy in a multiplayer arena. This is quite effective as a tutorial for assessing the students&apos; problem solving and programming skills. Finally, the project demands that the student study and report on the approach to or method of developing games. These new topics are excellent for marrying games development with software engineering, and provide for a wide range of learning and criteria for assessment of the students. This section discusses the new topics introduced into the game programming and other similar courses in a computer science/engineering program. The topics are simple and easily adapted for most forms of games courses, yet they are also extremely effective in presenting meaningful depth and breadth to any software games engineering course

Advances in games technology: Software, models, and intelligence

Games technology has undergone tremendous development. In this article, the authors report the rapid advancement that has been observed in the way games software is being developed, as well as in the development of games content using game engines. One area that has gained special attention is modeling the game environment such as terrain and buildings. This article presents the continuous level of detail terrain modeling techniques that can help generate and render realistic terrain in real time. Deployment of characters in the environment is increasingly common. This requires strategies to map scalable behavior characteristics for characters as well. The authors present two important aspects of crowd simulation: the realism of the crowd behavior and the computational overhead involved. A good simulation of crowd behavior requires delicate balance between these aspects. The focus in this article is on human behavior representation for crowd simulation. To enhance the player experience, the authors present the concept of player adaptive entertainment computing, which provides a personalized experience for each individual when interacting with the game. The current state of game development involves using very small percentage (typically 4% to 12%) of CPU time for game artificial intelligence (AI). Future game AI requires developing computational strategies that have little involvement of CPU for online play, while using CPU's idle capacity when the game is not being played, thereby emphasizing the construction of complex game AI models offline. A framework of such nonconventional game AI models is introduced

Imaging biomarker roadmap for cancer studies

Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing ‘translational gaps’ through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored ‘roadmap’. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use

Radiotherapy for prostate cancer: is it ‘what you do’ or ‘the way that you do it’? A UK perspective on technique and quality assurance

Aims: The treatment of prostate cancer has evolved markedly over the last 40 years, including radiotherapy, notably with escalated dose and targeting. However, the optimal treatment for localised disease has not been established in comparative randomised trials. The aim of this article is to describe the history of prostate radiotherapy trials, including their quality assurance processes, and to compare these with the ProtecT trial. Materials and methods: The UK ProtecT randomised trial compares external beam conformal radiotherapy, surgery and active monitoring for clinically localised prostate cancer and will report on the primary outcome (disease-specific mortality) in 2016 following recruitment between 1999 and 2009. The embedded quality assurance programme consists of on-site machine dosimetry at the nine trial centres, a retrospective review of outlining and adherence to dose constraints based on the trial protocol in 54 participants (randomly selected, around 10% of the total randomised to radiotherapy, n = 545). These quality assurance processes and results were compared with prostate radiotherapy trials of a comparable era. Results: There has been an increasingly sophisticated quality assurance programme in UK prostate radiotherapy trials over the last 15 years, reflecting dose escalation and treatment complexity. In ProtecT, machine dosimetry results were comparable between trial centres and with the UK RT01 trial. The outlining review showed that most deviations were clinically acceptable, although three (1.4%) may have been of clinical significance and were related to outlining of the prostate. Seminal vesicle outlining varied, possibly due to several prostate trials running concurrently with different protocols. Adherence to dose constraints in ProtecT was considered acceptable, with 80% of randomised participants having two or less deviations and planning target volume coverage was excellent. Conclusion: The ProtecT trial quality assurance results were satisfactory and comparable with trials of its era. Future trials should aim to standardise treatment protocols and quality assurance programmes where possible to reduce complexities for centres involved in multiple trials