Artificial Intelligence in Radiation Therapy

Artificial intelligence (AI) has great potential to transform the clinical workflow of radiotherapy. Since the introduction of deep neural networks, many AI-based methods have been proposed to address challenges in different aspects of radiotherapy. Commercial vendors have started to release AI-based tools that can be readily integrated to the established clinical workflow. To show the recent progress in AI-aided radiotherapy, we have reviewed AI-based studies in five major aspects of radiotherapy including image reconstruction, image registration, image segmentation, image synthesis, and automatic treatment planning. In each section, we summarized and categorized the recently published methods, followed by a discussion of the challenges, concerns, and future development. Given the rapid development of AI-aided radiotherapy, the efficiency and effectiveness of radiotherapy in the future could be substantially improved through intelligent automation of various aspects of radiotherapy

Expanding the medical physicist curricular and professional programme to include Artificial Intelligence

Purpose: To provide a guideline curriculum related to Artificial Intelligence (AI), for the education and training of European Medical Physicists (MPs). Materials and methods: The proposed curriculum consists of two levels: Basic (introducing MPs to the pillars of knowledge, development and applications of AI, in the context of medical imaging and radiation therapy) and Advanced. Both are common to the subspecialties (diagnostic and interventional radiology, nuclear medicine, and radiation oncology). The learning outcomes of the training are presented as knowledge, skills and competences (KSC approach). Results: For the Basic section, KSCs were stratified in four subsections: (1) Medical imaging analysis and AI Basics; (2) Implementation of AI applications in clinical practice; (3) Big data and enterprise imaging, and (4) Quality, Regulatory and Ethical Issues of AI processes. For the Advanced section instead, a common block was proposed to be further elaborated by each subspecialty core curriculum. The learning outcomes were also translated into a syllabus of a more traditional format, including practical applications. Conclusions: This AI curriculum is the first attempt to create a guideline expanding the current educational framework for Medical Physicists in Europe. It should be considered as a document to top the sub-specialties' curriculums and adapted by national training and regulatory bodies. The proposed educational program can be implemented via the European School of Medical Physics Expert (ESMPE) course modules and - to some extent - also by the national competent EFOMP organizations, to reach widely the medical physicist community in Europe.Peer reviewe

Winter Survival of Individual Honey Bees and Honey Bee Colonies Depends on Level of Varroa destructor Infestation

Background: Recent elevated winter loss of honey bee colonies is a major concern. The presence of the mite Varroa destructor in colonies places an important pressure on bee health. V. destructor shortens the lifespan of individual bees, while long lifespan during winter is a primary requirement to survive until the next spring. We investigated in two subsequent years the effects of different levels of V. destructor infestation during the transition from short-lived summer bees to long-lived winter bees on the lifespan of individual bees and the survival of bee colonies during winter. Colonies treated earlier in the season to reduce V. destructor infestation during the development of winter bees were expected to have longer bee lifespan and higher colony survival after winter. Methodology/Principal Findings: Mite infestation was reduced using acaricide treatments during different months (July, August, September, or not treated). We found that the number of capped brood cells decreased drastically between August and November, while at the same time, the lifespan of the bees (marked cohorts) increased indicating the transition to winter bees. Low V. destructor infestation levels before and during the transition to winter bees resulted in an increase in lifespan of bees and higher colony survival compared to colonies that were not treated and that had higher infestation levels. A variety of stress-related factors could have contributed to the variation in longevity and winter survival that we found between years. Conclusions/Significance: This study contributes to theory about the multiple causes for the recent elevated colony losses in honey bees. Our study shows the correlation between long lifespan of winter bees and colony loss in spring. Moreover, we show that colonies treated earlier in the season had reduced V. destructor infestation during the development of winter bees resulting in longer bee lifespan and higher colony survival after winter

Vulnerable Children, Young People, and Families: Policy, Practice, and Social Justice in England and Scotland

This chapter begins by highlighting the rise of vulnerability as a term in social policy, and the three-level approach that is used to examine it. The first level is definitional, examining the possibility of defining vulnerability and vulnerabilities through a consideration of relevant literature and a number of recent policy documents. The second looks at how policy developments in Scotland and England have diverged, particularly since 2010, and how vulnerability has become more central to education policy in England. The third level focuses on practice, presenting research undertaken by the authors into a programme developed to support vulnerable children, young people, and families in Northern England as a case study exemplifying some of the factors affecting the effectiveness of programmes in which schools played an important but not central part. This practice perspective is still too often overlooked in discussions of policy and definition, and it is suggested that its inclusion will contribute to the ongoing debate about both how best to support vulnerable families and the implications for education and social justice

Re-Visioning Public Health Approaches for Protecting Children

This volume provides readers around the globe with a focused and comprehensive examination of how to prevent and respond to child maltreatment using evidence-informed public health approaches and programs that meet the needs of vulnerable children, and struggling families and communities. It outlines the system failures of contemporary forensically-driven child protection practice. Detailed guidance is provided about how to re-think earlier intervention strategies, and establish stronger and more effective programs and services that prevent maltreatment at the population level. Service user and stakeholder perspectives, particularly from marginalized groups including Indigenous peoples, highlight how public health approaches can better support families and keep children safe. Case studies from different countries grapple with the fraught nature of large system change and the various strategies needed to effect multi-level reforms. Presenting the reader with an array of innovative services used in different institutional and community context, this volume confronts the complex challenges found in implementing successful prevention programs that are aligned with diverse cultural and political environments and community expectations

Reconstructing the workforce within public health protective systems : Improving resilience, retention, service responsiveness and outcomes

Background Unacceptably high staff turnover has plagued traditional approaches to child protection, seemingly forever. Around the globe, numerous studies, reports and inquiries have highlighted how statutory agencies, focusing on risk-oriented investigations of suspected maltreatment, experience significant issues with worker stress and its occupational and organisational consequences. Yet, promoting staff resilience within child protection agencies’ workforces has proved to be quite elusive at a systems level. While concern about child protection services often centers on the children and families agencies they intend to assist, the experiences of workers within the system provide further evidence that the system is itself failing. As a result, governments around the world are increasingly embracing system reforms that promote public health approaches focusing on early intervention and prevention to build child, family and neighbourhood support capacity and resilience and thereby reduce child maltreatment. Objective We review the workforce issues affecting traditional child protection approaches and its impacts. In light of this, we examine the knowledge to be applied in the development of public health approaches that embrace integrated and coordinated systems of community care. Such reforms, with altered organisational remits that are far broader than narrow tertiary responses of investigation and removal, utilize evidence-based interventions targeted at differentiated risk and service user needs to provide effective supports and reduce maltreatment. This article unpacks the strategies needed to build and properly prepare a re-tooled workforce capable of implementing a public health model of preventive interventions. Participants and setting Not applicable. Methods Current public health reforms are examined through the lens of their potential impacts upon contemporary workforce issues. Focusing upon building a stable, resilient and appropriately skilled workforce for a public health model, we examine the implications for key stakeholders including workers, program and organisational leaders, educators, researchers, academics and community members, especially children and vulnerable families. Results and conclusions Public health approaches to protecting children seek to provide effective supports and services in timely ways in order to prevent unnecessary statutory interventions, which affect those from cultural and poor communities disproportionately. But remodelling systems to embrace these approaches entails complex practice, program, policy and legislative changes, using evidence to intervene in ways that are primarily voluntary rather than coercive. In doing so they provide potential to recast the basis of the helping relationship to attend better to the relational aspects of changed behaviour. Embedding workforce resilience strategies in reformed systems is necessary to address retention and ensure service effectiveness and responsiveness to the diversity of needs of struggling families and impoverished communities. Thereby, public health approaches are well placed to achieve their true potential

The Personal Security of Children Demands Bold System Reform

In this article, we argue for a new approach to child welfare—one that replaces existing child protection systems beset by scandals and tragedies with broad-scale system re-alignment that places public health prevention and early intervention at the forefront of efforts to engage, support, and empower families. We explain that the ‘rescue and removal’ orientation that drives policies and practices in contemporary child welfare and child protection systems is deeply flawed in its orientation, lacking in its evidence of effectiveness, and fiscally unsustainable. We point to differential response as one attempt to reform child welfare systems from within, but note that the changes DR brings, while promising, are insufficient to achieve what is required to eradicate child maltreatment and bring about a more just and sustainable practice of promoting the welfare of children. Here, we also share some emerging and encouraging initiatives from around the globe to illustrate the promise of prevention and early intervention approaches—what we call beacons of hope. For the sake of all children, it is time think boldly about the potential that exists in broad-scale, systemic and cross-sectoral reform that fully and unabashedly embraces universal and primary prevention as a means to ensure children’s right to personal security

Core Components of Public Health Approaches to Preventing Child Abuse and Neglect

Contemporary approaches to child protection have significant limitations and unintended consequences for children, parents, families, and communities. Statutory services struggle to engage with families who need support, to address the broader safety needs of children across the community, and to drive a culture of prevention of all forms of child maltreatment. There is a significant gap between prevalence, and cases of child maltreatment that come to the attention of statutory child protection authorities. Also, child protection services typically are not oriented or equipped to deal with non-familial abuse or harm to which children are exposed (such as extra-familial child sexual abuse, including in youth-serving organizations, harmful behavior from peers, and online grooming/abuse). In response, many now call for a new prevention-focused approach that draws on the learnings from public health. In this chapter, we examine public health approaches to preventing maltreatment and increasing safety and wellbeing for children and young people. We identify six core components of effective public health approaches. Population-wide prevention strategies to address known risks, using evidence-based interventions, leveraging existing universal service delivery platforms as the springboard for additional targeted services, can facilitate and improve child outcomes

How COVID-19 is placing vulnerable children at riskand why we need a new approach to child welfare

The onset of the COVID-19 pandemic brings new worries about the welfare of children, particularly those of families living in poverty and impacted other risk factors. These children will struggle more during the pandemic because of financial pressures and stress placed on parents, as well as their limited access to services and systems of support. In this commentary, we explain how current circumstances reinforce the need for systemic change within statutory child welfare systems and the benefits that would accrue by implementing a continuum of services that combine universal supports with early intervention strategies. We also focus on promising approaches consistent with goals for public health prevention and draw out ideas related workforce development and cross-sector collaboration