Informatics Technology Research Articles

Непрохідність тонкої кишки продуктами харчування в дітей раннього віку: погляд на проблему, літературні дані та власні клінічні спостереження

Purpose - to improve the results of treatment of young children with small intestinal obstruction due to the introduction of informative imaging technologies and modern video treatment technologies; to present own clinical observations of food-related obstruction of the digestive tract in young children and their treatment. The article provides a review of the literature on small intestinal obstruction caused by food in young children. Only four cases have been established. There are 2 cases of food obstruction (corn kernels, pineapple, red fish) in children under 3 years of age. Based on my own experience, the use of the term «phytobezoar» in the treatment of small intestinal obstruction is substantiated. All underwent surgical treatment: 1 - laparotomy, 1 - laparoscopic. All children recovered and were discharged from the clinic. The diagnosis and verification of food-related intestinal obstruction in young children is primarily based on the results of a thorough history. It is advisable to use the following methods in order to verify the location of the obstruction and establish the factor: X-ray examination of the organs of the abdominal cavity, both during hospitalization and during the course of the disease, CT scan, as well as ultrasound of the abdominal cavity. The presence of doubts in determining the cause of small intestinal obstruction is an indication for diagnostic laparoscopy. The interpretation of the term phytobezoar should have a basis, taking into account the time of obstruction and stay of the product in the digestive system, conditions and types of food. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent from the child’s parents was obtained for the research. No conflict of interests was declared by the authors.

Lessons Learned in Change Management in Deploying Novel Informatics Solutions: Experience Implementing a Point-of-Care Patient Photography System with Radiography

We describe implementation of a point-of-care system for simultaneous acquisition of patient photographs along with portable radiographs at a large academic hospital. During the implementation process, we observed several technical challenges in the areas of (1) hardware—automatic triggering for photograph acquisition, camera hardware enclosure, networking, and system server hardware and (2) software—post-processing of photographs. Additionally, we also faced cultural challenges involving workflow issues, communication with technologists and users, and system maintenance. We describe our solutions to address these challenges. We anticipate that these experiences will provide useful insights into deploying and iterating new technologies in imaging informatics.

Pelatihan Pembuatan CV Yang Menarik Menggunakan Aplikasi Canva Pada SMK Muhammadiyah 3, Tangerang

Usually applying for a job one has to prepare supporting documents, one of which is a CV or Curiculum Vitae. However, in this globalization era, people usually make CVs as attractive as possible to attract users to continue to the next stage. Therefore, many people use platforms, applications or websites that can make an attractive CV, one of which is the Canva application. Canva is a graphic design application used to create social media graphics, presentations, posters, documents and other visual content. This application provides a variety of design examples to use. Canva consists of two types of services, namely free and paid. For paid services, Canva provides Canva Pro and Canva for Enterprise. In addition, users can also pay for products physically to be printed and shipped. Muhammadiyah 3 South Tangerang Vocational School, which was established on July 1 2009, has two Department Programs, namely Business Management with Accounting Skills Competency and Informatics Technology with Computer Network Engineering Skills Competency. Because of this, we hope that this training on making CVs can help friends at school to make CVs and later can be used to apply for jobs when friends have graduated from the Vocational School.

Analyzing and Measuring the Impact of the Digital Economy on International Trade, the Case of Jordan for the Period (1990-2020)

The digital economy is defined as the economy that relies mainly on the economics of information and informatics technology that is based on digital technology. The sectors of information, communication and informatics technology have become one of the most important sectors driving economic growth in the developed countries now, because of the great potential they contain in various fields of the modern economy. The research aims to study the impact of the digital economy on international trade. Descriptive, as a general introduction to the various concepts of the digital economy and its role in international trade, as well as relying on the statistical quantitative analytical approach to analyze the results obtained. The research concluded many results and proposals.

Paradigm Shift from Telemedicine to Autonomous Human Health and Performance for Long-Duration Space Missions

This paper discusses a Prognostics and Health Management [PHM]-based approach to implementing Human Health & Performance [HH&P] technologies. Targeted specifically are NASA Autonomous Medical Decision and Integrated Biomedical Informatics of Human Health, Life Support, and Habitation Systems in Technology Area 06 [TA 06] of NASA integrated technology roadmap [April 2012]. The proposed PHM-based implementation is to bridge PHM, an engineering discipline, to the HH&P technology domain to mitigate space travel risks by focusing on efforts to reduce countermeasure mass and volume, and drive down risks to an acceptable level. NASA Autonomous Medical Decision technology is based on wireless handheld devices and is a result of a necessary paradigm shift from telemedicine to HH&P autonomy. The Integrated Biomedical Informatics technology is based on Crew Electronic Health Records [CEHR], equipped with a predictive diagnostics capability developed for use by crew members rather than by healthcare professionals. This paper further explores the proposed PHM-based solutions for crew health maintenance in terms of predictive diagnostics to provide early and actionable real-time warnings to each crew member about health-related risks and impending health problems that otherwise might go undetected. The paper also discusses the paradigm’s hypothesis and its innovation methodology, as implemented with computed biomarkers. The suggested paradigm is to be validated on the International Space Station [ISS] to ensure that crew autonomy in terms of the inherent predictive capability and two-fault-tolerance of the methodology become the dominant design drivers in sustaining crew health and performance.

GEOINFORMATION REPRESENTATION MODEL FOR SOLVING PROBLEMS OF INFORMATIZATION OF URBAN ECONOMY

The development of management informatization technologies provides an opportunity to move to complex management, which is based on the analysis of big data and complex modeling mechanisms. A number of digital smart city management services require the use of geoinformation services for their implementation. Modern technical means make it possible to obtain the exact coordinates of the location from which the signal about the problem came from, but at present adequate mathematical models have not been developed. The article considers one of the variants of geoinformation presentation models. The location of the problem is a set of geocoordinates that determine the point of the fixed problem, determined using positioning systems on the ground. The problem location set is specified using a series of sets. Depending on the category of the problem being solved, on the basis of the existing rules for the execution of the application, a specific set of statuses is selected from the set of Sets of application statuses. A set of application statuses is a set of stages for performing work on an application that configures the sequence of work execution, their composition, and the list of performers. Sets of application statuses are formed on the basis of regulations, which prescribe the procedure for performing work and providing services for a particular problem. The model provides for specifying a set of problem locations, selecting, based on existing regulations, a specific set of statuses from a set of application status sets, taking into account the type of problem, accepted and used regulations and a set of access rights. The practical implementation of the proposed model is presented – a service for receiving applications from the population on urban issues MakeOrellBetter.rf.

The Coupling Between Tropical Meteorology, Aerosol Lifecycle, Convection, and Radiation during the Cloud, Aerosol and Monsoon Processes Philippines Experiment (CAMP2Ex)

Abstract The NASA Cloud, Aerosol, and Monsoon Processes Philippines Experiment (CAMP2Ex) employed the NASA P-3, Stratton Park Engineering Company (SPEC) Learjet 35, and a host of satellites and surface sensors to characterize the coupling of aerosol processes, cloud physics, and atmospheric radiation within the Maritime Continent’s complex southwest monsoonal environment. Conducted in the late summer of 2019 from Luzon, Philippines, in conjunction with the Office of Naval Research Propagation of Intraseasonal Tropical Oscillations (PISTON) experiment with its R/V Sally Ride stationed in the northwestern tropical Pacific, CAMP2Ex documented diverse biomass burning, industrial and natural aerosol populations, and their interactions with small to congestus convection. The 2019 season exhibited El Niño conditions and associated drought, high biomass burning emissions, and an early monsoon transition allowing for observation of pristine to massively polluted environments as they advected through intricate diurnal mesoscale and radiative environments into the monsoonal trough. CAMP2Ex’s preliminary results indicate 1) increasing aerosol loadings tend to invigorate congestus convection in height and increase liquid water paths; 2) lidar, polarimetry, and geostationary Advanced Himawari Imager remote sensing sensors have skill in quantifying diverse aerosol and cloud properties and their interaction; and 3) high-resolution remote sensing technologies are able to greatly improve our ability to evaluate the radiation budget in complex cloud systems. Through the development of innovative informatics technologies, CAMP2Ex provides a benchmark dataset of an environment of extremes for the study of aerosol, cloud, and radiation processes as well as a crucible for the design of future observing systems.

Generate Analysis-Ready Data for Real-world Evidence: Tutorial for Harnessing Electronic Health Records With Advanced Informatic Technologies.

Although randomized controlled trials (RCTs) are the gold standard for establishing the efficacy and safety of a medical treatment, real-world evidence (RWE) generated from real-world data has been vital in postapproval monitoring and is being promoted for the regulatory process of experimental therapies. An emerging source of real-world data is electronic health records (EHRs), which contain detailed information on patient care in both structured (eg, diagnosis codes) and unstructured (eg, clinical notes and images) forms. Despite the granularity of the data available in EHRs, the critical variables required to reliably assess the relationship between a treatment and clinical outcome are challenging to extract. To address this fundamental challenge and accelerate the reliable use of EHRs for RWE, we introduce an integrated data curation and modeling pipeline consisting of 4 modules that leverage recent advances in natural language processing, computational phenotyping, and causal modeling techniques with noisy data. Module 1 consists of techniques for data harmonization. We use natural language processing to recognize clinical variables from RCT design documents and map the extracted variables to EHR features with description matching and knowledge networks. Module 2 then develops techniques for cohort construction using advanced phenotyping algorithms to both identify patients with diseases of interest and define the treatment arms. Module 3 introduces methods for variable curation, including a list of existing tools to extract baseline variables from different sources (eg, codified, free text, and medical imaging) and end points of various types (eg, death, binary, temporal, and numerical). Finally, module 4 presents validation and robust modeling methods, and we propose a strategy to create gold-standard labels for EHR variables of interest to validate data curation quality and perform subsequent causal modeling for RWE. In addition to the workflow proposed in our pipeline, we also develop a reporting guideline for RWE that covers the necessary information to facilitate transparent reporting and reproducibility of results. Moreover, our pipeline is highly data driven, enhancing study data with a rich variety of publicly available information and knowledge sources. We also showcase our pipeline and provide guidance on the deployment of relevant tools by revisiting the emulation of the Clinical Outcomes of Surgical Therapy Study Group Trial on laparoscopy-assisted colectomy versus open colectomy in patients with early-stage colon cancer. We also draw on existing literature on EHR emulation of RCTs together with our own studies with the Mass General Brigham EHR.

Application of Information Technology to Education in the Age of the Fourth Industrial Revolution

The purpose of this study is to clarify the readiness and challenges of learning information technology, and the challenges of education in this fourth era in applying information technology to learning insights. That's it. As a driver of information technology for learning insights in Indonesia, Indonesia's willingness to face the challenges of the era 4th has made us a credible player in the field of education management to improve human resource management through education and analysts. The challenges of the fourth growth area will soon improve. Therefore, Indonesia's current educational administration policy prioritizes the use of digital technology and progress in educational informatics for her four-year-olds at all levels of education, especially in higher education institutions. Solutions that can be implemented include setting appropriate curricula and educational guidelines, preparing human resources to use information and communication technologies, optimizing student skills and personal development, and preparing for digital learning facilities and infrastructure.

Application of Information Technology to Education in the Age of the Fourth Industrial Revolution

The purpose of this study is to clarify the readiness and challenges of learning information technology, and the challenges of education in this fourth era in applying information technology to learning insights. That's it. As a driver of information technology for learning insights in Indonesia, Indonesia's willingness to face the challenges of the era 4th has made us a credible player in the field of education management to improve human resource management through education and analysts. The challenges of the fourth growth area will soon improve. Therefore, Indonesia's current educational administration policy prioritizes the use of digital technology and progress in educational informatics for her four-year-olds at all levels of education, especially in higher education institutions. Solutions that can be implemented include setting appropriate curricula and educational guidelines, preparing human resources to use information and communication technologies, optimizing student skills and personal development, and preparing for digital learning facilities and infrastructure.

Calibrated Uncertainty: How In-Vitro Fertilization Patients Use Information to Regulate Emotion

The acquisition of information and its use in decision making and coping by people with health concerns have garnered much attention in CSCW. This study investigated patients' information behavior during a critical treatment, in vitro fertilization (IVF). Based on in-depth interviews with 29 IVF patients, this study uncovered several underlying drivers and mechanisms accounting for patients' information behavior. Their behavior is shown to be driven by coping concerns - specifically, dealing with the unpredictability of the treatment outcome, overcoming feelings of powerlessness and the sense of being out of control, and managing difficult emotionality. These factors shape patients' information needs and drive their behaviors in seemingly irrational but ultimately logical and adaptive ways. In contrast to the conventional wisdom that patients typically seek information that can help them fill knowledge gaps to resolve treatment uncertainty and foster their positive emotions, we discovered that in response to the desire to control their perceptions of irresolvable uncertainty and the difficult emotional needs of the moment, IVF patients frequently used ?calibrated uncertainty" - a psychological mechanism or state driven by the simultaneous seeking of varying levels and contradictory valences of certainty - to actively conduct targeted searches and actively use the information sought. This behavior has not always been understood by the IVF clinicians, who have assumed that information was primarily for knowledge transfer. This study shows that coping, emotion regulation, and information-seeking are inextricably bound together in the patient experience, and that this intertwining must be considered in the clinical setting for physician-patient communication and for patient-facing information. The findings have several valuable design implications for improved health informatics technology and service delivery systems.

From Zero to Infinity: Research on the Development Process of Intelligent Manufacturing

Intelligent manufacturing is flourishing in the 21st century. This paper takes the brief history of exploring the development of intelligent manufacturing as a staring point, explains the current intelligent and informative technologies and achievements of intelligent manufacturing by describing the impact of intelligent manufacturing on traditional manufacturing, proposes reflections on the shortcomings and limitations of intelligent manufacturing in China. And our country advocates human-centered intelligent manufacturing, continuously improves the system and innovates technology, while reasonably plans the three directions. Finally, we extend to digital twin technology and explore it in the intelligent manufacturing to promote the further upgrade. Besides, the study shows that the country will continue to use intelligent manufacturing as a traction and the industrial internet as a means to seize new opportunities and create a new ecology of production.

Abstract 4275: Averon: informatics platform to discover Actionable Vulnerabilities Enabled by Rewired Oncogenic Networks

Abstract Missense mutations can change protein structure, cellular localization, and functions. Such changes lead to the rewiring of protein-protein interaction (PPI) networks, activation of oncogenic pathways, and acquisition of cancer hallmarks. However, the translation of the landscape of oncogenic mutations into clinically actionable biological models for cancer target discovery remains a major challenge. We address this challenge by leveraging the power of computational systems biology supported by high-throughput screening technologies. While some mutations can disrupt the PPIs, others may induce new PPIs that are not natural for the wild-type counterparts. Recently, we have established a quantitative High Throughput differential Screening (qHT-dS) platform [1] to discover such mutant-enabled or neomorph PPIs (neoPPIs). The screening of more than 13,000 mutant interactions revealed a landscape of gain-of-interactions encompassing both oncogenic and tumor suppressor mutations. This emerging neoPPI landscape may offer new mutant-directed therapeutic approaches for precision medicine. However, to infer clinically actionable mechanistic insights into how neoPPIs promote tumorigenesis special computational tools are needed. To inform the neoPPI-based target discovery, we develop a set of innovative informatics tools for discovering Actionable Vulnerabilities Enabled by Rewired Oncogenic Networks (Averon). Implemented in a widely-used Jupyter Notebook format, the Averon streamlines the identification of the oncogenic programs and clinically significant genes that are regulated by neoPPIs in cancer patients. The Averon can recapitulate well-established connectivity between known mutant-dependent PPIs and specific oncogenic pathways and reveal new, previously unknown mechanisms of neoPPI-mediated oncogenic signaling. To inform new therapeutic strategies in neoPPI-dependent cancers, Averon connects neoPPI-regulated genes with available approved drugs and clinical compounds. Together, the Averon provides a powerful informatics environment to determine therapeutically actionable vulnerabilities created by mutant-regulated protein-protein interactions to inform new personalized therapeutic strategies in cancer. Acknowledgments: This work was supported in part by NCI’s Informatics Technology for Cancer Research (ITCR) Program (R21CA274620, A.A.I.), Winship Cancer Institute #IRG-17-181-06 from the American Cancer Society (A.A.I.). Cancer Target Discovery and Development (CTD2) Network (U01CA217875, H.F.), NCI Emory Lung Cancer SPORE (P50CA217691, H.F.), Career Enhancement Program (A.A.I., P50CA217691), Winship Cancer Institute (NIH 5P30CA138292).

Abstract 441: Targeting MKK3-MYC complex to reduce racial survival disparity in breast cancer

Abstract Breast cancer is the most common cancer and the leading cause of cancer-related death in women. The triple-negative breast cancer (TNBC) is the most aggressive type of breast cancer. African American women experience up to 2-fold higher incidence of TNBC as compared to White women. Moreover, African Americans die from breast cancer at up to 40% higher rate than White and Hispanic women. However, there is no therapeutic options are currently available to reduce survival disparity in breast cancer. To address this unmet medical need, we develop novel computational methods combined with experimental chemical biology and high-throughput screening (HTS) technologies. Using our specially designed bioinformatics workflow, we discovered that high expression of mitogen-activated protein kinase kinase 3 (MKK3) strongly correlates with worsened clinical outcomes in African American TNBC patients. The analysis of TNBC patient genomic profiles revealed that MKK3 promotes TNBC in part by activating the major tumor driver transcription factor MYC. MYC is a highly appealing therapeutic target in TNBC, however, no approved MYC inhibitors are available. We found that MKK3 binds and activates MYC through protein-protein interaction (PPI) in TNBC cells. Both genetic and pharmacological inhibition of the MKK3/MYC complex suppresses MYC activity and the viability of TNBC cells. Thus, MKK3/MYC interaction represents a novel vulnerability for therapeutic intervention in TNBC. By combining computational modeling with experimental HTS, we have discovered the first small molecule MKK3/MYC PPI inhibitors. For example, a quinoline derivative SGI-1027 disrupts the MKK3/MYC complex in cells and in vitro, inhibits MYC transcriptional activity, and suppresses the viability of TNBC cells. Together, our studies revealed a novel mechanism of TNBC tumorigenesis through MKK3-induced MYC activation, establish a new HTS to enable the discovery of potent and selective inhibitors to regulate MKK3/MYC complex, and may open new clinical strategies to reduce racial disparity in TNBC mortality. Acknowledgments: This work was supported in part by Mary Kay Ash Foundation Grant for Cancer Research (A.A.I.), Emory initiative on Biological Discovery through Chemical Innovation (A.A.I.), NCI’s Informatics Technology for Cancer Research (ITCR) Program (R21CA274620, A.A.I.), NCI Cancer Target Discovery and Development (CTD^2) Network (U01CA217875, H.F.), NCI Emory Lung Cancer SPORE (P50CA217691, H.F.), Career Enhancement Program (A.A.I., P50CA217691), Winship Cancer Institute (NIH 5P30CA138292).

Large scale crowdsourced radiotherapy segmentations across a variety of cancer anatomic sites

Clinician generated segmentation of tumor and healthy tissue regions of interest (ROIs) on medical images is crucial for radiotherapy. However, interobserver segmentation variability has long been considered a significant detriment to the implementation of high-quality and consistent radiotherapy dose delivery. This has prompted the increasing development of automated segmentation approaches. However, extant segmentation datasets typically only provide segmentations generated by a limited number of annotators with varying, and often unspecified, levels of expertise. In this data descriptor, numerous clinician annotators manually generated segmentations for ROIs on computed tomography images across a variety of cancer sites (breast, sarcoma, head and neck, gynecologic, gastrointestinal; one patient per cancer site) for the Contouring Collaborative for Consensus in Radiation Oncology challenge. In total, over 200 annotators (experts and non-experts) contributed using a standardized annotation platform (ProKnow). Subsequently, we converted Digital Imaging and Communications in Medicine data into Neuroimaging Informatics Technology Initiative format with standardized nomenclature for ease of use. In addition, we generated consensus segmentations for experts and non-experts using the Simultaneous Truth and Performance Level Estimation method. These standardized, structured, and easily accessible data are a valuable resource for systematically studying variability in segmentation applications.

Relationship between Cyber Security and Civil Protection in the Greek Reality

The links between cybersecurity and civil protection in the last decades became strong due to the rapid increase in the use of Informatics Technologies (IT) worldwide and the need to increase citizens’ protection from various disasters and uncertainties. The objective of the present study is to explore the role of cyber security in enhancing civil protection in Greek reality. Methodologically, the study has been based on a survey with a sample of 345 executives of IT companies in Greece by using a structured questionnaire. The basic results of the research study showed that cyber security technologies positively affect civil protection, cybercrime reduction practices have a positive influence on civil protection, and there is a significant relationship between the government’s role in cyber security and civil protection. Cybersecurity also may have a significant influence on the principles of emergency operations: prevention, mitigation, preparation, response, or emergency evacuation and recovery. The main conclusion from the study is that it is very important for public and private agencies in Greece, as well as in the rest of Europe, to embrace new emerging cybersecurity technologies to help enhance cyber security and civil protection. Potential vulnerabilities in cybersecurity pose substantial risks to the effectiveness and efficiency of such critical infrastructure and directly impact the functioning of states, economies, and societies.

Traditional Chinese medicine microbiomics and its research strategies

The tight relationships between microbiome and traditional Chinese medicine(TCM)have been widely recognized. New technologies, results, and theories are emerging in the field of microbiomics in recent years with the advances in high-throughput sequencing and multi-omics technologies. Based on the previous research, the present study has proposed the concept of TCM microbiomics(TCMM), which is an interdisciplinary subject aiming at elucidating the functions and applications of microbiome in the areas of herb resources, herb processing, herb storage, and clinical effects by using modern technology of biology, ecology, and informatics. This subject essentially contains the structures, functions, interactions, molecular mechanisms, and application strategies of the microbiome associated with the quality, safety, and efficacy of TCM. Firstly, the development of the TCMM concept was summarized, with the profound understanding of TCMM on the complexity and entirety of microbiome being emphasized. Then, the research contents and applications of TCMM in promoting the sustainable development of herb resources, improving the standardization and diversification of herb fermentation, strengthening the safety of herb storage, and resolving the scientific connotation of theories and clinical efficacy of TCM are reviewed. Finally, the research strategies and methods of TCM microbiomics were elaborated from basic research, application research, and system research. TCMM is expected to promote the integrative development of TCM with frontier science and technology, thereby expanding the depth and scope of TCM study and facilitating TCM modernization.

Membuat Aplikasi Penginputan Data Siswa pada Taman Kanak Kanak Harith Foundation Berbasis AppSheet

The development of informatics technology and science is very rapid and affects the field of information and management, especially in the field of data processing using computer technology. Computer technology is something that is highly coveted by every organization, because it will produce accurate and perfect information. The need for computers as a means of solving problems quickly and precisely cannot be denied. Currently, the Harith Foundation Kindergarten manages data. Managing Student and Student data, especially in recapitulating and filtering Student and Student data, is still using MS Excel and writing manually. Therefore the purpose of this study is to make an Apsheet-based application for entering student data at the Harith Foundation Kindergarten. The method used in this study is the Waterfall method. The waterfall method is a work method that emphasizes sequential and systematic phases. This application uses the AppSheet platform to process Student and Student data at Harith Foundation Kindergarten which can be used with computers and Android operating system, with the results of making Student and Student data collection applications at Harith Foundation Kindergarten making it easier for Kindergarten Secretaries and Teachers to collect data.

Bioengineering and medical informatics education in MD programs: perspectives from three Italian experiences

BackgroundGiven the impact of bioengineering and medical informatics technologies in health care, the design and implementation of education programs able to combine medical curricula with a proper teaching on engineering and informatics is now of paramount importance. In Italy, this goal has to fit in with the existing higher education system, which is structured into Bachelor programs and Master programs. Medicine and Surgery programs, instead, are designed as a six-year single-cycle Degree Program in Medicine and Surgery which comprises both class attendance and hospital internship and training. This program allows students to become Medical Doctors (MD). The different organization of this University program makes it not easy to introduce further contents, namely hard science courses, in the educational program. Notwithstanding this, we present here some recent innovative programs aimed at widening MD curriculum by including biomedical engineering and informatics subjects. In particular, we will introduce three of them. Two are joint-degree programs, the first between Humanitas University and Politecnico di Milano (MEDTEC School), and the second between University of Calabria and University Magna Graecia of Catanzaro (Medicina e Chirurgia TD). The Third one is a Professional Master coupled with an MD degree, based on a joint program among Pavia University, Pisa University, the Institute of Advanced studies in Pavia and the Scuola Superiore S. Anna in Pisa (MEET). ContributionThe paper provides a description of the fundamental design principles of the three above mentioned programs, and explores some aspects of the teaching modules, highlighting their positive aspects. In particular, we show how the three different programs allow students to enrich their knowledge by studying engineering subjects and innovative methods and technologies, as well as their applications to patient care. ConclusionsThe MEDTEC program is the first degree program at Italian and international scale which integrates medical and engineering subjects. In the following years, other programs were issued in Italy, defining similar education programs to couple a degree in medicine education with bioengineering and medical informatics, among which Medicina e Chirurgia TD and MEET. We believe the experiences described here in this paper represent the possibility of bridging the gap between medical and technological competencies.

Quality improvements in radiation oncology clinical trials.

Clinical trials have become the primary mechanism to validate process improvements in oncology clinical practice. Over the past two decades there have been considerable process improvements in the practice of radiation oncology within the structure of a modern department using advanced technology for patient care. Treatment planning is accomplished with volume definition including fusion of multiple series of diagnostic images into volumetric planning studies to optimize the definition of tumor and define the relationship of tumor to normal tissue. Daily treatment is validated by multiple tools of image guidance. Computer planning has been optimized and supported by the increasing use of artificial intelligence in treatment planning. Informatics technology has improved, and departments have become geographically transparent integrated through informatics bridges creating an economy of scale for the planning and execution of advanced technology radiation therapy. This serves to provide consistency in department habits and improve quality of patient care. Improvements in normal tissue sparing have further improved tolerance of treatment and allowed radiation oncologists to increase both daily and total dose to target. Radiation oncologists need to define a priori dose volume constraints to normal tissue as well as define how image guidance will be applied to each radiation treatment. These process improvements have enhanced the utility of radiation therapy in patient care and have made radiation therapy an attractive option for care in multiple primary disease settings. In this chapter we review how these changes have been applied to clinical practice and incorporated into clinical trials. We will discuss how the changes in clinical practice have improved the quality of clinical trials in radiation therapy. We will also identify what gaps remain and need to be addressed to offer further improvements in radiation oncology clinical trials and patient care.