Competency in evidence-based medicine and associated factors among medical radiology technologists in Addis Ababa, Ethiopia.

INTRODUCTION: Evidence-based medicine integrates clinical expertise, patient values and best research evidence in clinical decision-making. This study aimed to assess evidence-based medicine knowledge, attitudes, practices and associated factors among medical radiology technologists in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted among 392 medical radiology technologists from May to August 2022 using a self-administered questionnaire. Bivariate and multivariate logistic regression identified factors associated with evidence-based medicine practice. RESULTS: Most medical radiology technologists (57.7%) had moderate evidence-based medicine knowledge and 94.9% had favourable attitudes. However, 64.8% demonstrated poor evidence-based medicine practice. Factors significantly associated with better evidence-based medicine practice were moderate knowledge (AOR 1.949, 95% CI 1.155-3.291), good statistical understanding (AOR 1.824, 95% CI 1.135-2.930), sufficient time for evidence-based medicine (AOR 1.892, 95% CI 1.140-3.141), institutional support (AOR 2.093, 95% CI 1.271-3.440) and evidence-based medicine resource access (AOR 1.653, 95% CI 1.028-2.656). CONCLUSION: Despite moderate knowledge and positive attitudes towards evidence-based medicine, most medical radiology technologists had suboptimal utilisation. Strategies to improve knowledge, ensure dedicated time, provide institutional support and resources could enhance evidence-based radiology practice.

Overview of dental radiology education for medical radiology students in Taiwan.

Background/purpose: In Taiwan, the formal education for cultivating medical radiation technologists began in 1965. However, there are very few dental radiology curricula in Taiwan's medical radiology schools. We investigated mainly the appearance of dental radiology education for medical radiology students in Taiwan. Materials and methods: We used documentary analysis, a survey of dental radiology education, and secondary data analysis in this study to find the appearance of Taiwan's dental radiology education for medical radiology students. Results: There were currently ten medical radiology schools. Among them, five offered independent curricula in their subject schedules and another five had dental radiology education included in their general medical radiology curricula. Of the 53 dental radiology teaching hospitals, 21 (39.62%) were medical centers and 25 (47.17%) were regional hospitals, and these large hospitals were concentrated in the northern region of Taiwan. These large dental radiology teaching hospitals offered more training hours of dental radiology internship for medical radiology students and had a higher availability for the medical radiology students. Conclusion: In Taiwan, the current status of dental radiology curricula in the medical radiology schools is indeed seriously insufficient. A dental radiology education system should be established in the future, including the innovative dental radiology curricula developed for medical radiology students and more dental radiology curricula designed for dental students. This in turn can create new career options for medical radiology students and new practice directions for medical radiation technologists, and then expand their potential involvement in dental radiology.

Thyroid abnormalities and influencing factors in medical radiology workers in Guangdong Province / 环境与职业医学

Background The thyroid gland is one of the organs sensitive to ionizing radiation, and there are few studies on the effects of long-term exposure to low doses of ionizing radiation on the thyroid gland of radiation workers. Objective To investigate thyroid abnormalities in workers in medical radiology departments in Guangdong Province and to identify potential influencing factors of thyroid abnormalities. Methods A total of 1657 radiation workers from 48 hospitals in Guangdong Province were selected as survey subjects using convenience sampling, and their personal dose monitoring results and health examination information were retrospectively analyzed to determine the factors affecting thyroid abnormalities. Results The M (P25, P75) of thyroid absorbed dose (DT) was 1.55 (0.65, 3.96) mGy in the 1657 investigated workers. The attribute-specific medians of DT were 1.29, 1.38, 1.99, and 3.51 mGy for departments of diagnostic radiology, interventional radiology, radiotherapy, and nuclear medicine, respectively; and 1.10, 1.55, and 1.80 mGy for job titles of nurse, technician, and physician, respectively. Differences in DT by gender, age, years of radiological work, age of radiation exposure onset, occupational category, and job title were statistically significant (Z=−6.35, H=708.52, 918.20, 31.19, 95.64, 39.28, P<0.05). The positive rate of thyroid abnormalities in investigated workers was 46.53% (771/1657). Among them, the positive rate of abnormal thyroid function was 22.87% (379/1657), that of abnormal thyroid morphology was 33.98% (563/1657), and that of thyroid nodule was 26.55% (440/1657). The differences in thyroid abnormality rates by gender, age, years of radiation work, age of radiation exposure onset, DT, and job title of radiation workers were statistically significant (χ2=51.89, 49.64, 20.54, 18.29, 12.07, 16.16, P<0.05). The differences in abnormal thyroid function positive rate by gender, age of radiation exposure onset, and job title were statistically significant (χ2=26.21, 6.21, 8.32, P<0.05). The differences in the positive rates of abnormal thyroid morphology and nodules were statistically significant by gender, age, years of radiological work, age of radiation exposure onset, DT, and job title (abnormal thyroid morphology, χ2=40.24, 64.17, 37.63, 15.17, 19.28, 15.05; nodules, χ2=31.41, 77.98, 42.11, 19.16, 21.70, 13.52, P<0.05). The positive rates of thyroid abnormality, thyroid morphology abnormality, and nodules all showed a linear increasing trend with increasing age, years of radiation work, and age of radiation exposure onset (P<0.05). The results of logistic regression analysis indicated that the factors influencing thyroid abnormalities were female (OR=2.17, 95%CI: 1.72-2.74), increased years of radiological work (OR=1.04, 95%CI: 1.03-1.06), onset of radiation exposure in age groups of 30-34 and ≥35 years (OR=1.63, 95%CI: 1.12-2.37; OR=2.58, 95%CI: 1.74-3.29), and working in department of diagnostic radiology (OR=1.40, 95%CI: 1.07-1.84). Conclusion Long-term exposure to low doses of ionizing radiation has an effect on thyroid abnormalities in medical radiation workers. Among them, being female, physicians, and working in department of diagnostic radiology are at a higher risk of abnormal thyroid function; being female, increased years of radiation work, and radiation exposure onset at age ≥30 years are associated with a higher risk of reporting abnormal thyroid morphology.

Image-Based Differentiation of Benign and Malignant Peripheral Nerve Sheath Tumors in Neurofibromatosis Type 1.

Neurofibromatosis type 1 (NF1) is a dominant hereditary disease characterized by the mutation of the NF1 gene, affecting 1/3000 individuals worldwide. Most NF1 patients are predisposed to benign peripheral nerve sheath tumors (PNSTs), including cutaneous neurofibromas (CNFs) and plexiform neurofibromas (PNFs). However, 5%-10% of PNFs will ultimately develop into malignant peripheral nerve sheath tumors (MPNSTs), which have a poor prognosis. Early and reliable differentiation of benign and malignant tumors in NF1 patients is of great necessity. Pathological evaluation is the "gold standard" for a definite diagnosis, but the invasive nature of the biopsy procedure restricts it from applying as a screening tool during the decades-long follow-up of these patients. Non-invasive image-based diagnostic methods such as CT and MRI are often considered essential screening tools for multiple types of tumors. For NF1 patients' lifelong regular follow-ups, these radiological methods are currently used for tumor evaluation. However, no consensus was established on screening the malignant transformation of benign PNSTs. Moreover, novel technologies like radiogenomics and PET-MRI have not been well evaluated and fully adopted for NF1 patients. This review summarizes current studies of different imaging methods for differentiating benign and malignant tumors in NF1. Meanwhile, we discussed the prospects of the usage of new tools such as radiogenomics and PET-MRI to distinguish MPNST from benign PNSTs more precisely. Summarizing these findings will help clarify the directions of future studies in this area and ultimately contribute to the radiology images-based clinical screening of MPNST in NF1 patients and finally improve the overall survival rates of these patients.

The effect of waste medical radiology as fiber reinforcement on the behavior of eco-efficient self-compacting concrete.

An effort is being conducted to enhance some characteristics of self-compacted concrete (SCC) and clean the environment through the addition of waste plastic fibers resulting from the cuts of waste medical radiology. A number of tests were carried out to examine the impact of waste medical radiology (WMR) fiber additions with various aspect ratios and various percentages on SCC characteristics. Thus, various SCC mixes were designed at a constant water-to-binder ratio of 0.33 and 550 kg/m3 of binder content. The four groups of WMR fiber content were specified with different aspect ratios of (0, 40, 50, and 60) with various ratios of (1%, 1.25, and 1.5%) by volume of concrete. The workability characteristics of SCC mixes were determined by fresh density, segregation resistance, L-box height ratio, T50 slump with V-funnel flow time, and slump flow diameter. Also, the measurement of thermal conductivity, compressive, flexural, and splitting tensile strengths were performed at 28 days for SCC mixtures. The findings revealed that WMR fibers have a negative impact on the fresh characteristics of SCC except for segregation resistance, which improved. However, the results of splitting tensile and compressive strengths were enhanced at 1% WMR fiber content with various aspect ratios then decreased. However, all results of flexural strength were reduced in comparison with the control mixture excluding samples containing 1% WMR fibers with an aspect ratio of 50 which showed a higher result. The outcomes of thermal conductivity were reduced with the usage of various WMR fiber percentages and various aspect ratios in comparison with the control mixture, and the best result was obtained at 1.25% WMR fiber with an aspect ratio of 50.

Analysis of the current status of radiation protection in non-medical sectors in China / 中华放射医学与防护杂志

Objective:To analyzes the current status of radiation protection in non-medical sectors, together with the vulnerable spots in the prevention and control of occupational radiation sickness in China in order to provides both technical basis for occupational health management in non-medical radiation sectors and the better protection of occupational health benefits for radiation workers.Methods:The monitoring plan for this survey was worked out on the part of the National Institute for Radiological Protection, China CDC. Survey and monitoring of the current status of radiation protection and occupational health management were, under the monitoring the plan, completed by the relevant agencies of all provincial-level regions for the key industries of non-medical sectors countrywide, involving occupational health monitoring, personal dose monitoring, radiation protection monitoring instruments equipped, and radiation protection monitoring in workplace. Based on the survey result , the deficiencies in radiation protection and occupational health monitoring in non-medical sectors were analyzed.Results:The survey of non-medical sectors was divided into general investigation and detailed monitoring, with the general investigations covering 9 075 non-medical institutions in 31 provincial-level regions across the country. Of them, a total of 4 911 institutions within 329 district-level regions received detailed investigation and radiation protection monitoring. As survey result , the X, γ ambient dose equivalent rates for the institutions using ray-generator are greater than 2.5 μSv/h, about 2.35% of the total, with a maximum of 817 μSv/h. The values for those using radioactive sources were greater than 2.5 μSv/h, about 9.57%, with a maximum of 1 700 μSv/h. The frequencies of personal dose monitoring and occupational health examination were 72.9% and 82.1%, respectively.Conclusions:There is still a gap in radiation protection between the current status and the national regulations and standards in non-medical sectors, so both regulation and management of radiation protection should be further strengthened.

X-Ray Hesitancy: Patients' Radiophobic Concerns Over Medical X-rays.

All too often the family physician, orthopedic surgeon, dentist or chiropractor is met with radiophobic concerns about X-ray imaging in the clinical setting. These concerns, however, are unwarranted fears based on common but ill-informed and perpetuated ideology versus current understanding of the effects of low-dose radiation exposures. Themes of X-ray hesitancy come in 3 forms: 1. All radiation exposures are harmful (i.e. carcinogenic); 2. Radiation exposures are cumulative; 3. Children are more susceptible to radiation. Herein we address these concerns and find that low-dose radiation activates the body's adaptive responses and leads to reduced cancers. Low-dose radiation is not cumulative as long as enough time (e.g. 24 hrs) passes prior to a repeated exposure, and any damage is repaired, removed, or eliminated. Children have more active immune systems; the literature shows children are no more affected than adults by radiation exposures. Medical X-rays present a small, insignificant addition to background radiation exposure that is not likely to cause harm. Doctors and patients alike should be better informed of the lack of risks from diagnostic radiation and the decision to image should rely on the best evidence, unique needs of the patient, and the expertise of the physician-not radiophobia.

Radiologists as Educators: A Narrative Review of the Literature.

OBJECTIVE: The purpose of this study was to examine literature on how radiologists are trained to be effective educators for both residents and undergraduates in the health professions. METHODS: A review of the literature was performed using relevant key words. Articles were retrieved through from 1990 through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. RESULTS: Of the 4716 unique abstracts reviewed by the author, 51 were found to be relevant to the purpose of this study. Faculty teaching skills seem to be solidified during residency. This may be due to a failure to include scholarship of teaching and learning in education and faculty development. Preliminary research shows that creating opportunity for faculty development is beneficial with much of this literature focused on explaining educational concepts to radiologists. CONCLUSION: The literature examining faculty training in the area of radiology education is sparse. Several articles address the need for more academic radiologists and the need for better training of academic radiologists. The few articles aimed at providing insight to radiologists in this area introduce basic educational concepts such as lecture creation, examination writing, and learning styles or simply delineating what makes an effective educator.

Italian registry of cardiac magnetic resonance.

OBJECTIVES: Forty sites were involved in this multicenter and multivendor registry, which sought to evaluate indications, spectrum of protocols, impact on clinical decision making and safety profile of cardiac magnetic resonance (CMR). MATERIALS AND METHODS: Data were prospectively collected on a 6-month period and included 3376 patients (47.2 ± 19 years; range 1-92 years). Recruited centers were asked to complete a preliminary general report followed by a single form/patient. Referral physicians were not required to exhibit any specific certificate of competency in CMR imaging. RESULTS: Exams were performed with 1.5T scanners in 96% of cases followed by 3T (3%) and 1T (1%) magnets and contrast was administered in 84% of cases. The majority of cases were performed for the workup of inflammatory heart disease/cardiomyopathies representing overall 55.7% of exams followed by the assessment of myocardial viability and acute infarction (respectively 6.9% and 5.9% of patients). In 49% of cases the final diagnosis provided was considered relevant and with impact on patient's clinical/therapeutic management. Safety evaluation revealed 30 (0.88%) clinical events, most of which due to patient's preexisting conditions. Radiological reporting was recorded in 73% of exams. CONCLUSIONS: CMR is performed in a large number of centers in Italy with relevant impact on clinical decision making and high safety profile.

Radiology departments development in secondary hospitals and above in Shandong province / 中华医院管理杂志

Objective To study the development of medical imaging in Shandong province and identify existing problems. Methods 378 secondary hospitals and above were surveyed with questionnaires and other means for a general picture of their radiology departments. The survey covered medical imaging examinations, human resources and equipment configurations. Results The recent five years have found a rapid growth of a variety of medical imaging examinations, digital imaging in dominance, high-end equipments as the mainstream, sufficient staffing, shortage of high-level talents in these hospitals. Conclusion The medical imaging examinations should be regarded as justified and reasonable, the competence of hospital staff should be upgraded, and operation of medical imaging examinations should be normalized.