A Retrospective Within-Subjects Analysis of Vancomycin Bayesian Modeling With Pre-steady-State vs Steady-State Concentrations.

Bayesian modeling of vancomycin can estimate 24-hour area under the curve (AUC) using pre-steady-state concentrations. Limited literature exists comparing Bayesian AUC calculations derived from steady-state versus pre-steady-state concentrations. To assess the agreement between vancomycin AUC calculations using pre-steady-state versus steady-state concentrations, employing Bayesian modeling.

Head-to-head: Anthropomorphic phantoms for evaluating the effect of skin tone on the accuracy of surface imaging systems.

Purpose: To study the localization accuracy of two commercial surface imaging (SI) systems used for intrafraction motion monitoring during stereotactic radiosurgery (SRS) and quantify the difference in accuracy due to skin tone.

Methods: Using a publicly available CT dataset, anthropomorphic phantoms were 3D printed using filament in four skin tones: rose tan, light brown, medium brown, and dark brown (3DUniverse, Chicago, IL, USA). Three SI systems from two vendors were utilized to measure the SI-reported offsets of the stationary phantoms in various gantry and couch configurations to create SRS-like conditions, including when the gantry obscured one camera pod.

Scaffolding a clinical debate assignment in an infectious disease pharmacy elective: A mixed methods analysis.

Objective: To evaluate the impact of instructional scaffolding on student performance and perceptions in a clinical debate activity within an infectious disease pharmacy elective course.

Methods: A sequential explanatory mixed-methods study was conducted from 2018 to 2022, involving pharmacy students enrolled in an infectious disease elective course. Students in the pre-scaffolding arm (2018) received traditional instruction, while those in the post-scaffolding arm (2019-2022) engaged in a scaffolded debate activity, comprising five milestone assignments and a mock debate.

Technical and Quality Considerations for Stereotactic Radiation Treatment Techniques.

Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), collectively termed SRS-SBRT, are advanced treatment modalities delivering high doses of radiation in a single treatment or condensed treatment phase. Due to the small margins and steep dose gradient used in SRS-SBRT, the technical and safety considerations are more stringent than traditional radiation therapy and may include more advanced simulation, patient immobilization, treatment planning, and treatment delivery techniques. Respiratory motion management and intrafraction motion monitoring are often used during SRS-SBRT to ensure treatments are robust to both internal organ motion and patient movement during treatment.

Best Practice Guidelines for Use of Reference Points in Radiation Oncology Information Systems to Aggregate Longitudinal Dosimetric Data.

Purpose: Tracking patient doses in radiation oncology is challenging because of disparate electronic systems from various vendors. Treatment planning systems (TPS), radiation oncology information systems (ROIS), and electronic health records (EHR) lack uniformity, complicating dose tracking and reporting. To address this, we examined practices in multiple radiation oncology settings and proposed guidelines for current systems.

Rifampin in device-related infections: Assessing the modern evidence.

Purpose: Rifampin is commonly used to treat device-related infections (DRIs) due to its activity against biofilms, despite a history of limited clinical evidence to support its use. Evidence published since 2011 regarding rifampin use for DRIs is reviewed to describe the contemporary findings and ongoing considerations for rifampin use in these infections.

Summary: A literature review was performed by searching PubMed and Google Scholar to identify relevant studies evaluating systemic rifampin use for the treatment of DRIs published from 2011 to 2023.

The Future of Safety and Quality in Radiation Oncology.

The increasing complexity of radiation therapy treatment presents new potentials for error and suboptimal care. High-performing programs thus not only require adherence to, but also ongoing improvement of, key safety and quality practices. In this article, we review these practices including standardization, risk analysis, peer review, and maintenance of strong safety culture, while also describing recent innovations and promising future directions.

Unlocking the future of patient Education: ChatGPT vs. LexiComp® as sources of patient education materials.

Background: ChatGPT is a conversational artificial intelligence technology that has shown application in various facets of healthcare. With the increased use of AI, it is imperative to assess the accuracy and comprehensibility of AI platforms.

Objective: This pilot project aimed to assess the understandability, readability, and accuracy of ChatGPT as a source of medication-related patient education as compared with an evidence-based medicine tertiary reference resource, LexiComp®.

Perceptions on and roadblocks to implementation of standardized nomenclature in radiation oncology: A survey from TG-263U1.

Purpose: AAPM Task Group No. 263U1 (Update to Report No. 263 - Standardizing Nomenclatures in Radiation Oncology) disseminated a survey to receive feedback on utilization, gaps, and means to facilitate further adoption.

Order From Chaos: The Benefits of Standardized Nomenclature in Radiation Oncology.

Although standardization has been shown to improve patient safety and improve the efficiency of workflows, implementation of standards can take considerable effort and requires the engagement of all clinical stakeholders. Engaging team members includes increasing awareness of the proposed benefit of the standard, a clear implementation plan, monitoring for improvements, and open communication to support successful implementation. The benefits of standardization often focus on large institutions to improve research endeavors, yet all clinics can benefit from standardization to increase quality and implement more efficient or automated workflow.

A Baker's Dozen of Top Antimicrobial Stewardship Intervention Publications in 2022.

Keeping abreast of the antimicrobial stewardship-related articles published each year is challenging. The Southeastern Research Group Endeavor identified antimicrobial stewardship-related, peer-reviewed literature that detailed an actionable intervention during 2022. The top 13 publications were selected using a modified Delphi technique.

Women in the Medical Physics Workforce: Insights from Membership Trends of the American Association of Physicists in Medicine, 1993 to 2023.

Purpose: Women remain underrepresented in medical physics in the United States, and determinants of persisting disparities remain unclear. Here, we performed a detailed investigation of American Association of Physicists in Medicine (AAPM) membership trajectories to evaluate trends in Full membership with respect to gender, age, and highest degree.

Methods And Materials: Membership data, including gender, date of birth, highest degree, membership type, and years of active membership for 1993 to 2023 were obtained from AAPM.

Prospective pilot study evaluating a vitamin D3 loading dose in critically ill children with vitamin D deficiency.

Background: Vitamin D deficiency is a common finding in critically ill children. However, the optimal supplementation strategy in this patient population is unknown. The objective of this study was to evaluate the effects of high-dose (10 000 IU/kg, max.

Open RT Structures: A Solution for TG-263 Accessibility.

Purpose: Consistency of nomenclature within radiation oncology is increasingly important as big data efforts and data sharing become more feasible. Automation of radiation oncology workflows depends on standardized contour nomenclature that enables toxicity and outcomes research, while also reducing medical errors and facilitating quality improvement activities. Recommendations for standardized nomenclature have been published in the American Association of Physicists in Medicine (AAPM) report from Task Group 263 (TG-263).

Evaluation and correlation of patient movement during online adaptive radiotherapy with CBCT and a surface imaging system.

Purpose: With the clinical implementation of kV-CBCT-based daily online-adaptive radiotherapy, the ability to monitor, quantify, and correct patient movement during adaptive sessions is paramount. With sessions lasting between 20-45 min, the ability to detect and correct for small movements without restarting the entire session is critical to the adaptive workflow and dosimetric outcome. The purpose of this study was to quantify and evaluate the correlation of observed patient movement with machine logs and a surface imaging (SI) system during adaptive radiation therapy.

Agreement Between Two-Concentration and One-Concentration Area Under the Curve (AUC) Estimates When Using Bayesian Modeling to Dose Vancomycin in Patients With Obesity.

Background: Vancomycin Bayesian modeling provides 24-hour area under the curve (AUC24) estimations. However, the agreement between two-concentration and one-concentration Bayesian estimates in patients with obesity is unknown.

Objective: The purpose of this study was to determine the agreement between two-concentration and one-concentration Bayesian AUC24 estimates in patients with obesity receiving vancomycin.

Acute Kidney Injury Incidence With Bayesian Dosing Software Versus 2-Level First-Order Area Under the Curve-Based Dosing of Vancomycin With Piperacillin-Tazobactam.

Two methods of area under the curve (AUC) dosing are recommended in vancomycin consensus guidelines: first-order calculations utilizing 2 vancomycin concentrations or a Bayesian approach. It is unknown if there is a difference in acute kidney injury (AKI) between the 2 dosing strategies for patients receiving concomitant piperacillin-tazobactam and vancomycin (VPT). The objective of this study was to compare incidence of AKI in patients being administered VPT with first-order calculations versus model-informed precision dosing (MIPD)/Bayesian dosing.

Commissioning and clinical evaluation of the IDENTIFY surface imaging system for frameless stereotactic radiosurgery.

Purpose: To commission and assess the clinical performance of a new commercial surface imaging (SI) system by analyzing intra-fraction motion from the initial cohort of patients treated with frameless stereotactic radiosurgery (fSRS).

Methods: The IDENTIFY SI system was commissioned for clinical use on an Edge (Varian Medical Systems, Palo Alto, CA) linear accelerator. All patients who received intracranial radiotherapy with HyperArc (Varian Medical Systems, Palo Alto, CA) were immobilized with the Encompass (Qfix, Avondale, PA) thermoplastic mask and monitored for intra-fraction motion with SI.

Operational Ontology for Oncology (O3): A Professional Society-Based, Multistakeholder, Consensus-Driven Informatics Standard Supporting Clinical and Research Use of Real-World Data From Patients Treated for Cancer.

Purpose: The ongoing lack of data standardization severely undermines the potential for automated learning from the vast amount of information routinely archived in electronic health records (EHRs), radiation oncology information systems, treatment planning systems, and other cancer care and outcomes databases. We sought to create a standardized ontology for clinical data, social determinants of health, and other radiation oncology concepts and interrelationships.

Methods And Materials: The American Association of Physicists in Medicine's Big Data Science Committee was initiated in July 2019 to explore common ground from the stakeholders' collective experience of issues that typically compromise the formation of large inter- and intra-institutional databases from EHRs.