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- Exploring how research skills are taught and assessed in medical imaging and radiation therapy higher education: an international snapshotPublication . Di Michele, L.; Johnson, N.; McDermott, B.; Podkrajšek, M.; Ranshi, R.; Silva, I.; Vieira, Lina Oliveira; Ghotra, S.S.Introduction: Research competence is a core attribute of contemporary medical imaging and radiation therapy (MIRT); however, how research skills are taught and assessed across international radiography programs remains poorly understood. This study aims to explore research skills that are taught and assessed in different medical imaging and radiation therapy (MIRT) higher education institutions internationally, focusing on the curricula, experience of students, and academics. Methods: A two-phase design study was employed. Phase one involved an analysis of undergraduate MIRT curricula from nine international higher education institutions, examining programme structure, research credit allocation, research-related subjects, and teaching strategies. Phase two consisted of semi-structured focus groups with students and academic staff. All sessions were audio-recorded and transcribed using Zoom, with the transcripts checked for accuracy, and analysed using reflexive thematic analysis supported by NVivo software. Results: Data were collected from nine institutions across three continents. Curriculum analysis revealed international variability in the scope, timing, and depth of research integration, with research-related content embedded at differing stages of training. Reflexive thematic analysis identified three overarching themes: 1. research skills in the curriculum, 2. Navigating the research learning experience, and 3. Professional identity and practice. Conclusion: This study demonstrates substantial international variability in research education for medical imaging and radiation therapy students, leading to differences in research capability among graduates. Importantly, research education also shapes how practitioners value and engage with research, influencing professional culture within the field. Impacts on practice: Systematically scaffolding research skills across undergraduate radiography programs can support progressive learning and promote sustained engagement with research throughout the curriculum. Embedding clinically relevant research throughout education can sustain engagement with research, strengthening evidence-based practice and supporting a professional culture that values research in MIRT practice.
- Sickle cell disease: can genetic variability influence pregnancy outcomes?Publication . Ginete, Catarina; Cruz, Carolina; Delgadinho, Mariana; Mendes, Manuela; Simão, Fernanda; Alves, Ligia; Vasconcelos, Jocelyne; Borralho, Paula; Brito, MiguelPregnancy in Sickle Cell Disease (SCD), a severe hereditary genetic condition, highly prevalent in Sub-Saharan African countries, is associated with increased risk of complications and severe outcomes in pregnancy, like intrauterine growth restriction, low birth weight, premature birth, miscarriage, stillbirth, pre-eclampsia, and maternal mortality. Several factors have been identified as associated with the heterogeneity of SCD phenotypes, namely the hemoglobin subunit beta (HBB) haplotype and −3.7 kb α-thalassemia deletion. Objective: This study aimed to identify pregnancy complications and severe outcomes, and their association with genetic variability in women with SCD. Methods: In a cohort of 162 pregnant women followed at Maternidade Lucrécia Paim, Luanda, Angola, we collected clinical, hematological, biochemical, and genetic data (Sickle Cell Disease genotype, HBB haplotype, and −3.7 kb α-thalassemia). Findings: The Central African Republic (CAR) haplotype was the most prevalent, being 87% of women homozygous. For the −3.7 kb α-gene deletion, 11.7% of women were homozygous, and 36.4% were heterozygous. In this cohort, CAR/CAR women had over 9 times higher odds of having a premature birth, and homozygous women for the −3.7 kb α-thalassemia had over four times higher odds of having a livebirth than the other genotypes. Over 50% of babies were born with low birth weight, and 52,7% were considered premature. Severe maternal complications were registered in 68% of current pregnancies. Conclusion: These findings highlight the high burden of adverse outcomes in SCD pregnancy and the need for individualized and closer healthcare, especially in low and middle-income countries.
- The comet assay as a tool for human biomonitoring of exposure to environmental and occupational agents: a summary of systematic reviews and meta-analysesPublication . Møller, Peter; Gajski, Goran; Gerić, Marko; Azqueta, Amaya; Giovannelli, Lisa; Haveric, Anja; Stopper, Helga; Bankoglu, Ezgi Eyluel; Collins, Andrew; Ladeira, CarinaThis paper compiles results from six systematic reviews and meta-analyses on associations between environmental and occupational exposure to chemicals and levels of DNA strand breaks in human leukocytes, measured by the comet assay. There are no differences in effect sizes when using different comet descriptors. However, lower central tendencies are obtained by using a non-parametric test as compared to the standard parametric analysis, indicating that the standard meta-analyses tend to overestimate the effect size. The compiled results indicate that exposures can be sorted into three groups with decreasing effect size: high (pesticides), moderate (volatile organic compounds, heavy metals, and antineoplastic drugs), and low (anaesthetic gases and air pollution). Interestingly, studies from middle-income countries have higher effect sizes than those seen in studies from high-income countries. This may be related to higher exposures or lower socioeconomic status in middle-income countries. However, there is also some co-variability between studies from middle-income countries and the risk of comet assay measurement bias, assessed as information provided in published papers. Lack of information on assay controls and blinded/coded sample analysis appears to be a general issue in studies on comet assay results. Risk of exposure misclassification is mainly related to the type of exposure; there are good biomarkers for some exposures (e.g., heavy metals), whereas other exposures are more challenging to assess with biomarkers (e.g., pesticides). In conclusion, all examined exposures result in significant increases in DNA strand breaks at the population level, though to varying degrees.
- Functionalized smart surfaces to control the wound healing after glaucoma’s surgeryPublication . Machado, Mónica; Silva, Gabriela Araújo; Ferreira, Joana; Pinto, Luís A.; Ferreira, QuririnaOver the past decade, considerable attention has been directed toward the development of drug delivery systems capable of releasing therapeutic agents in a controlled and sustained manner over extended periods. Glaucoma, one of the leading causes of irreversible blindness worldwide, is commonly managed with topical eye drops. However, this treatment strategy often suffers from poor patient compliance and limited efficacy. When pharmacological therapy is insufficient, surgical intervention becomes necessary. Among the available surgical options, implantation of drainage devices to divert aqueous humor is widely performed. Despite their functional performance, postoperative wound healing frequently induces an exaggerated fibroblast response that obstructs the drainage channel, resulting in bleb failure. Consequently, the long-term success rate of such procedures is reported to be approximately 70% at one year. To mitigate this challenge, strategies involving localized and time-controlled delivery of antifibrotic drugs have been investigated. In the present study, a nanostructured film was engineered to release precise doses of the antimetabolite 5-Fluorouracil (5-FU) at defined time intervals, aiming to modulate post-operative scarring. Previous work has demonstrated that encapsulation of 5-FU within β-Cyclodextrin (β-CD) cavities enhances drug solubility and reduces toxicity. Building on this concept, films were fabricated on quartz and poly(methyl methacrylate) (PMMA) substrates using the layer-by-layer (LBL) technique. Film growth and drug release kinetics were successfully monitored by ultraviolet–visible spectroscopy (UV–Vis), demonstrating that PMMA substrates enable a more sustained and prolonged drug release compared to quartz. In conclusion, these findings highlight the significant advantages of polymeric materials commonly used in biomedical devices and wound-contact applications for controlled drug delivery systems.
- Breast cancer patients’ questions about radiotherapy-induced skin toxicity: a comparative analysis of ChatGPT-4.0 and Gemini 2.5 flashPublication . Caetano, Marco; Vicente, D.; Caetano, Leonor; Carolino, Elisabete; Grilo, AnaIntroduction: Artificial Intelligence (AI) is increasingly being deployed in health communication, a trend particularly visible in specialised domains, such as breast cancer radiotherapy. The subsequent clinical and educational value is fundamentally determined by the reliability and clarity of the responses generated. However, the comparative performance of different AI models in addressing patient concerns about radiotherapy side effects remains unclear, creating uncertainty regarding the optimal tool selection for patient education and support. This study aimed to compare the performance of ChatGPT 4.0 and Gemini 2.5 FLASH using a mixed-methods analytical-descriptive approach. Methods: Twenty-three unique questions, derived from a literature review and rephrased to simulate patient enquiries about the skin effects of radiotherapy, were submitted to both models. Sixteen expert Radiation Therapists (RTTs) independently assessed the responses using a seven-point Likert scale. The analyses included semantic cosine similarity and linguistic readability (Flesch Reading Ease/Flesch-Kincaid Grade Level), with statistical comparisons performed using Mann-Whitney tests. Results: Gemini 2.5 FLASH achieved higher median scores (6/7) than ChatGPT 4.0 (5/7), demonstrating particular strengths in clinical detail and empathy. Conversely, ChatGPT 4.0 produced more direct and structured answers, although it occasionally simplified complex concepts. Models showed low semantic similarity (median 0.78). Readability analysis revealed that ChatGPT aligned with an 8th-grade level, whereas Gemini operated at an 11th-grade level. Expert agreement was robust, with Gemini achieving greater consistency (α = 0.78; κ = 0.70) than ChatGPT (α = 0.72; κ = 0.65). Conclusion: Gemini was more effective for complex psychosocial issues, whereas ChatGPT provided more accessible guidance, necessitating ongoing professional validation for reliable integration into patient education workflows. Implications for practice: The use of AI in counselling patients undergoing breast radiotherapy enhances accessibility but requires ongoing professional validation to ensure clinical reliability.
- Strengthening incident learning in radiotherapy practice: insights from the MARLIN studyPublication . Prieto, C.; Kelly, C.; Brusadin, G.; Kearney, M.; Pourel, N.; Rogers, A.; Geao, Ana; Akata, D.; Andersson, J.; Paulo, Graciano; Nekolla, S. G.; Mille, E.; Pellerin, O.; Israel, O.; Hallinan, B.; Peld, N.; Hierath, M.Background and purpose: Incident Learning Systems (ILSs) are central to patient safety in radiotherapy, enabling learning from adverse events and near misses. Despite EU regulatory requirements, substantial variability persists across Europe in the implementation and effectiveness of ILSs in radiotherapy. This paper presents radiotherapy-specific recommendations derived from the MARLIN study to support harmonised, risk-informed implementation of ILSs. Methods: The 24-month MARLIN study, conducted under the SAMIRA Action Plan, employed a structured literature review, an online European survey of clinical facilities, competent authorities and professional societies, expert interviews, and a multi-stakeholder consensus workshop. Survey data from 172 respondents in 28 countries were analysed to identify current practices, barriers and enabling factors for ILS implementation in radiotherapy. Results: Although all responding countries reported transposition of the Directive, substantial variability was observed in criteria for reporting significant radiotherapy events, feedback mechanisms and use of international databases. Fear of punitive actions, limited resources, lack of training in incident analysis, and insufficient dissemination of lessons learned were identified as key barriers. External-beam radiotherapy showed more mature ILS implementation than brachytherapy. Findings from the MARLIN study informed recommendations on category-based event classification, radiotherapy-specific taxonomies, multidisciplinary incident-learning committees, and collaboration between clinical facilities, competent authorities, and professional societies. Conclusion: The MARLIN recommendations provide a practical framework to strengthen ILS implementation in radiotherapy, promote a just culture, enhance learning from incidents and support regulatory compliance, ultimately improving patient safety and quality of care across Europe, while the broader RP-208 report extends these principles to all medical fields using ionising radiation, supporting cross-disciplinary harmonisation.