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Introduction: Diagnostic reference levels (DRLs) are typical dose levels for medical imaging examinations for groups of standard‐sized patients or standard phantoms for broadly defined types of equipment used as a tool to aid optimisation of protection for medical exposures. Currently, there are no paediatric DRLs for conventional radiography (i.e. general X‐rays) published in Australia. The aim of this study was to establish typical radiation doses and risks that are representative of those delivered for commonly performed X‐ray projections for a 5‐year‐old/20 kg child using a 5‐year‐old anthropomorphic 'bone fracture' phantom in three dedicated paediatric radiology departments in Victoria. Methods: A total of 20 projection images were acquired for a standard 5‐year‐old/20 kg phantom using digital radiography X‐ray equipment. The air kerma‐area product (KAP) measured at each centre by a KAP metre, which was calibrated to a national primary standard, was considered to represent the median value for that centre for each X‐ray projection. Organ doses and effective dose were estimated using PCXMC software, and risks of radiation‐induced cancer and radiation‐induced death were calculated based on the BEIR VII report. Results: The typical doses for the individual X‐ray projections ranged from 3 mGy•cm2 to 86 mGy•cm2, whilst the effective doses ranged from 0.00004 to 0.07 mSv. The radiation risks were 'minimal' to 'negligible'. Conclusion: The estimation of typical radiation doses and associated risks for a 5‐year‐old/20 kg phantom study provides reference values for guidance and is a first step in assisting optimisation at other institutions until national DRLs, based on patient data from the clinical setting, are published. [ABSTRACT FROM AUTHOR]

Background: Cough is a defense mechanism that protects the airways and lungs in response to airway irritation. The sensory neurons involved in detecting airway irritants and the neural pathways mediating cough share similarities with those that encode pain from the body. Painful conditioning stimuli applied to one body site are known to reduce the perception of pain at another. However, whether the neural regulation of cough is influenced by painful stimuli is not known.Research Question: What are the behavioral and neural outcomes of painful conditioning stimuli on urge-to-cough (UTC) and cough evoked by inhaled capsaicin?Study Design and Methods: Sixteen healthy participants underwent psychophysical testing and functional MRI while completing a series of capsaicin inhalations to induce UTC and cough. The responses associated with capsaicin inhalation without pain were compared with those after the application of painful conditioning stimuli.Results: Significant decreases were seen behaviorally of 18.7% ± 17.3% (P < .001) and 47.0% ± 30.8% (P < .001) in participants' UTC ratings and cough frequencies, respectively, during the application of pain. UTC ratings were reduced by 24.2% ± 36.5% (P < .005) and increased by 67% ± 40% (P < .001) for capsaicin and saline inhalation, respectively, during the scanning session. Painful conditioning stimuli were associated with widespread decreases in regional brain responses to capsaicin inhalation (P < .001). Several brain regions showed levels of reduced activation attributable to painful conditioning that correlated with related changes in behavioral responses during scanning (R2 = 0.53).Interpretation: Pain-related decreases of cough and UTC are accompanied by widespread changes in brain activity during capsaicin inhalation, suggesting that pain can modify the central processing of inputs arising from the airways. A mechanistic understanding of how cough and pain processing interact within the brain may help develop more effective therapies to reduce unwanted coughing. [ABSTRACT FROM AUTHOR]

Purpose: Advances in additive manufacturing processes are enabling the fabrication of surrogate bone structures for applications including use in high‐resolution anthropomorphic phantoms. In this research, a simple numerical model is proposed that enables the generation of microarchitecture with similar statistical distribution to trabecular bone. Methods: A human humerus, radius, ulna, and several vertebrae were scanned on the Imaging and Medical beamline at the Australian Synchrotron and the proposed numerical model was developed through the definition of two complex functions that encode the trabecular thickness and position‐dependant spacing to generate volumetric surrogate trabecular structures. The structures reproduced those observed at 19 separate axial locations through the experimental bone volumes. The applicability of the model when incorporating a two‐material approximation to absorption‐ and phase‐contrast CT was also investigated through simulation. Results: The synthetic structures, when compared with the real trabecular microarchitecture, yielded an average mean thickness error of 2 μm, and a mean difference in standard deviation of 33 μm for the humerus, 24 μm for the ulna and radius, and 15 μm for the vertebrae. Simulated absorption‐ and propagation‐based phase contrast CT projection data were generated and reconstructed using the derived mathematical simplifications from the two‐material approximation, and the phase‐contrast effects were successfully demonstrated. Conclusions: The presented model reproduced trabecular distributions that could be used to generate phantoms for quality assurance and validation processes. The implication of utilizing a two‐material approximation results in simplification of the additive manufacturing process and the generation of synthetic data that could be used for training of machine learning applications. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: An immersive virtual reality (VR) simulation clinic with dynamic patient interaction and communication was developed to facilitate the training of medical radiation science students. The software “CETSOL VR Clinic” was integrated into the Medical Imaging programme at Monash University in 2016 in order to benchmark student experiences against existing simulation techniques (Shaderware™). Methods: An iterative approach to development, based on two cycles of user feedback, was used to develop and refine the simulated clinical environment. This environment uses realistic 3D models, embedded clinical scenarios, dynamic communication, 3D hand gesture interaction, gaze and positional stereoscopic tracking and online user capabilities using the Unity™ game and physics engines. Students’ perceptions of educational enhancement of their positioning skills following the use of the simulation tools were analysed via a 5‐point Likert scale questionnaire. Results: Student perception scores indicated a significant difference between simulation modalities in favour of the immersive CETSOL VR Clinic, χ2 (4, N = 92) = 9.5, P‐value <0.001. Conclusion: Student perception scores on improvement of their clinical and technical skills were higher for the hand‐positioning tasks performed with the CETSOL VR Clinic™ than with the comparative benchmark simulation that did not provide dynamic patient interaction and communication. [ABSTRACT FROM AUTHOR]