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Over the past two decades Biomedical Engineering has emerged as a major discipline that bridges societal needs of human health care with the development of novel technologies. Every medical institution is now equipped at varying degrees of sophistication with the ability to monitor human health in both non-invasive and invasive modes. The multiple scales at which human physiology can be interrogated provide a profound perspective on health and disease. We are at the nexus of creating avatars (herein defined as an extension of digital twins) of human patho/physiology to serve as paradigms for interrogation and potential intervention. Motivated by the emergence of these new capabilities, the IEEE Engineering in Medicine and Biology Society, the Departments of Biomedical Engineering at Johns Hopkins University and Bioengineering at University of California at San Diego sponsored an interdisciplinary workshop to define the grand challenges that face biomedical engineering and the mechanisms to address these challenges. The Workshop identified five grand challenges with cross-cutting themes and provided a roadmap for new technologies, identified new training needs, and defined the types of interdisciplinary teams needed for addressing these challenges. The themes presented in this paper include: 1) accumedicine through creation of avatars of cells, tissues, organs and whole human; 2) development of smart and responsive devices for human function augmentation; 3) exocortical technologies to understand brain function and treat neuropathologies; 4) the development of approaches to harness the human immune system for health and wellness; and 5) new strategies to engineer genomes and cells.

The article begins with a fictional example of a life that has been spent frugally in several different ways and for different reasons over time: in wartime, through many decades of simple living, through a period marked by anxiety over the threat to future generations from the depletion of global resources and the climate crisis, to the COVID-19 emergency. The mini-biography serves as an introduction to a more systematic account of these various perspectives on frugality and reasons for adopting a frugal way of living. This provides the framework for a discussion of different aspects of education for frugality in the main body of the article. There are two brief sections at the end dealing, first, with a caveat about the climate change argument for education in frugality and, second, with wider issues that the topic raises.

PurposeThe RefleXion X1 is a novel radiotherapy machine designed for image-guided radiotherapy (IGRT) and biology-guided radiotherapy (BgRT). Its treatment planning system (TPS) generates IMRT and SBRT plans for a 6MV-FFF beam delivered axially via 50 firing positions with the couch advancing every 2.1 mm. The purpose of this work is to report the TPS commissioning results for the first clinical installation of RefleXion™ X1.MethodsCT images of multiple phantoms were imported into the RefleXion TPS to evaluate the accuracy of data transfer, anatomical modeling, plan evaluation, and dose calculation. Comparisons were made between the X1, Eclipse™, and MIM™. Dosimetric parameters for open static fields were evaluated in water and heterogeneous slab phantoms. Representative clinical IMRT and SBRT cases were planned and verified with ion chamber, film, and ArcCHECK@ measurements. The agreement between TPS and measurements for various clinical plans was evaluated using Gamma analysis with a criterion of 3%/2 mm for ArcCHECK@ and film. End-to-end (E2E) testing was performed using anthropomorphic head and lung phantoms.ResultsThe average difference between the TPS-reported and known HU values was -1.4 ± 6.0 HU. For static fields, the agreements between the TPS-calculated and measured PDD10 , crossline profiles, and inline profiles (FWHM) were within 1.5%, 1.3%, and 0.5 mm, respectively. Measured output factors agreed with the TPS within 1.3%. Measured and calculated dose for static fields in heterogeneous phantoms agreed within 2.5%. The ArcCHECK@ mean absolute Gamma passing rate was 96.4% ± 3.4% for TG 119 and TG 244 plans and 97.8% ± 3.6% for the 21 clinical plans. E2E film analysis showed 0.8 mm total targeting error for isocentric and 1.1 mm for off-axis treatments.ConclusionsThe TPS commissioning results of the RefleXion X1 TPS were within the tolerances specified by AAPM TG 53, MPPG 5.a, TG 119, and TG 148. A subset of the commissioning tests has been identified as baseline data for an ongoing QA program.

Preventing attrition for racially minoritized, first-generation, and low SES postsecondary students continues to be a challenge despite significant efforts of educational researchers, college administrators, and high school teachers and counselors. Cultural capital (skills necessary to successfully navigate an environment) may help to explain and address this issue. Applying cultural capital and college readiness frameworks, we attempt to better understand the challenges four racially minoritized, first-generation, low-SES students face in attempting to get a "read" (understand the workings) on college. Students were in their second semester of their first year and on academic probation. Each participated in interviews and journal writing throughout one semester. Analysis revealed that cultural capital served as a foundation for reading the college environment in four key areas required for college readiness: understanding and calculating GPAs; computer literacy required for completing assignments; understanding the course listing and registration process; and finding other campus resources for addressing needs.

This article examines two scenarios for the future of education over the coming decades, mainly in England but also in comparable countries. It does so against the background of six large-scale historical processes now in progress: increasing longevity, the expansion of the internet, changes in work patterns, climate change, the rise in inequality and the coming of populism. Scenario 1 continues current patterns in general politics and education, while Scenario 2 radically diverges from them. Over half the article is devoted to the future of education in Scenario 2.

This study reports the beam commissioning results for the first clinical RefleXion Linac.MethodsThe X1 produces a 6 MV photon beam and the maximum clinical field size is 40 × 2 cm2 at source-to-axis distance of 85 cm. Treatment fields are collimated by a binary multileaf collimator (MLC) system with 64 leaves with width of 0.625 cm and y-jaw pairs to provide either a 1 or 2 cm opening. The mechanical alignment of the radiation source, the y-jaw, and MLC were checked with film and ion chambers. The beam parameters were characterized using a diode detector in a compact water tank. In-air lateral profiles and in-water percentage depth dose (PDD) were measured for beam modeling of the treatment planning system (TPS). The lateral profiles, PDDs, and output factors were acquired for field sizes from 1.25 × 1 to 40 × 2 cm2 field to verify the beam modeling. The rotational output variation and synchronicity were tested to check the gantry angle, couch motion, and gantry rotation.ResultsThe source misalignments were 0.049 mm in y-direction, 0.66% out-of-focus in x-direction. The divergence of the beam axis was 0.36 mm with a y-jaw twist of 0.03°. Clinical off-axis treatment fields shared a common center in y-direction were within 0.03 mm. The MLC misalignment and twist were 0.57 mm and 0.15°. For all measured fields ranging from the size from 1.25 × 1 to 40 × 2 cm2 , the mean difference between measured and TPS modeled PDD at 10 cm depth was -0.3%. The mean transverse profile difference in the field core was -0.3% ± 1.1%. The full-width half maximum (FWHM) modeling was within 0.5 mm. The measured output factors agreed with TPS within 0.8%.ConclusionsThis study summarizes our specific experience commissioning the first novel RefleXion linac, which may assist future users of this technology when implementing it into their own clinics.

This is a response to two discussions of my article 'The Weakness of "Powerful Knowledge"' featuring in 2018 in the "London Review of Education" 16 (2), the first by Johan Muller and Michael Young and the second by Jim Hordern. It also makes brief comments on pieces on powerful knowledge in the "London Review of Education" Special Issue 16 (3). The question I focus on here, as in 2018, is 'What is powerful knowledge?' I raise doubts about Muller and Young's new answer to this question as well as about Hordern's defence of Young's position more generally. I suggest in conclusion that it would be helpful to abandon the term 'powerful knowledge' and use language more suitable to impartial scholarly investigations. [For The Weakness of 'Powerful Knowledge,' see EJ1185908.]

This brief paper welcomes the notion of local pockets of resistance while raising two problems about it. One of these concerns teachers' values and leads into wider considerations about what the underlying aims of education should be. This prepares the ground for the 'deeper pocket' of the title. This has to do with challenging the lack of official -- i.e. public, not hidden -- aims informing English school curricula. In this, England will soon be at odds with the three other UK nations, all of which, as from September 2022, will have aims-based curricula. A many-sided national campaign is recommended to target this weakness in the English system, working closely with more local pockets of resistance.

This article offers a philosophical critique of Michael Young's notion of 'powerful knowledge', as found largely in his own but also in others' writings since 2009. The first part of the article focuses on the definitional connection that Young makes between 'powerful knowledge' and systematic relationships between concepts. It argues that most of the school subjects that Young sees as providing 'powerful knowledge' fall short on this requirement. It also comments on the place of educational aims and of everyday concepts in Young's thinking. The second part of the article draws attention to similarities and differences between Young's notion and the philosopher Paul Hirst's notion of 'forms of knowledge', claiming that Young's position is vulnerable to many of the critiques of Hirst's notion formulated between the 1960s and the 1990s.