 Thank you. Welcome, everybody. Today, with the degree award ceremony, we are closing the sixth cycle, 2019-2020, of the Joint Master in Medical Physics, graduating eight new students from the 12 students of the cycle. Out of them, one went back to Uganda last spring at the beginning of COVID, and will come back soon to complete her clinical training. Two more will also complete their clinical training this spring, and one was graduated already last December. As everywhere, due to the COVID pandemic, also for the MMP, it has been a very difficult year. In spite of all these difficulties, thanks to the efforts of the teachers, of the students, of the ICTP and UNIS administrations, we have been able and will be able to run our master. The ICTP has been forced to cancel both last year and at least until June this year a number of training activities in presence. We are indeed very grateful to the ICTP director and staff who have made possible to continue the MMP both last year and in the coming year. Indeed, starting from 1st February, 24 students of the seventh cycle will proceed for the second year of clinical training in the hospitals. At the same time, 24 new students of the eighth cycle are arriving in Trieste in these days to start their first year. I do not want to bother you with detailed statistical data. I will simply say that including the students of the next cycle, the total number of students in all the cycles will be 146, 52 females and 94 males. Almost half of the total, exactly 69, come from African countries. But perhaps even more important, the total number of countries represented is 63 and 27 of them from Africa. Last year, 2020, we added to the list of countries, Algeria, Malawi, Myanmar, Uzbekistan, Costa Rica and Belarus. This year, we are adding Albania, India, Kyrgyzstan, Namibia and Suriname. I can assert again that the joint Abdul Salama and CTP Unis Master in Medical Physics is now a well-established program. This is also due to the enthusiastic support of the two institutions which are running the master program, the Abdul Salama and CTP and the Trieste University in the persons of the CTP director, Professor Atish Dabholkar and director of the Trieste University, Professor Roberto DiLenarda. It is only thanks to the support of the staff at all levels of the university, of the Department of Physics, of the CTP offices that we have been able to cope with the many bureaucratic difficulties both at the university and the CTP as well as with the new unexpected and serious problems due to the COVID. It would be too long to name all the persons and offices who have helped, but I must mention express our special gratitude to one person. Mrs. Susi Radozits has been since the beginning the secretary of the master. She retired at the end of 2020. Susi has not only served during all these years with great competence and dedication. She was also able to establish close friendly relationships with the students. She has been replaced at the MMP Secretariat by Mrs. Francesca Prelazzi. I'm sure that she will serve the MMP with the same competence and dedication. The master is fully organized and hosted by Diablo Salama, CTP. Professor Atish Dabholkar, the CTP director is the master of the house. Professor Dabholkar, please. Thank you, Luciano. So it's my great pleasure to be here for this very, very pleasant occasion. I always feel great pleasure when I attend these graduation ceremony, and particularly in medical physics because you really see it's like a rainbow of people coming from all over the world, from all countries. Also, I noticed that the percentage of women is quite high, so it actually, in terms of diversity, it's really fantastic. And I know what a big impact this course has. You will go back to your country and you will make a very important contribution. So I know that this year has been very difficult, and I congratulate you. I think it's a big achievement to really live through this and still persist and actually complete your course. And I think you should be doubly proud that you have done it. And I want to thank my colleagues from Trieste University and from ICTP, your teachers who have for their dedication and their commitment to this program even during these very difficult times. And today I'm happy that in fact, as you know, this program is supported by the International Atomic Energy Agency and the Director General of IAEA, he has kindly sent us a recorded, pre-recorded message for this occasion, so I'm particularly grateful. And also we invited the Deputy Permanent Delegate of Nicaragua to UNESCO, the Ambassador, Deputy Ambassador. And I spoke with her on Zoom. She had some other engagement, so she will be represented, so Madame Paniagua, she will be represented by her Aptache Daniel Mitchell in this ceremony. It's because actually Nicaragua, we have had actually six or seven students over the period of this program from Nicaragua. And this year's best student is from Nicaragua, so I think it's a particularly nice occasion for both for UNESCO colleagues and for IAEA to see the kind of contribution this program is making. So congratulations once again, and all the best. Thank you, Atish. The students of the Advanced Master in Medical Physics are students of the Trieste University. The Trieste University is represented today by Professor Walter Sergo, Deputy Director of the Trieste University. Professor Sergo. Thank you, thank you to you all. And actually, I was not aware of this program, and it has been one of the best surprises I've had since coming in office as Deputy Director. I think it brings out the best that this territory, not only our institutions, but this territory has to offer. We have the effort of the University, whose first mission is to educate, and that has been put to work. We have the effort of ICTP, which is broader in a sense. You will know that ICTP was founded by Boudinich with the idea to act as liaison among scientists from developing countries and the so-called advanced countries. And moreover, this master, the specific program, has to do with the health of people. And I think there is nothing more noble than this. So University, ICTP, and the wealth of countries participating in this program, the International Atomic Energy Institution, they are all collaborating somehow to improve the health of people all over the world. I believe that all people graduating today should be very proud of this. I wish you the very best for the rest of your career. And I hope that you will not forget this special link that you have with the city and with this territory. So thank again for introducing me to this beautiful reality of ICTP and University of Trieste. And with this, I would like to leave the stage to the next speaker. Thank you. Thank you, Professor Sergo. We have been honored by messages from the International Atomic Energy Agency Director General, Mr. Rafael Grossi, and by representative of the Deputy Ambassador of Nicaragua, Mr. Daniel Mitzel. They will be introduced by Professor Dabholkar. Well, I'm very happy that the Director General of IAEA, Rafael Grossi, he has kindly agreed to give a message to you because this program is funded very substantially by IAEA. So we are grateful for their contribution and it's therefore particularly opportune that on this very festive occasion, we have a few words from the Director General. Dear graduates, my sincere congratulations on becoming the newest masters of advanced studies in medical physics. I am proud of you and I am grateful to the people who got you here. Your studies have been organized by the International Center for Theoretical Physics and the Trieste University. The collaboration between the IAEA, the ICTP and the university go this collaboration which will go stronger. Since 2014, the IAEA has co-sponsored this two year program which has taught 146 students from 63 countries. You come from Latin America, the Caribbean and Africa and you have completed training in either medical physics for diagnostic imaging or for radiation therapy. The world needs your talents. Now it's the time to give back. Too many people are dying needlessly of preventable and treatable cancers. For example, of the 300,000 women around the world who succumb to cervical cancer each year, 270,000 live in low to middle income countries. Every second African country does not have a single radio therapy machine. I urge you to seek not only to heal people but also to heal their communities. Fight for equality whether it is standing up against gender bias or helping the poorest get the chance at a healthy life that everyone deserves. I've spent almost all my life in the nuclear field and I have a profound appreciation for what nuclear science and technology can do. From fighting cancer and so on all diseases like COVID-19 to cleaning the oceans of plastic. Moments like this make me grateful to have the job that I do. My advice for you at this moment is keep learning and do something that is good for others and this is what you are going to do. With that I leave you to celebrate. Thank you, congratulations and good luck. Okay, thank you for this very nice inspiring message. And the next I would invite Mr. Daniel Mitchell who's the attachee to the Deputy Permanent Delegate, Madame Pani Agua. Please go ahead. Buenos dias. Hello, can you hear me? Yes. Yes. Thanks. Graduates of the masters of advanced studies in medical physics, Director Atish Debroucal, Deputy Rector Valdesergo, I want to extend to you all the warmest greetings from the government of Nicaragua. I had to take this opportunity to thank the International Center for Theoretical Physics for inviting the Nicaraguan delegation to UNESCO to speak at this important ceremony. I do not want to leave unmentioned our appreciation to the International Agency for Atomic Energy, the International Organization for Medical Physics, the European Federation of Organizations in Medical Physics, the Italian Association of Medical Physics, and of course, De Este Hospitals for supporting this program and accompanying students throughout their studies. The government and people of Nicaragua advocate for a peaceful world of respect and equality where human beings can live fully and seek to promote the best conditions for sustainable and equitable development so that progress in science, education, communication, and culture are reflected in all areas of our lives, accessible and in the service of humanity. As a member of state of UNESCO, Nicaragua stands in solidarity with the world and its commitment regarding the promotion of education, the reduction of inequalities, and the empowerment of women who today in Nicaragua and in many countries have assumed a central and leading role, especially in decision-making at all levels and in all fora. It is in this light that we want to especially congratulate Elis Natalia Villegas Garcia, a Nicaraguan student for outstanding work throughout this program and for a designation as best student in this graduating class. We also want to express our appreciation to and congratulate the entire graduating class. All of you have experienced two wonderful years of learning and discovery in medical physics together. While you have each traveled your own paths, your journeys in life brought you to participate and experience this program together. And while you will continue your journeys individually in each of your countries, you must not forget that you are a part of a network with a common purpose to use your abilities, which have been shaped by yourselves and the people around you to improve and shape other people's lives. You all have come from different countries with different cultures, varying values and beliefs, but I believe that we all have one thing in common that makes us all humans, the profound need to help and serve others. It's not only at the national and global level that we must invest in the health and well-being of people to achieve the world we want to live in. It's also investing in people at the individual level through your work, your daily work and care, working for better health, peace, dignity and prosperity. So to the graduating class, to teachers, the counselors, the doctors, the administrators, and to the organizations that made this possible, thank you for your precious time and efforts, contributing your energies to shaping optimistic and intelligent souls in these pessimistic times. In order to continue overcoming the obstacles that life throws our way in our individual and common search for peace, liberty and individual and collective fulfillment. Mucha gracia. Thank you, Mr. Mitchell. Thank you. Indeed, the best student of the cycle is from Nicaragua. Mrs. Natalia Visegas. Natalia, please stand up. Okay. Thanks, Natalia. Yes, I think in normal circumstances, we would have been happy to give you the award in person, perhaps even from the hands of the ambassador, but okay, these are the times you live in. We continue then. The third pillar of our master after ICTP and university is the International Atomic Energy Agency. From the scientific viewpoint, they gave us an invaluable support in designing the master and providing teaching material. But there is another equal important aspect of the cooperation with the agency. It is the assistance of the technical cooperation of the agency. The master has received a few fellowship and financial support from various organizations, but it is the agency to see that contributes most of the fellowships for the master students. Just to give you an example, 17 out of the 24 students of the next cycle are receiving an agency to see fellowship. Without the cooperation of the agency in terms of fellowship, the master could not continue. The agency considers, as you have heard from the director general, our master program a very important component of its program in the area of technical cooperation. The agency is represented today by Mrs. Debli van der Merbe, the head of the medical physics division of the human health department of the agency. She's also one of the external scientific advisors of our master. Debli. Hello, everybody. Distinguished organizers, distinguished guests. I wish you all a good day. I would like to speak directly to the graduands. I have very little to add compared to what our DG said. Obviously we are in complete agreement. And I would like to highlight that this process of selecting students for the masters in medical physics is a highly competitive process. And so what the graduands should realize is that they are very specially selected students and people on the global stage. And they have been provided with a great opportunity. We are very proud to have been involved in this program since 2014. Obviously from the agency perspective, we have a real global picture of the situation. And we are very clearly aware of the challenges that are faced by the lack of clinically qualified medical physicists. And therefore it is a great thing that this program exists to address exactly this shortage. I'm very happy to announce that very shortly we will be issuing guidance on certification guidelines. And this is another step in the effort that the agency is making to try to promote recognition of this very special profession. I think that most of the graduands have by now learned that the way in which you develop as a medical physicist is really to see something, do something. And the next step is to teach that. Well, you are part of the way along all these milestones that you take to become a really good professional. And I hope that all of you, when you go home, start teaching others so that we can create a bigger and bigger family of medical physicists. From our perspective at the agency, we will endeavor to stay in touch with you. And we are always ready to assist any member states in developing this profession as much as we can. I hope that you are as proud as we are of being a graduate of this great flagship project. Thank you very much for the opportunity to be able to say something today. Thank you, Debbie. In the area of medical physics, there are a number of international organizations. The one that covers the whole world is IOMP, International Organization of Medical Physics. Professor Slavik Tabakov has been president of IOMP. He's also one of our external advisors and also the director of the ICTP Biennial College in medical physics. Slavik. Distinguished directors and organizers, dear colleagues and graduates. On behalf of the International Union of Physical and Engineering Sciences in Medicine and on behalf of the International Organization of Medical Physics, I would like to sincerely congratulate the ICTP, the University of TST, and the leads of the Master of Advanced Service in Medical Physics for producing yet another excellent alumni of medical physicists from around the world. Dear graduates, together with my official congratulations, let me tell you that your projects yesterday were excellent. And I'm sure that you should be a real asset to the healthcare in your countries. The current COVID pandemic showed how important is the harmonious development of global healthcare for saving the mankind. Your place in contemporary medicine is very important. Take responsibility this place and always be proud of your profession medical physics. Congratulations and all the best. Thank you. Thank you very much, Slavik. In addition to IOMP, another important international body is EFOMP, the European Federation of the Organization for Medical Physics. EFOMP is represented today by Dr. Paddy Gilligan, EFOMP president. Professor Gilligan, the pierce is not connected. Then, since the pierce is not connected, then we can continue. There is one more organization of medical physics. Hello, Professor, it's Paddy Gilligan. I actually am connected now. Somebody has connected me, so thank you. Oh, very good. I'll just try and see. Can I turn on my camera and here we go. Hello. Greetings, distinguished guests and graduation. I had, graduates, I had the privilege of lecturing at the QA workshop in November in Trieste, and it was one of the most special events I was organized in. And the thing that made it most special was the enthusiasm, the intelligence of the students and their willingness to help patients. And that's one thing that we all have in common. And I think it's very privileged for EFOMP to be involved in the ICTP courses. And we hope to continue to provide support and expertise for future programs. One thing that you learn from all of the different, all of the different languages and cultures is that we all speak the same language of medical physics and how we should benefit patients. I would like to also say that EFOMP is here to help set up initiatives. So many initiatives that we have set up as volunteers throughout the European community started off as small initiatives and then they became the norm and then we were able to set up things like national registration schemes. And we rely on the energy, enthusiasm and voices of volunteers. And I would urge you that when you go back to your own country, please set up such similar structures and we are here to help because we have models that have brought us from small beginnings up to national registration schemes. Through our educational programs and recently under the presidency of Marco Brambile, he introduced the individual associate member, which allows people from outside the European national member organizations join EFOMP to access their educational and other offerings. So I just want to congratulate you again. I think that the program is wonderful. And as I said, it's a great honor and privilege to be able to attend with such brilliant graduates and such esteemed lecturers. And I just want to pledge that you have EFOMP support in the future. And when you do return to your own countries, just EFOMP is here to help. So thank you. Thank you, Dr. Diligan. There is one more organization of medical physics, the Italian Association Italiana di Fisica Medica. Renato Padovani will later illustrate the importance of the cooperation of the Italian hospitals, which are hosting our students for the second clinical year. I might add that in spite of all the present difficulties, all the 24 students starting the second cycle will be placed in the Italian hospitals. The Italian Association of the Fisica Medica is represented by its president, Dr. Michele Stasi. Dr. Stasi. Okay, thank you very much for your invitation. I'm very pleasure to be here in online method. It's a great pleasure to bring the greetings of Italian Association of Medical Physics in this ceremony. It is a pride for our scientific society to contribute to the internship activity in our hospital, our ICTP students. I think it is a great source of growth for all of us, cultural and human growth. Congratulations and best wishes for your career and your life or the best good luck to everyone. Thank you, Dr. Stasi. In the last few years, we have added to the formal graduation ceremony an advanced scientific lecture. This year, Professor Marco Durante from the GSI Helmholtz Centrum Gesellschaft für Schwerion und Forschung Darflat will lecture on pros and cons of particle therapy, general overview, state of the art, future perspectives. Professor Durante. Yes, thank you very much for inviting me to give this lecture in this very important ceremony. It's a great honor for me. Thank you, everybody. As is clear from the title, it's a little bit long, but what I will try to summarize a little bit the status and the problems in particle therapy with emphasis on the medical physics issues and problems. So I will now share my screen so that I hope you can see the slides without problem. If there is any problems, just let me know. So the basis of particle therapy can be summarized in this slide that tells most of the characteristics of particle therapy. This is the depth dose distribution for X-rays in green, protons and carbon ions in red and blue. So what is amazing from the physics here is that while X-rays deposit most of their energy in the entrance channel and then the dose decrease exponentially for particles like protons, carbon ions or any other light ion because of the better block formula that determines the energy loss per unit track, most of the energy is deposited in the end of the range, what is called the Bragg peak. So it's pretty natural that particle therapy is conformal almost automatically. You don't need to irradiate from many angles like with the IMRT that I'm sure you are familiar to cross fire on the tumor to increase the dose of the tumor because with the Bragg peak you already have a situation where the dose to the tumor will be higher than the dose to the normal tissue. That's not the only difference between photon therapy and particle therapy. There's a lot of biological differences too that stand from the fact that in the Bragg peak you have densely ionizing radiation and densely ionizing radiation as different radiobiological properties than X-rays. For example, there is an increase in the R-B in the relative biological effectiveness so you kill more cells per unit dose and there is a decrease in the O-R, the oxygen enhancement ratio. So you are less, so the radio resistance of the hypoxic tumors is meshed but we will focus on the physical properties in this lecture, not on the biological properties. What is the consequence of the Bragg peak? The consequence of the Bragg peak is that of course you can spare much more normal tissue that you do with photons. These are treatment plans for eventually all kind of tumor sites, from CNS, head and neck, lung, abdomen, pelvis. And you see that in terms of conformality on the target, IMRT, the X-ray treatment, is excellent, it is not any worse than proton therapy, but you pay a ticket, let's say, you have to pay a fee for this conformality and that is the dose bath that you have very substantially in every site that you treat. This dose bath is drastically reduced when you use particles. You see that for a CNS tumor, you spare completely a large part of the brain. That's why for pediatric tumors where CNS are relatively common, proton therapy is generally recommended because of course you will spare a lot of brain, of young brain of a pediatric patient with clear long-term benefit for the future cognitive performance of that patient. So that's the situation. You see, that's another example that I like to show you. Let's say, what is the nice thing and what can be the problem with particle therapy for the medical physicists? You see, this is a plural mesotelioma treated with proton therapy. And you see how nice is the plan, you know, this nicely sharp stopping here and the contralateral lung. So you only read the ipsilateral lung. The contralateral lung is essentially completely spare. So that's nice. I mean, a proton therapy is that protons stop. That's what is nice in the physics. The problem is that we don't know exactly where they stop. And you see, I've never seen a springboard break like that. They stop in the wrong position, as you have seen in this movie, which is just to tell you that particle therapy is only a matter of precision. If you put the Bragg peak in the wrong spot, you can make a lot of damage, much more damage that you do with normal photons. So here is the problem of the uncertainty of the range uncertainty that is for medical physicists, one of the main issues for particle therapy. And you see in this figure how just a little bit of air gives very little effect on x-rays but can drastically impact a spread out Bragg peak with the heavy ions. Where are the sources of the range uncertainty? There are many, many sources. There are these treatment planning, those uncertainties like enobiogenities, metallic plant, the conversion of Houndsfield units that are used in planning from CT in water-equivalent path lengths that you need to use for ions. CTR, the facts as well as the anatomic and physiological changes that include daily setup variations and the internal organ motion. So all these factors are affecting the range uncertainty. And what happens, how do you compensate this? You compensate by increasing the margins. And you can say, okay, but if I increase the margin a little bit, it's not a big deal. Actually, I like this image that come from a Belgian paper of some years ago that shows that if you take the skin of an orange, your margin now in the normal tissue, I said the orange is the tumor and the skin is the margin in the normal tissue, apparently it's very thin, but if you take it all together, the volume is almost the same as the tumor. So the margins are, even if they are relatively thin, even if you add four millimeter, five millimeters margins, in terms of total normal tissue irradiated, this is quite significant. We want to kind of get rid of these margins. Like in this, this is something I found particularly fascinated that they are selling now pre-cracked egg without margins, let's see. This case, the margin is the shell of the egg. You see some practical example now, a little bit more serious. This is a real example, it's quite dramatic. You see, the proton penumbra, which means the physical margin that comes from the lateral scattering of the protons. In this treatment plan here, where you have several organs at risk, you see you have the esophagus, you have the spinal cord, is about two millimeter. But if you want to take into account range uncertainty, you can go up to something like one centimeter, which means that now the esophagus goes into the red zone and the spinal cord, which would be completely spared if you can keep the margins low. Now it's in the high dose region. And of course, if we can reduce the range uncertainty, we can have a very nice effect. That's an exercise we are doing, replanting the patients that were treated at GSI with carbon ions. This is another non-cystic carcinoma. And the range uncertainty that was used at that time was plus or minus 3.5%. And you see that if we can reduce the range uncertainty to plus or minus 1%, we can still spare the optic nerve, but giving the full coverage of the tumor. So there is a real advantage, both in terms of lower toxicity and in terms of better treatment of the tumor itself. One of the main complications, these days, spot scanning, pencil beam scanning is the standard in particle therapy. And it's very nice. As you see, you can have a cool dose distribution because you treat your tumor as a set of slices. And then you go with your pencil, like in a TV, and you scan slice by slice in a very, very precise way. This is quite nice, as long as the target is perfectly fixed. Because if the target is moving, then the situation gets definitely worse. You see here, for example, for a lung tumor, which is actually moving, the interplay of the movement of the lung and of the movement of the beam generates this lousy dose distributions with overshooting and undershooting in the tumor. And also a large range of problem, because of course the density of the lung is much lower than the density of the tumor. So you have a lot of particles now shooting at high depth in the lung. How is this normally approached? This is normally approached by, again, it's like in the orange. You make a large ITV, internal target volume, that includes the movement of the tumor, you see here. That's fine, but you see that now you are radiating a very large portion of the lung. A more sensible approach will be to do a 4D optimization and to synchronize the beam delivery, which is, as you see here, a very interesting approach. Now a system for synchronized delivery with the movement has been studied at GSI in our group and has been installed in now, which is the Center for Particle Therapy in Italy, which is in Pavia. So now it will be possible in Pavia to irradiate the moving organs with the synchronized beam delivery with the movement of the patient. But of course, this is, you need to see the beam. You need to visualize somehow the position of the beam if you want to reduce the uncertainty. And there are many ways you can do it. You can use prompt gamma, which is now commercial, is used in several proton therapy centers like Dresden and in UPenn and I think it was in Trento now. You can use proton radiography and you can use PET, Positron Emission Tomography. This is actually one of the early method for beam verification during treatment was used at GSI. This is still, this is the Bastai PET camera at GSI, which is still there. And it was used for verification of the range, exploiting the fact that with carbon ions, you produce a lot of carbon-11 ions by fragmentation of the projectile. So you can actually, and carbon-11 is a Positron Emitter, so you can use this with a PET camera to visualize the beam. You can also use in proton therapy. In this case, of course, you cannot use the fragments of the projectile, but you can still use the fragments of the target because oxygen-16 can be fragmented in oxygen-15, which is a beta plus emitter too. We used it recently in an experiment, a very interesting experiment in treatment of cardiac ventricular fibrillation, heart arrhythmia, using carbon ions. We had the SWine model, as you see, fixed here. That's the, during the process of fixation. And this was the treatment plan, you see where the dose was supposed to be delivered here in the ventricle of the heart. And this was the in-beam PET. You see, it's a very nice spot. You see how PET verifies that the dose was actually delivered here. But what is interesting, you see, is that if you do an offline PET, which is sometimes used, for example, in Heidelberg, there is, and also in Chiba, there are PET, not in the radiation room, but in another room. And you see that after 20 minutes, the signal of PET is already gone. That's because of the wash-out. So the radioisotopes that are produced during the radiation are washed out by the blood flow and you lose the signal, or you just move the signal to another position. This is also a nice example. This is an head and neck tumor. So it's less sensible to wash-out and this is now the image taken with this very sophisticated instrument called INSIDE, which is a very nice detector built by the National Institute of Nuclear Physics and which is now installed in canal to use PET for beam verification. Now, what is the problem, though, if you use oxygen, I mean, you see here, for example, if you use protons, the activity will have this shape and this is the dose, the black peak. So you see that the activity is kind of distributed all along the track and the peak is quite far from the peak of protons. But even if you use carbon or oxygen beams, as it will be done in Heidelberg, you see that there is a shift between the activity peak and the carbon peak. That's not because of the wash-out, it's because of the physics, because of course the carbon-11 or the oxygen-15 that are formed by fragmentation, they have pretty much the same velocity of the primary ion, but they have lower mass, so they have different range. They stop before the primary ion. That's seen also in this picture here. So how nice would it be if we could instead treat the patients directly with radioactive ion beams? That would be really nice and that's not the new idea at all because it was actually introduced in Berkeley many years ago in the 70s by Bill Chu and this coworker. They were thinking to use Neon 19, which is a positron emitter for beam verification. And this has also been used in Japan, you see here where they built a very nice open pet, which is ideal for measuring the radioactive ion beams. But the problem in the past was generally the low intensity of the radioactive ion beams. But it would be fantastic if we can use it. This is a Monte Carlo simulation you see on the pet at 20 seconds and 20 minutes. When you use a carbon 12, so essentially you are visualizing the carbon 11 now, carbon 11 beam or even carbon 10 beam. You see how the signal now is extremely stronger. This is an ideal case of a sort of mono energetic and mono energetic beam. You see that the signal here is spread because of the difference between the peak of the primary ion and the peak of the fragment. But here you have very clear signal. And if you use carbon 10 that has a half life of only 20 seconds, you can nicely see it while you irradiate your tumor, you can actually see the beam. That's, you see an example of how the image looks like. This is a fluca simulation on how the image looks like when you use carbon 12, you see this large spread of activity here and also here. But if you use carbon 11, look how nice it could be. This only simulation, how nice it could be. You see very nice and strong signal to noise ratio. So the main problem in the past for doing this was the intensity of the beam, as I said, because you need the high intensity beams. But this is now overcoming the new accelerators in particular in the fair accelerator in Germany where we can actually get for ions like carbon 11, carbon 10, oxygen 15 and oxygen 14, intensities that are in the range of the treatment. And you see these ions like carbon 10 or oxygen 14 are very promising because of their very short half life. Of course, the cross section starts to be low and so the intensity will be even lower than the one for carbon 11 and oxygen 15. But we will test these ions within an ERC program program funded by the European Research Council, the GSI Fair in collaboration with the University of Munich. And that's a stepwise program where essentially we will extract the radioactive beams which is nuclear physics. We will build a new detector which is a gamma pet detector. We will then have a lot of medical physics because we will have to study biological and physical dosimetry in phantoms. We will have imaging, we have to visualize the beam. And finally, we will actually treat an animal model. Of course, for the first time with radioactive beams to assess the real potential of this technique. With this, I like to conclude and to thank all of you to congratulate all of you for entering in this field that as you see is not only a clinical professional field but is a research field. And I'll be happy to answer any question. Thank you very much. Thank you very much Professor Durante for this fascinating view on the future. When eight years ago we started designing the master, we had an invaluable contribution from Dr. Ahmed Magdifene. At the time working at the agency in Vienna. Ahmed is also one of the external scientific advisors of our master. Ahmed. Good morning everyone. I have worked for the IEA for almost 20 years. So it would take some time for people to disconnect my name from the IEA. That's why my affiliation is shown as the IEA in this video transmission. But as an external advisor to the MPP program, I want to take this moment to congratulate you for completing your studies and thus earning your master's degree in this challenging time of COVID-19. You should be proud of your accomplishments. Briefly, let me give you three tech home messages for you. Get prepared for a certification either in your country if a certification board exists or through the IMPCB, the International Medical Physics Certification Board, if you have no certification in your countries and remain devoted to a lifetime of learning. Second tech home message is always to use your critical thinking in your everyday work. And finally, always remain committed to the ethical standards of the medical physics profession. Stay safe, I wish for all of you all the good things that life can offer. And thank you to the ICTP for giving me this opportunity to address the graduates. Thank you, Ahmed, also for your messages. Again, when eight years ago we started designing this project of this master, we have been very fortunate to have the enthusiastic operation of two professional medical physicists, Professor Renato Longo, full professor of medical physics at the Trieste University, and Dr. Renato Padovani, who at that time was the head of the medical physics at the Odin Hospital. Renata is now the director of our master and Renato, its coordinator. Renato. Dear graduates, first of all, I'd like to congratulate with you for your achievement. After two years of studies and clinical experience, far from your family, your friends, you have finally succeeded to this day and to complete the program. Last year, we had... You had... It was very difficult here for everybody. And especially you, where this has been mentioned before, you have been alone in a new town without friends closed, frequently closing a room for two, three months. So it was not easy to manage this situation. But today we are here, healthy and safe. So this is... What is important? But also this, in Italy, we are looking to the glass half full. So we can say that also this is an experience in the life. And you learn, for example, how a health system has to rapidly change the organization, the internal rules and everything in the fast way to answer to a new demand of health. So this is, I think, is another useful experience that you have. After these two years, you have gained competencies that will be very important for your future, for your future activities and profession. But what is also important in this experience is that you had the opportunity, as other panelists said today, to be involved in international environment like ICTP. And this is another important. So now, in the future, you can count of many international relationships that certainly will help you in your country to grow in your activity, in your life. And also this is an important experience, in my opinion. You have learned how easy it is to live in a multilingual, multicultural, multi-ethical environment. And this, I can say, is a clear demonstration that it's possible to live in a more peaceful world. And we learn every day how easy it is in this environment, how easy it is to live in a peaceful way. But, okay, you have learned a lot, many experiences, but this is giving you, is charging you more and more responsibilities. In fact, your working environment, your country, your hospital is waiting a lot, a lot from you in terms of profession, in terms of teaching and everything. But I'm sure that you, or many of you, will play an important role in developing medical physics in your country. And at the same time, with your profession, rising the quality of the health service in your hospital, in your country. So, for all this, I congratulate you again for your achievement. I take Professor Bertocchi said before how important is our environment, what we have created in these seven years in this program. And for this reason, I'd like to thank all the teachers, head of medical physics department, supervisors for the work they are doing in making this program a success program. I can say that today more than 100 medical physicists are collaborating in this program. And this is an important aspect of this program. In fact, we have a network. We have the pleasure to collaborate with 26 hospitals. And this is a fundamental pillar of the program. So without, as Professor Bertocchi said before, without this collaboration, this program will be not so important. So, finally, I'd like to join Professor Bertocchi and all of us to thank Miss Susie Radosic that helped us in these seven years and contributed to build this program. And at the same time, I welcome Miss Francesca Prelasi that is taking this position now. I'm concluding, congratulating again with you all the best for your future. Thank you, Renato. Then we'll call Renata. Thank you. I'm wondering who are in these lecture hall that seems empty. But maybe it is not empty. I mean, we have the graduate students, 11 persons, students on their way to clinical training in the hospital. In this moment, they are at home in Trieste, maybe 23 persons. Then we have students just arrived in Trieste. They are in the quarantine in the Galleria Augustaus, another 23 people. And here with us, we have the supervisor of the clinical training, about 30 persons. The heads of the clinical, of the medical physics department, 20 people. The teacher of the first year, about 20, the external advisor, atomic agency, European Federation of Medical Physics, IFM, IOMP, 5, 10 people. The board of the master and a number of past graduated students that are with us. So, roughly speaking, in these all we are no less than 150 persons. So, a large number of people. So, who or what are we celebrating? For sure, we are celebrating the graduation of 11 students, including the delayed graduation of two of your group. You are ready to serve as medical physicists in your countries. You have been trained to share your knowledge within your hospital and with your colleagues. Knowledge is an obligation, a responsibility, not a privilege for a faster career only. So, the sharing the knowledge is the spirit that move the teachers and the supervisor. Please go on with this spirit. We need it. But we are celebrating also the arrival of the new students, those that are in quarantine. In this special year, traveling and organizing the departure and arrival is needed a specific effort by the team in Trieste and by the candidates. So, their arrival deserves a celebration. We are celebrating the end of the first year of the students that are enrolled one year ago. The very active community suffered a lot for the moving towards the online classes. Now they are spreading the hospital and they are required to be part of new teams. And be able to join new teams will be a very important lesson to learn during the first year. Moreover, we are celebrating the retirement of Susie Radosic. It's a pity that she's not with us, but we're sure that she's in this room thanks to Zoom. We appreciate the strong passion and the highly professional work. We wish her all the best. Summarizing, we are celebrating a large international community of medical physics based on cooperation, enthusiasm and friendship. As medical physicists, we will be never alone. Congratulations and thanks again. We are now proceeding with the actual degree of awarding. This will be done by Professor Dabholkar and Professor Sarongo. I don't know either how to do that. Unfortunately, it is a very static ceremony so we cannot do anything. My understanding was static. Exactly. We have to call one by one and as soon as we call your names, you have to stand up and show your graduation cube. But let me... So you cannot do the usual stairs and the picture, but okay. So let me start with Mohammed Abduljami from Palestine because this is the graduation ceremony not only of these eight candidates but of the whole team of the whole group. So Mohammed gets his degree in December but he's part of this graduation ceremony so Mohammed is from Palestine and he did his clinical training in Milan. And now we go to this here and so Capis Otino Eric he did his training in Rome. Congratulations. And then we have Sabah Hussein from Pakistan. She did her thesis in Vicenza and well, core of the project from Fort Devois and she performed his thesis in Bergamo. Rosa Angelica Petitsevilla from Venezuela and she performed the thesis in Siena. Reema Maschacarada Ramathan from Tanzania and she performed the thesis in Novara. Benabesha Fu Samarfour from Chad. Benabesha Fu Samarfour from Chad. And he worked at his thesis in Trento. Piccadillo from Senegal who performed his training in Trieste after Edith Natalia from Nicaragua and he performed his thesis in Padua. Wait, wait, wait, wait, we have two more. Okay, so we are celebrating also the future graduation of the Khashog Khokharel from Nepal. He is working in Ferrara and Hamad Nawid Bulkham from Afghanistan. He is working in Trento. Both of them have the delayed graduation of Nawid and Khashog. I'm sorry. Khashog is due to the lockdown. I mean, no. Khashog arrived later in Italy and am I right? No, it's the opposite. I'm sorry. Khashog had a very long lockdown due to the truce of the Ferrara hospital due to bureaucracy problem. And so both of them need a longer clinical training but due to technical reasons it's not the fault of them. It's simply related to before closing, a representative of the students has asked to say a few words. So the students of the master have asked me to say a few words from them, from all of us. We would like to take this time to thank the University of Trieste and in particular Professor Renata Longo for her work. Also IAA for the fellowships to most of the students. ICTP, here we have a lot of people saying Professor Renato Pazovani and Professor Bertoki for all the work but also to our former secretaries Susie Radousik that was always present for us. The centers for clinical training and our supervisors at all the different Italian students and our lecturers for all their patients during the last year. We also can't forget being thankful to Professor Longo and Professor Pazovani for all the time they spent with us during lockdown last year. That was a very difficult time but we are very thankful that you took the time to try to entertain us and keep us motivated. Thank you very much. Thank you for the graduation of a class of only 12 students but we should not concentrate just on this small number because we are from 12 different countries spread across the world and now our mission will be to share with our countries the knowledge that we have. Thank you to all. Thank you everybody and good luck. He wants to say something. Thank you so much. I also want to take this opportunity to give a small award for this year. We prepared something small and we are very grateful that we are able to present it in an unusual way. Can you show it? It is a clock representing a fellow of ours so in each clock it is the flag of our respective countries. Thank you so much. I will take a photo later. Thank you.