Benefits of a Pharmacology Antimalarial Reference Standard and Proficiency Testing Program Provided by the Worldwide Antimalarial Resistance Network (WWARN)

PubMed Central

Lourens, Chris; Lindegardh, Niklas; Barnes, Karen I.; Guerin, Philippe J.; Sibley, Carol H.; White, Nicholas J.

2014-01-01

Comprehensive assessment of antimalarial drug resistance should include measurements of antimalarial blood or plasma concentrations in clinical trials and in individual assessments of treatment failure so that true resistance can be differentiated from inadequate drug exposure. Pharmacometric modeling is necessary to assess pharmacokinetic-pharmacodynamic relationships in different populations to optimize dosing. To accomplish both effectively and to allow comparison of data from different laboratories, it is essential that drug concentration measurement is accurate. Proficiency testing (PT) of laboratory procedures is necessary for verification of assay results. Within the Worldwide Antimalarial Resistance Network (WWARN), the goal of the quality assurance/quality control (QA/QC) program is to facilitate and sustain high-quality antimalarial assays. The QA/QC program consists of an international PT program for pharmacology laboratories and a reference material (RM) program for the provision of antimalarial drug standards, metabolites, and internal standards for laboratory use. The RM program currently distributes accurately weighed quantities of antimalarial drug standards, metabolites, and internal standards to 44 pharmacology, in vitro, and drug quality testing laboratories. The pharmacology PT program has sent samples to eight laboratories in four rounds of testing. WWARN technical experts have provided advice for correcting identified problems to improve performance of subsequent analysis and ultimately improved the quality of data. Many participants have demonstrated substantial improvements over subsequent rounds of PT. The WWARN QA/QC program has improved the quality and value of antimalarial drug measurement in laboratories globally. It is a model that has potential to be applied to strengthening laboratories more widely and improving the therapeutics of other infectious diseases. PMID:24777099

Daily QA of linear accelerators using only EPID and OBI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sun, Baozhou, E-mail: bsun@radonc.wustl.edu; Goddu, S. Murty; Yaddanapudi, Sridhar

2015-10-15

Purpose: As treatment delivery becomes more complex, there is a pressing need for robust quality assurance (QA) tools to improve efficiency and comprehensiveness while simultaneously maintaining high accuracy and sensitivity. This work aims to present the hardware and software tools developed for comprehensive QA of linear accelerator (LINAC) using only electronic portal imaging devices (EPIDs) and kV flat panel detectors. Methods: A daily QA phantom, which includes two orthogonally positioned phantoms for QA of MV-beams and kV onboard imaging (OBI) is suspended from the gantry accessory holder to test both geometric and dosimetric components of a LINAC and an OBI.more » The MV component consists of a 0.5 cm water-equivalent plastic sheet incorporating 11 circular steel plugs for transmission measurements through multiple thicknesses and one resolution plug for MV-image quality testing. The kV-phantom consists of a Leeds phantom (TOR-18 FG phantom supplied by Varian) for testing low and high contrast resolutions. In the developed process, the existing LINAC tools were used to automate daily acquisition of MV and kV images and software tools were developed for simultaneous analysis of these images. A method was developed to derive and evaluate traditional QA parameters from these images [output, flatness, symmetry, uniformity, TPR{sub 20/10}, and positional accuracy of the jaws and multileaf collimators (MLCs)]. The EPID-based daily QA tools were validated by performing measurements on a detuned 6 MV beam to test its effectiveness in detecting errors in output, symmetry, energy, and MLC positions. The developed QA process was clinically commissioned, implemented, and evaluated on a Varian TrueBeam LINAC (Varian Medical System, Palo Alto, CA) over a period of three months. Results: Machine output constancy measured with an EPID (as compared against a calibrated ion-chamber) is shown to be within ±0.5%. Beam symmetry and flatness deviations measured using an EPID and a 2D ion-chamber array agree within ±0.5% and ±1.2% for crossline and inline profiles, respectively. MLC position errors of 0.5 mm can be detected using a picket fence test. The field size and phantom positioning accuracy can be determined within 0.5 mm. The entire daily QA process takes ∼15 min to perform tests for 5 photon beams, MLC tests, and imaging checks. Conclusions: The exclusive use of EPID-based QA tools, including a QA phantom and simultaneous analysis software tools, has been demonstrated as a viable, efficient, and comprehensive process for daily evaluation of LINAC performance.« less

Comprehensive Testing Guidelines to Increase Efficiency in INDOT Operations

DOT National Transportation Integrated Search

2012-08-01

When INDOT designs a pavement project, the decision for QC/QA or nonQC/QA is made solely based on the quantity of pavement materials. However, the actual risk will vary depending on the severity of road conditions. The question is how to different...

Comprehensive Testing Guidelines to Increase Efficiency in INDOT Operations

DOT National Transportation Integrated Search

2012-08-01

When INDOT designs a pavement project, the decision for QC/QA or nonQC/QA is made solely based on the quantity of : pavement materials. However, the actual risk will vary depending on the severity of road conditions. The question is how : to diffe...

Comprehensive Testing Guidelines to Increase Efficiency in INDOT Operations : [Technical Summary

DOT National Transportation Integrated Search

2012-01-01

When the Indiana Department of Transportation designs a pavement project, a decision for QC/QA (Quality Control/ Quality Assurance) or nonQC/QA is made solely based on the quantity of pavement materials to be used in the project. Once the pavement...

Comprehensive Testing Guidelines to Increase Efficiency in INDOT Operations : [Technical Summary

DOT National Transportation Integrated Search

2012-01-01

When the Indiana Department of Transportation designs : a pavement project, a decision for QC/QA (Quality Control/ : Quality Assurance) or nonQC/QA is made solely : based on the quantity of pavement materials to be used : in the project. Once the ...

Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials

PubMed Central

Bekelman, Justin E.; Deye, James A.; Vikram, Bhadrasain; Bentzen, Soren M.; Bruner, Deborah; Curran, Walter J.; Dignam, James; Efstathiou, Jason A.; FitzGerald, T. J.; Hurkmans, Coen; Ibbott, Geoffrey S.; Lee, J. Jack; Merchant, Timothy E.; Michalski, Jeff; Palta, Jatinder R.; Simon, Richard; Ten Haken, Randal K.; Timmerman, Robert; Tunis, Sean; Coleman, C. Norman; Purdy, James

2012-01-01

Background In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute (NCI) sponsored a two day workshop to examine the challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. Lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities like proton beam therapy, and the international harmonization of clinical trial QA. Results Four recommendations were made: 1) Develop a tiered (and more efficient) system for radiotherapy QA and tailor intensity of QA to clinical trial objectives. Tiers include (i) general credentialing, (ii) trial specific credentialing, and (iii) individual case review; 2) Establish a case QA repository; 3) Develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and 4) Explore the feasibility of consolidating clinical trial QA in the United States. Conclusion Radiotherapy QA may impact clinical trial accrual, cost, outcomes and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. PMID:22425219

NEVER AUDIT ALONE--THE CASE FOR AUDIT TEAMS

EPA Science Inventory

On-site audits conducted by technical and quality assurance (QA) experts at the data-gathering location are the core of an effective QA program. However, inadequate resources for such audits are the bane of a QA program, and the proposed solution frequently is to send only one au...

Quality Assurance and Control Considerations in Environmental Measurements and Monitoring

NASA Astrophysics Data System (ADS)

Sedlet, Jacob

1982-06-01

Quality assurance and quality control have become accepted as essential parts of all environmental surveillance, measurements, and monitoring programs, both nuclear and non-nuclear. The same principles and details apply to each. It is primarily the final measurement technique that differs. As the desire and need to measure smaller amounts of pollutants with greater accuracy has increased, it has been recognized that quality assurance and control programs are cost-effective in achieving the expected results. Quality assurance (QA) consists of all the actions necessary to provide confidence in the results. Quality control (QC) is a part of QA, and consists of those actions and activities that permit the control of the individual steps in the environmental program. The distinction between the two terms is not always clearly defined, but a sharp division is not necessary. The essential principle of QA and QC is a commitment to high quality results. The essential components of a QA and QC program are a complete, written procedures manual for all parts of the environmental program, the use of standard or validated procedures, participation in applicable interlaboratory comparison or QA programs, replicate analysis and measurement, training of personnel, and a means of auditing or checking that the QA and QC programs are properly conducted. These components are discussed below in some detail.

SU-F-T-226: QA Management for a Large Institution with Multiple Campuses for FMEA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tang, G; Chan, M; Lovelock, D

2016-06-15

Purpose: To redesign our radiation therapy QA program with the goal to improve quality, efficiency, and consistency among a growing number of campuses at a large institution. Methods: A QA committee was established with at least one physicist representing each of our six campuses (22 linacs). Weekly meetings were scheduled to advise on and update current procedures, to review end-to-end and other test results, and to prepare composite reports for internal and external audits. QA procedures for treatment and imaging equipment were derived from TG Reports 142 and 66, practice guidelines, and feedback from ACR evaluations. The committee focused onmore » reaching a consensus on a single QA program among all campuses using the same type of equipment and reference data. Since the recommendations for tolerances referenced to baseline data were subject to interpretation in some instances, the committee reviewed the characteristics of all machines and quantified any variations before choosing between treatment planning system (i.e. treatment planning system commissioning data that is representative for all machines) or machine-specific values (i.e. commissioning data of the individual machines) as baseline data. Results: The configured QA program will be followed strictly by all campuses. Inventory of available equipment has been compiled, and additional equipment acquisitions for the QA program are made as needed. Dosimetric characteristics are evaluated for all machines using the same methods to ensure consistency of beam data where possible. In most cases, baseline data refer to treatment planning system commissioning data but machine-specific values are used as reference where it is deemed appropriate. Conclusion: With a uniform QA scheme, variations in QA procedures are kept to a minimum. With a centralized database, data collection and analysis are simplified. This program will facilitate uniformity in patient treatments and analysis of large amounts of QA data campus-wide, which will ultimately facilitate FMEA.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mundy, D; Tryggestad, E; Beltran, C

Purpose: To develop daily and monthly quality assurance (QA) programs in support of a new spot-scanning proton treatment facility using a combination of commercial and custom equipment and software. Emphasis was placed on efficiency and evaluation of key quality parameters. Methods: The daily QA program was developed to test output, spot size and position, proton beam energy, and image guidance using the Sun Nuclear Corporation rf-DQA™3 device and Atlas QA software. The program utilizes standard Atlas linear accelerator tests repurposed for proton measurements and a custom jig for indexing the device to the treatment couch. The monthly QA program wasmore » designed to test mechanical performance, image quality, radiation quality, isocenter coincidence, and safety features. Many of these tests are similar to linear accelerator QA counterparts, but many require customized test design and equipment. Coincidence of imaging, laser marker, mechanical, and radiation isocenters, for instance, is verified using a custom film-based device devised and manufactured at our facility. Proton spot size and position as a function of energy are verified using a custom spot pattern incident on film and analysis software developed in-house. More details concerning the equipment and software developed for monthly QA are included in the supporting document. Thresholds for daily and monthly tests were established via perturbation analysis, early experience, and/or proton system specifications and associated acceptance test results. Results: The periodic QA program described here has been in effect for approximately 9 months and has proven efficient and sensitive to sub-clinical variations in treatment delivery characteristics. Conclusion: Tools and professional guidelines for periodic proton system QA are not as well developed as their photon and electron counterparts. The program described here efficiently evaluates key quality parameters and, while specific to the needs of our facility, could be readily adapted to other proton centers.« less

Redesigning Radiotherapy Quality Assurance: Opportunities to Develop an Efficient, Evidence-Based System to Support Clinical Trials-Report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bekelman, Justin E., E-mail: bekelman@uphs.upenn.edu; Deye, James A.; Vikram, Bhadrasain

2012-07-01

Purpose: In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Methods and Materials: Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such asmore » proton beam therapy, and the international harmonization of clinical trial QA. Results: Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Conclusion: Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based.« less

Redesigning radiotherapy quality assurance: opportunities to develop an efficient, evidence-based system to support clinical trials--report of the National Cancer Institute Work Group on Radiotherapy Quality Assurance.

PubMed

Bekelman, Justin E; Deye, James A; Vikram, Bhadrasain; Bentzen, Soren M; Bruner, Deborah; Curran, Walter J; Dignam, James; Efstathiou, Jason A; FitzGerald, T J; Hurkmans, Coen; Ibbott, Geoffrey S; Lee, J Jack; Merchant, Thomas E; Michalski, Jeff; Palta, Jatinder R; Simon, Richard; Ten Haken, Randal K; Timmerman, Robert; Tunis, Sean; Coleman, C Norman; Purdy, James

2012-07-01

In the context of national calls for reorganizing cancer clinical trials, the National Cancer Institute sponsored a 2-day workshop to examine challenges and opportunities for optimizing radiotherapy quality assurance (QA) in clinical trial design. Participants reviewed the current processes of clinical trial QA and noted the QA challenges presented by advanced technologies. The lessons learned from the radiotherapy QA programs of recent trials were discussed in detail. Four potential opportunities for optimizing radiotherapy QA were explored, including the use of normal tissue toxicity and tumor control metrics, biomarkers of radiation toxicity, new radiotherapy modalities such as proton beam therapy, and the international harmonization of clinical trial QA. Four recommendations were made: (1) to develop a tiered (and more efficient) system for radiotherapy QA and tailor the intensity of QA to the clinical trial objectives (tiers include general credentialing, trial-specific credentialing, and individual case review); (2) to establish a case QA repository; (3) to develop an evidence base for clinical trial QA and introduce innovative prospective trial designs to evaluate radiotherapy QA in clinical trials; and (4) to explore the feasibility of consolidating clinical trial QA in the United States. Radiotherapy QA can affect clinical trial accrual, cost, outcomes, and generalizability. To achieve maximum benefit, QA programs must become more efficient and evidence-based. Copyright © 2012 Elsevier Inc. All rights reserved.

QA program plan plutonium stabilization and handling project W-460

DOE Office of Scientific and Technical Information (OSTI.GOV)

SCHULTZ, J.W.

This Quality Assurance Program Plan (QAPP) identifies Project Quality Assurance (QA) program requirements for all parties participating in the design, procurement, demolition, construction, installation, inspection and testing for Project W-460.

Template for updating regulations in QA manuals

DOE Office of Scientific and Technical Information (OSTI.GOV)

White, M.G.; Banerjee, B.

1992-01-01

Recently, the U.S. Department of Energy (DOE) issued new quality assurance (QA) orders to reflect current policies for conduct and operation of DOE-authorized programs and facilities. Establishing traceability to new QA criteria and requirements from former multidraft orders, QA manuals, and guidance documentation for DOE-funded work can be confusing. Identified critical considerations still must be addressed. Most of the newly stated QA criteria can be cross referenced, where applicable, to former QA plans and manuals. Where additional criteria occur, new procedures may be required, together with revisions in QA plans and manuals.

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea.

PubMed

Cho, Yu Kyung; Moon, Jeong Seop; Han, Dong Su; Lee, Yong Chan; Kim, Yeol; Park, Bo Young; Chung, Il-Kwun; Kim, Jin-Oh; Im, Jong Pil; Cha, Jae Myung; Kim, Hyun Gun; Lee, Sang Kil; Lee, Hang Lak; Jang, Jae Young; Kim, Eun Sun; Jung, Yunho; Moon, Chang Mo

2016-11-01

In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions. We surveyed the staff of institutional endoscopic units via e-mail. Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program. Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

Using Classroom Observations to Measure Teacher Effectiveness: Q&A with Rob Ramsdell. REL Mid-Atlantic Webinar

ERIC Educational Resources Information Center

Regional Educational Laboratory Mid-Atlantic, 2013

2013-01-01

In this webinar, Mr. Rob Ramsdell, Vice President, Cambridge Education, discussed the use of classroom observations as one measure of teacher effectiveness in a comprehensive educator support system. Mr. Ramsdell presented research-based recommendations for improving the quality and rigor of classroom observations. This Q&A addressed the…

Surgical quality assessment. A simplified approach.

PubMed

DeLong, D L

1991-10-01

The current approach to QA primarily involves taking action when problems are discovered and designing a documentation system that records the deliverance of quality care. Involving the entire staff helps eliminate problems before they occur. By keeping abreast of current problems and soliciting input from staff members, the QA at our hospital has improved dramatically. The cross-referencing of JCAHO and AORN standards on the assessment form and the single-sheet reporting form expedite the evaluation process and simplify record keeping. The bulletin board increases staff members' understanding of QA and boosts morale and participation. A sound and effective QA program does not require reorganizing an entire department, nor should it invoke negative connotations. Developing an effective QA program merely requires rethinking current processes. The program must meet the department's specific needs, and although many departments concentrate on documentation, auditing charts does not give a complete picture of the quality of care delivered. The QA committee must employ a variety of data collection methods on multiple indicators to ensure an accurate representation of the care delivered, and they must not overlook any issues that directly affect patient outcomes.

Key Performance Indicators in Radiology: You Can't Manage What You Can't Measure.

PubMed

Harvey, H Benjamin; Hassanzadeh, Elmira; Aran, Shima; Rosenthal, Daniel I; Thrall, James H; Abujudeh, Hani H

2016-01-01

Quality assurance (QA) is a fundamental component of every successful radiology operation. A radiology QA program must be able to efficiently and effectively monitor and respond to quality problems. However, as radiology QA has expanded into the depths of radiology operations, the task of defining and measuring quality has become more difficult. Key performance indicators (KPIs) are highly valuable data points and measurement tools that can be used to monitor and evaluate the quality of services provided by a radiology operation. As such, KPIs empower a radiology QA program to bridge normative understandings of health care quality with on-the-ground quality management. This review introduces the importance of KPIs in health care QA, a framework for structuring KPIs, a method to identify and tailor KPIs, and strategies to analyze and communicate KPI data that would drive process improvement. Adopting a KPI-driven QA program is both good for patient care and allows a radiology operation to demonstrate measurable value to other health care stakeholders. Copyright © 2015 Mosby, Inc. All rights reserved.

Quality assurance and quality control of geochemical data—A primer for the research scientist

USGS Publications Warehouse

Geboy, Nicholas J.; Engle, Mark A.

2011-01-01

Geochemistry is a constantly expanding science. More and more, scientists are employing geochemical tools to help answer questions about the Earth and earth system processes. Scientists may assume that the responsibility of examining and assessing the quality of the geochemical data they generate is not theirs but rather that of the analytical laboratories to which their samples have been submitted. This assumption may be partially based on knowledge about internal and external quality assurance and quality control (QA/QC) programs in which analytical laboratories typically participate. Or there may be a perceived lack of time or resources to adequately examine data quality. Regardless of the reason, the lack of QA/QC protocols can lead to the generation and publication of erroneous data. Because the interpretations drawn from the data are primary products to U.S. Geological Survey (USGS) stakeholders, the consequences of publishing erroneous results can be significant. The principal investigator of a scientific study ultimately is responsible for the quality and interpretation of the project's findings, and thus must also play a role in the understanding, implementation, and presentation of QA/QC information about the data. Although occasionally ignored, QA/QC protocols apply not only to procedures in the laboratory but also in the initial planning of a research study and throughout the life of the project. Many of the tenets of developing a sound QA/QC program or protocols also parallel the core concepts of developing a good study: What is the main objective of the study? Will the methods selected provide data of enough resolution to answer the hypothesis? How should samples be collected? Are there known or unknown artifacts or contamination sources in the sampling and analysis methods? Assessing data quality requires communication between the scientists responsible for designing the study and those collecting samples, analyzing samples, treating data, and interpreting results. This primer has been developed to provide basic information and guidance about developing QA/QC protocols for geochemical studies. It is not intended to be a comprehensive guide but rather an introduction to key concepts tied to a list of relevant references for further reading. The guidelines are presented in stepwise order beginning with presampling considerations and continuing through final data interpretation. The goal of this primer is to outline basic QA/QC practices that scientists can use before, during, and after chemical analysis to ensure the validity of the data they collect with the goal of providing defendable results and conclusions.

Educator Effectiveness Series: Assessing School Climate. Q&A with Jonathan Cohen, Ph.D. REL Mid-Atlantic Webinar

ERIC Educational Resources Information Center

Cohen, Jonathan

2015-01-01

The REL Mid-Atlantic Webinar discussed the elements in a positive school climate and shared different methods for assessing school data, including the Comprehensive School Climate Inventory. The Q&A presented in this document address the questions participants had for Dr. Cohen following the webinar. The webinar recording and PowerPoint…

SU-E-T-11: A Cloud Based CT and LINAC QA Data Management System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiersma, R; Grelewicz, Z; Belcher, A

Purpose: The current status quo of QA data management consists of a mixture of paper-based forms and spreadsheets for recording the results of daily, monthly, and yearly QA tests for both CT scanners and LINACs. Unfortunately, such systems suffer from a host of problems as, (1) records can be easily lost or destroyed, (2) data is difficult to access — one must physically hunt down records, (3) poor or no means of historical data analysis, and (4) no remote monitoring of machine performance off-site. To address these issues, a cloud based QA data management system was developed and implemented. Methods:more » A responsive tablet interface that optimizes clinic workflow with an easy-to-navigate interface accessible from any web browser was implemented in HTML/javascript/CSS to allow user mobility when entering QA data. Automated image QA was performed using a phantom QA kit developed in Python that is applicable to any phantom and is currently being used with the Gammex ACR, Las Vegas, Leeds, and Catphan phantoms for performing automated CT, MV, kV, and CBCT QAs, respectively. A Python based resource management system was used to distribute and manage intensive CPU tasks such as QA phantom image analysis or LaTeX-to-PDF QA report generation to independent process threads or different servers such that website performance is not affected. Results: To date the cloud QA system has performed approximately 185 QA procedures. Approximately 200 QA parameters are being actively tracked by the system on a monthly basis. Electronic access to historical QA parameter information was successful in proactively identifying a Linac CBCT scanner’s performance degradation. Conclusion: A fully comprehensive cloud based QA data management system was successfully implemented for the first time. Potential machine performance issues were proactively identified that would have been otherwise missed by a paper or spreadsheet based QA system.« less

[Cross-sectoral quality assurance in ambulatory care].

PubMed

Albrecht, Martin; Loos, Stefan; Otten, Marcus

2013-01-01

Overcoming rigid sectoral segmentation in healthcare has also become a health policy target in quality assurance. With the Act to Enhance Competition in Statutory Health Insurance (GKV-WSG) coming into effect, quality assurance measures are to be designed in a cross-sectoral fashion for in- and outpatient sectors equally. An independent institution is currently mandated to develop specific quality indicators for eleven indications. For three of these operating tests have already been commissioned by the Federal Joint Committee. This article depicts the major results of a feasibility study, including a compliance cost estimate, for the aforementioned indications of cross-sectoral quality assurance (cQA). In conclusion, a number of both practical and conceptual basic challenges are still to be resolved prior to the full implementation of cQA, such as a sufficient specification to activate documentation requirements and an inspection system capable of separating actual quality problems from documentary deficits. So far, a comprehensive cost-utility analysis of cQA has not been provided, in particular with comparison to existing QA systems. In order to optimise cost and utility of cQA an evidence-based approach is required for both the extension of cQA areas and for QA provisions. Copyright © 2013. Published by Elsevier GmbH.

Practical utility of on-line clearance and blood temperature monitors as noninvasive techniques to measure hemodialysis blood access flow.

PubMed

Fontseré, Néstor; Blasco, Miquel; Maduell, Francisco; Vera, Manel; Arias-Guillen, Marta; Herranz, Sandra; Blanco, Teresa; Barrufet, Marta; Burrel, Marta; Montaña, Javier; Real, Maria Isabel; Mestres, Gaspar; Riambau, Vicenç; Campistol, Josep M

2011-01-01

Access blood flow (Qa) measurements are recommended by the current guidelines as one of the most important components in vascular access maintenance programs. This study evaluates the efficiency of Qa measurement with on-line conductivity (OLC-Qa) and blood temperature monitoring (BTM-Qa) in comparison with the gold standard saline dilution method (SDM-Qa). 50 long-term hemodialysis patients (42 arteriovenous fistulas/8 arteriovenous grafts) were studied. Bland-Altman and Lin's coefficient (ρ(c)) were used to study accuracy and precision. Mean values were 1,021.7 ± 502.4 ml/min SDM-Qa, 832.8 ± 574.3 ml/min OLC-Qa (p = 0.007) and 1,094.9 ± 491.9 ml/min with BTM-Qa (p = NS). Biases and ρ(c) obtained were -188.8 ml/min (ρ(c) 0.58) OLC-Qa and 73.2 ml/min (ρ(c) 0.89) BTM-Qa. The limits of agreement (bias ± 1.96 SD) obtained were from -1,119 to 741.3 ml/min (OLC-Qa) and -350.6 to 497.2 ml/min (BTM-Qa). BTM-Qa and OLC-Qa are valid noninvasive and practical methods to estimate Qa, although BTM-Qa was more accurate and had better concordance than OLC-Qa compared with SDM-Qa. Copyright © 2010 S. Karger AG, Basel.

Implementing hospital quality assurance policies in Iran: balancing licensing, annual evaluation, inspections and quality management systems.

PubMed

Aghaei Hashjin, Asgar; Delgoshaei, Bahram; Kringos, Dionne S; Tabibi, Seyed Jamaladin; Manouchehri, Jila; Klazinga, Niek S

2015-01-01

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran. A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government's strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Electronic laboratory quality assurance program: A method of enhancing the prosthodontic curriculum and addressing accreditation standards.

PubMed

Moghadam, Marjan; Jahangiri, Leila

2015-08-01

An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.44 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98.44 Section 98.44 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electricity Generation § 98.44 Monitoring and QA/QC...

40 CFR 98.64 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Monitoring and QA/QC requirements. 98.64 Section 98.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Aluminum Production § 98.64 Monitoring and QA/QC requirements...

40 CFR 98.64 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.64 Section 98.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Aluminum Production § 98.64 Monitoring and QA/QC requirements...

40 CFR 98.84 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98.84 Section 98.84 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Cement Production § 98.84 Monitoring and QA/QC requirements...

How Are the Results of Quality Assurance Programs Used to Inform Practices at a Distance Higher Education?

ERIC Educational Resources Information Center

Darojat, Ojat

2018-01-01

This paper is to examine the implementation of quality assurance (QA) programs in distance higher education. Different challenges related to the development of QA programs at a distance higher institution and how to manage and implement the programs are discussed to show how the programs have been used to ensure the survival of the institution. A…

A proposed protocol for acceptance and constancy control of computed tomography systems: a Nordic Association for Clinical Physics (NACP) work group report.

PubMed

Kuttner, Samuel; Bujila, Robert; Kortesniemi, Mika; Andersson, Henrik; Kull, Love; Østerås, Bjørn Helge; Thygesen, Jesper; Tarp, Ivanka Sojat

2013-03-01

Quality assurance (QA) of computed tomography (CT) systems is one of the routine tasks for medical physicists in the Nordic countries. However, standardized QA protocols do not yet exist and the QA methods, as well as the applied tolerance levels, vary in scope and extent at different hospitals. To propose a standardized protocol for acceptance and constancy testing of CT scanners in the Nordic Region. Following a Nordic Association for Clinical Physics (NACP) initiative, a group of medical physicists, with representatives from four Nordic countries, was formed. Based on international literature and practical experience within the group, a comprehensive standardized test protocol was developed. The proposed protocol includes tests related to the mechanical functionality, X-ray tube, detector, and image quality for CT scanners. For each test, recommendations regarding the purpose, equipment needed, an outline of the test method, the measured parameter, tolerance levels, and the testing frequency are stated. In addition, a number of optional tests are briefly discussed that may provide further information about the CT system. Based on international references and medical physicists' practical experiences, a comprehensive QA protocol for CT systems is proposed, including both acceptance and constancy tests. The protocol may serve as a reference for medical physicists in the Nordic countries.

National Ignition Facility quality assurance program plan revision 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolfe, C R

1998-06-01

NIF Project activities will be conducted in a manner consistent with the guidance and direction of the DOE Order on Quality Assurance (414.1), the LLNL QA Program, and the Laser Directorate QA Plan. Quality assurance criteria will be applied in a graded manner to achieve a balance between the rigor of application of QA measures and the scale, cost, and complexity of the work involved. Accountability for quality is everyone's, extending from the Project Manager through established lines of authority to all Project personnel, who are responsible for the requisite quality of their own work. The NLF QA Program willmore » be implemented by personnel conducting their activities to meet requirements and expectations, according to established plans and procedures that reflect the way business is to be conducted on the Project.« less

Lessons Learned From Developing Reactor Pressure Vessel Steel Embrittlement Database

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jy-An John

Materials behaviors caused by neutron irradiation under fission and/or fusion environments can be little understood without practical examination. Easily accessible material information system with large material database using effective computers is necessary for design of nuclear materials and analyses or simulations of the phenomena. The developed Embrittlement Data Base (EDB) at ORNL is this comprehensive collection of data. EDB database contains power reactor pressure vessel surveillance data, the material test reactor data, foreign reactor data (through bilateral agreements authorized by NRC), and the fracture toughness data. The lessons learned from building EDB program and the associated database management activity regardingmore » Material Database Design Methodology, Architecture and the Embedded QA Protocol are described in this report. The development of IAEA International Database on Reactor Pressure Vessel Materials (IDRPVM) and the comparison of EDB database and IAEA IDRPVM database are provided in the report. The recommended database QA protocol and database infrastructure are also stated in the report.« less

CUSTOMER/SUPPLIER ACCOUNTABILITY AND PROGRAM IMPLEMENTATION

EPA Science Inventory

Quality assurance (QA) and quality control (QC) are the basic components of a QA program, which is a fundamental quality management tool. he quality of outputs and services strongly depends on the caliber of the communications between the "customer" and the "supplier." lear under...

An Automatic Image Processing Workflow for Daily Magnetic Resonance Imaging Quality Assurance.

PubMed

Peltonen, Juha I; Mäkelä, Teemu; Sofiev, Alexey; Salli, Eero

2017-04-01

The performance of magnetic resonance imaging (MRI) equipment is typically monitored with a quality assurance (QA) program. The QA program includes various tests performed at regular intervals. Users may execute specific tests, e.g., daily, weekly, or monthly. The exact interval of these measurements varies according to the department policies, machine setup and usage, manufacturer's recommendations, and available resources. In our experience, a single image acquired before the first patient of the day offers a low effort and effective system check. When this daily QA check is repeated with identical imaging parameters and phantom setup, the data can be used to derive various time series of the scanner performance. However, daily QA with manual processing can quickly become laborious in a multi-scanner environment. Fully automated image analysis and results output can positively impact the QA process by decreasing reaction time, improving repeatability, and by offering novel performance evaluation methods. In this study, we have developed a daily MRI QA workflow that can measure multiple scanner performance parameters with minimal manual labor required. The daily QA system is built around a phantom image taken by the radiographers at the beginning of day. The image is acquired with a consistent phantom setup and standardized imaging parameters. Recorded parameters are processed into graphs available to everyone involved in the MRI QA process via a web-based interface. The presented automatic MRI QA system provides an efficient tool for following the short- and long-term stability of MRI scanners.

Developing a quality assurance program for online services.

PubMed Central

Humphries, A W; Naisawald, G V

1991-01-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas. PMID:1909197

Developing a quality assurance program for online services.

PubMed

Humphries, A W; Naisawald, G V

1991-07-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

LABORATORY AND FIELD AUDITS AS PART OF THE EPA (ENVIRONMENTAL PROTECTION AGENCY) HAZARDOUS WASTE ENGINEERING RESEARCH LABORATORY (HWERL) QUALITY ASSURANCE PROGRAM

EPA Science Inventory

Audits are an important and integral part of the EPA Hazardous Waste Engineering Research Laboratory (HWERL) Quality Assurance (QA) Program. As part of the overall QA program, audits are used to determine contractor compliance with quality assurance plans and to assess the overal...

Safety, Reliability, and Quality Assurance Provisions for the Office of Aeronautics, Exploration and Technology Centers

NASA Technical Reports Server (NTRS)

1991-01-01

This Handbook establishes general safety, reliability, and quality assurance (SR&QA) guidelines for use on flight and ground-based projects conducted at the Ames, Langley, and Lewis Research Centers, hereafter identified as the Office of Aeronautics, Exploration and Technology (OAET) Centers. This document is applicable to all projects and operations conducted at these Centers except for those projects covered by more restrictive provisions such as the Space Shuttle, Space Station, and unmanned spacecraft programs. This Handbook is divided into two parts. The first (Chapters 1 and 2) establishes the SR&QA guidelines applicable to the OAET Centers, and the second (Appendices A, B, C, and D) provides examples and definitions for the total SR&QA program. Each center should implement SR&QA programs using these guidelines with tailoring appropriate to the special projects conducted by each Center. This Handbook is issued in loose-leaf form and will be revised by page changes.

Quality Assurance: Administrator's Panacea or Pandemonium.

ERIC Educational Resources Information Center

Comerford, Ralph; Silverman, Wade H.

Where mental health administrators used to rely on subjective judgments of senior clinicians to evaluate the effectiveness of mental health services, they now rely more on a quality assurance (QA) plan. The primary motive for undertaking a QA program should be better service. QA may start out being very expensive in terms of personnel and…

[Physical and technical quality assurance in German breast cancer screening: progress report of the Reference Center Muenster after three years].

PubMed

Sommer, A; Girnus, R; Wendt, B; Czwoydzinski, J; Wüstenbecker, C; Heindel, W; Lenzen, H

2009-05-01

German breast cancer screening is monitored by a large physical quality assurance program. This report refers to the first experiences of the Reference Center (RC) Muenster after three years of the technical quality control of digital and analog mammography units (MU). This paper also shows whether the presently used quality assurance (QA) method is able to ensure that the MUs in the screening program are functioning without any serious problems. RC Muenster supervises 95 units (May 2008). The daily, weekly and monthly quality assurance of these units is controlled by web-based QA software named "MammoConrol" and developed by RC Muenster. The annual QA for the units must be conducted in the form of an on-site inspection by medical physics experts of the RC and is scored by an objective ranking system. The results of these QA routines were evaluated and analyzed for this paper. During the period from 3/1/2006 to 5/31/2008, 8 % of the analog systems and 1 % of the digital systems exhibited problems in the daily QA. For 9 % of the analog MUs and 17 % of the digital MUs, failures appeared in the monthly QA. In the annual control, 86.7 % of the analog units exhibited slight problems and 13.3 % had serious problems. With respect to the digital units, 12 % were without any defects, 58 % had slight problems, 27 % had serious failures and 3 % had to be reported to the responsible authorities and were temporarily shut down. The special quality control requirements for German breast cancer screening, including annual on-site checks of the units, have shown in the last three years that QA with a high monitoring standard can be ensured for a large number of decentralized MUs. The currently used QA method sufficiently ensures that the screening program is technically safe. Further studies must show whether the density and focus of the QA measures must be reconfigured.

Quality Assurance and Risk Management: A Survey of Dental Schools and Recommendations for Integrated Program Management.

ERIC Educational Resources Information Center

Fredekind, Richard E.; Cuny, Eve J.; Nadershahi, Nader A.

2002-01-01

Surveyed U.S. and Canadian dental schools about integration of quality assurance (QA) and risk management (RM) and what mechanisms have been most effective in measuring accomplishments. Main findings included that a majority of schools had a written QA program and committee and many reported significant changes resulting from the program; over…

Quality Assurance of Joint Degree Programs from the Perspective of Quality Assurance Agencies: Experience in East Asia

ERIC Educational Resources Information Center

Hou, Yung-Chi; Ince, Martin; Tsai, Sandy; Wang, Wayne; Hung, Vicky; Lin Jiang, Chung; Chen, Karen Hui-Jung

2016-01-01

Joint degree programs have gained popularity in East Asia, due to the growth of transnational higher education in the region since 2000. However, the external quality assurance (QA) and accreditation of joint degree programs is a challenge for QA agencies, as it normally involves the engagement of several institutions and multiple national…

Managing health habits for myocardial infarction (MI) patients.

PubMed

Song, R; Lee, H

2001-08-01

The study examined effects of the heart camp as a motivation enhancement program on cardiac risk reduction and behavioral modification in myocardial infarction (MI) patients. A total of 86 outpatients participated at the first heart camp and 45 returned to the second one in 8 weeks. The first and second heart camps were daylong programs consisted of health assessment, education classes, and Q&A session with interdisciplinary team approach. At the completion of the heart camp, the participants showed significantly lower scores in cardiac risk factors, and significant improvements in motivational variables, especially, perceived benefits and perceived barriers as well as in the performance of diet and exercise behaviors. The study results confirm that it is possible to enhance motivation for chronic patients like MI patients by even short period of comprehensive educational program.

Quality Assurance in Gerontological and Geriatric Training Programs: The European Case

ERIC Educational Resources Information Center

Politynska, Barbara; van Rijsselt, Rene J. T.; Lewko, Jolanta; Philp, Ian; Figueiredo, Daniella; De Sousa, Lilliana

2012-01-01

Quality assurance (QA) in gerontological and geriatric education programs is regarded as essential to maintain standards, strengthen accountability, improve readability of qualifications, and facilitate professional mobility. In this article the authors present a summary of international developments in QA and elaborate four international trends,…

Environmental Technology Verification Program Quality Management Plan, Version 3.0

EPA Science Inventory

The ETV QMP is a document that addresses specific policies and procedures that have been established for managing quality-related activities in the ETV program. It is the “blueprint” that defines an organization’s QA policies and procedures; the criteria for and areas of QA appli...

SU-F-T-227: A Comprehensive Patient Specific, Structure Specific, Pre-Treatment 3D QA Protocol for IMRT, SBRT and VMAT - Clinical Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gueorguiev, G; Cotter, C; Young, M

2016-06-15

Purpose: To present a 3D QA method and clinical results for 550 patients. Methods: Five hundred and fifty patient treatment deliveries (400 IMRT, 75 SBRT and 75 VMAT) from various treatment sites, planned on Raystation treatment planning system (TPS), were measured on three beam-matched Elekta linear accelerators using IBA’s COMPASS system. The difference between TPS computed and delivered dose was evaluated in 3D by applying three statistical parameters to each structure of interest: absolute average dose difference (AADD, 6% allowed difference), absolute dose difference greater than 6% (ADD6, 4% structure volume allowed to fail) and 3D gamma test (3%/3mm DTA,more » 4% structure volume allowed to fail). If the allowed value was not met for a given structure, manual review was performed. The review consisted of overlaying dose difference or gamma results with the patient CT, scrolling through the slices. For QA to pass, areas of high dose difference or gamma must be small and not on consecutive slices. For AADD to manually pass QA, the average dose difference in cGy must be less than 50cGy. The QA protocol also includes DVH analysis based on QUANTEC and TG-101 recommended dose constraints. Results: Figures 1–3 show the results for the three parameters per treatment modality. Manual review was performed on 67 deliveries (27 IMRT, 22 SBRT and 18 VMAT), for which all passed QA. Results show that statistical parameter AADD may be overly sensitive for structures receiving low dose, especially for the SBRT deliveries (Fig.1). The TPS computed and measured DVH values were in excellent agreement and with minimum difference. Conclusion: Applying DVH analysis and different statistical parameters to any structure of interest, as part of the 3D QA protocol, provides a comprehensive treatment plan evaluation. Author G. Gueorguiev discloses receiving travel and research funding from IBA for unrelated to this project work. Author B. Crawford discloses receiving travel funding from IBA for unrelated to this project work.« less

Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218.

PubMed

Miften, Moyed; Olch, Arthur; Mihailidis, Dimitris; Moran, Jean; Pawlicki, Todd; Molineu, Andrea; Li, Harold; Wijesooriya, Krishni; Shi, Jie; Xia, Ping; Papanikolaou, Nikos; Low, Daniel A

2018-04-01

Patient-specific IMRT QA measurements are important components of processes designed to identify discrepancies between calculated and delivered radiation doses. Discrepancy tolerance limits are neither well defined nor consistently applied across centers. The AAPM TG-218 report provides a comprehensive review aimed at improving the understanding and consistency of these processes as well as recommendations for methodologies and tolerance limits in patient-specific IMRT QA. The performance of the dose difference/distance-to-agreement (DTA) and γ dose distribution comparison metrics are investigated. Measurement methods are reviewed and followed by a discussion of the pros and cons of each. Methodologies for absolute dose verification are discussed and new IMRT QA verification tools are presented. Literature on the expected or achievable agreement between measurements and calculations for different types of planning and delivery systems are reviewed and analyzed. Tests of vendor implementations of the γ verification algorithm employing benchmark cases are presented. Operational shortcomings that can reduce the γ tool accuracy and subsequent effectiveness for IMRT QA are described. Practical considerations including spatial resolution, normalization, dose threshold, and data interpretation are discussed. Published data on IMRT QA and the clinical experience of the group members are used to develop guidelines and recommendations on tolerance and action limits for IMRT QA. Steps to check failed IMRT QA plans are outlined. Recommendations on delivery methods, data interpretation, dose normalization, the use of γ analysis routines and choice of tolerance limits for IMRT QA are made with focus on detecting differences between calculated and measured doses via the use of robust analysis methods and an in-depth understanding of IMRT verification metrics. The recommendations are intended to improve the IMRT QA process and establish consistent, and comparable IMRT QA criteria among institutions. © 2018 American Association of Physicists in Medicine.

Review of the Constellation Level II Safety, Reliability, and Quality Assurance (SR&QA) Requirements Documents during Participation in the Constellation Level II SR&QA Forum

NASA Technical Reports Server (NTRS)

Cameron, Kenneth D.; Gentz, Steven J.; Beil, Robert J.; Minute, Stephen A.; Currie, Nancy J.; Scott, Steven S.; Thomas, Walter B., III; Smiles, Michael D.; Schafer, Charles F.; Null, Cynthia H.;

Web Implementation of Quality Assurance (QA) for X-ray Units in Balkanic Medical Institutions.

PubMed

Urošević, Vlade; Ristić, Olga; Milošević, Danijela; Košutić, Duško

2015-08-01

Diagnostic radiology is the major contributor to the total dose of the population from all artificial sources. In order to reduce radiation exposure and optimize diagnostic x-ray image quality, it is necessary to increase the quality and efficiency of quality assurance (QA) and audit programs. This work presents a web application providing completely new QA solutions for x-ray modalities and facilities. The software gives complete online information (using European standards) with which the corresponding institutions and individuals can evaluate and control a facility's Radiation Safety and QA program. The software enables storage of all data in one place and sharing the same information (data), regardless of whether the measured data is used by an individual user or by an authorized institution. The software overcomes the distance and time separation of institutions and individuals who take part in QA. Upgrading the software will enable assessment of the medical exposure level to ionizing radiation.

Breaking down the communication barrier.

PubMed

Hawkins, R A

1991-01-01

Dr. Hawkins addresses the problem of how QA managers can best persuade physicians of the importance of QA programs. Since communication is the basis of educating clinicians, the author analyzes the diametrically opposite perspectives of QA managers and physicians even as they pursue the common goal of quality healthcare. While doctors are primarily loyal to patients and peers with an immediate care focus, process-oriented QA managers emphasize the institution and its longer-term goals. To overcome physician resistance to change, Dr. Hawkins offers an adult learner model that stresses understanding the medical staff's viewpoint, negotiation and respect. Physicians are enthusiastic about QA when it helps solve "the endemic daily system problems." The author concludes by recommending that QA managers join physicians on their clinical rounds to bridge the gap between their different approaches.

QA4, a language for artificial intelligence.

NASA Technical Reports Server (NTRS)

Derksen, J. A. C.

1973-01-01

Introduction of a language for problem solving and specifically robot planning, program verification, and synthesis and theorem proving. This language, called question-answerer 4 (QA4), embodies many features that have been found useful for constructing problem solvers but have to be programmed explicitly by the user of a conventional language. The most important features of QA4 are described, and examples are provided for most of the material introduced. Language features include backtracking, parallel processing, pattern matching, set manipulation, and pattern-triggered function activation. The language is most convenient for use in an interactive way and has extensive trace and edit facilities.

SU-E-T-419: Workflow and FMEA in a New Proton Therapy (PT) Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheng, C; Wessels, B; Hamilton, H

2014-06-01

Purpose: Workflow is an important component in the operational planning of a new proton facility. By integrating the concept of failure mode and effect analysis (FMEA) and traditional QA requirements, a workflow for a proton therapy treatment course is set up. This workflow serves as the blue print for the planning of computer hardware/software requirements and network flow. A slight modification of the workflow generates a process map(PM) for FMEA and the planning of QA program in PT. Methods: A flowchart is first developed outlining the sequence of processes involved in a PT treatment course. Each process consists of amore » number of sub-processes to encompass a broad scope of treatment and QA procedures. For each subprocess, the personnel involved, the equipment needed and the computer hardware/software as well as network requirements are defined by a team of clinical staff, administrators and IT personnel. Results: Eleven intermediate processes with a total of 70 sub-processes involved in a PT treatment course are identified. The number of sub-processes varies, ranging from 2-12. The sub-processes within each process are used for the operational planning. For example, in the CT-Sim process, there are 12 sub-processes: three involve data entry/retrieval from a record-and-verify system, two controlled by the CT computer, two require department/hospital network, and the other five are setup procedures. IT then decides the number of computers needed and the software and network requirement. By removing the traditional QA procedures from the workflow, a PM is generated for FMEA analysis to design a QA program for PT. Conclusion: Significant efforts are involved in the development of the workflow in a PT treatment course. Our hybrid model of combining FMEA and traditional QA program serves a duo purpose of efficient operational planning and designing of a QA program in PT.« less

Quality Assurance: Patient Chart Reviews

NASA Astrophysics Data System (ADS)

Oginni, B. M.; Odero, D. O.

2009-07-01

Recent developments in radiation therapy have immensely impacted the way the radiation dose is delivered to patients undergoing radiation treatments. However, the fundamental quality assurance (QA) issues underlying the radiation therapy still remain the accuracy of the radiation dose and the radiation safety. One of the major duties of clinical medical physicists in the radiation therapy departments still revolves around ensuring the accuracy of dose delivery to the planning target volume (PTV), the reduction of unintended radiation to normal organs and minimization of the radiation exposure to the medical personnel based on ALARA (as low as reasonably achievable) principle. Many of the errors in radiation therapy can be minimized through a comprehensive program of periodic checks. One of the QA procedures on the patient comes in the form of chart reviews which could be in either electronic or paper-based format. We present the quality assurance procedures that have to be performed on the patient records from the beginning and periodically to the end of the treatment, based on the guidelines from the American Association of Physicists in Medicine (AAPM) and American College of Physicians (ACP).

Quality assurance and quality control in mammography: a review of available guidance worldwide.

PubMed

Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos

2013-10-01

Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources. •An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.

Project Quality Assurance Plan for research and development services provided by Oak Ridge National Laboratory in support of the Westinghouse Materials Company of Ohio Operable Unit 1 Stabilization Development and Treatability Studies Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gilliam, T.M.

1991-05-01

This Project Quality Assurance Plan (PQAP) sets forth the quality assurance (QA) requirements that are applied to those elements of the Westinghouse Materials Company of Ohio (WMCO) Operable Unit 1 support at Oak Ridge National Laboratory (ORNL) project that involve research and development (R D) performed at ORNL. This is in compliance with the applicable criteria of 10 CFR Part 50, Appendix B, ANSI/ASME NQA-1, as specified by Department of Energy (DOE) Oak Ridge Operations (ORO) Order 5700.6B. For this application, NQA-1 is the core QA Program requirements document. QA policy, normally found in the requirements document, is contained herein.more » The requirements of this PQAP apply to project activities that affect the quality and reliability/credibility of research, development, and investigative data and documentation. These activities include the functions of attaining quality objectives and assuring that an appropriate QA program scope is established. The scope of activities affecting quality includes organization; personnel training and qualifications; design control; procurement; material handling and storage; operating procedures; testing, surveillance, and auditing; R D investigative activities and documentation; deficiencies; corrective actions; and QA record keeping. 12 figs.« less

QAIT: a quality assurance issue tracking tool to facilitate the improvement of clinical data quality.

PubMed

Zhang, Yonghong; Sun, Weihong; Gutchell, Emily M; Kvecher, Leonid; Kohr, Joni; Bekhash, Anthony; Shriver, Craig D; Liebman, Michael N; Mural, Richard J; Hu, Hai

2013-01-01

In clinical and translational research as well as clinical trial projects, clinical data collection is prone to errors such as missing data, and misinterpretation or inconsistency of the data. A good quality assurance (QA) program can resolve many such errors though this requires efficient communications between the QA staff and data collectors. Managing such communications is critical to resolving QA problems but imposes a major challenge for a project involving multiple clinical and data processing sites. We have developed a QA issue tracking (QAIT) system to support clinical data QA in the Clinical Breast Care Project (CBCP). This web-based application provides centralized management of QA issues with role-based access privileges. It has greatly facilitated the QA process and enhanced the overall quality of the CBCP clinical data. As a stand-alone system, QAIT can supplement any other clinical data management systems and can be adapted to support other projects. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

SU-E-T-649: Quality Assurances for Proton Therapy Delivery Equipment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arjomandy, B; Kase, Y; Flanz, J

2015-06-15

Purpose: The number of proton therapy centers has increased dramatically over the past decade. Currently, there is no comprehensive set of guidelines that addresses quality assurance (QA) procedures for the different technologies used for proton therapy. The AAPM has charged task group 224 (TG-224) to provide recommendations for QA required for accurate and safe dose delivery, using existing and next generation proton therapy delivery equipment. Methods: A database comprised of QA procedures and tolerance limits was generated from many existing proton therapy centers in and outside of the US. These consist of proton therapy centers that possessed double scattering, uniformmore » scanning, and pencil beams delivery systems. The diversity in beam delivery systems as well as the existing devices to perform QA checks for different beam parameters is the main subject of TG-224. Based on current practice at the clinically active proton centers participating in this task group, consensus QA recommendations were developed. The methodologies and requirements of the parameters that must be verified for consistency of the performance of the proton beam delivery systems are discussed. Results: TG-224 provides procedures and QA checks for mechanical, imaging, safety and dosimetry requirements for different proton equipment. These procedures are categorized based on their importance and their required frequencies in order to deliver a safe and consistent dose. The task group provides daily, weekly, monthly, and annual QA check procedures with their tolerance limits. Conclusions: The procedures outlined in this protocol provide sufficient information to qualified medical physicists to perform QA checks for any proton delivery system. Execution of these procedures should provide confidence that proton therapy equipment is functioning as commissioned for patient treatment and delivers dose safely and accurately within the established tolerance limits. The report will be published in late 2015.« less

Accuracy requirements and uncertainties in radiotherapy: a report of the International Atomic Energy Agency.

PubMed

van der Merwe, Debbie; Van Dyk, Jacob; Healy, Brendan; Zubizarreta, Eduardo; Izewska, Joanna; Mijnheer, Ben; Meghzifene, Ahmed

2017-01-01

Radiotherapy technology continues to advance and the expectation of improved outcomes requires greater accuracy in various radiotherapy steps. Different factors affect the overall accuracy of dose delivery. Institutional comprehensive quality assurance (QA) programs should ensure that uncertainties are maintained at acceptable levels. The International Atomic Energy Agency has recently developed a report summarizing the accuracy achievable and the suggested action levels, for each step in the radiotherapy process. Overview of the report: The report seeks to promote awareness and encourage quantification of uncertainties in order to promote safer and more effective patient treatments. The radiotherapy process and the radiobiological and clinical frameworks that define the need for accuracy are depicted. Factors that influence uncertainty are described for a range of techniques, technologies and systems. Methodologies for determining and combining uncertainties are presented, and strategies for reducing uncertainties through QA programs are suggested. The role of quality audits in providing international benchmarking of achievable accuracy and realistic action levels is also discussed. The report concludes with nine general recommendations: (1) Radiotherapy should be applied as accurately as reasonably achievable, technical and biological factors being taken into account. (2) For consistency in prescribing, reporting and recording, recommendations of the International Commission on Radiation Units and Measurements should be implemented. (3) Each institution should determine uncertainties for their treatment procedures. Sample data are tabulated for typical clinical scenarios with estimates of the levels of accuracy that are practically achievable and suggested action levels. (4) Independent dosimetry audits should be performed regularly. (5) Comprehensive quality assurance programs should be in place. (6) Professional staff should be appropriately educated and adequate staffing levels should be maintained. (7) For reporting purposes, uncertainties should be presented. (8) Manufacturers should provide training on all equipment. (9) Research should aid in improving the accuracy of radiotherapy. Some example research projects are suggested.

Prospective Qualitative and Quantitative Analysis of Real-Time Peer Review Quality Assurance Rounds Incorporating Direct Physical Examination for Head and Neck Cancer Radiation Therapy.

PubMed

Cardenas, Carlos E; Mohamed, Abdallah S R; Tao, Randa; Wong, Andrew J R; Awan, Mussadiq J; Kuruvila, Shirly; Aristophanous, Michalis; Gunn, G Brandon; Phan, Jack; Beadle, Beth M; Frank, Steven J; Garden, Adam S; Morrison, William H; Fuller, Clifton D; Rosenthal, David I

2017-07-01

Our department has a long-established comprehensive quality assurance (QA) planning clinic for patients undergoing radiation therapy (RT) for head and neck cancer. Our aim is to assess the impact of a real-time peer review QA process on the quantitative and qualitative radiation therapy plan changes in the era of intensity modulated RT (IMRT). Prospective data for 85 patients undergoing head and neck IMRT who presented at a biweekly QA clinic after simulation and contouring were collected. A standard data collection form was used to document alterations made during this process. The original pre-QA clinical target volumes (CTVs) approved by the treating-attending physicians were saved before QA and compared with post-QA consensus CTVs. Qualitative assessment was done according to predefined criteria. Dice similarity coefficients (DSC) and other volume overlap metrics were calculated for each CTV level and were used for quantitative comparison. Changes are categorized as major, minor, and trivial according to the degree of overlap. Patterns of failure were analyzed and correlated to plan changes. All 85 patients were examined by at least 1 head and neck subspecialist radiation oncologist who was not the treating-attending physician; 80 (94%) were examined by ≥3 faculty members. New clinical findings on physical examination were found in 12 patients (14%) leading to major plan changes. Quantitative DSC analysis revealed significantly better agreement in CTV1 (0.94 ± 0.10) contours than in CTV2 (0.82 ± 0.25) and CTV3 (0.86 ± 0.2) contours (P=.0002 and P=.03, respectively; matched-pair Wilcoxon test). The experience of the treating-attending radiation oncologist significantly affected DSC values when all CTV levels were considered (P=.012; matched-pair Wilcoxon text). After a median follow-up time of 38 months, only 10 patients (12%) had local recurrence, regional recurrence, or both, mostly in central high-dose areas. Comprehensive peer review planning clinic is an essential component of IMRT QA that led to major changes in one-third of the study population. This process ensured safety related to target definition and led to favorable disease control profiles, with no identifiable recurrences attributable to geometric misses or delineation errors. Copyright © 2016 Elsevier Inc. All rights reserved.

SU-E-T-29: A Web Application for GPU-Based Monte Carlo IMRT/VMAT QA with Delivered Dose Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Folkerts, M; University of California, San Diego, La Jolla, CA; Graves, Y

Purpose: To enable an existing web application for GPU-based Monte Carlo (MC) 3D dosimetry quality assurance (QA) to compute “delivered dose” from linac logfile data. Methods: We added significant features to an IMRT/VMAT QA web application which is based on existing technologies (HTML5, Python, and Django). This tool interfaces with python, c-code libraries, and command line-based GPU applications to perform a MC-based IMRT/VMAT QA. The web app automates many complicated aspects of interfacing clinical DICOM and logfile data with cutting-edge GPU software to run a MC dose calculation. The resultant web app is powerful, easy to use, and is ablemore » to re-compute both plan dose (from DICOM data) and delivered dose (from logfile data). Both dynalog and trajectorylog file formats are supported. Users upload zipped DICOM RP, CT, and RD data and set the expected statistic uncertainty for the MC dose calculation. A 3D gamma index map, 3D dose distribution, gamma histogram, dosimetric statistics, and DVH curves are displayed to the user. Additional the user may upload the delivery logfile data from the linac to compute a 'delivered dose' calculation and corresponding gamma tests. A comprehensive PDF QA report summarizing the results can also be downloaded. Results: We successfully improved a web app for a GPU-based QA tool that consists of logfile parcing, fluence map generation, CT image processing, GPU based MC dose calculation, gamma index calculation, and DVH calculation. The result is an IMRT and VMAT QA tool that conducts an independent dose calculation for a given treatment plan and delivery log file. The system takes both DICOM data and logfile data to compute plan dose and delivered dose respectively. Conclusion: We sucessfully improved a GPU-based MC QA tool to allow for logfile dose calculation. The high efficiency and accessibility will greatly facilitate IMRT and VMAT QA.« less

SU-E-J-53: A Phantom Design to Assist Patient Position Verification System in Daily Image-Guided RT and Comprehensive QA Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Syh, J; Wu, H

2015-06-15

Purpose This study is to implement a homemade novel device with surface locking couch index to check daily radiograph (DR) function of adaPTInsight™, stereoscopic image guided system (SIGS), for proton therapy. The comprehensive daily QA checks of proton pencil beam output, field size, flatness and symmetry of spots and energy layers will be followed by using MatriXX dosimetry device. Methods The iBa MatriXX device was used to perform daily dosimetry which is also used to perform SIGS checks. A set of markers were attached to surface of MatriXX device in alignment of DRR of reconstructed CT images and daily DR.more » The novel device allows MatriXX to be fit into the cradle which was locked by couch index bars on couch surface. This will keep the MatriXX at same XY plane daily with exact coordinates. Couch height Z will be adjusted according to imaging to check isocenter-laser coincidence accuracy. Results adaPTInsight™ provides robotic couch to move in 6-degree coordinate system to align the dosimetry device to be within 1.0 mm / 1.0°. The daily constancy was tightened to be ± 0.5 mm / 0.3° compared to 1.0 mm / 1.0° before. For gantry at 0° and couch all 0° angles (@ Rt ARM 0 setting), offsets measured of the couch systems were ≤ 0.5° in roll, yaw and pitch dimensions. Conclusion Simplicity of novel device made daily image guided QA consistent with accuracy. The offset of the MatriXX isocenter-laser coincident was reproducible. Such easy task not only speeds up the setup, but it increases confidence level in detailed daily comprehensive measurements. The total SIGS alignment time has been shortened with less setup error. This device will enhance our experiences for the future QA when cone beam CT imaging modality becomes available at proton therapy center.« less

Quality assessment program for EuroFlow protocols: summary results of four-year (2010-2013) quality assurance rounds.

PubMed

Kalina, Tomas; Flores-Montero, Juan; Lecrevisse, Quentin; Pedreira, Carlos E; van der Velden, Vincent H J; Novakova, Michaela; Mejstrikova, Ester; Hrusak, Ondrej; Böttcher, Sebastian; Karsch, Dennis; Sędek, Łukasz; Trinquand, Amelie; Boeckx, Nancy; Caetano, Joana; Asnafi, Vahid; Lucio, Paulo; Lima, Margarida; Helena Santos, Ana; Bonaccorso, Paola; van der Sluijs-Gelling, Alita J; Langerak, Anton W; Martin-Ayuso, Marta; Szczepański, Tomasz; van Dongen, Jacques J M; Orfao, Alberto

2015-02-01

Flow cytometric immunophenotyping has become essential for accurate diagnosis, classification, and disease monitoring in hemato-oncology. The EuroFlow Consortium has established a fully standardized "all-in-one" pipeline consisting of standardized instrument settings, reagent panels, and sample preparation protocols and software for data analysis and disease classification. For its reproducible implementation, parallel development of a quality assurance (QA) program was required. Here, we report on the results of four consecutive annual rounds of the novel external QA EuroFlow program. The novel QA scheme aimed at monitoring the whole flow cytometric analysis process (cytometer setting, sample preparation, acquisition and analysis) by reading the median fluorescence intensities (MedFI) of defined lymphocytes' subsets. Each QA participant applied the predefined reagents' panel on blood cells of local healthy donors. A uniform gating strategy was applied to define lymphocyte subsets and to read MedFI values per marker. The MedFI values were compared with reference data and deviations from reference values were quantified using performance score metrics. In four annual QA rounds, we analyzed 123 blood samples from local healthy donors on 14 different instruments in 11 laboratories from nine European countries. The immunophenotype of defined cellular subsets appeared sufficiently standardized to permit unified (software) data analysis. The coefficient of variation of MedFI for 7 of 11 markers performed repeatedly below 30%, average MedFI in each QA round ranged from 86 to 125% from overall median. Calculation of performance scores was instrumental to pinpoint standardization failures and their causes. Overall, the new EuroFlow QA system for the first time allowed to quantify the technical variation that is introduced in the measurement of fluorescence intensities in a multicentric setting over an extended period of time. EuroFlow QA is a proficiency test specific for laboratories that use standardized EuroFlow protocols. It may be used to complement, but not replace, established proficiency tests. © 2014 International Society for Advancement of Cytometry. © 2014 International Society for Advancement of Cytometry.

TU-G-BRD-06: The Imaging and Radiation Oncology Core Houston (IROC Houston) QA Center International Activities Outside North America

DOE Office of Scientific and Technical Information (OSTI.GOV)

Followill, D; Kry, S; Molineu, A

Purpose: To describe the extent of IROC Houston’s (formerly the RPC) QA activities and audit results for radiotherapy institutions outside of North America (NA). Methods: The IROC Houston’s QA program components were designed to audit the radiation dose calculation chain from the NIST traceable reference beam calibration, to inclusion of dosimetry parameters used to calculate tumor doses, to the delivery of the radiation dose. The QA program provided to international institutions includes: 1) remote TLD/OSLD audit of machine output, 2) credentialing for advanced technologies, and 3) review of patient treatment records. IROC Houston uses the same standards and acceptance criteriamore » for all of its audits whether for North American or international sites. Results: IROC Houston’s QA program has reached out to radiotherapy sites in 43 different countries since 2013 through their participation in clinical trials. In the past two years, 2,778 international megavoltage beam outputs were audited with OSLD/TLD. While the average IROC/Inst ratio is near unity for all sites monitored, there are international regions whose results are significantly different from the NA region. In the past 2 years, 477 and 87 IMRT H&N phantoms were irradiated at NA and international sites, respectively. Regardless of the OSLD beam audit results, the overall pass rate (87 percent) for all international sites (no region separation) is equal to the NA sites. Of the 182 international patient charts reviewed, 10.7 percent of the dose calculation points did not meet our acceptance criterion as compared to 13.6 percent for NA sites. The lower pass rate for NA sites results from a much larger brachytherapy component which has been shown to be more error prone. Conclusion: IROC Houston has expanded its QA services worldwide and continues a long history of improving radiotherapy dose delivery in many countries. Funding received for QA audit services from the Korean GOG, DAHANCA, EORTC, ICON and CMIC Group.« less

MO-D-BRB-02: SBRT Treatment Planning and Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Y.

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (inmore » particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.« less

Poster - 09: A MATLAB-based Program for Automated Quality Assurance of a Prostate Brachytherapy Ultrasound System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poon, Justin; Sabondjian, Eric; Sankreacha, Raxa

Purpose: A robust Quality Assurance (QA) program is essential for prostate brachytherapy ultrasound systems due to the importance of imaging accuracy during treatment and planning. Task Group 128 of the American Association of Physicists in Medicine has recommended a set of QA tests covering grayscale visibility, depth of penetration, axial and lateral resolution, distance measurement, area measurement, volume measurement, and template/electronic grid alignment. Making manual measurements on the ultrasound system can be slow and inaccurate, so a MATLAB program was developed for automation of the described tests. Methods: Test images were acquired using a BK Medical Flex Focus 400 ultrasoundmore » scanner and 8848 transducer with the CIRS Brachytherapy QA Phantom – Model 045A. For each test, the program automatically segments the inputted image(s), makes the appropriate measurements, and indicates if the test passed or failed. The program was tested by analyzing two sets of images, where the measurements from the first set were used as baseline values. Results: The program successfully analyzed the images for each test and determined if any action limits were exceeded. All tests passed – the measurements made by the program were consistent and met the requirements outlined by Task Group 128. Conclusions: The MATLAB program we have developed can be used for automated QA of an ultrasound system for prostate brachytherapy. The GUI provides a user-friendly way to analyze images without the need for any manual measurement, potentially removing intra- and inter-user variability for more consistent results.« less

40 CFR 98.434 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98.434 Section 98.434 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Importers and Exporters of Fluorinated Greenhouse Gases...

Developing cross-sectoral quality assurance for cataract surgery in the statutory quality assurance program of the German health care system: Experiences and lessons learned.

PubMed

Bramesfeld, Anke; Pauletzki, Jürgen; Behrenz, Lars; Szecsenyi, Joachim; Willms, Gerald; Broge, Björn

2015-08-01

Since 2001, statutory external quality assurance (QA) for hospital care has been in place in the German health system. In 2009, the decision was taken to expand it to cross-sectoral procedures. This novel and unprecedented form of national QA aims at (1) making the quality procedures comparable that are provided both in inpatient and outpatient care, (2) following-up outcomes of hospital care after patients' discharge and (3) measuring the quality of complex treatment chains across interfaces. As a pioneer procedure a QA procedure in cataract surgery QA was developed. Using this as an example, challenges of cross-sectoral QA are highlighted. These challenges relate, in particular, to three technical problems: triggering cases for documentation, following-up patients' after hospital discharge, and the burden of documentation in outpatient care. These problems resulted finally in the haltering of the development of the QA procedure. However, the experiences gained with this first development of cross-sectoral QA inspired the reorientation and further development of the field in Germany. Future cross-sectoral QA will rigorously aim at keeping burden of documentation small. It will draw data for QA mainly at three sources: routine data, patient surveys and peer reviews using indicators. Policy implications of this reorientation are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The IROC Houston Quality Assurance Program: Potential benefits of 3D dosimetry

NASA Astrophysics Data System (ADS)

Followill, D. S.; Molineu, H. A.; Lafratta, R.; Ibbott, G. S.

2017-05-01

The IROC Houston QA Center has provided QA core support for NCI clinical trials by ensuring that radiation doses delivered to trial patients are accurate and comparable between participating institutions. Within its QA program, IROC Houston uses anthropomorphic QA phantoms to credential sites. It is these phantoms that have the highest potential to benefit from the use of 3D dosimeters. Credentialing is performed to verify that institutions that are using advanced technologies to deliver complex treatment plans that conform to targets. This makes it increasingly difficult to assure the intended calculated dose is being delivered correctly using current techniques that are 2D-based. A 3D dosimeter such as PRESAGE® is able to provide a complete 3D measured dosimetry dataset with one treatment plan delivery. In our preliminary studies, the 3D dosimeters in our H&N and spine phantoms were found to be appropriate for remote dosimetry for relative dose measurements. To implement 3D dosimetry in IROC Houston’s phantoms, the benefit of this significant change to its current infrastructure would have to be assessed and further work would be needed before bringing 3D dosimeters into the phantom dosimetry program.

MO-D-BRB-02: The Radiological Physics Center's Quality Audit Program: Where Can We Improve?

PubMed

Followill, D; Lowenstein, J; Molineu, A; Alvarez, P; Aguirre, J; Kry, S; Summers, P; Ibbott, G

2012-06-01

To analyze the findings of the Radiological Physics Center's (RPC) QA audits of institutions participating in NCI sponsored clinical trials. The RPC has developed an extensive Quality Assurance (QA) program over the past 44 years. This program includes on-site dosimetry reviews where measurements on therapy machines are made, records are reviewed and personnel are interviewed. The program's remote audit tools include mailed dosimeters (OSLD/TLD) to verify output calibration, comparison of dosimetry data with RPC 'standard' data, evaluation of benchmark and patient calculations to verify the treatment planning algorithms, review of institution's QA procedures and records, and use of anthropomorphic phantoms to verify tumor dose delivery. The RPC endeavors to assist institutions in finding the origins of any detected discrepancies, and to resolve them. Ninety percent of institutions receiving dosimetry recommendations has remained level for the past 5 years. The most frequent recommendations were for not performing TG-40 QA tests, wedge factors, small field size output factors and off-axis factors. Since TG-51 was published, the number of beam calibrations audited during visits with ion chambers, that met the RPC's ±3% criterion, decreased initially but has risen to pre-TG-51 levels. The OSLD/TLD program shows that only ∼3% of the beams are outside our ±5% criteria, but these discrepancies are distributed over 12-20% of the institutions. The percent of institutions with ï, 3 l beam outside the RPC's criteria is approximately the same whether OSLD/TLD or ion chambers were used. The first time passing rate for the anthropomorphic phantoms is increasing with time. The prostate phantom has the highest pass rate while the spine phantom has the lowest. Numerous dosimetry errors continue to be discovered by the RPC's QA program and the RPC continues to play an important role in helping institutions resolve these errors. This work was supported by PHS grants CA10953 and CA081647 awarded by NCI. © 2012 American Association of Physicists in Medicine.

WE-B-BRD-00: MRI for Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The use of MRI in radiation therapy is rapidly increasing. Applications vary from the MRI simulator, to the MRI fused with CT, and to the integrated MRI+RT system. Compared with the standard MRI QA, a broader scope of QA features has to be defined in order to maximize the benefits of using MRI in radiation therapy. These QA features include geometric fidelity, image registration, motion management, cross-system alignment, and hardware interference. Advanced MRI techniques require a specific type of QA, as they are being widely used in radiation therapy planning, dose calculations, post-implant dosimetry, and prognoses. A vigorous and adaptivemore » QA program is crucial to defining the responsibility of the entire radiation therapy group and detecting deviations from the performance of high-quality treatment. As a drastic departure from CT simulation, MRI simulation requires changes in the work flow of treatment planning and image guidance. MRI guided radiotherapy platforms are being developed and commercialized to take the advantage of the advance in knowledge, technology and clinical experience. This symposium will from an educational perspective discuss the scope and specific issues related to MRI guided radiotherapy. Learning Objectives: Understand the difference between a standard and a radiotherapy-specific MRI QA program. Understand the effects of MRI artifacts (geometric distortion and motion) on radiotherapy. Understand advanced MRI techniques (ultrashort echo, fast MRI including dynamic MRI and 4DMRI, diffusion, perfusion, and MRS) and related QA. Understand the methods to prepare MRI for treatment planning (electron density assignment, multimodality image registration, segmentation and motion management). Current status of MRI guided treatment platforms. Dr. Jihong Wang has a research grant with Elekta-MRL project. Dr. Ke Sheng receives research grants from Varian Medical systems.« less

Project officer's perspective: quality assurance as a management tool.

PubMed

Heiby, J

1993-06-01

Advances in the management of health programs in less developed countries (LDC) have not kept pace with the progress of the technology used. The US Agency for International Development mandated the Quality Assurance Project (QAP) to provide quality improvement technical assistance to primary health care systems in LDCs while developing appropriate quality assurance (QA) strategies. The quality of health care in recent years in the US and Europe focused on the introduction of management techniques developed for industry into health systems. The experience of the QAP and its predecessor, the PRICOR Project, shows that quality improvement techniques facilitate measurement of quality of care. A recently developed WHO model for the management of the sick child provides scientifically based standards for actual care. Since 1988, outside investigators measuring how LDC clinicians perform have revealed serious deficiencies in quality compared with the program's own standards. This prompted developed of new QA management initiatives: 1) communicating standards clearly to the program staff; 2) actively monitoring actual performance corresponds to these standards; and 3) taking action to improve performance. QA means that managers are expected to monitor service delivery, undertake problem solving, and set specific targets for quality improvement. Quality improvement methods strengthen supervision as supervisors can objectively assess health worker performance. QA strengthens the management functions that support service delivery, e.g., training, records management, finance, logistics, and supervision. Attention to quality can contribute to improved health worker motivation and effective incentive programs by recognition for a job well done and opportunities for learning new skills. These standards can also address patient satisfaction. QA challenges managers to aim for the optimal level of care attainable.

Quality assurance of HDR prostate plans: program implementation at a community hospital.

PubMed

Rush, Jennifer B; Thomas, Michael D

2005-01-01

Adenocarcinoma of the prostate is currently the most commonly diagnosed cancer in men in the United States, and the second leading cause of cancer mortality. The utilization of radiation therapy is regarded as the definitive local therapy of choice for intermediate- and high-risk disease, in which there is increased risk for extracapsular extension, seminal vesicle invasion, or regional node involvement. High-dose-rate (HDR) brachytherapy is a logical treatment modality to deliver the boost dose to an external beam radiation therapy (EBRT) treatment to increase local control rates. From a treatment perspective, the utilization of a complicated treatment delivery system, the compressed time frame in which the procedure is performed, and the small number of large dose fractions make the implementation of a comprehensive quality assurance (QA) program imperative. One aspect of this program is the QA of the HDR treatment plan. Review of regulatory and medical physics professional publications shows that substantial general guidance is available. We provide some insight to the implementation of an HDR prostate plan program at a community hospital. One aspect addressed is the utilization of the low-dose-rate (LDR) planning system and the use of existing ultrasound image sets to familiarize the radiation therapy team with respect to acceptable HDR implant geometries. Additionally, the use of the LDR treatment planning system provided a means to prospectively determine the relationship between the treated isodose volume and the product of activity and time for the department's planning protocol prior to the first HDR implant. For the first 12 HDR prostate implants, the root-mean-square (RMS) deviation was 3.05% between the predicted product of activity and time vs. the actual plan values. Retrospective re-evaluation of the actual implant data reduced the RMS deviation to 2.36%.

Towards a Fuzzy Expert System on Toxicological Data Quality Assessment.

PubMed

Yang, Longzhi; Neagu, Daniel; Cronin, Mark T D; Hewitt, Mark; Enoch, Steven J; Madden, Judith C; Przybylak, Katarzyna

2013-01-01

Quality assessment (QA) requires high levels of domain-specific experience and knowledge. QA tasks for toxicological data are usually performed by human experts manually, although a number of quality evaluation schemes have been proposed in the literature. For instance, the most widely utilised Klimisch scheme1 defines four data quality categories in order to tag data instances with respect to their qualities; ToxRTool2 is an extension of the Klimisch approach aiming to increase the transparency and harmonisation of the approach. Note that the processes of QA in many other areas have been automatised by employing expert systems. Briefly, an expert system is a computer program that uses a knowledge base built upon human expertise, and an inference engine that mimics the reasoning processes of human experts to infer new statements from incoming data. In particular, expert systems have been extended to deal with the uncertainty of information by representing uncertain information (such as linguistic terms) as fuzzy sets under the framework of fuzzy set theory and performing inferences upon fuzzy sets according to fuzzy arithmetic. This paper presents an experimental fuzzy expert system for toxicological data QA which is developed on the basis of the Klimisch approach and the ToxRTool in an effort to illustrate the power of expert systems to toxicologists, and to examine if fuzzy expert systems are a viable solution for QA of toxicological data. Such direction still faces great difficulties due to the well-known common challenge of toxicological data QA that "five toxicologists may have six opinions". In the meantime, this challenge may offer an opportunity for expert systems because the construction and refinement of the knowledge base could be a converging process of different opinions which is of significant importance for regulatory policy making under the regulation of REACH, though a consensus may never be reached. Also, in order to facilitate the implementation of Weight of Evidence approaches and in silico modelling proposed by REACH, there is a higher appeal of numerical quality values than nominal (categorical) ones, where the proposed fuzzy expert system could help. Most importantly, the deriving processes of quality values generated in this way are fully transparent, and thus comprehensible, for final users, which is another vital point for policy making specified in REACH. Case studies have been conducted and this report not only shows the promise of the approach, but also demonstrates the difficulties of the approach and thus indicates areas for future development. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

WE-G-BRA-09: Microsphere Brachytherapy Failure Mode and Effects Analysis in a Dual-Vendor Environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Younge, K C; Lee, C I; Feng, M

2015-06-15

Purpose: To improve the safety and quality of a dual-vendor microsphere brachytherapy program with failure mode and effects analysis (FMEA). Methods: A multidisciplinary team including physicists, dosimetrists, a radiation oncologist, an interventional radiologist, and radiation safety personnel performed an FMEA for our dual-vendor microsphere brachytherapy program employing SIR-Spheres (Sirtex Medical Limited, Australia) and Theraspheres (BTG, England). We developed a program process tree and step-by-step instructions which were used to generate a comprehensive list of failure modes. These modes were then ranked according to severity, occurrence rate, and detectability. Risk priority numbers (RPNs) were calculated by multiplying these three scores together.more » Three different severity scales were created: one each for harmful effects to the patient, staff, or the institution. Each failure mode was ranked on one or more of these scales. Results: The group identified 164 failure modes for the microsphere program. 113 of these were ranked using the patient severity scale, 52 using the staff severity scale, and 50 using the institution severity scale. The highest ranked items on the patient severity scale were an error in the automated dosimetry worksheet (RPN = 297.5), and the incorrect target specified on the planning study (RPN = 135). Some failure modes ranked differently between vendors, especially those corresponding to dose vial preparation because of the different methods used. Based on our findings, we made several improvements to our QA program, including documentation to easily identify which product is being used, an additional hand calculation during planning, and reorganization of QA steps before treatment delivery. We will continue to periodically review and revise the FMEA. Conclusion: We have applied FMEA to our dual-vendor microsphere brachytherapy program to identify potential key weaknesses in the treatment chain. Our FMEA results were used to improve the effectiveness of our overall microsphere program.« less

Construction Quality Assurance for Federally Funded Local Public Agency Projects

DOT National Transportation Integrated Search

2015-03-01

The purpose of this TechBrief is to summarize a comprehensive investigation of current construction QA practices from both SHA and LPA perspectives undertaken in 2012 and to present recommendations from this analysis. The review included a content an...

Power Supplies for Space Systems Quality Assurance by Sandia Laboratories

DOE R&D Accomplishments Database

Hannigan, R. L.; Harnar, R. R.

1976-07-01

The Sandia Laboratories` participation in Quality Assurance programs for Radioisotopic Thermoelectric Generators which have been used in space systems over the past 10 years is summarized. Basic elements of this QA program are briefly described and recognition of assistance from other Sandia organizations is included. Descriptions of the various systems for which Sandia has had the QA responsibility are presented, including SNAP 19 (Nimbus, Pioneer, Viking), SNAP 27 (Apollo), Transit, Multi Hundred Watt (LES 8/9 and MJS), and a new program, High Performance Generator Mod 3. The outlook for Sandia participation in RTG programs for the next several years is noted.

International Perspectives on Quality Assurance and New Techniques in Radiation Medicine: Outcomes of an IAEA Conference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shortt, Ken; Davidsson, Lena; Hendry, Jolyon

2008-05-01

The International Atomic Energy Agency organized an international conference called, 'Quality Assurance and New Techniques in Radiation Medicine' (QANTRM). It dealt with quality assurance (QA) in all aspects of radiation medicine (diagnostic radiology, nuclear medicine, and radiotherapy) at the international level. Participants discussed QA issues pertaining to the implementation of new technologies and the need for education and staff training. The advantage of developing a comprehensive and harmonized approach to QA covering both the technical and the managerial issues was emphasized to ensure the optimization of benefits to patient safety and effectiveness. The necessary coupling between medical radiation imaging andmore » radiotherapy was stressed, particularly for advanced technologies. However, the need for a more systematic approach to the adoption of advanced technologies was underscored by a report on failures in intensity-modulated radiotherapy dosimetry auditing tests in the United States, which could imply inadequate implementation of QA for these new technologies. A plenary session addressed the socioeconomic impact of introducing advanced technologies in resource-limited settings. How shall the dual gaps, one in access to basic medical services and the other in access to high-quality modern technology, be addressed?.« less

International perspectives on quality assurance and new techniques in radiation medicine: outcomes of an IAEA conference.

PubMed

Shortt, Ken; Davidsson, Lena; Hendry, Jolyon; Dondi, Maurizio; Andreo, Pedro

2008-01-01

The International Atomic Energy Agency organized an international conference called, "Quality Assurance and New Techniques in Radiation Medicine" (QANTRM). It dealt with quality assurance (QA) in all aspects of radiation medicine (diagnostic radiology, nuclear medicine, and radiotherapy) at the international level. Participants discussed QA issues pertaining to the implementation of new technologies and the need for education and staff training. The advantage of developing a comprehensive and harmonized approach to QA covering both the technical and the managerial issues was emphasized to ensure the optimization of benefits to patient safety and effectiveness. The necessary coupling between medical radiation imaging and radiotherapy was stressed, particularly for advanced technologies. However, the need for a more systematic approach to the adoption of advanced technologies was underscored by a report on failures in intensity-modulated radiotherapy dosimetry auditing tests in the United States, which could imply inadequate implementation of QA for these new technologies. A plenary session addressed the socioeconomic impact of introducing advanced technologies in resource-limited settings. How shall the dual gaps, one in access to basic medical services and the other in access to high-quality modern technology, be addressed?

Analytical approaches to quality assurance and quality control in rangeland monitoring data

USDA-ARS?s Scientific Manuscript database

Producing quality data to support land management decisions is the goal of every rangeland monitoring program. However, the results of quality assurance (QA) and quality control (QC) efforts to improve data quality are rarely reported. The purpose of QA and QC is to prevent and describe non-sampling...

Practical utility of thermodilution versus doppler ultrasound to measure hemodialysis blood access flow.

PubMed

Fontseré, Néstor; Mestres, Gaspar; Barrufet, Marta; Burrel, Marta; Vera, Manel; Arias, Marta; Masso, Elisabeth; Cases, Aleix; Maduell, Francisco; Campistol, Josep M

2013-01-01

The current clinical guidelines recommend indirect access blood flow (Qa) measurement as one of the most important components in vascular access maintenance programs. The best-know methods are doppler ultrasound (DU) and saline dilution method. This study evaluates the efficiency of Qa measurement with thermodilution method (TD) in comparison with the DU. Transversal study in 64 patients in hemodialysis (41 men); mean age 59.9 years with 54 AVFs and 10 PTFE. Qa reference value was obtained with DU in brachial artery (AVFs) or at the zone of arterial puncture (AVGs). Bland-Altman and interclass correlation coefficient (ICC) were used to study accuracy. Mean values obtained with DU-Qa were 1426 ± 753 mL/min AVFs and 1186 ± 789 mL/min AVGs. The mean Qa with TD was 1372 ± 770 AVFs (bias 54.6; ICC 0.923) and 1176 ± 758 AVGs (bias 10.2; ICC 0.992). In the subgroup of 28 patients with radiocephalic latero-terminal AVFs the DU-Qa was 1232 ± 767 mL/min. The Qa was in radial artery 942 (ICC 0.805); radial-ulnar artery 1103 (ICC 0.973); cephalic vein 788 (ICC 0.772) and TD 1026 (ICC 0.971). We detected 5 cases of significant stenosis. After endovascular treatment the Kt was 79 liters (61; p=0.043) and TD-Qa 895 mL/min (663; p=0.043). TD represents a good indirect method of Qa measurement. In the subgroup of patients with radiocephalic AVFs, Qa measurements in the radial and ulnar artery are more accurate. Therefore, in this situation the TD method obtained an excellent correlation in comparison to brachial artery.

TU-AB-201-02: An Automated Treatment Plan Quality Assurance Program for Tandem and Ovoid High Dose-Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tan, J; Shi, F; Hrycushko, B

2015-06-15

Purpose: For tandem and ovoid (T&O) HDR brachytherapy in our clinic, it is required that the planning physicist manually capture ∼10 images during planning, perform a secondary dose calculation and generate a report, combine them into a single PDF document, and upload it to a record- and-verify system to prove to an independent plan checker that the case was planned correctly. Not only does this slow down the already time-consuming clinical workflow, the PDF document also limits the number of parameters that can be checked. To solve these problems, we have developed a web-based automatic quality assurance (QA) program. Methods:more » We set up a QA server accessible through a web- interface. A T&O plan and CT images are exported as DICOMRT files and uploaded to the server. The software checks 13 geometric features, e.g. if the dwell positions are reasonable, and 10 dosimetric features, e.g. secondary dose calculations via TG43 formalism and D2cc to critical structures. A PDF report is automatically generated with errors and potential issues highlighted. It also contains images showing important geometric and dosimetric aspects to prove the plan was created following standard guidelines. Results: The program has been clinically implemented in our clinic. In each of the 58 T&O plans we tested, a 14- page QA report was automatically generated. It took ∼45 sec to export the plan and CT images and ∼30 sec to perform the QA tests and generate the report. In contrast, our manual QA document preparation tooks on average ∼7 minutes under optimal conditions and up to 20 minutes when mistakes were made during the document assembly. Conclusion: We have tested the efficiency and effectiveness of an automated process for treatment plan QA of HDR T&O cases. This software was shown to improve the workflow compared to our conventional manual approach.« less

WE-A-BRE-01: Debate: To Measure or Not to Measure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moran, J; Miften, M; Mihailidis, D

2014-06-15

Recent studies have highlighted some of the limitations of patient-specific pre-treatment IMRT QA measurements with respect to assessing plan deliverability. Pre-treatment QA measurements are frequently performed with detectors in phantoms that do not involve any patient heterogeneities or with an EPID without a phantom. Other techniques have been developed where measurement results are used to recalculate the patient-specific dose volume histograms. Measurements continue to play a fundamental role in understanding the initial and continued performance of treatment planning and delivery systems. Less attention has been focused on the role of computational techniques in a QA program such as calculation withmore » independent dose calculation algorithms or recalculation of the delivery with machine log files or EPID measurements. This session will explore the role of pre-treatment measurements compared to other methods such as computational and transit dosimetry techniques. Efficiency and practicality of the two approaches will also be presented and debated. The speakers will present a history of IMRT quality assurance and debate each other regarding which types of techniques are needed today and for future quality assurance. Examples will be shared of situations where overall quality needed to be assessed with calculation techniques in addition to measurements. Elements where measurements continue to be crucial such as for a thorough end-to-end test involving measurement will be discussed. Operational details that can reduce the gamma tool effectiveness and accuracy for patient-specific pre-treatment IMRT/VMAT QA will be described. Finally, a vision for the future of IMRT and VMAT plan QA will be discussed from a safety perspective. Learning Objectives: Understand the advantages and limitations of measurement and calculation approaches for pre-treatment measurements for IMRT and VMAT planning Learn about the elements of a balanced quality assurance program involving modulated techniques Learn how to use tools and techniques such as an end-to-end test to enhance your IMRT and VMAT QA program.« less

Comprehensive quality assurance phantom for cardiovascular imaging systems

NASA Astrophysics Data System (ADS)

Lin, Pei-Jan P.

1998-07-01

With the advent of high heat loading capacity x-ray tubes, high frequency inverter type generators, and the use of spectral shaping filters, the automatic brightness/exposure control (ABC) circuit logic employed in the new generation of angiographic imaging equipment has been significantly reprogrammed. These new angiographic imaging systems are designed to take advantage of the power train capabilities to yield higher contrast images while maintaining, or lower, the patient exposure. Since the emphasis of the imaging system design has been significantly altered, the system performance parameters one is interested and the phantoms employed for the quality assurance must also change in order to properly evaluate the imaging capability of the cardiovascular imaging systems. A quality assurance (QA) phantom has been under development in this institution and was submitted to various interested organizations such as American Association of Physicists in Medicine (AAPM), Society for Cardiac Angiography & Interventions (SCA&I), and National Electrical Manufacturers Association (NEMA) for their review and input. At the same time, in an effort to establish a unified standard phantom design for the cardiac catheterization laboratories (CCL), SCA&I and NEMA have formed a joint work group in early 1997 to develop a suitable phantom. The initial QA phantom design has since been accepted to serve as the base phantom by the SCA&I- NEMA Joint Work Group (JWG) from which a comprehensive QA Phantom is being developed.

Quality assurance in gerontological and geriatric training programs: the European case.

PubMed

Politynska, Barbara; van Rijsselt, René J T; Lewko, Jolanta; Philp, Ian; Figueiredo, Daniella; De Sousa, Lilliana

2012-01-01

Quality assurance (QA) in gerontological and geriatric education programs is regarded as essential to maintain standards, strengthen accountability, improve readability of qualifications, and facilitate professional mobility. In this article the authors present a summary of international developments in QA and elaborate four international trends, including the pros and cons of QA. Furthermore, the authors focus on accreditation and credit transfer opportunities in vocational and academic education programs for primary care practitioners, including nurses, home care workers, social workers, physiotherapists, and family doctors involved in the care of older people in nine European countries and highlight changes that have occurred over the last decade. Vocational education and professional training in elderly care at the basic and postgraduate specialization level remains extremely diversified, reflecting the lack of standardization for programs outside the higher education sector. The situation is ripe for the implementation of the European Qualifications Framework, which is intended to promote transparency, comparability and portability of qualifications at different levels and the introduction of a credit transfer system for vocational education to be established in 2012.

A quality management systems approach for CD4 testing in resource-poor settings.

PubMed

Westerman, Larry E; Kohatsu, Luciana; Ortiz, Astrid; McClain, Bernice; Kaplan, Jonathan; Spira, Thomas; Marston, Barbara; Jani, Ilesh V; Nkengasong, John; Parsons, Linda M

2010-10-01

Quality assurance (QA) is a systematic process to monitor and improve clinical laboratory practices. The fundamental components of a laboratory QA program include providing a functional and safe laboratory environment, trained and competent personnel, maintained equipment, adequate supplies and reagents, testing of appropriate specimens, internal monitoring of quality, accurate reporting, and external quality assessments. These components are necessary to provide accurate and precise CD4 T-cell counts, an essential test to evaluate start of and monitor effectiveness of antiretroviral therapy for HIV-infected patients. In recent years, CD4 testing has expanded dramatically in resource-limited settings. Information on a CD4 QA program as described in this article will provide guidelines not only for clinical laboratory staff but also for managers of programs responsible for supporting CD4 testing. All agencies involved in implementing CD4 testing must understand the needs of the laboratory and provide advocacy, guidance, and financial support to established CD4 testing sites and programs. This article describes and explains the procedures that must be put in place to provide reliable CD4 determinations in a variety of settings.

A Quality Assurance Method that Utilizes 3D Dosimetry and Facilitates Clinical Interpretation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oldham, Mark, E-mail: mark.oldham@duke.edu; Thomas, Andrew; O'Daniel, Jennifer

2012-10-01

Purpose: To demonstrate a new three-dimensional (3D) quality assurance (QA) method that provides comprehensive dosimetry verification and facilitates evaluation of the clinical significance of QA data acquired in a phantom. Also to apply the method to investigate the dosimetric efficacy of base-of-skull (BOS) intensity-modulated radiotherapy (IMRT) treatment. Methods and Materials: Two types of IMRT QA verification plans were created for 6 patients who received BOS IMRT. The first plan enabled conventional 2D planar IMRT QA using the Varian portal dosimetry system. The second plan enabled 3D verification using an anthropomorphic head phantom. In the latter, the 3D dose distribution wasmore » measured using the DLOS/Presage dosimetry system (DLOS = Duke Large-field-of-view Optical-CT System, Presage Heuris Pharma, Skillman, NJ), which yielded isotropic 2-mm data throughout the treated volume. In a novel step, measured 3D dose distributions were transformed back to the patient's CT to enable calculation of dose-volume histograms (DVH) and dose overlays. Measured and planned patient DVHs were compared to investigate clinical significance. Results: Close agreement between measured and calculated dose distributions was observed for all 6 cases. For gamma criteria of 3%, 2 mm, the mean passing rate for portal dosimetry was 96.8% (range, 92.0%-98.9%), compared to 94.9% (range, 90.1%-98.9%) for 3D. There was no clear correlation between 2D and 3D passing rates. Planned and measured dose distributions were evaluated on the patient's anatomy, using DVH and dose overlays. Minor deviations were detected, and the clinical significance of these are presented and discussed. Conclusions: Two advantages accrue to the methods presented here. First, treatment accuracy is evaluated throughout the whole treated volume, yielding comprehensive verification. Second, the clinical significance of any deviations can be assessed through the generation of DVH curves and dose overlays on the patient's anatomy. The latter step represents an important development that advances the clinical relevance of complex treatment QA.« less

SU-C-304-05: Use of Local Noise Power Spectrum and Wavelets in Comprehensive EPID Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, S; Gopal, A; Yan, G

2015-06-15

Purpose: As EPIDs are increasingly used for IMRT QA and real-time treatment verification, comprehensive quality assurance (QA) of EPIDs becomes critical. Current QA with phantoms such as the Las Vegas and PIPSpro™ can fail in the early detection of EPID artifacts. Beyond image quality assessment, we propose a quantitative methodology using local noise power spectrum (NPS) to characterize image noise and wavelet transform to identify bad pixels and inter-subpanel flat-fielding artifacts. Methods: A total of 93 image sets including bar-pattern images and open exposure images were collected from four iViewGT a-Si EPID systems over three years. Quantitative metrics such asmore » modulation transform function (MTF), NPS and detective quantum efficiency (DQE) were computed for each image set. Local 2D NPS was calculated for each subpanel. A 1D NPS was obtained by radial averaging the 2D NPS and fitted to a power-law function. R-square and slope of the linear regression analysis were used for panel performance assessment. Haar wavelet transformation was employed to identify pixel defects and non-uniform gain correction across subpanels. Results: Overall image quality was assessed with DQE based on empirically derived area under curve (AUC) thresholds. Using linear regression analysis of 1D NPS, panels with acceptable flat fielding were indicated by r-square between 0.8 and 1, and slopes of −0.4 to −0.7. However, for panels requiring flat fielding recalibration, r-square values less than 0.8 and slopes from +0.2 to −0.4 were observed. The wavelet transform successfully identified pixel defects and inter-subpanel flat fielding artifacts. Standard QA with the Las Vegas and PIPSpro phantoms failed to detect these artifacts. Conclusion: The proposed QA methodology is promising for the early detection of imaging and dosimetric artifacts of EPIDs. Local NPS can accurately characterize the noise level within each subpanel, while the wavelet transforms can detect bad pixels and inter-subpanel flat fielding artifacts.« less

Specific application for Oak Ridge National Laboratory dismantlement of Building 3004. Appendix A -- Quality assurance plan; Appendix B -- Records management plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

This quality assurance (QA) plan defines the QA requirements for the dismantlement and removal of Building 3004 at Oak Ridge National Laboratory (ORNL). The building is a four-story wooden trained structure with wooden siding, which resides approximately 150 ft west of the Bulk Shielding Reactor, and only several feet away from the visitors entrance to the Graphite Reactor museum. Complete descriptions and sketches are in the Performance Specification document for this project. This project is being conducted as a non-CERCLA maintenance action. This plan is an appendix to the QA plan for the ORNL Environmental Restoration (ER) Program. ORNL/ER-225, whichmore » is the source of the project QA requirements, tailors those QA requirements to the specific needs of this project as defined in ORNL/ER-225. Project-specific description and organization are also provided in this plan. Appendix B, Records Management Plan, is included.« less

Technical Note: Development and performance of a software tool for quality assurance of online replanning with a conventional Linac or MR-Linac.

PubMed

Chen, Guang-Pei; Ahunbay, Ergun; Li, X Allen

2016-04-01

To develop an integrated quality assurance (QA) software tool for online replanning capable of efficiently and automatically checking radiation treatment (RT) planning parameters and gross plan quality, verifying treatment plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary monitor unit (MU) calculation with or without a presence of a magnetic field from MR-Linac, and validating the delivery record consistency with the plan. The software tool, named ArtQA, was developed to obtain and compare plan and treatment parameters from both the TPS and the R&V system database. The TPS data are accessed via direct file reading and the R&V data are retrieved via open database connectivity and structured query language. Plan quality is evaluated with both the logical consistency of planning parameters and the achieved dose-volume histograms. Beams in between the TPS and R&V system are matched based on geometry configurations. To consider the effect of a 1.5 T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. ArtQA has been used in their clinic and can quickly detect inconsistencies and deviations in the entire RT planning process. With the use of the ArtQA tool, the efficiency for plan check including plan quality, data transfer, and delivery check can be improved by at least 60%. The newly developed independent MU calculation tool for MR-Linac reduces the difference between the plan and calculated MUs by 10%. The software tool ArtQA can be used to perform a comprehensive QA check from planning to delivery with conventional Linac or MR-Linac and is an essential tool for online replanning where the QA check needs to be performed rapidly.

Technical Note: Development and performance of a software tool for quality assurance of online replanning with a conventional Linac or MR-Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Guang-Pei, E-mail: gpchen@mcw.edu; Ahunbay, Ergun; Li, X. Allen

Purpose: To develop an integrated quality assurance (QA) software tool for online replanning capable of efficiently and automatically checking radiation treatment (RT) planning parameters and gross plan quality, verifying treatment plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary monitor unit (MU) calculation with or without a presence of a magnetic field from MR-Linac, and validating the delivery record consistency with the plan. Methods: The software tool, named ArtQA, was developed to obtain and compare plan and treatment parameters from both the TPS and the R&V system database. The TPS data aremore » accessed via direct file reading and the R&V data are retrieved via open database connectivity and structured query language. Plan quality is evaluated with both the logical consistency of planning parameters and the achieved dose–volume histograms. Beams in between the TPS and R&V system are matched based on geometry configurations. To consider the effect of a 1.5 T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. Results: ArtQA has been used in their clinic and can quickly detect inconsistencies and deviations in the entire RT planning process. With the use of the ArtQA tool, the efficiency for plan check including plan quality, data transfer, and delivery check can be improved by at least 60%. The newly developed independent MU calculation tool for MR-Linac reduces the difference between the plan and calculated MUs by 10%. Conclusions: The software tool ArtQA can be used to perform a comprehensive QA check from planning to delivery with conventional Linac or MR-Linac and is an essential tool for online replanning where the QA check needs to be performed rapidly.« less

A rapid communication from the AAPM Task Group 201: recommendations for the QA of external beam radiotherapy data transfer. AAPM TG 201: quality assurance of external beam radiotherapy data transfer.

PubMed

Siochi, R Alfredo; Balter, Peter; Bloch, Charles D; Santanam, Lakshmi; Blodgett, Kurt; Curran, Bruce H; Engelsman, Martijn; Feng, Wenzheng; Mechalakos, Jim; Pavord, Dan; Simon, Tom; Sutlieff, Steven; Zhu, X Ronald

2010-12-04

The transfer of radiation therapy data among the various subsystems required for external beam treatments is subject to error. Hence, the establishment and management of a data transfer quality assurance program is strongly recommended. It should cover the QA of data transfers of patient specific treatments, imaging data, manually handled data and historical treatment records. QA of the database state (logical consistency and information integrity) is also addressed to ensure that accurate data are transferred.

Implementation of R & QA practices in Research and Development programs

NASA Technical Reports Server (NTRS)

Bankaitis, H.

1983-01-01

DOE has established a number of broad programs aimed at reducing fuel consumption. Several programs address the R&D of ground transportation propulsion alternatives to the conventional spark-ignition engine. NASA Lewis is responsible for managing the effort between the Government and industry teams involving American and foreign companies. Thus, existing NASA SR&QA procedure were modified/adapted to these R&D programs and implemented to assure that the test hardware design intent was met, the hardware was not hazardous to personnel, it would demonstrate reliable operation, and it would help establish the future R&D quality assurance and maintainability requirements. This successful low-cost approach might be applicable to other similar projects.

Assessment Report Sandia National Laboratories Fuel Cycle Technologies Quality Assurance Evaluation of FY15 SNL FCT M2 Milestone Deliverables

DOE Office of Scientific and Technical Information (OSTI.GOV)

Appel, Gordon John

Sandia National Laboratories (SNL) Fuel Cycle Technologies (FCT) program activities are conducted in accordance with FCT Quality Assurance Program Document (FCT-QAPD) requirements. The FCT-QAPD interfaces with SNL approved Quality Assurance Program Description (SNL-QAPD) as explained in the Sandia National Laboratories QA Program Interface Document for FCT Activities (Interface Document). This plan describes SNL's FY16 assessment of SNL's FY15 FCT M2 milestone deliverable's compliance with program QA requirements, including SNL R&A requirements. The assessment is intended to confirm that SNL's FY15 milestone deliverables contain the appropriate authenticated review documentation and that there is a copy marked with SNL R&A numbers.

Good reasons to implement quality assurance in nationwide breast cancer screening programs in Croatia and Serbia: results from a pilot study.

PubMed

Ciraj-Bjelac, Olivera; Faj, Dario; Stimac, Damir; Kosutic, Dusko; Arandjic, Danijela; Brkic, Hrvoje

2011-04-01

The purpose of this study is to investigate the need for and the possible achievements of a comprehensive QA programme and to look at effects of simple corrective actions on image quality in Croatia and in Serbia. The paper focuses on activities related to the technical and radiological aspects of QA. The methodology consisted of two phases. The aim of the first phase was the initial assessment of mammography practice in terms of image quality, patient dose and equipment performance in selected number of mammography units in Croatia and Serbia. Subsequently, corrective actions were suggested and implemented. Then the same parameters were re-assessed. Most of the suggested corrective actions were simple, low-cost and possible to implement immediately, as these were related to working habits in mammography units, such as film processing and darkroom conditions. It has been demonstrated how simple quantitative assessment of image quality can be used for optimisation purposes. Analysis of image quality parameters as OD, gradient and contrast demonstrated general similarities between mammography practices in Croatia and Serbia. The applied methodology should be expanded to larger number of hospitals and applied on a regular basis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

An open source automatic quality assurance (OSAQA) tool for the ACR MRI phantom.

PubMed

Sun, Jidi; Barnes, Michael; Dowling, Jason; Menk, Fred; Stanwell, Peter; Greer, Peter B

2015-03-01

Routine quality assurance (QA) is necessary and essential to ensure MR scanner performance. This includes geometric distortion, slice positioning and thickness accuracy, high contrast spatial resolution, intensity uniformity, ghosting artefact and low contrast object detectability. However, this manual process can be very time consuming. This paper describes the development and validation of an open source tool to automate the MR QA process, which aims to increase physicist efficiency, and improve the consistency of QA results by reducing human error. The OSAQA software was developed in Matlab and the source code is available for download from http://jidisun.wix.com/osaqa-project/. During program execution QA results are logged for immediate review and are also exported to a spreadsheet for long-term machine performance reporting. For the automatic contrast QA test, a user specific contrast evaluation was designed to improve accuracy for individuals on different display monitors. American College of Radiology QA images were acquired over a period of 2 months to compare manual QA and the results from the proposed OSAQA software. OSAQA was found to significantly reduce the QA time from approximately 45 to 2 min. Both the manual and OSAQA results were found to agree with regard to the recommended criteria and the differences were insignificant compared to the criteria. The intensity homogeneity filter is necessary to obtain an image with acceptable quality and at the same time keeps the high contrast spatial resolution within the recommended criterion. The OSAQA tool has been validated on scanners with different field strengths and manufacturers. A number of suggestions have been made to improve both the phantom design and QA protocol in the future.

23 CFR 650.305 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... in a comprehensive training course). Critical finding. A structural or safety related deficiency that... fulfilled education and experience requirements and passed rigorous exams that, under State licensure laws.... Public road. The term “public road” is defined in 23 U.S.C. 101(a)(27). Quality assurance (QA). The use...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR FORM QA AND QC CHECKS (UA-C-2.0)

EPA Science Inventory

The purpose of this SOP is to outline the process of field quality assurance and quality control checks. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the Border study. Keywords: custody; QA/QC; field checks.

The U.S.-Mex...

Quality Assurance and Foreign Languages--Reflecting on Oral Assessment Practices in Two University Spanish Language Programs in Australia

ERIC Educational Resources Information Center

Díaz, Adriana R.; Hortiguera, Hugo; Espinoza Vera, Marcia

2015-01-01

In the era of quality assurance (QA), close scrutiny of assessment practices has been intensified worldwide across the board. However, in the Australian context, trends in QA efforts have not reached the field of modern/foreign languages. This has largely resulted in leaving the establishment of language proficiency benchmarking up to individual…

222-S Laboratory Quality Assurance Plan. Revision 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meznarich, H.K.

1995-07-31

This Quality Assurance Plan provides,quality assurance (QA) guidance, regulatory QA requirements (e.g., 10 CFR 830.120), and quality control (QC) specifications for analytical service. This document follows the U.S Department of Energy (DOE) issued Hanford Analytical Services Quality Assurance Plan (HASQAP). In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. Quality assurance elements required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAMS-004) and Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans (QAMS-005) from the US Environmental Protection Agency (EPA) are covered throughout this document. A qualitymore » assurance index is provided in the Appendix A. This document also provides and/or identifies the procedural information that governs laboratory operations. The personnel of the 222-S Laboratory and the Standards Laboratory including managers, analysts, QA/QC staff, auditors, and support staff shall use this document as guidance and instructions for their operational and quality assurance activities. Other organizations that conduct activities described in this document for the 222-S Laboratory shall follow this QA/QC document.« less

Criteria Considered in Selecting Feed Items for Americium-241 Oxide Production Operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schulte, Louis D.

The analysis in this document serves the purpose of defining a number of attributes in selection of feed items to be utilized in recovery/recycle of Pu and also production operations of 241AmO 2 material intended to meet specification requirements. This document was written in response to a specific request on the part of the 2014 annual program review which took place over the dates of October 28-29, 2014. A number of feed attributes are noted including: (1) Non-interference with existing Pu recovery operations; (2) Content of sufficient 241Am to allow process efficiency in recovery operations; (3) Absence of indications thatmore » 243Am might be mixed in with the Pu/ 241Am material; (4) Absence of indications that Cm might be mixed in with the Pu/ 241Am material; (5) Absence of indications of other chemical elements that would present difficulty in chemical separation from 241Am; (6) Feed material not expected to present difficulty in dissolution; (7) Dose issues; (8) Process efficiency; (9) Size; (10) Hazard associated with items and package configuration in the vault; (11) Within existing NEPA documentation. The analysis in this document provides a baseline of attributes considered for feed materials, but does not presume to replace the need for technical expertise and judgment on the part of individuals responsible for selecting the material feed to be processed. This document is not comprehensive as regards all attributes that could prove to be important. The value of placing a formal QA hold point on accepting feed items versus more informal management of feed items is discussed in the summation of this analysis. The existing planned QA hold points on 241AmO 2 products produced and packaged may be adequate as the entire project is based on QA of the product rather than QA of the process. The probability of introduction of items that would inherently cause the 241AmO 2 products produced to be outside of specification requirements appears to be rather small.« less

Quality, management, and the interplay of self-assessment, process assessments, and performance-based observations

NASA Astrophysics Data System (ADS)

Willett, D. J.

1993-04-01

In this document, the author presents his observations on the topic of quality assurance (QA). Traditionally the focus of quality management has been on QA organizations, manuals, procedures, audits, and assessments; quality was measured by the degree of conformance to specifications or standards. Today quality is defined as satisfying user needs and is measured by user satisfaction. The author proposes that quality is the responsibility of line organizations and staff and not the responsibility of the QA group. This work outlines an effective Conduct of Operations program. The author concludes his observations with a discussion of how quality is analogous to leadership.

Country experience in organizing for quality: Niger.

PubMed

Marquez, L; Madubuike, C

1999-01-01

This article describes the efforts of Niger's Ministry of Health Tahoua Quality Assurance Project (QAP) since 1994. QAP aims to improve the delivery of critical primary health care (PHC) services by integrating and institutionalizing the QA approach in the PHC system in 1 demonstration site (Tahoua) and eventually, countrywide. The QAP selected 8 clinical interventions in its package of minimum services. The QAP project provided training, clarified and communicated clinical and management standards, and monitored and initiated a process for preventing and correcting problems. During 1994-96, QAP collaborated with BASICS to assist all 7 District Health Management Teams (DHMTs) in developing data collection tools for rapid performance assessments of the Integrated Management of Childhood Illnesses program. The pilot program proved that measurable gains in QA were possible, even with limited resources. DHMTs will have oversight of QA activities. A special unit within the MOH is not yet fully staffed. The central strategy has been to train teams of health staff at the regional and district level. A multilevel team developed manuals for norms and standards for vaccinations and for managerial operating procedures. The Quality Council redesigned the supervision system. Performance is monitored at quarterly regional and district meetings. A quarterly bulletin is the main dissemination tool. The loss of USAID support led to the loss of technical support from the QAP. The MOH is committed to QA and plans to institutionalize the process. The World Bank and UNICEF agreed to support QA projects in 1999.

Capturing, using, and managing quality assurance knowledge for shuttle post-MECO flight design

NASA Technical Reports Server (NTRS)

Peters, H. L.; Fussell, L. R.; Goodwin, M. A.; Schultz, Roger D.

1991-01-01

Ascent initialization values used by the Shuttle's onboard computer for nominal and abort mission scenarios are verified by a six degrees of freedom computer simulation. The procedure that the Ascent Post Main Engine Cutoff (Post-MECO) group uses to perform quality assurance (QA) of the simulation is time consuming. Also, the QA data, checklists and associated rationale, though known by the group members, is not sufficiently documented, hindering transfer of knowledge and problem resolution. A new QA procedure which retains the current high level of integrity while reducing the time required to perform QA is needed to support the increasing Shuttle flight rate. Documenting the knowledge is also needed to increase its availability for training and problem resolution. To meet these needs, a knowledge capture process, embedded into the group activities, was initiated to verify the existing QA checks, define new ones, and document all rationale. The resulting checks were automated in a conventional software program to achieve the desired standardization, integrity, and time reduction. A prototype electronic knowledge base was developed with Macintosh's HyperCard to serve as a knowledge capture tool and data storage.

Test/QA plan for the verification testing of alternative or reformulated liquid fuels, fuel additives, fuel emulsions, and lubricants for highway and nonroad use heavy-duty diesel engines

EPA Science Inventory

This Environmental Technology Verification Program test/QA plan for heavy-duty diesel engine testing at the Southwest Research Institute’s Department of Emissions Research describes how the Federal Test Procedure (FTP), as listed in 40 CFR Part 86 for highway engines and 40 CFR P...

Enhancing the Instructional Program with Creative Arts: Q&A with Susan Riley, M.Ed. Educator Effectiveness Webinar Series

ERIC Educational Resources Information Center

Regional Educational Laboratory Mid-Atlantic, 2016

2016-01-01

This document provides Q&A with webinar presenter, Susan Riley. Riley's presentation looks at broad ideas of clarifying best practices in using arts integration (AI) and/or STEAM at any grade level. Questions cover topics such as: the creativity crisis in US schools, integrating art into math adult education (GED and ESL), theater arts in the…

Cervical cancer screening in Europe: Quality assurance and organisation of programmes.

PubMed

Elfström, K Miriam; Arnheim-Dahlström, Lisen; von Karsa, Lawrence; Dillner, Joakim

2015-05-01

Cervical screening programmes have reduced cervical cancer incidence and mortality but the level of success is highly variable between countries. Organisation of programmes is essential for equity and cost-effectiveness. However, there are differences in effectiveness, also among organised programmes. In order to identify the key organisational components that determine effectiveness, we performed a Europe-wide survey on the current status of organisation and organised quality assurance (QA) measures in cervical cancer prevention programmes, as well as organisation-associated costs. A comprehensive questionnaire was developed through systematic review of literature and existing guidelines. The survey was sent to programme organisers, Ministries of Health and experts in 34 European Union (EU) and European Free Trade Agreement (EFTA) countries. Detailed aspects of programme organisation, quality assurance, monitoring, evaluation and corresponding line-item costs were recorded. Documentation of programme guidelines, protocols and publications was requested. Twenty-nine of 34 countries responded. The results showed that organised efforts for QA, monitoring and evaluation were carried out to a differing extent and were not standardised, making it difficult to compare the cost-effectiveness of organisation and QA strategies. Most countries found it hard to estimate the costs associated with launching and operating the organised programme. To our knowledge, this is the first questionnaire to request detailed information on the actual organisation and QA of programmes. The results of this survey can be used as a basis for further development of standardised guidelines on organisation and QA of cervical cancer screening programmes in Europe. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quality assurance testing of acoustic doppler current profiler transform matrices

USGS Publications Warehouse

Armstrong, Brandy; Fulford, Janice M.; Thibodeaux, Kirk G.

2015-01-01

The U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility (HIF) is nationally responsible for the design, testing, evaluation, repair, calibration, warehousing, and distribution of hydrologic instrumentation in use within the USGS Water Mission Area (WMA). The HIF's Hydraulic Laboratory has begun routine quality assurance (QA) testing and documenting the performance of every USGS WMA acoustic Doppler current profiler (ADCP) used for making velocity and discharge measurements. All existing ADCPs are being registered and tracked in a database maintained by the HIF, and called for QA checks in the HIF's Hydraulic Laboratory on a 3- year cycle. All new ADCPs purchased directly from the manufacturer as well as ADCPs sent to the HIF or the manufacturer for repair are being registered and tracked in the database and QA checked in the laboratory before being placed into service. Meters failing the QA check are sent directly to the manufacturer for repairs and rechecked by HIF or removed from service. Although this QA program is specific to the SonTek1 and Teledyne RD Instruments1, ADCPs most commonly used within the WMA, it is the intent of the USGS Office of Surface Water and the HIF to expand this program to include all bottom tracking ADCPs as they become available and more widely used throughout the WMA. As part of the HIF QA process, instruments are inspected for physical damage, the instrument must pass the ADCP diagnostic self-check tests, the temperature probe must be within ± 2 degrees Celsius of a National Institute of Standards and Technology traceable reference thermometer and the distance made good over a fixed distance must meet the manufacturer's specifications (+/-0.25% or +/-1% difference). The transform matrix is tested by conducting distance-made-good (DMG) tests comparing the straight-line distance from bottom tracking to the measured tow-track distance. The DMG test is conducted on each instrument twice in the forward and reverse directions (4 tows) at four orientations (16 total tows); with beam 1 orientated 0 degrees to the towing direction; turned 45 degrees to the towing direction; turned 90 degrees to the towing direction; and turned 135 degrees to the towing direction. All QA data files and summary results are archived. This paper documents methodology, participation and preliminary results of WMA ADCP QA testing.

SU-E-T-354: Efficient and Enhanced QA Testing of Linear Accelerators Using a Real-Time Beam Monitor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jung, J; Farrokhkish, M; Norrlinger, B

2015-06-15

Purpose: To investigate the feasibility of performing routine QA tests of linear accelerators (Linac) using the Integral Quality Monitoring (IQM) system. The system, consisting of a 1-D sensitivity gradient large area ion-chamber mounted at the collimator, allows automatic collection and analysis of beam data. Methods: The IQM was investigated to perform several QA constancy tests, similar to those recommended by AAPM TG142, of a Linac including: beam output, MLC calibration, beam symmetry, relative dose factor (RDF), dose linearity, output as a function of gantry angle and dose rate. All measurements by the IQM system accompanied a reference measurement using amore » conventional dosimetry system and were performed on an Elekta Infinity Linac with Agility MLC. The MLC calibration check is done using a Picket-Fence type 2×10cm{sup 2} field positioned at different off-axis locations along the chamber gradient. Beam symmetry constancy values are established by signals from an 4×4cm{sup 2} aperture located at various off-axis positions; the sensitivity of the test was determined by the changes in the signals in response to a tilt in the beam. The data for various square field sizes were used to develop a functional relationship with RDF. Results: The IQM tracked the beam output well within 1% of the reference ion-chamber readings. The Picket-Fence type field test detected a 1mm shift error of one MLC bank. The system was able to detect 2.5% or greater beam asymmetry. The IQM results for all other QA tests were found to agree with the reference values to within 0.5%. Conclusion: It was demonstrated that the IQM system can effectively monitor the Linac performance parameters for the purpose of routine QA constancy tests. With minimum user interactions a comprehensive set of tests can be performed efficiently, allowing frequent monitoring of the Linac. The presenting author’s salary is funded by the manufacturer of the QA device. All the other authors have financial interests with the commercialization of this QA device.« less

A novel DTI-QA tool: Automated metric extraction exploiting the sphericity of an agar filled phantom.

PubMed

Chavez, Sofia; Viviano, Joseph; Zamyadi, Mojdeh; Kingsley, Peter B; Kochunov, Peter; Strother, Stephen; Voineskos, Aristotle

2018-02-01

To develop a quality assurance (QA) tool (acquisition guidelines and automated processing) for diffusion tensor imaging (DTI) data using a common agar-based phantom used for fMRI QA. The goal is to produce a comprehensive set of automated, sensitive and robust QA metrics. A readily available agar phantom was scanned with and without parallel imaging reconstruction. Other scanning parameters were matched to the human scans. A central slab made up of either a thick slice or an average of a few slices, was extracted and all processing was performed on that image. The proposed QA relies on the creation of two ROIs for processing: (i) a preset central circular region of interest (ccROI) and (ii) a signal mask for all images in the dataset. The ccROI enables computation of average signal for SNR calculations as well as average FA values. The production of the signal masks enables automated measurements of eddy current and B0 inhomogeneity induced distortions by exploiting the sphericity of the phantom. Also, the signal masks allow automated background localization to assess levels of Nyquist ghosting. The proposed DTI-QA was shown to produce eleven metrics which are robust yet sensitive to image quality changes within site and differences across sites. It can be performed in a reasonable amount of scan time (~15min) and the code for automated processing has been made publicly available. A novel DTI-QA tool has been proposed. It has been applied successfully on data from several scanners/platforms. The novelty lies in the exploitation of the sphericity of the phantom for distortion measurements. Other novel contributions are: the computation of an SNR value per gradient direction for the diffusion weighted images (DWIs) and an SNR value per non-DWI, an automated background detection for the Nyquist ghosting measurement and an error metric reflecting the contribution of EPI instability to the eddy current induced shape changes observed for DWIs. Copyright © 2017 Elsevier Inc. All rights reserved.

Lesson Development for English Learners in Content Area Settings: Key Considerations. Q&A with Sarah Catherine K. Moore, Ph.D. 2016 Educator Effectiveness Webinar Series

ERIC Educational Resources Information Center

Moore, Sarah Catherine K.

2016-01-01

In this webinar, Dr. Sarah Catherine K. Moore, Program Director at the Center for Applied Linguistics, outlined factors for content area teachers to consider as they design and deliver lessons for mainstream classrooms that include English learner (EL) students. This Q&A addressed the questions participants had for Dr. Moore following the…

Quality Assurance of Real-Time Oceanographic Data from the Cabled Array of the Ocean Observatories Initiative

NASA Astrophysics Data System (ADS)

Kawka, O. E.; Nelson, J. S.; Manalang, D.; Kelley, D. S.

2016-02-01

The Cabled Array component of the NSF-funded Ocean Observatories Initiative (OOI) provides access to real-time physical, chemical, geological, and biological data from water column and seafloor platforms/instruments at sites spanning the southern half of the Juan de Fuca Plate. The Quality Assurance (QA) program for OOI data is designed to ensure that data products meet OOI science requirements. This overall data QA plan establishes the guidelines for assuring OOI data quality and summarizes Quality Control (QC) protocols and procedures, based on best practices, which can be utilized to ensure the highest quality data across the OOI program. This presentation will highlight, specifically, the QA/QC approach being utilized for the OOI Cabled Array infrastructure and data and will include a summary of both shipboard and shore-based protocols currently in use. Aspects addressed will be pre-deployment instrument testing and calibration checks, post-deployment and pre-recovery field verification of data, and post-recovery "as-found" testing of instruments. Examples of QA/QC data will be presented and specific cases of cabled data will be discussed in the context of quality assessments and adjustment/correction of OOI datasets overall for inherent sensor drift and/or instrument fouling.

Comprehensive two-dimensional liquid chromatography of therapeutic monoclonal antibody digests.

PubMed

Vanhoenacker, Gerd; Vandenheede, Isabel; David, Frank; Sandra, Pat; Sandra, Koen

2015-01-01

Comprehensive two-dimensional liquid chromatography (LC×LC) is here proposed as a novel tool for peptide mapping of therapeutic monoclonal antibodies in both R&D and routine (QA/QC) environments. This is illustrated by the analysis of the tryptic digest of trastuzumab (Herceptin) applying a commercially available two-dimensional 2D-LC system. Three different LC×LC combinations, i.e., strong cation-exchange × reversed-phase (SCX×RP), reversed-phase × reversed-phase (RP×RP), and hydrophilic interaction × reversed-phase (HILIC×RP), are reported. Detection was carried out using both UV detection (DAD) and mass spectrometry (MS). Several challenges related to the application of LC×LC in peptide mapping and the hyphenation to MS are addressed. The applicability of LC×LC in the assessment of identity, purity, and comparability is demonstrated by the analysis of different Herceptin innovator production batches, a Herceptin biosimilar in development and of stressed samples. The described methodology was shown to be precise in terms of peak volume and (2)D retention time opening interesting perspectives for use in QA/QC testing.

MO-FG-202-04: Gantry-Resolved Linac QA for VMAT: A Comprehensive and Efficient System Using An Electronic Portal Imaging Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zwan, B J; University of Newcastle, Newcastle, NSW; Barnes, M

2016-06-15

Purpose: To automate gantry-resolved linear accelerator (linac) quality assurance (QA) for volumetric modulated arc therapy (VMAT) using an electronic portal imaging device (EPID). Methods: A QA system for VMAT was developed that uses an EPID, frame-grabber assembly and in-house developed image processing software. The system relies solely on the analysis of EPID image frames acquired without the presence of a phantom. Images were acquired at 8.41 frames per second using a frame grabber and ancillary acquisition computer. Each image frame was tagged with a gantry angle from the linac’s on-board gantry angle encoder. Arc-dynamic QA plans were designed to assessmore » the performance of each individual linac component during VMAT. By analysing each image frame acquired during the QA deliveries the following eight machine performance characteristics were measured as a function of gantry angle: MLC positional accuracy, MLC speed constancy, MLC acceleration constancy, MLC-gantry synchronisation, beam profile constancy, dose rate constancy, gantry speed constancy, dose-gantry angle synchronisation and mechanical sag. All tests were performed on a Varian iX linear accelerator equipped with a 120 leaf Millennium MLC and an aS1000 EPID (Varian Medical Systems, Palo Alto, CA, USA). Results: Machine performance parameters were measured as a function of gantry angle using EPID imaging and compared to machine log files and the treatment plan. Data acquisition is currently underway at 3 centres, incorporating 7 treatment units, at 2 weekly measurement intervals. Conclusion: The proposed system can be applied for streamlined linac QA and commissioning for VMAT. The set of test plans developed can be used to assess the performance of each individual components of the treatment machine during VMAT deliveries as a function of gantry angle. The methodology does not require the setup of any additional phantom or measurement equipment and the analysis is fully automated to allow for regular routine testing.« less

SU-F-T-237: The Imaging and Radiation Oncology Core (IROC) Cooperatives Activities Supporting the NCI’s National Clinical Trial Network

DOE Office of Scientific and Technical Information (OSTI.GOV)

Followill, D; Galvin, J; Michalski, J

Purpose: The Imaging and Radiation Oncology Core (IROC) Cooperative has been active for the past two years supporting the National Clinical Trial Network and the details of that support are reported. Methods: There are six QA centers (Houston, Ohio, Philadelphia-RT, Philadelphia-DI, Rhode Island, St. Louis) providing an integrated RT and DI quality control program in support of the NCI’s clinical trials. The QA Center’s efforts are focused on assuring high quality data for clinical trials designed to improve the clinical outcomes for cancer patients worldwide. This program is administered through five core services: site qualification, trial design support, credentialing, datamore » management, and case review. Results: IROC currently provides core support for 172 NCTN trials with RT, DI and RT/DI components. Many of these trials were legacy trial from the previous cooperative group program. IROC monitors nearly 1800 RT photon and 20 proton institutions. Over 28,000 beams outputs were monitored with 8% of the sites requiring repeat audits due to beam out of criteria. As part of credentialing, 950 QA phantoms have been irradiated, 515 imaging modalities evaluated and almost 4000 credentialing letters have been issued. In just year 2, 5290 RT and 4934 DI patient datasets were received (many using TRIAD) by IROC QA Centers to be prepared for review. During the past 2 years, a total of 6300 RT cases and 19,000 DI image sets were reviewed by IROC technical staff. To date, IROC has published 36 manuscripts. Conclusion: The QA services provided by IROC are numerous and are continually being evaluated for effectiveness, harmonized across all NCTN Groups and administered in an efficient and timely manner to enhance accurate and per protocol trial data submission. These efforts increase each NCTN Group’s ability to derive meaningful outcomes from their clinical trials. This work was supported by DHHS NIH grant 5U24CA180803.« less

Quality assurance of intensity-modulated radiation therapy.

PubMed

Palta, Jatinder R; Liu, Chihray; Li, Jonathan G

2008-01-01

The current paradigm for the quality assurance (QA) program for intensity-modulated radiation therapy (IMRT) includes QA of the treatment planning system, QA of the delivery system, and patient-specific QA. Although the IMRT treatment planning and delivery system is the same as for conventional three-dimensional conformal radiation therapy, it has more parameters to coordinate and verify. Because of complex beam intensity modulation, each IMRT field often includes many small irregular off-axis fields, resulting in isodose distributions for each IMRT plan that are more conformal than those from conventional treatment plans. Therefore, these features impose a new and more stringent set of QA requirements for IMRT planning and delivery. The generic test procedures to validate dose calculation and delivery accuracy for both treatment planning and IMRT delivery have to be customized for each type of IMRT planning and delivery strategy. The rationale for such an approach is that the overall accuracy of IMRT delivery is incumbent on the piecewise uncertainties in both the planning and delivery processes. The end user must have well-defined evaluation criteria for each element of the planning and delivery process. Such information can potentially be used to determine a priori the accuracy of IMRT planning and delivery.

Control of Suspect/Counterfeit and Defective Items

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheriff, Marnelle L.

2013-09-03

This procedure implements portions of the requirements of MSC-MP-599, Quality Assurance Program Description. It establishes the Mission Support Alliance (MSA) practices for minimizing the introduction of and identifying, documenting, dispositioning, reporting, controlling, and disposing of suspect/counterfeit and defective items (S/CIs). employees whose work scope relates to Safety Systems (i.e., Safety Class [SC] or Safety Significant [SS] items), non-safety systems and other applications (i.e., General Service [GS]) where engineering has determined that their use could result in a potential safety hazard. MSA implements an effective Quality Assurance (QA) Program providing a comprehensive network of controls and verification providing defense-in-depth by preventingmore » the introduction of S/CIs through the design, procurement, construction, operation, maintenance, and modification of processes. This procedure focuses on those safety systems, and other systems, including critical load paths of lifting equipment, where the introduction of S/CIs would have the greatest potential for creating unsafe conditions.« less

Supine craniospinal irradiation in pediatric patients by proton pencil beam scanning.

PubMed

Farace, Paolo; Bizzocchi, Nicola; Righetto, Roberto; Fellin, Francesco; Fracchiolla, Francesco; Lorentini, Stefano; Widesott, Lamberto; Algranati, Carlo; Rombi, Barbara; Vennarini, Sabina; Amichetti, Maurizio; Schwarz, Marco

2017-04-01

Proton therapy is the emerging treatment modality for craniospinal irradiation (CSI) in pediatric patients. Herein, special methods adopted for CSI at proton Therapy Center of Trento by pencil beam scanning (PBS) are comprehensively described. Twelve pediatric patients were treated by proton PBS using two/three isocenters. Special methods refer to: (i) patient positioning in supine position on immobilization devices crossed by the beams; (ii) planning field-junctions via the ancillary-beam technique; (iii) achieving lens-sparing by three-beams whole-brain-irradiation; (iv) applying a movable-snout and beam-splitting technique to reduce the lateral penumbra. Patient-specific quality assurance (QA) program was performed using two-dimensional ion chamber array and γ-analysis. Daily kilovoltage alignment was performed. PBS allowed to obtain optimal target coverage (mean D98%>98%) with reduced dose to organs-at-risk. Lens sparing was obtained (mean D1∼730cGyE). Reducing lateral penumbra decreased the dose to the kidneys (mean Dmean<600cGyE). After kilovoltage alignment, potential dose deviations in the upper and lower junctions were small (average 0.8% and 1.2% respectively). Due to imperfect modeling of range shifter, QA showed better agreements between measurements and calculations at depths >4cm (mean γ>95%) than at depths<4cm. The reported methods allowed to effectively perform proton PBS CSI. Copyright © 2017 Elsevier B.V. All rights reserved.

SU-F-T-296: Modulated Therapy Down Under: A Survey of IMRT & VMAT Physics Practice in Australia and New Zealand

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barber, J; School of Physics, University of Sydney; Vial, P

Purpose: A comprehensive survey of Australasian radiation oncology physics departments was undertaken to capture a snapshot of current usage, commissioning and QA practices for intensity-modulated therapies. Methods: An online survey was developed and advertised to Australian and New Zealand radiation oncology physicists through the local college (ACPSEM) in April 2015. The survey consisted of 147 questions in total, covering IMRT, VMAT and Tomotherapy, and details specific to different treatment planning systems. Questions captured detailed information on equipment, policies and procedures for the commissioning and QA of each treatment technique. Results: 41 partial or complete responses were collected, representing 59 departmentsmore » out of the 78 departments operational. 137 and 84 linacs from these departments were using IMRT and VMAT respectively, from a total 150 linacs. 100% and 78% of respondents were treating with IMRT and VMAT respectively. There are at least 8 different treatment planning systems being used for IMRT or VMAT, and large variations in all aspects of QA policies and procedures. 29 responses indicated 72 methods routinely used for pre-treatment QA, when breaking down by device and analysis type. Similar numbers of departments use field-by-field analysis compared to composite analysis (56% to 44%) while a majority use true gantry angle delivery compared to fixed gantry at 0° (72% to 28%). 19 different implementations of gamma index analysis parameters were reported from 33 responses. A follow-up one-day workshop to highlight the results, discuss the role of QA and share equipment-specific knowledge across users was conducted in November 2015. Conclusion: While IMRT and VMAT are almost universally available in Australasia, large variations in practice indicate a need for national or consensus guidelines.« less

78 FR 37850 - Quality Assurance Program Requirements (Operations)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0021] Quality Assurance Program Requirements (Operations... Regulatory Commission (NRC) is issuing a revision to Regulatory Guide (RG) 1.33, ``Quality Assurance Program... managerial and administrative Quality Assurance (QA) controls for nuclear power plants during operations...

Remedial investigation/feasibility study for the Clinch River/Poplar Creek operable unit. Volume 5. Appendixes G, H, I, J

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-09-01

The Quality Assurance/Quality Control (QA/QC) Program for Phase 2 of the Clinch River Remedial Investigation (CRRI) was designed to comply with both Department of Energy (DOE) Order 5700.6C and Environmental Protection Agency (EPA) QAMS-005/80 (EPA 1980a) guidelines. QA requirements and the general QA objectives for Phase 2 data were defined in the Phase 2 Sampling and Analysis Plan (SAP)-Quality Assurance Project Plan, and scope changes noted in the Phase 2 Sampling and Analysis Plan Addendum. The QA objectives for Phase 2 data were the following: (1) Scientific data generated will withstand scientific and legal scrutiny. (2) Data will be gatheredmore » using appropriate procedures for sample collection, sample handling and security, chain of custody (COC), laboratory analyses, and data reporting. (3) Data will be of known precision and accuracy. (4) Data will meet data quality objectives (DQOs) defined in the Phase 2 SAP.« less

USGS Laboratory Review Program Ensures Analytical Quality

USGS Publications Warehouse

Erdmann, David E.

1995-01-01

The USGS operates a review program for laboratories that analyze samples for USGS environmental investigations. This program has been effective in providing QA feedback to laboratories while ensuring that analytical data are consistent, of satisfactory quality, and meet the data objectives of the investigation.

Research in advanced formal theorem-proving techniques. [design and implementation of computer languages

NASA Technical Reports Server (NTRS)

Raphael, B.; Fikes, R.; Waldinger, R.

1973-01-01

The results are summarised of a project aimed at the design and implementation of computer languages to aid in expressing problem solving procedures in several areas of artificial intelligence including automatic programming, theorem proving, and robot planning. The principal results of the project were the design and implementation of two complete systems, QA4 and QLISP, and their preliminary experimental use. The various applications of both QA4 and QLISP are given.

Commissioning and comprehensive quality assurance of commercial 3D treatment planning system using IAEA Technical Report Series-430.

PubMed

Jamema, S V; Upreti, R R; Sharma, S; Deshpande, D D

2008-09-01

The purpose of this work is to report the results of commissioning and to establish a quality assurance (QA) program for commercial 3D treatment planning system (TPS) based on IAEA Technical Report Series 430. Eclipse v 7.3.10, (Varian Medical Systems, Palo Alto, CA, U.S.A.) TPS was commissioned for a Clinac 6EX (Varian Medical Systems, Palo Alto, CA, USA) linear accelerator. CT images of a phantom with various known in-homogeneities were acquired. The images were transferred to TPS and tested for various parameters related to patient data acquisition, anatomical modeling, plan evaluation and dose calculation. Dosimetric parameters including open, asymmetric and wedged shaped fields, oblique incidence, buildup region behavior and SSD dependence were evaluated. Representative clinical cases were tested for MU calculation and point doses. The maximum variation between the measured and the known CT numbers was 20 +/- 11.7 HU (1 SD). The results of all non-dosimetric tests were found within tolerance, however expansion at the sharp corners was found distorted. The accuracy of the DVH calculations depends on the grid size. TPS calculations of all the dosimetric parameters were in good agreement with the measured values, however for asymmetric open and wedged fields, few points were found out of tolerance. Smaller grid size calculation showed better agreement of dose calculation in the build-up region. Independent tests for MU calculation showed a variation within +/-2% (relative to planning system), meanwhile variation of 3.0% was observed when the central axis was blocked. The test results were in agreement with the tolerance specified by IAEA TRS 430. A subset of the commissioning tests has been identified as a baseline data for an ongoing QA program.

Quality assurance in an adult intensive care unit, Eastern region, Saudi Arabia.

PubMed

Iqbal, Mobeen; Rehmani, Rifat; Venter, Joan; Alaithan, Abdulsalam M

2007-03-01

Quality assurance (QA) is an increasingly important element in the administrative management of Intensive Care Unit (ICU). This is not only to improve clinical practices and patient's outcome, but also helps in proper resource utilization. We introduced a comprehensive quality assurance program in ICU at King Abdulaziz National Guard Hospital, Alhasa, Saudi Arabia, based on the existing medical evidence. We identified an already-validated set of quality indicators in intensive care and grouped them in categories of outcome measures (which reflect patient's subsequent health status) and process measures (related to patient-healthcare professional's interaction). Data collection forms were developed for nurses and physicians. Data were reported on monthly basis starting from January 2005, and the first 10 months data are presented. Three hundred eighty-seven patients were admitted during the study period. Approximately 56.9% had cardiac related diseases, 33.5% had medical ailments, and 9.6% had surgery related issues. There were 54.6% males and 45.4% females. Mean age of the patients was 58.4 +/- 18.3 years. The mean acute physiology and chronic health evaluation II (APACHE-II) score was 13.6 +/- 4.9. Outcome measures were either better or comparable to international data, while adherence to process measures was found to be excellent. Standardized mortality ratio for the duration of study was 0.24 with 95% confidence interval from 0.15-0.36. Implementation of QA program is practical in an ICU. Disseminating the quality monitoring information at national level can lead to a broad data base, which can identify the best performing ICUs, thus, leading to bench marking and creating risk adjusted models applicable to local population.

Quality control and assurance for validation of DOS/I measurements

NASA Astrophysics Data System (ADS)

Cerussi, Albert; Durkin, Amanda; Kwong, Richard; Quang, Timothy; Hill, Brian; Tromberg, Bruce J.; MacKinnon, Nick; Mantulin, William W.

2010-02-01

Ongoing multi-center clinical trials are crucial for Biophotonics to gain acceptance in medical imaging. In these trials, quality control (QC) and assurance (QA) are key to success and provide "data insurance". Quality control and assurance deal with standardization, validation, and compliance of procedures, materials and instrumentation. Specifically, QC/QA involves systematic assessment of testing materials, instrumentation performance, standard operating procedures, data logging, analysis, and reporting. QC and QA are important for FDA accreditation and acceptance by the clinical community. Our Biophotonics research in the Network for Translational Research in Optical Imaging (NTROI) program for breast cancer characterization focuses on QA/QC issues primarily related to the broadband Diffuse Optical Spectroscopy and Imaging (DOS/I) instrumentation, because this is an emerging technology with limited standardized QC/QA in place. In the multi-center trial environment, we implement QA/QC procedures: 1. Standardize and validate calibration standards and procedures. (DOS/I technology requires both frequency domain and spectral calibration procedures using tissue simulating phantoms and reflectance standards, respectively.) 2. Standardize and validate data acquisition, processing and visualization (optimize instrument software-EZDOS; centralize data processing) 3. Monitor, catalog and maintain instrument performance (document performance; modularize maintenance; integrate new technology) 4. Standardize and coordinate trial data entry (from individual sites) into centralized database 5. Monitor, audit and communicate all research procedures (database, teleconferences, training sessions) between participants ensuring "calibration". This manuscript describes our ongoing efforts, successes and challenges implementing these strategies.

Alchemy: A Web 2.0 Real-time Quality Assurance Platform for Human Immunodeficiency Virus, Hepatitis C Virus, and BK Virus Quantitation Assays.

PubMed

Agosto-Arroyo, Emmanuel; Coshatt, Gina M; Winokur, Thomas S; Harada, Shuko; Park, Seung L

2017-01-01

The molecular diagnostics laboratory faces the challenge of improving test turnaround time (TAT). Low and consistent TATs are of great clinical and regulatory importance, especially for molecular virology tests. Laboratory information systems (LISs) contain all the data elements necessary to do accurate quality assurance (QA) reporting of TAT and other measures, but these reports are in most cases still performed manually: a time-consuming and error-prone task. The aim of this study was to develop a web-based real-time QA platform that would automate QA reporting in the molecular diagnostics laboratory at our institution, and minimize the time expended in preparing these reports. Using a standard Linux, Nginx, MariaDB, PHP stack virtual machine running atop a Dell Precision 5810, we designed and built a web-based QA platform, code-named Alchemy. Data files pulled periodically from the LIS in comma-separated value format were used to autogenerate QA reports for the human immunodeficiency virus (HIV) quantitation, hepatitis C virus (HCV) quantitation, and BK virus (BKV) quantitation. Alchemy allowed the user to select a specific timeframe to be analyzed and calculated key QA statistics in real-time, including the average TAT in days, tests falling outside the expected TAT ranges, and test result ranges. Before implementing Alchemy, reporting QA for the HIV, HCV, and BKV quantitation assays took 45-60 min of personnel time per test every month. With Alchemy, that time has decreased to 15 min total per month. Alchemy allowed the user to select specific periods of time and analyzed the TAT data in-depth without the need of extensive manual calculations. Alchemy has significantly decreased the time and the human error associated with QA report generation in our molecular diagnostics laboratory. Other tests will be added to this web-based platform in future updates. This effort shows the utility of informatician-supervised resident/fellow programming projects as learning opportunities and workflow improvements in the molecular laboratory.

QA/QC requirements for physical properties sampling and analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Innis, B.E.

1993-07-21

This report presents results of an assessment of the available information concerning US Environmental Protection Agency (EPA) quality assurance/quality control (QA/QC) requirements and guidance applicable to sampling, handling, and analyzing physical parameter samples at Comprehensive Environmental Restoration, Compensation, and Liability Act (CERCLA) investigation sites. Geotechnical testing laboratories measure the following physical properties of soil and sediment samples collected during CERCLA remedial investigations (RI) at the Hanford Site: moisture content, grain size by sieve, grain size by hydrometer, specific gravity, bulk density/porosity, saturated hydraulic conductivity, moisture retention, unsaturated hydraulic conductivity, and permeability of rocks by flowing air. Geotechnical testing laboratories alsomore » measure the following chemical parameters of soil and sediment samples collected during Hanford Site CERCLA RI: calcium carbonate and saturated column leach testing. Physical parameter data are used for (1) characterization of vadose and saturated zone geology and hydrogeology, (2) selection of monitoring well screen sizes, (3) to support modeling and analysis of the vadose and saturated zones, and (4) for engineering design. The objectives of this report are to determine the QA/QC levels accepted in the EPA Region 10 for the sampling, handling, and analysis of soil samples for physical parameters during CERCLA RI.« less

Developing a mailed phantom to implement a local QA program in Egypt radiotherapy centers

NASA Astrophysics Data System (ADS)

Soliman, H. A.; Aletreby, M.

2016-07-01

In this work, a simple method that differs from the IAEA/WHO Thermoluminescent dosimeters (TLD) postal quality assurance (QA) program is developed. A small perspex; polymethyl methacrylate (PMMA), phantom measured 50 mm × 50 mm × 50 mm is constructed to be used for absorbed dose verification of high-energy photon beams in some major radiotherapy centers in Egypt. The phantom weighted only 140.7 g with two buildup covers weighted 14.8 and 43.19 g for the Cobalt-60 and the 6-MV X-ray beams, respectively. This phantom is aimed for use in the future's external audit/QA services in Egypt for the first time. TLD-700 chips are used for testing and investigating a convenient and national dosimetry QA program. Although the used methodology is comparable to previously introduced but new system; it has smaller size, less weight, and different more available material. Comparison with the previous similar designs is introduced. Theoretical calculations were done by the commercial Eclipse treatment planning system, implementing the pencil beam convolution algorithm to verify the accuracy of the experimental calculation of the dose conversion factor of water to the perspex phantom. The new constructed small phantom and methodology was applied in 10 participating radiotherapy centers. The absorbed dose was verified under the reference conditions for both 60Co and 6-MV high-energy photon beams. The checked beams were within the 5% limit except for four photon beams. There was an agreement of 0.2% between our experimental data and those previously published confirming the validity of the applied method in verifying radiotherapy absorbed dose.

WE-G-BRA-05: IROC Houston On-Site Audits and Parameters That Affect Performance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kry, S; Dromgoole, L; Alvarez, P

Purpose: To highlight the IROC Houston on-site dosimetry audit program, and to investigate the impact of clinical conditions on the frequency of errors/recommendations noted by IROC Houston. Methods: The results of IROC Houston on-site audits from 2000-present were abstracted and compared to clinical parameters, this included 409 institutions and 1020 linacs. In particular, we investigated the frequency of recommendations versus year, and the impact of repeat visits on the number of recommendations. We also investigated the impact on the number of recommendations of several clinical parameters: the number and age of the linacs, the linac/TPS combination, and the scope ofmore » the QA program. Results: The number of recommendations per institution (3.1 average) has shown decline between 2000 and present, although the number of recommendations per machine (0.89) has not changed. Previous IROC Houston site visits did not Result in fewer recommendations on a repeat visit, but IROC Houston tests have changed substantially during the last 15 years as radiotherapy technology has changed. There was no impact on the number of recommendations based on the number of machines at the institution or the age of a given machine. The fewest recommendations were observed for Varian-Eclipse combinations (0.71 recs/machine), while Elekta- Pinnacle combinations yielded the most (1.62 recs/machine). Finally, in the TG-142 era (post-2010), those institutions that had a QA recommendation (n=77) had significantly more other recommendations (1.83 per institution) than those that had no QA rec (n=12, 1.33 per institution). Conclusion: Establishing and maintaining a successful radiotherapy program is challenging and areas of improvement can routinely be identified. Clinical conditions such as linac-TPS combinations and the establishment of a good QA program impact the frequency of errors/deficiencies identified by IROC Houston during their on-site review process.« less

Patient-specific quality assurance for the delivery of (60)Co intensity modulated radiation therapy subject to a 0.35-T lateral magnetic field.

PubMed

Li, H Harold; Rodriguez, Vivian L; Green, Olga L; Hu, Yanle; Kashani, Rojano; Wooten, H Omar; Yang, Deshan; Mutic, Sasa

2015-01-01

This work describes a patient-specific dosimetry quality assurance (QA) program for intensity modulated radiation therapy (IMRT) using ViewRay, the first commercial magnetic resonance imaging-guided RT device. The program consisted of: (1) a 1-dimensional multipoint ionization chamber measurement using a customized 15-cm(3) cube-shaped phantom; (2) 2-dimensional (2D) radiographic film measurement using a 30- × 30- × 20-cm(3) phantom with multiple inserted ionization chambers; (3) quasi-3D diode array (ArcCHECK) measurement with a centrally inserted ionization chamber; (4) 2D fluence verification using machine delivery log files; and (5) 3D Monte Carlo (MC) dose reconstruction with machine delivery files and phantom CT. Ionization chamber measurements agreed well with treatment planning system (TPS)-computed doses in all phantom geometries where the mean ± SD difference was 0.0% ± 1.3% (n=102; range, -3.0%-2.9%). Film measurements also showed excellent agreement with the TPS-computed 2D dose distributions where the mean passing rate using 3% relative/3 mm gamma criteria was 94.6% ± 3.4% (n=30; range, 87.4%-100%). For ArcCHECK measurements, the mean ± SD passing rate using 3% relative/3 mm gamma criteria was 98.9% ± 1.1% (n=34; range, 95.8%-100%). 2D fluence maps with a resolution of 1 × 1 mm(2) showed 100% passing rates for all plan deliveries (n=34). The MC reconstructed doses to the phantom agreed well with planned 3D doses where the mean passing rate using 3% absolute/3 mm gamma criteria was 99.0% ± 1.0% (n=18; range, 97.0%-100%), demonstrating the feasibility of evaluating the QA results in the patient geometry. We developed a dosimetry program for ViewRay's patient-specific IMRT QA. The methodology will be useful for other ViewRay users. The QA results presented here can assist the RT community to establish appropriate tolerance and action limits for ViewRay's IMRT QA. Copyright © 2015 Elsevier Inc. All rights reserved.

TU-B-19A-01: Image Registration II: TG132-Quality Assurance for Image Registration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brock, K; Mutic, S

2014-06-15

AAPM Task Group 132 was charged with a review of the current approaches and solutions for image registration in radiotherapy and to provide recommendations for quality assurance and quality control of these clinical processes. As the results of image registration are always used as the input of another process for planning or delivery, it is important for the user to understand and document the uncertainty associate with the algorithm in general and the Result of a specific registration. The recommendations of this task group, which at the time of abstract submission are currently being reviewed by the AAPM, include themore » following components. The user should understand the basic image registration techniques and methods of visualizing image fusion. The disclosure of basic components of the image registration by commercial vendors is critical in this respect. The physicists should perform end-to-end tests of imaging, registration, and planning/treatment systems if image registration is performed on a stand-alone system. A comprehensive commissioning process should be performed and documented by the physicist prior to clinical use of the system. As documentation is important to the safe implementation of this process, a request and report system should be integrated into the clinical workflow. Finally, a patient specific QA practice should be established for efficient evaluation of image registration results. The implementation of these recommendations will be described and illustrated during this educational session. Learning Objectives: Highlight the importance of understanding the image registration techniques used in their clinic. Describe the end-to-end tests needed for stand-alone registration systems. Illustrate a comprehensive commissioning program using both phantom data and clinical images. Describe a request and report system to ensure communication and documentation. Demonstrate an clinically-efficient patient QA practice for efficient evaluation of image registration.« less

LOVE CANAL MONITORING PROGRAM. GCA QA/QC (QUALITY ASSURANCE/QUALITY CONTROL) SUMMARY REPORT

EPA Science Inventory

One of the most important responsibilities of the Love Canal prime contractor was the institution and maintenance of a quality assurance program. An important objective of the quality assurance program was to alert the subcontractors to the importance of high quality work on thei...

United3D: a protein model quality assessment program that uses two consensus based methods.

PubMed

Terashi, Genki; Oosawa, Makoto; Nakamura, Yuuki; Kanou, Kazuhiko; Takeda-Shitaka, Mayuko

2012-01-01

In protein structure prediction, such as template-based modeling and free modeling (ab initio modeling), the step that assesses the quality of protein models is very important. We have developed a model quality assessment (QA) program United3D that uses an optimized clustering method and a simple Cα atom contact-based potential. United3D automatically estimates the quality scores (Qscore) of predicted protein models that are highly correlated with the actual quality (GDT_TS). The performance of United3D was tested in the ninth Critical Assessment of protein Structure Prediction (CASP9) experiment. In CASP9, United3D showed the lowest average loss of GDT_TS (5.3) among the QA methods participated in CASP9. This result indicates that the performance of United3D to identify the high quality models from the models predicted by CASP9 servers on 116 targets was best among the QA methods that were tested in CASP9. United3D also produced high average Pearson correlation coefficients (0.93) and acceptable Kendall rank correlation coefficients (0.68) between the Qscore and GDT_TS. This performance was competitive with the other top ranked QA methods that were tested in CASP9. These results indicate that United3D is a useful tool for selecting high quality models from many candidate model structures provided by various modeling methods. United3D will improve the accuracy of protein structure prediction.

Use of Radio Frequency Identification (RFID) for Tracking Hazardous Waste Shipments Across International Borders -Test/QA Plan

EPA Science Inventory

The Environmental Technology Verification (ETV) – Environmental and Sustainable Technology Evaluations (ESTE) Program conducts third-party verification testing of commercially available technologies that may accomplish environmental program management goals. In this verification...

Development and implementation of EPID-based quality assurance tests for the small animal radiation research platform (SARRP).

PubMed

Anvari, Akbar; Poirier, Yannick; Sawant, Amit

2018-04-28

Although small animal image-guided radiotherapy (SA-IGRT) systems are used increasingly in preclinical research, tools for performing routine quality assurance (QA) have not been optimized and are not readily available. Robust, efficient, and reliable QA tools are needed to ensure the accuracy and reproducibility of SA-IGRT systems. Several investigators have reported custom-made phantoms and protocols for SA-IGRT systems QA. These are typically time and resource intensive and are therefore not well suited to the preclinical radiotherapy environment, in which physics support is limited and routine QA is performed by technical staff. We investigated the use of the inbuilt electronic portal imaging device (EPID) to develop and validate routine QA tests and procedures. In this work, we focus on the Xstrahl Small Animal Radiation Research Platform (SARRP) EPID. However, the methodology and tests developed here are applicable to any SA-IGRT system that incorporates an EPID. We performed a comprehensive characterization of the dosimetric properties of the camera-based EPID at kilovoltage energies over a 11-month period, including detector warm-up time, radiation dose history effect, stability and short- and long-term reproducibility, gantry angle dependency, output factor, and linearity of the EPID response. We developed a test to measure the constancy of beam quality in terms of half-value layer and tube peak potential using the EPID. We verified the SARRP daily output and beam profile constancy using the imager. We investigated the use of the imager to monitor beam-targeting accuracy at various gantry and couch angles. The EPID response was stable and reproducible, exhibiting maximum variations of ≤0.3% and ≤1.9% for short and long terms, respectively. The detector showed no dependence on response at different gantry angles, with a maximum variation ≤0.5%. We found close agreement in output factor measurement between the portal imager and reference dosimeters, with maximum differences ≤3% for ionization chamber and ≤1.7% for Gafchromic EBT3 dosimetry film, respectively. We have shown that the EPID response is linear with tube current (mA) for the entire range of tube kilovoltage peak. Notably, a close relationship was seen between the detector response vs mA slope, and the kilovoltage peak, allowing an independent verification of kilovoltage peak stability based solely on EPID response. In addition to dosimetry tests, according to the beam-targeting measurement using portal images, maximum displacement of the central axis of the x-ray beam (due to sag) was 0.76 ± 0.09 mm at gantry 135°/couch 0° and 0.89 ± 0.06 mm at gantry 0°/couch -135°. We performed the first comprehensive analysis on the dosimetric properties of an EPID operating at kilovoltage x-ray energies. We characterized the detector performance over a 11-month period. Our results indicate that the imager is a stable and convenient tool for SARRP routine QA tests. We then developed EPID-based tests to perform routine SA-IGRT systems QA tasks, such as verifying constancy of beam quality, energy, output, and profile measurements, relative output factors, and beam targeting. © 2018 American Association of Physicists in Medicine.

SU-F-T-287: A Preliminary Study On Patient Specific VMAT Verification Using a Phosphor-Screen Based Geometric QA System (Raven QA)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, M; Yi, B; Wong, J

Purpose: The RavenQA system (LAP Laser, Germany) is a QA device with a phosphor screen detector for performing the QA tasks of TG-142. This study tested if it is feasible to use the system for the patient specific QA of the Volumetric Modulated Arc Therapy (VMAT). Methods: Water equivalent material (5cm) is attached to the front of the detector plate of the RavenQA for dosimetry purpose. Then the plate is attached to the gantry to synchronize the movement between the detector and the gantry. Since the detector moves together with gantry, The ’Reset gantry to 0’ function of the Eclipsemore » planning system (Varian, CA) is used to simulate the measurement situation when calculating dose of the detector plate. The same gantry setup is used when delivering the treatment beam for feasibility test purposes. Cumulative dose is acquired for each arc. The optical scatter component of each captured image from the CCD camera is corrected by deconvolving the 2D spatial invariant optical scatter kernel (OSK). We assume that the OSK is a 2D isotropic point spread function with inverse-squared decrease as a function of radius from the center. Results: Three cases of VMAT plans including head & neck, whole pelvis and abdomen-pelvis are tested. Setup time for measurements was less than 5 minutes. Passing rates of absolute gamma were 99.3, 98.2, 95.9 respectively for 3%/3mm criteria and 96.2, 97.1, 86.4 for 2%/2mm criteria. The abdomen-pelvis field has long treatment fields, 37cm, which are longer than the detector plate (25cm). This plan showed relatively lower passing rate than other plans. Conclusion: An algorithm for IMRT/VMAT verification using the RavenQA has been developed and tested. The model of spatially invariant OSK works well for deconvolution purpose. It is proved that the RavenQA can be used for the patient specific verification of VMAT. This work is funded in part by a Maryland Industrial Partnership Program grant to University of Maryland and to JPLC who owns the Raven technology. John Wong is a co-founder of JPLC.« less

Alchemy: A Web 2.0 Real-time Quality Assurance Platform for Human Immunodeficiency Virus, Hepatitis C Virus, and BK Virus Quantitation Assays

PubMed Central

Agosto-Arroyo, Emmanuel; Coshatt, Gina M.; Winokur, Thomas S.; Harada, Shuko; Park, Seung L.

2017-01-01

Background: The molecular diagnostics laboratory faces the challenge of improving test turnaround time (TAT). Low and consistent TATs are of great clinical and regulatory importance, especially for molecular virology tests. Laboratory information systems (LISs) contain all the data elements necessary to do accurate quality assurance (QA) reporting of TAT and other measures, but these reports are in most cases still performed manually: a time-consuming and error-prone task. The aim of this study was to develop a web-based real-time QA platform that would automate QA reporting in the molecular diagnostics laboratory at our institution, and minimize the time expended in preparing these reports. Methods: Using a standard Linux, Nginx, MariaDB, PHP stack virtual machine running atop a Dell Precision 5810, we designed and built a web-based QA platform, code-named Alchemy. Data files pulled periodically from the LIS in comma-separated value format were used to autogenerate QA reports for the human immunodeficiency virus (HIV) quantitation, hepatitis C virus (HCV) quantitation, and BK virus (BKV) quantitation. Alchemy allowed the user to select a specific timeframe to be analyzed and calculated key QA statistics in real-time, including the average TAT in days, tests falling outside the expected TAT ranges, and test result ranges. Results: Before implementing Alchemy, reporting QA for the HIV, HCV, and BKV quantitation assays took 45–60 min of personnel time per test every month. With Alchemy, that time has decreased to 15 min total per month. Alchemy allowed the user to select specific periods of time and analyzed the TAT data in-depth without the need of extensive manual calculations. Conclusions: Alchemy has significantly decreased the time and the human error associated with QA report generation in our molecular diagnostics laboratory. Other tests will be added to this web-based platform in future updates. This effort shows the utility of informatician-supervised resident/fellow programming projects as learning opportunities and workflow improvements in the molecular laboratory. PMID:28480121

EPA Region 3 Quality Management Plans

EPA Pesticide Factsheets

Has links to resources that describe the Region's Quality Assurance Program, which is a collection of the Region's ongoing quality assurance (QA) policies, procedures, responsibilities and management systems.

Physical and biological pretreatment quality assurance of the head and neck cancer plan with the volumetric modulated arc therapy

NASA Astrophysics Data System (ADS)

Park, So-Hyun; Lee, Dong-Soo; Lee, Yun-Hee; Lee, Seu-Ran; Kim, Min-Ju; Suh, Tae-Suk

2015-09-01

The aim of this work is to demonstrate both the physical and the biological quality assurance (QA) aspects as pretreatment QA of the head and neck (H&N) cancer plan for the volumetric modulated arc therapy (VMAT). Ten H&N plans were studied. The COMPASS® dosimetry analysis system and the tumor control probability (TCP) and the normal tissue complication probability (NTCP) calculation free program were used as the respective measurement and calculation tools. The reliability of these tools was verified by a benchmark study in accordance with the TG-166 report. For the physical component of QA, the gamma passing rates and the false negative cases between the calculated and the measured data were evaluated. The biological component of QA was performed based on the equivalent uniform dose (EUD), TCP and NTCP values. The evaluation was performed for the planning target volumes (PTVs) and the organs at risks (OARs), including the eyes, the lens, the parotid glands, the esophagus, the spinal cord, and the brainstem. All cases had gamma passing rates above 95% at an acceptance tolerance level with the 3%/3 mm criteria. In addition, the false negative instances were presented for the PTVs and OARs. The gamma passing rates exhibited a weak correlation with false negative cases. For the biological QA, the physical dose errors affect the EUD and the TCP for the PTVs, but no linear correlation existed between them. The EUD and NTCP for the OARs were shown the random differences that could not be attributed to the dose errors from the physical QA. The differences in the EUD and NTCP between the calculated and the measured results were mainly demonstrated for the parotid glands. This study describes the importance and the necessity of improved QA to accompany both the physical and the biological aspects for accurate radiation treatment.

Quality assurance in materials and construction

DOT National Transportation Integrated Search

2007-06-01

This review is a product of the FHWA 2006, National Review Program (NRP). Quality Assurance (QA) was selected for review in 2006 because the program was ranked as one of the top five areas of interest for review by FHWA. Over the last 10 years an ave...

QA procedures needed for advanced RT techniques and its impact on treatment outcome

NASA Astrophysics Data System (ADS)

Knöös, T.

2015-01-01

The radiotherapy process is reviewed briefly and potential risks or pitfalls are identified. The focus is on modern advanced modalities in radiation therapy such as IMRT, VMAT, gating and tracking and also for the unknown to come. Existing methods, or quality controls (QC), or with better word barriers, are introduced at important steps of process with the purpose of prohibiting errors to continue through the process and thus avoiding an unwanted erroneous irradiation of the patient. The soft branch of quality assurance (QA) such as peer-review is also a major component of today's process and its safety. The importance of knowing your QCs is pointed out. The role of dosimetry method i.e. 3D-dosimetry is reviewed. Staff have to be working with awareness and alertness that can reduce most of the risks. Having comprehensive protocols known by all involved together with well-trained staff at the department with dedicated functions and responsibilities will further reduce the risk for unintended irradiations of patient. Having a well-designed QA system with the appropriate barriers have the possibility of producing high quality radiotherapy, which will also result in better outcome for the patients. The international head and neck trial illustrates very well the importance of accurate radiotherapy.

Announcement—guidance document for acquiring reliable data in ecological restoration projects

USGS Publications Warehouse

Stapanian, Martin A.; Rodriguez, Karen; Lewis, Timothy E.; Blume, Louis; Palmer, Craig J.; Walters, Lynn; Schofield, Judith; Amos, Molly M.; Bucher, Adam

2016-01-01

The Laurentian Great Lakes are undergoing intensive ecological restoration in Canada and the United States. In the United States, an interagency committee was formed to facilitate implementation of quality practices for federally funded restoration projects in the Great Lakes basin. The Committee's responsibilities include developing a guidance document that will provide a common approach to the application of quality assurance and quality control (QA/QC) practices for restoration projects. The document will serve as a “how-to” guide for ensuring data quality during each aspect of ecological restoration projects. In addition, the document will provide suggestions on linking QA/QC data with the routine project data and hints on creating detailed supporting documentation. Finally, the document will advocate integrating all components of the project, including QA/QC applications, into an overarching decision-support framework. The guidance document is expected to be released by the U.S. EPA Great Lakes National Program Office in 2017.

Quality assurance of radiotherapy in cancer treatment: toward improvement of patient safety and quality of care.

PubMed

Ishikura, Satoshi

2008-11-01

The process of radiotherapy (RT) is complex and involves understanding of the principles of medical physics, radiobiology, radiation safety, dosimetry, radiation treatment planning, simulation and interaction of radiation with other treatment modalities. Each step in the integrated process of RT needs quality control and quality assurance (QA) to prevent errors and to give high confidence that patients will receive the prescribed treatment correctly. Recent advances in RT, including intensity-modulated and image-guided RT, focus on the need for a systematic RTQA program that balances patient safety and quality with available resources. It is necessary to develop more formal error mitigation and process analysis methods, such as failure mode and effect analysis, to focus available QA resources optimally on process components. External audit programs are also effective. The International Atomic Energy Agency has operated both an on-site and off-site postal dosimetry audit to improve practice and to assure the dose from RT equipment. Several countries have adopted a similar approach for national clinical auditing. In addition, clinical trial QA has a significant role in enhancing the quality of care. The Advanced Technology Consortium has pioneered the development of an infrastructure and QA method for advanced technology clinical trials, including credentialing and individual case review. These activities have an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution, and have been adopted globally; by the USA, Europe and Japan also.

Thermochemical Stability Study of Alkyl-Tethered Quaternary Ammonium Cations for Anion Exchange Membrane Fuel Cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mohanty, Angela D.; Tignor, Steven E.; Sturgeon, Matthew R.

2017-01-01

The increased interest in the use of anion exchange membranes (AEMs) for applications in electrochemical devices has prompted significant efforts in designing materials with robust stability in alkaline media. Most reported AEMs suffer from polymer backbone degradation as well as cation functional group degradation. In this report, we provide comprehensive experimental investigations for the analysis of cation functional group stability under alkaline media. A silver oxide-mediated ion exchange method and an accelerated stability test in aqueous KOH solutions at elevated temperatures using a Parr reactor were used to evaluate a broad scope of quaternary ammonium (QA) cationic model compound structures,more » particularly focusing on alkyl-tethered cations. Additionally, byproduct analysis was employed to gain better understanding of degradation pathways and trends of alkaline stability. Experimental results under different conditions gave consistent trends in the order of cation stability of various QA small molecule model compounds. Overall, cations that are benzyl-substituted or that are near to electronegative atoms (such as oxygen) degrade faster in alkaline media in comparison to alkyl-tethered QAs. These comprehensive model compound stability studies provide valuable information regarding the relative stability of various cation structures and can help guide researchers towards designing new and promising candidates for AEM materials.« less

Quality assurance program for isotopic power systems

NASA Astrophysics Data System (ADS)

Hannigan, R. L.; Harnar, R. R.

1982-12-01

The Sandia National Laboratories Quality Assurance Program that applies to non-weapon (reimbursable) Radioisotopic Thermoelectric Generators is summarized. The program was implemented over the past 16 years on power supplies used in various space and terrestrial systems. The quality assurance (QA) activity of the program is in support of the Department of Energy, Office of Space Nuclear Projects. Basic elements of the program are described and examples of program documentation are presented.

A new Tla region antigen Qa-11, similar to Qa-2 and associated with B-type beta 2-microglobulin.

PubMed

van de Meugheuvel, W; van Seventer, G; Demant, P

1985-04-01

A new antigen, Qa-11, is detected as a 40,000 dalton band in the SDS-PAGE of immunoprecipitates of radiolabeled lymphocyte membrane preparations. In C57BL H-2 congenic strains, its presence is controlled by a gene in the Tla region. In strains with genetic background other than C57BL it is not expressed. Tests with recombinant inbred strains and with H-3 congenic strains show that, in addition to the Tla region, a gene linked to or identical with the beta 2-microglobulin-b-allele is required for the expression of Qa-11 as well. The mobility of the Qa-11 antigen in SDS-PAGE and in isoelectrofocusing is the same as that of Qa-2 antigen. The Cleveland peptide maps of Qa-2 and Qa-11 are identical as well. This finding, that the Tla region controlled Qa-11 antigen is structurally very similar to the Qa-2 antigen, contrasts with the fact that Tla region products do not react with anti-Qa-2 sera. This paradox could be explained by a separate Qa-11 region between Qa-2 and Tla. Alternatively, it is possible that the Qa-11 antigen is the result of the action of a modifying gene in the Tla region upon a Qa-2 gene product, or that the structural gene for Qa-11 is located in the Qa-2 region and a Tla region gene controls its expression.

Evaluation of the new respiratory gating system

PubMed Central

Shi, Chengyu; Tang, Xiaoli; Chan, Maria

2018-01-01

Objective The newly released Respiratory Gating for Scanners (RGSC; Varian Medical Systems, Palo Alto, CA, USA) system has limited existing quality assurance (QA) protocols and pertinent publications. Herein, we report our experiences of the RGSC system acceptance and QA. Methods The RGSC system integration was tested with peripheral equipment, spatial reproducibility, and dynamic localization accuracy for regular and irregular breathing patterns, respectively. A QUASAR Respiratory Motion Phantom and a mathematical fitting method were used for data acquisition and analysis. Results The results showed that the RGSC system could accurately measure regular motion periods of 3–10 s. For irregular breathing patterns, differences from the existing Real-time Position Management (RPM; Varian Medical Systems, Palo Alto, CA) system were observed. For dynamic localization measurements, the RGSC system showed 76% agreement with the programmed test data within ±5% tolerance in terms of fitting period. As s comparison, the RPM system showed 66% agreement within ±5% tolerance, and 65% for the RGSC versus RPM measurements. Conclusions New functions and positioning accuracy improve the RGSC system’s ability to achieve higher dynamic treatment precision. A 4D phantom is helpful for the QA tests. Further investigation is required for the whole RGSC system performance QA. PMID:29722356

Study of quality assurance regulations for linear accelerators in Korea: A comparison study between the current status in Korea and the international guidelines

NASA Astrophysics Data System (ADS)

Lee, Hyunho; Jeong, Seonghoon; Jo, Yunhui; Yoon, Myonggeun

2015-07-01

Quality assurance (QA) for medical linear accelerators is indispensable for appropriate cancer treatment. Some international organizations and advanced Western countries have provided QA guidelines for linear accelerators. Currently, QA regulations for linear accelerators in Korean hospitals specify a system in which each hospital stipulates its independent hospital-based protocols for QA procedures (HP_QAPs) and conducts QA based on those HP_QAPs while regulatory authorities verify whether items under those HP_QAPs have been performed. However, because this regulatory method cannot guarantee the quality of universal treatment and QA items with tolerance criteria are different in many hospitals, the presentation of standardized QA items and tolerance criteria is essential. In this study, QA items in HP_QAPs from various hospitals and those presented by international organizations, such as the International Atomic Energy Agency, the European Union, and the American Association of Physicist in Medicine, and by advanced Western countries, such as the USA, the UK, and Canada, were compared. Concordance rates between QA items for linear accelerators that were presented by the aforementioned organizations and those currently being implemented in Korean hospitals were shown to exhibit a daily QA of 50%, a weekly QA of 22%, a monthly QA of 43%, and an annual QA of 65%, and the overall concordance rates of all QA items were approximately 48%. In the comparison between QA items being implemented in Korean hospitals and those being implemented in advanced Western countries, concordance rates were shown to exhibit a daily QA of 50%, a weekly QA of 33%, a monthly QA of 60%, and an annual QA of 67%, and the overall concordance rates of all QA items were approximately 57%. The results of this study indicate that the HP_QAPs currently implemented by Korean hospitals as QA standards for linear accelerators used in radiation therapy do not meet international standards. If this problem is to be solved, national standardized QA items and procedures for linear accelerators need to be developed.

LONG-STANDING PE PROGRAM AT HERL->NHEERL-NC: BENEFITS & PITFALLS

EPA Science Inventory

The instrument performance evaluation (PE) program now in place at the health divisions of the National Health and Environmental Effects Research Laboratory originated with the predecessor Health Effects Research Laboratory a few years prior to the initial 1979 QA mandate by Admi...

SU-G-BRB-02: An Open-Source Software Analysis Library for Linear Accelerator Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kerns, J; Yaldo, D

Purpose: Routine linac quality assurance (QA) tests have become complex enough to require automation of most test analyses. A new data analysis software library was built that allows physicists to automate routine linear accelerator quality assurance tests. The package is open source, code tested, and benchmarked. Methods: Images and data were generated on a TrueBeam linac for the following routine QA tests: VMAT, starshot, CBCT, machine logs, Winston Lutz, and picket fence. The analysis library was built using the general programming language Python. Each test was analyzed with the library algorithms and compared to manual measurements taken at the timemore » of acquisition. Results: VMAT QA results agreed within 0.1% between the library and manual measurements. Machine logs (dynalogs & trajectory logs) were successfully parsed; mechanical axis positions were verified for accuracy and MLC fluence agreed well with EPID measurements. CBCT QA measurements were within 10 HU and 0.2mm where applicable. Winston Lutz isocenter size measurements were within 0.2mm of TrueBeam’s Machine Performance Check. Starshot analysis was within 0.2mm of the Winston Lutz results for the same conditions. Picket fence images with and without a known error showed that the library was capable of detecting MLC offsets within 0.02mm. Conclusion: A new routine QA software library has been benchmarked and is available for use by the community. The library is open-source and extensible for use in larger systems.« less

Patient-specific quality assurance for the delivery of 60Co intensity modulated radiation therapy subject to a 0.35 T lateral magnetic field

PubMed Central

Li, H. Harold; Rodriguez, Vivian L.; Green, Olga L.; Hu, Yanle; Kashani, Rojano; Wooten, H. Omar; Yang, Deshan; Mutic, Sasa

2014-01-01

Purpose This work describes a patient-specific dosimetry quality assurance (QA) program for intensity modulated radiation therapy (IMRT) using ViewRay, the first commercial magnetic resonance imaging guided radiation therapy device. Methods and materials The program consisted of the following components: 1) one-dimensional multipoint ionization chamber measurement using a customized 15 cm3 cubic phantom, 2) two-dimensional (2D) radiographic film measurement using a 30×30×20 cm3 phantom with multiple inserted ionization chambers, 3) quasi- three-dimensional (3D) diode array (ArcCHECK) measurement with a centrally inserted ionization chamber, 4) 2D fluence verification using machine delivery log files, and 5) 3D Monte-Carlo (MC) dose reconstruction with machine delivery files and phantom CT. Results The ionization chamber measurements agreed well with treatment planning system (TPS) computed doses in all phantom geometries where the mean difference (mean ± SD) was 0.0% ± 1.3% (n=102, range, −3.0 % to 2.9%). The film measurements also showed excellent agreement with the TPS computed 2D dose distributions where the mean passing rate using 3% relative/3 mm gamma criteria was 94.6% ± 3.4% (n=30, range, 87.4% to 100%). For ArcCHECK measurements, the mean passing rate using 3% relative/3 mm gamma criteria was 98.9% ± 1.1% (n=34, range, 95.8% to 100%). 2D fluence maps with a resolution of 1×1 mm2 showed 100% passing rates for all plan deliveries (n=34). The MC reconstructed doses to the phantom agreed well with planned 3D doses where the mean passing rate using 3% absolute/3 mm gamma criteria was 99.0% ± 1.0% (n=18, range, 97.0% to100%), demonstrating the feasibility of evaluating the QA results in the patient geometry. Conclusions We have developed a dosimetry program for ViewRay’s patient-specific IMRT QA. The methodology will be useful for other ViewRay users. The QA results presented here can assist the RT community to establish appropriate tolerance and action limits for ViewRay’s IMRT QA. PMID:25442343

Organization of the qa Gene Cluster in NEUROSPORA CRASSA: Direction of Transcription of the qa-3 Gene

PubMed Central

Strøman, Per; Reinert, William; Case, Mary E.; Giles, Norman H.

1979-01-01

In Neurospora crassa, the enzyme quinate (shikimate) dehydrogenase catalyzes the first reaction in the inducible quinic acid catabolic pathway and is encoded in the qa-3 gene of the qa cluster. In this cluster, the order of genes has been established as qa-1 qa-3 qa-4 qa-2. Amino-terminal sequences have been determined for purified quinate dehydrogenase from wild type and from UV-induced revertants in two different qa-3 mutants. These two mutants (M16 and M45) map at opposite ends of the qa-3 locus. In addition, mapping data (Case et al. 1978) indicate that the end of the qa-3 gene specified by M45 is closer to the adjacent qa-1 gene than is the end specified by the M16 mutant site. In one of the revertants (R45 from qa-3 mutant M45), the aminoterminal sequence for the first ten amino acids is identical to that of wild type. The other revertant (R1 from qa-3 mutant M16) differs from wild type at the amino-terminal end by a single altered residue at position three in the sequence. The observed change involves the substitution of an isoleucine in M16-R1 for a proline in wild type. This substitution requires a two-nucleotide change in the corresponding wild-type codon.——The combined genetic and biochemical data indicate that the qa-3 mutants M16 and M45 carry amino acid substitutions near the amino-terminal and carboxyl-terminal ends of the quinate dehydrogenase enzyme, respectively. On this basis we conclude that transcription of the qa-3 gene proceeds from the end specified by the M16 mutant site in the direction of the qa-1 gene. It appears probable that transcription is initiated from a promoter site within the qa cluster, possibly immediately adjacent to the qa-3 gene. PMID:159203

77 FR 61046 - The Amendment of the Designation of Al-Qa'ida in the Arabian Peninsula, aka Al-Qa'ida of Jihad...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

... DEPARTMENT OF STATE [Public Notice 8054] The Amendment of the Designation of Al-Qa'ida in the Arabian Peninsula, aka Al-Qa'ida of Jihad Organization in the Arabian Peninsula, aka Tanzim Qa'idat al-Jihad fi Jazirat al-Arab, aka Al- Qa'ida in Yemen, aka Al-Qa'ida in the South Arabian Peninsula, as a...

77 FR 61046 - The Review and Amendment of the Designation of Al-Qa'ida in the Arabian Peninsula, aka Al-Qa'ida...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

... DEPARTMENT OF STATE [Public Notice 8055] The Review and Amendment of the Designation of Al-Qa'ida in the Arabian Peninsula, aka Al-Qa'ida of Jihad Organization in the Arabian Peninsula, aka Tanzim Qa'idat al-Jihad fi Jazirat al-Arab, aka Al- Qa'ida in Yemen, aka Al-Qa'ida in the South Arabian Peninsula...

TU-C-201-03: The Use of Checklists and Audit Tools for Safety and QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prisciandaro, J.

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

Statistical process control analysis for patient-specific IMRT and VMAT QA.

PubMed

Sanghangthum, Taweap; Suriyapee, Sivalee; Srisatit, Somyot; Pawlicki, Todd

2013-05-01

This work applied statistical process control to establish the control limits of the % gamma pass of patient-specific intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) quality assurance (QA), and to evaluate the efficiency of the QA process by using the process capability index (Cpml). A total of 278 IMRT QA plans in nasopharyngeal carcinoma were measured with MapCHECK, while 159 VMAT QA plans were undertaken with ArcCHECK. Six megavolts with nine fields were used for the IMRT plan and 2.5 arcs were used to generate the VMAT plans. The gamma (3%/3 mm) criteria were used to evaluate the QA plans. The % gamma passes were plotted on a control chart. The first 50 data points were employed to calculate the control limits. The Cpml was calculated to evaluate the capability of the IMRT/VMAT QA process. The results showed higher systematic errors in IMRT QA than VMAT QA due to the more complicated setup used in IMRT QA. The variation of random errors was also larger in IMRT QA than VMAT QA because the VMAT plan has more continuity of dose distribution. The average % gamma pass was 93.7% ± 3.7% for IMRT and 96.7% ± 2.2% for VMAT. The Cpml value of IMRT QA was 1.60 and VMAT QA was 1.99, which implied that the VMAT QA process was more accurate than the IMRT QA process. Our lower control limit for % gamma pass of IMRT is 85.0%, while the limit for VMAT is 90%. Both the IMRT and VMAT QA processes are good quality because Cpml values are higher than 1.0.

SU-E-I-20: Comprehensive Quality Assurance Test of Second Generation Toshiba Aquilion Large Bore CT Simulator Based On AAPM TG-66 Recommendations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, D

2015-06-15

Purpose: AAPM radiation therapy committee task group No. 66 (TG-66) published a report which described a general approach to CT simulator QA. The report outlines the testing procedures and specifications for the evaluation of patient dose, radiation safety, electromechanical components, and image quality for a CT simulator. The purpose of this study is to thoroughly evaluate the performance of a second generation Toshiba Aquilion Large Bore CT simulator with 90 cm bore size (Toshiba, Nasu, JP) based on the TG-66 criteria. The testing procedures and results from this study provide baselines for a routine QA program. Methods: Different measurements andmore » analysis were performed including CTDIvol measurements, alignment and orientation of gantry lasers, orientation of the tabletop with respect to the imaging plane, table movement and indexing accuracy, Scanogram location accuracy, high contrast spatial resolution, low contrast resolution, field uniformity, CT number accuracy, mA linearity and mA reproducibility using a number of different phantoms and measuring devices, such as CTDI phantom, ACR image quality phantom, TG-66 laser QA phantom, pencil ion chamber (Fluke Victoreen) and electrometer (RTI Solidose 400). Results: The CTDI measurements were within 20% of the console displayed values. The alignment and orientation for both gantry laser and tabletop, as well as the table movement and indexing and scanogram location accuracy were within 2mm as specified in TG66. The spatial resolution, low contrast resolution, field uniformity and CT number accuracy were all within ACR’s recommended limits. The mA linearity and reproducibility were both well below the TG66 threshold. Conclusion: The 90 cm bore size second generation Toshiba Aquilion Large Bore CT simulator that comes with 70 cm true FOV can consistently meet various clinical needs. The results demonstrated that this simulator complies with the TG-66 protocol in all aspects including electromechanical component, radiation safety component, and image quality component. Employee of Toshiba America Medical Systems.« less

A Randomised, Double-Blind, Controlled Efficacy Trial of the LiESP/QA-21 Vaccine in Naïve Dogs Exposed to Two Leishmania infantum Transmission Seasons

PubMed Central

Oliva, Gaetano; Nieto, Javier; Foglia Manzillo, Valentina; Cappiello, Silvia; Fiorentino, Eleonora; Di Muccio, Trentina; Scalone, Aldo; Moreno, Javier; Chicharro, Carmen; Carrillo, Eugenia; Butaud, Therese; Guegand, Laurie; Martin, Virginie; Cuisinier, Anne-Marie; McGahie, David; Gueguen, Sylvie; Cañavate, Carmen; Gradoni, Luigi

2014-01-01

Canine leishmaniasis is an important zoonosis caused by uncontrolled infection with Leishmania infantum, where an inappropriate immune response is not only responsible for permitting this intracellular parasite to multiply, but is also responsible for several of the pathological processes seen in this disease. Effective canine vaccines are therefore a highly desirable prevention tool. In this randomised, double-blinded, controlled trial, the efficacy of the LiESP/QA-21 vaccine (CaniLeish, Virbac, France) was assessed by exposing 90 naïve dogs to natural L. infantum infection during 2 consecutive transmission seasons, in two highly endemic areas of the Mediterranean basin. Regular PCR, culture, serological and clinical examinations were performed, and the infection/disease status of the dogs was classified at each examination. The vaccine was well-tolerated, and provided a significant reduction in the risk of progressing to uncontrolled active infection (p = 0.025) or symptomatic disease (p = 0.046), with an efficacy of 68.4% and a protection rate of 92.7%. The probability of becoming PCR positive was similar between groups, but the probability of returning to a PCR negative condition was higher in the vaccinated group (p = 0.04). In conclusion, we confirmed the interest of using this vaccine as part of a comprehensive control program for canine leishmaniasis, and validated the use of a protocol based on regular in-depth assessments over time to assess the efficacy of a canine leishmaniasis vaccine. PMID:25299614

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PERFORMANCE OF COMPUTER SOFTWARE: VERIFICATION AND VALIDATION (UA-D-2.0)

EPA Science Inventory

The purpose of this SOP is to define the procedures used for the initial and periodic verification and validation of computer programs used during the Arizona NHEXAS project and the Border study. Keywords: Computers; Software; QA/QC.

The U.S.-Mexico Border Program is sponsored ...

Forest Inventory and Analysis National Data Quality Assessment Report for 2000 to 2003

Treesearch

James E. Pollard; James A. Westfall; Paul L. Patterson; David L. Gartner; Mark Hansen; Olaf Kuegler

2006-01-01

The Forest Inventory and Analysis program (FIA) is the key USDA Forest Service (USFS) program that provides the information needed to assess the status and trends in the environmental quality of the Nation's forests. The goal of the FIA Quality Assurance (QA) program is to provide a framework to assure the production of complete, accurate and unbiased forest...

References on EPA Quality Assurance Project Plans

EPA Pesticide Factsheets

Provides requirements for the conduct of quality management practices, including quality assurance (QA) and quality control (QC) activities, for all environmental data collection and environmental technology programs performed by or for this Agency.

Nondestructive Testing of Additive Manufactured Metal Parts Used in Aerospace Applications

NASA Technical Reports Server (NTRS)

Waller, Jess M.

2018-01-01

NDE inspectors, QA/QE professionals, and program managers responsible for the out-sourcing, procurement, fabrication, finishing, inspection, and qualification and certification of additively manufactured (AM) parts should attend this course.

Quality Assurance Through Quality Improvement and Professional Development in the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Siegl, Elvira J.; Miller, Jacqueline W.; Khan, Kris; Harris, Susan E.

2015-01-01

Quality assurance (QA) is the process of providing evidence that the outcome meets the established standards. Quality improvement (QI), by contrast, is the act of methodically developing ways to meet acceptable quality standards and evaluating current processes to improve overall performance. In the case of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the desired outcome is the delivery of quality health care services to program clients. The NBCCEDP provides professional development to ensure that participating providers have current knowledge of evidence-based clinical standards regarding breast and cervical cancer screening and diagnosis and are monitoring women with abnormal screening results for timely follow-up. To assess the quality of clinical care provided to NBCCEDP clients, performance data are collected by NBCCEDP grantees and compared against predetermined Centers for Disease Control and Prevention (CDC) benchmarks known as Data Quality Indicator Guides. In this article, the authors describe 1) the development and use of indicators for QI in the NBCCEDP and 2) the professional development activities implemented to improve clinical outcomes. QA identifies problems, whereas QI systematically corrects them. The quality of service delivery and improved patient outcomes among NBCCEDP grantees has enhanced significantly because of continuous monitoring of performance and professional development. By using QA, NBCCEDP grantees can maximize the quality of patient screening, diagnostic services, and follow-up. Examples of grantee activities to maintain quality of care are also described in this report. PMID:25099901

The FAA's postmortem forensic toxicology self-evaluated proficiency test program: the second seven years.

PubMed

Chaturvedi, Arvind K; Craft, Kristi J; Cardona, Patrick S; Rogers, Paul B; Canfield, Dennis V

2009-05-01

During toxicological evaluations of samples from fatally injured pilots involved in civil aviation accidents, a high degree of quality control/quality assurance (QC/QA) is maintained. Under this philosophy, the Federal Aviation Administration (FAA) started a forensic toxicology proficiency-testing (PT) program in July 1991. In continuation of the first seven years of the PT findings reported earlier, PT findings of the next seven years are summarized herein. Twenty-eight survey samples (12 urine, 9 blood, and 7 tissue homogenate) with/without alcohols/volatiles, drugs, and/or putrefactive amine(s) were submitted to an average of 31 laboratories, of which an average of 25 participants returned their results. Analytes in survey samples were correctly identified and quantitated by a large number of participants, but some false positives of concern were reported. It is anticipated that the FAA's PT program will continue to serve the forensic toxicology community through this important part of the QC/QA for laboratory accreditations.

GIS FOR QA PROFESSIONALS

EPA Science Inventory

GIS scientists and QA Professionals have combined their efforts to create this one day course that provides the QA community with a basic understanding of Geographic Information Systems (GIS). The course emphasizes the QA Aspects of GIS so that the QA Professional is better prep...

Microbiological water methods: quality control measures for Federal Clean Water Act and Safe Drinking Water Act regulatory compliance.

PubMed

Root, Patsy; Hunt, Margo; Fjeld, Karla; Kundrat, Laurie

2014-01-01

Quality assurance (QA) and quality control (QC) data are required in order to have confidence in the results from analytical tests and the equipment used to produce those results. Some AOAC water methods include specific QA/QC procedures, frequencies, and acceptance criteria, but these are considered to be the minimum controls needed to perform a microbiological method successfully. Some regulatory programs, such as those at Code of Federal Regulations (CFR), Title 40, Part 136.7 for chemistry methods, require additional QA/QC measures beyond those listed in the method, which can also apply to microbiological methods. Essential QA/QC measures include sterility checks, reagent specificity and sensitivity checks, assessment of each analyst's capabilities, analysis of blind check samples, and evaluation of the presence of laboratory contamination and instrument calibration and checks. The details of these procedures, their performance frequency, and expected results are set out in this report as they apply to microbiological methods. The specific regulatory requirements of CFR Title 40 Part 136.7 for the Clean Water Act, the laboratory certification requirements of CFR Title 40 Part 141 for the Safe Drinking Water Act, and the International Organization for Standardization 17025 accreditation requirements under The NELAC Institute are also discussed.

The importance of quality control in validating concentrations ...

EPA Pesticide Factsheets

A national-scale survey of 247 contaminants of emerging concern (CECs), including organic and inorganic chemical compounds, and microbial contaminants, was conducted in source and treated drinking water samples from 25 treatment plants across the United States. Multiple methods were used to determine these CECs, including six analytical methods to measure 174 pharmaceuticals, personal care products, and pesticides. A three-component quality assurance/quality control (QA/QC) program was designed for the subset of 174 CECs which allowed us to assess and compare performances of the methods used. The three components included: 1) a common field QA/QC protocol and sample design, 2) individual investigator-developed method-specific QA/QC protocols, and 3) a suite of 46 method comparison analytes that were determined in two or more analytical methods. Overall method performance for the 174 organic chemical CECs was assessed by comparing spiked recoveries in reagent, source, and treated water over a two-year period. In addition to the 247 CECs reported in the larger drinking water study, another 48 pharmaceutical compounds measured did not consistently meet predetermined quality standards. Methodologies that did not seem suitable for these analytes are overviewed. The need to exclude analytes based on method performance demonstrates the importance of additional QA/QC protocols. This paper compares the method performance of six analytical methods used to measure 174 emer

Quality Assurance for Clinical Trials

PubMed Central

Ibbott, Geoffrey S.; Haworth, Annette; Followill, David S.

2013-01-01

Cooperative groups, of which the Radiation Therapy Oncology Group is one example, conduct national clinical trials that often involve the use of radiation therapy. In preparation for such a trial, the cooperative group prepares a protocol to define the goals of the trial, the rationale for its design, and the details of the treatment procedure to be followed. The Radiological Physics Center (RPC) is one of several quality assurance (QA) offices that is charged with assuring that participating institutions deliver doses that are clinically consistent and comparable. The RPC does this by conducting a variety of independent audits and credentialing processes. The RPC has compiled data showing that credentialing can help institutions comply with the requirements of a cooperative group clinical protocol. Phantom irradiations have been demonstrated to exercise an institution’s procedures for planning and delivering advanced external beam techniques (1–3). Similarly, RPC data indicate that a rapid review of patient treatment records or planning procedures can improve compliance with clinical trials (4). The experiences of the RPC are presented as examples of the contributions that a national clinical trials QA center can make to cooperative group trials. These experiences illustrate the critical need for comprehensive QA to assure that clinical trials are successful and cost-effective. The RPC is supported by grants CA 10953 and CA 81647 from the National Cancer Institute, NIH, DHHS. PMID:24392352

77 FR 73455 - Change to the Military Freight Carrier Registration Program (FCRP)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

... Deployment and Distribution Command (SDDC) is providing notice that it will, effective 1 December 2012, only...: Submit comments to Military Surface Deployment and Distribution Command, ATTN: AMSSD-SBD-QA, 1 Soldier...

A conceptual study of automatic and semi-automatic quality assurance techniques for round image processing

NASA Technical Reports Server (NTRS)

1983-01-01

This report summarizes the results of a study conducted by Engineering and Economics Research (EER), Inc. under NASA Contract Number NAS5-27513. The study involved the development of preliminary concepts for automatic and semiautomatic quality assurance (QA) techniques for ground image processing. A distinction is made between quality assessment and the more comprehensive quality assurance which includes decision making and system feedback control in response to quality assessment.

Visual Analysis of the Daily QA Results of Photon and Electron Beams of a Trilogy Linac over a Five-year Period

PubMed Central

Chan, Maria F.; Li, Qiongge; Tang, Xiaoli; Li, Xiang; Li, Jingdong; Tang, Grace; Hunt, Margie A.; Deasy, Joseph O.

2016-01-01

Data visualization technique was applied to analyze the daily QA results of photon and electron beams. Special attention was paid to any trend the beams might display. A Varian Trilogy Linac equipped with dual photon energies and five electron energies was commissioned in early 2010. Daily Linac QA tests including the output constancy, beam flatness and symmetry (radial and transverse directions) were performed with an ionization chamber array device (QA BeamChecker Plus, Standard Imaging). The data of five years were collected and analyzed. For each energy, the measured data were exported and processed for visual trending using an in-house Matlab program. These daily data were cross-correlated with the monthly QA and annual QA results, as well as the preventive maintenance records. Majority of the output were within 1% of variation, with a consistent positive/upward drift for all seven energies (~+0.25% per month). The baseline of daily device is reset annually right after the TG-51 calibration. This results in a sudden drop of the output. On the other hand, the large amount of data using the same baseline exhibits a sinusoidal behavior (cycle = 12 months; amplitude = 0.8%, 0.5% for photons, electrons, respectively) on symmetry and flatness when normalization of baselines is accounted for. The well known phenomenon of new Linac output drift was clearly displayed. This output drift was a result of the air leakage of the over-pressurized sealed monitor chambers for the specific vendor. Data visualization is a new trend in the era of big data in radiation oncology research. It allows the data to be displayed visually and therefore more intuitive. Based on the visual display from the past, the physicist might predict the trend of the Linac and take actions proactively. It also makes comparisons, alerts failures, and potentially identifies causalities. PMID:27547595

Algorithm theoretical baseline for formaldehyde retrievals from S5P TROPOMI and from the QA4ECV project

NASA Astrophysics Data System (ADS)

De Smedt, Isabelle; Theys, Nicolas; Yu, Huan; Danckaert, Thomas; Lerot, Christophe; Compernolle, Steven; Van Roozendael, Michel; Richter, Andreas; Hilboll, Andreas; Peters, Enno; Pedergnana, Mattia; Loyola, Diego; Beirle, Steffen; Wagner, Thomas; Eskes, Henk; van Geffen, Jos; Folkert Boersma, Klaas; Veefkind, Pepijn

2018-04-01

On board the Copernicus Sentinel-5 Precursor (S5P) platform, the TROPOspheric Monitoring Instrument (TROPOMI) is a double-channel, nadir-viewing grating spectrometer measuring solar back-scattered earthshine radiances in the ultraviolet, visible, near-infrared, and shortwave infrared with global daily coverage. In the ultraviolet range, its spectral resolution and radiometric performance are equivalent to those of its predecessor OMI, but its horizontal resolution at true nadir is improved by an order of magnitude. This paper introduces the formaldehyde (HCHO) tropospheric vertical column retrieval algorithm implemented in the S5P operational processor and comprehensively describes its various retrieval steps. Furthermore, algorithmic improvements developed in the framework of the EU FP7-project QA4ECV are described for future updates of the processor. Detailed error estimates are discussed in the light of Copernicus user requirements and needs for validation are highlighted. Finally, verification results based on the application of the algorithm to OMI measurements are presented, demonstrating the performances expected for TROPOMI.

Fine pitch thermosonic wire bonding: analysis of state-of-the-art manufacturing capability

NASA Astrophysics Data System (ADS)

Cavasin, Daniel

1995-09-01

A comprehensive process characterization was performed at the Motorola plastic package assembly site in Selangor, Malaysia, to document the current fine pitch wire bond process capability, using state-of-the-art equipment, in an actual manufacturing environment. Two machines, representing the latest technology from two separate manufacturers, were operated one shift per day for five days, bonding a 132 lead Plastic Quad Flat Pack. Using a test device specifically designed for fine pitch wire bonding, the bonding programs were alternated between 107 micrometers and 92 micrometers pad pitch, running each pitch for a total of 1600 units per machine. Wire, capillary type, and related materials were standardized and commercially available. A video metrology measurement system, with a demonstrated six sigma repeatability band width of 0.51 micrometers , was utilized to measure the bonded units for bond dimensions and placement. Standard Quality Assurance (QA) metrics were also performed. Results indicate that state-of-the-art thermosonic wire bonding can achieve acceptable assembly yields at these fine pad pitches.

EPA Region 9 Guidance for Quality Assurance Program Plans - R9qa/03.2

EPA Pesticide Factsheets

In order for decision makers to have confidence in the quality of environmental data used to support their decisions, the organization must have structured and documented process for quality in place.

Quality assurance of research protocols conducted in the community: the National Institute on Drug Abuse Clinical Trials Network experience.

PubMed

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-04-01

Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. : QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed.

Quality assurance of research protocols conducted in the community: The National Institute on Drug Abuse Clinical Trials Network Experience

PubMed Central

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-01-01

Background: Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. Purpose: This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. Methods: The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Results: Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. Limitations: QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. Conclusions: The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed. PMID:19342468

The on-site quality-assurance system for Hyper Suprime-Cam: OSQAH

NASA Astrophysics Data System (ADS)

Furusawa, Hisanori; Koike, Michitaro; Takata, Tadafumi; Okura, Yuki; Miyatake, Hironao; Lupton, Robert H.; Bickerton, Steven; Price, Paul A.; Bosch, James; Yasuda, Naoki; Mineo, Sogo; Yamada, Yoshihiko; Miyazaki, Satoshi; Nakata, Fumiaki; Koshida, Shintaro; Komiyama, Yutaka; Utsumi, Yousuke; Kawanomoto, Satoshi; Jeschke, Eric; Noumaru, Junichi; Schubert, Kiaina; Iwata, Ikuru; Finet, Francois; Fujiyoshi, Takuya; Tajitsu, Akito; Terai, Tsuyoshi; Lee, Chien-Hsiu

2018-01-01

We have developed an automated quick data analysis system for data quality assurance (QA) for Hyper Suprime-Cam (HSC). The system was commissioned in 2012-2014, and has been offered for general observations, including the HSC Subaru Strategic Program, since 2014 March. The system provides observers with data quality information, such as seeing, sky background level, and sky transparency, based on quick analysis as data are acquired. Quick-look images and validation of image focus are also provided through an interactive web application. The system is responsible for the automatic extraction of QA information from acquired raw data into a database, to assist with observation planning, assess progress of all observing programs, and monitor long-term efficiency variations of the instrument and telescope. Enhancements of the system are being planned to facilitate final data analysis, to improve the HSC archive, and to provide legacy products for astronomical communities.

75 FR 2920 - In the Matter of the Designation of al-Qa'ida in the Arabian Peninsula (AQAP), Also Known as al...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

... Known as Tanzim Qa'idat al-Jihad fi Jazirat al- Arab, Also Known as al-Qa'ida Organization in the... Tanzim Qa'idat al- Jihad fi Jazirat al-Arab, also known as al-Qa'ida Organization in the Arabian...

WE-AB-201-00: Treatment Planning System Commissioning and QA

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in termsmore » of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar defects in the future. Finally, the Gamma test has become a popular metric for reporting TPS Commissioning and QA results. It simplifies complex testing into a numerical index, but noisy data and casual application can make it misleading. A brief review of the issues around the use of the Gamma test will be presented. TPS commissioning and QA: A process orientation and application of control charts (Michael Sharpe) A framework for commissioning a treatment planning system will be presented, focusing on preparations, practical aspects of configuration, priorities, specifications, and establishing performance. The complexity of the modern TPS make modular testing of features inadequate, and modern QA tools can provide “too much information” about the performance of techniques like IMRT and VMAT. We have adopted a process orientation and quality tools, like control charts, for ongoing TPS QA and assessment of patient-specific tests. The trending nature of these tools reveals the overall performance of the TPS system, and quantifies the variations that arise from individual plans, discrete calculations, and experimentation based on discrete measurements. Examples demonstrating application of these tools to TPS QA will be presented. TPS commissioning and QA: Incorporating the entire planning process (Sasa Mutic) The TPS and its features do not perform in isolation. Instead, the features and modules are key components in a complex process that begins with CT Simulation and extends to treatment delivery, along with image guidance and verification. Most importantly, the TPS is used by people working in a multi-disciplinary environment. It is very difficult to predict the outcomes of human interactions with software. Therefore, an interdisciplinary approach to training, commissioning and QA will be presented, along with an approach to the physics chart check and end-to-end testing as a tool for TPS QA. The role of standardization and automation in QA will also be discussed. The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG # 5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.« less

WE-AB-201-03: TPS Commissioning and QA: Incorporating the Entire Planning Process

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mutic, S.

Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in termsmore » of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar defects in the future. Finally, the Gamma test has become a popular metric for reporting TPS Commissioning and QA results. It simplifies complex testing into a numerical index, but noisy data and casual application can make it misleading. A brief review of the issues around the use of the Gamma test will be presented. TPS commissioning and QA: A process orientation and application of control charts (Michael Sharpe) A framework for commissioning a treatment planning system will be presented, focusing on preparations, practical aspects of configuration, priorities, specifications, and establishing performance. The complexity of the modern TPS make modular testing of features inadequate, and modern QA tools can provide “too much information” about the performance of techniques like IMRT and VMAT. We have adopted a process orientation and quality tools, like control charts, for ongoing TPS QA and assessment of patient-specific tests. The trending nature of these tools reveals the overall performance of the TPS system, and quantifies the variations that arise from individual plans, discrete calculations, and experimentation based on discrete measurements. Examples demonstrating application of these tools to TPS QA will be presented. TPS commissioning and QA: Incorporating the entire planning process (Sasa Mutic) The TPS and its features do not perform in isolation. Instead, the features and modules are key components in a complex process that begins with CT Simulation and extends to treatment delivery, along with image guidance and verification. Most importantly, the TPS is used by people working in a multi-disciplinary environment. It is very difficult to predict the outcomes of human interactions with software. Therefore, an interdisciplinary approach to training, commissioning and QA will be presented, along with an approach to the physics chart check and end-to-end testing as a tool for TPS QA. The role of standardization and automation in QA will also be discussed. The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.« less

WE-AB-201-01: Treatment Planning System Commissioning and QA: Challenges and Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salomons, G.

Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in termsmore » of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar defects in the future. Finally, the Gamma test has become a popular metric for reporting TPS Commissioning and QA results. It simplifies complex testing into a numerical index, but noisy data and casual application can make it misleading. A brief review of the issues around the use of the Gamma test will be presented. TPS commissioning and QA: A process orientation and application of control charts (Michael Sharpe) A framework for commissioning a treatment planning system will be presented, focusing on preparations, practical aspects of configuration, priorities, specifications, and establishing performance. The complexity of the modern TPS make modular testing of features inadequate, and modern QA tools can provide “too much information” about the performance of techniques like IMRT and VMAT. We have adopted a process orientation and quality tools, like control charts, for ongoing TPS QA and assessment of patient-specific tests. The trending nature of these tools reveals the overall performance of the TPS system, and quantifies the variations that arise from individual plans, discrete calculations, and experimentation based on discrete measurements. Examples demonstrating application of these tools to TPS QA will be presented. TPS commissioning and QA: Incorporating the entire planning process (Sasa Mutic) The TPS and its features do not perform in isolation. Instead, the features and modules are key components in a complex process that begins with CT Simulation and extends to treatment delivery, along with image guidance and verification. Most importantly, the TPS is used by people working in a multi-disciplinary environment. It is very difficult to predict the outcomes of human interactions with software. Therefore, an interdisciplinary approach to training, commissioning and QA will be presented, along with an approach to the physics chart check and end-to-end testing as a tool for TPS QA. The role of standardization and automation in QA will also be discussed. The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.« less

WE-AB-201-02: TPS Commissioning and QA: A Process Orientation and Application of Control Charts

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sharpe, M.

Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in termsmore » of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar defects in the future. Finally, the Gamma test has become a popular metric for reporting TPS Commissioning and QA results. It simplifies complex testing into a numerical index, but noisy data and casual application can make it misleading. A brief review of the issues around the use of the Gamma test will be presented. TPS commissioning and QA: A process orientation and application of control charts (Michael Sharpe) A framework for commissioning a treatment planning system will be presented, focusing on preparations, practical aspects of configuration, priorities, specifications, and establishing performance. The complexity of the modern TPS make modular testing of features inadequate, and modern QA tools can provide “too much information” about the performance of techniques like IMRT and VMAT. We have adopted a process orientation and quality tools, like control charts, for ongoing TPS QA and assessment of patient-specific tests. The trending nature of these tools reveals the overall performance of the TPS system, and quantifies the variations that arise from individual plans, discrete calculations, and experimentation based on discrete measurements. Examples demonstrating application of these tools to TPS QA will be presented. TPS commissioning and QA: Incorporating the entire planning process (Sasa Mutic) The TPS and its features do not perform in isolation. Instead, the features and modules are key components in a complex process that begins with CT Simulation and extends to treatment delivery, along with image guidance and verification. Most importantly, the TPS is used by people working in a multi-disciplinary environment. It is very difficult to predict the outcomes of human interactions with software. Therefore, an interdisciplinary approach to training, commissioning and QA will be presented, along with an approach to the physics chart check and end-to-end testing as a tool for TPS QA. The role of standardization and automation in QA will also be discussed. The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.« less

TU-FG-201-01: 18-Month Clinical Experience of a Linac Daily Quality Assurance (QA) Solution Using Only EPID and OBI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cai, B; Sun, B; Yaddanapudi, S

Purpose: To describe the clinical use of a Linear Accelerator (Linac) DailyQA system with only EPID and OBI. To assess the reliability over an 18-month period and improve the robustness of this system based on QA failure analysis. Methods: A DailyQA solution utilizing an in-house designed phantom, combined EPID and OBI image acquisitions, and a web-based data analysis and reporting system was commissioned and used in our clinic to measure geometric, dosimetry and imaging components of a Varian Truebeam Linac. During an 18-month period (335 working days), the Daily QA results, including the output constancy, beam flatness and symmetry, uniformity,more » TPR20/10, MV and KV imaging quality, were collected and analyzed. For output constancy measurement, an independent monthly QA system with an ionization chamber (IC) and annual/incidental TG51 measurements with ADCL IC were performed and cross-compared to Daily QA system. Thorough analyses were performed on the recorded QA failures to evaluate the machine performance, optimize the data analysis algorithm, adjust the tolerance setting and improve the training procedure to prevent future failures. Results: A clinical workflow including beam delivery, data analysis, QA report generation and physics approval was established and optimized to suit daily clinical operation. The output tests over the 335 working day period cross-correlated with the monthly QA system within 1.3% and TG51 results within 1%. QA passed with one attempt on 236 days out of 335 days. Based on the QA failures analysis, the Gamma criteria is revised from (1%, 1mm) to (2%, 1mm) considering both QA accuracy and efficiency. Data analysis algorithm is improved to handle multiple entries for a repeating test. Conclusion: We described our 18-month clinical experience on a novel DailyQA system using only EPID and OBI. The long term data presented demonstrated the system is suitable and reliable for Linac daily QA.« less

Commissioning and quality assurance for VMAT delivery systems: An efficient time-resolved system using real-time EPID imaging.

PubMed

Zwan, Benjamin J; Barnes, Michael P; Hindmarsh, Jonathan; Lim, Seng B; Lovelock, Dale M; Fuangrod, Todsaporn; O'Connor, Daryl J; Keall, Paul J; Greer, Peter B

2017-08-01

An ideal commissioning and quality assurance (QA) program for Volumetric Modulated Arc Therapy (VMAT) delivery systems should assess the performance of each individual dynamic component as a function of gantry angle. Procedures within such a program should also be time-efficient, independent of the delivery system and be sensitive to all types of errors. The purpose of this work is to develop a system for automated time-resolved commissioning and QA of VMAT control systems which meets these criteria. The procedures developed within this work rely solely on images obtained, using an electronic portal imaging device (EPID) without the presence of a phantom. During the delivery of specially designed VMAT test plans, EPID frames were acquired at 9.5 Hz, using a frame grabber. The set of test plans was developed to individually assess the performance of the dose delivery and multileaf collimator (MLC) control systems under varying levels of delivery complexities. An in-house software tool was developed to automatically extract features from the EPID images and evaluate the following characteristics as a function of gantry angle: dose delivery accuracy, dose rate constancy, beam profile constancy, gantry speed constancy, dynamic MLC positioning accuracy, MLC speed and acceleration constancy, and synchronization between gantry angle, MLC positioning and dose rate. Machine log files were also acquired during each delivery and subsequently compared to information extracted from EPID image frames. The largest difference between measured and planned dose at any gantry angle was 0.8% which correlated with rapid changes in dose rate and gantry speed. For all other test plans, the dose delivered was within 0.25% of the planned dose for all gantry angles. Profile constancy was not found to vary with gantry angle for tests where gantry speed and dose rate were constant, however, for tests with varying dose rate and gantry speed, segments with lower dose rate and higher gantry speed exhibited less profile stability. MLC positional accuracy was not observed to be dependent on the degree of interdigitation. MLC speed was measured for each individual leaf and slower leaf speeds were shown to be compensated for by lower dose rates. The test procedures were found to be sensitive to 1 mm systematic MLC errors, 1 mm random MLC errors, 0.4 mm MLC gap errors and synchronization errors between the MLC, dose rate and gantry angle controls systems of 1°. In general, parameters measured by both EPID and log files agreed with the plan, however, a greater average departure from the plan was evidenced by the EPID measurements. QA test plans and analysis methods have been developed to assess the performance of each dynamic component of VMAT deliveries individually and as a function of gantry angle. This methodology relies solely on time-resolved EPID imaging without the presence of a phantom and has been shown to be sensitive to a range of delivery errors. The procedures developed in this work are both comprehensive and time-efficient and can be used for streamlined commissioning and QA of VMAT delivery systems. © 2017 American Association of Physicists in Medicine.

The Marburg-Münster Affective Disorders Cohort Study (MACS): A quality assurance protocol for MR neuroimaging data.

PubMed

Vogelbacher, Christoph; Möbius, Thomas W D; Sommer, Jens; Schuster, Verena; Dannlowski, Udo; Kircher, Tilo; Dempfle, Astrid; Jansen, Andreas; Bopp, Miriam H A

2018-05-15

Large, longitudinal, multi-center MR neuroimaging studies require comprehensive quality assurance (QA) protocols for assessing the general quality of the compiled data, indicating potential malfunctions in the scanning equipment, and evaluating inter-site differences that need to be accounted for in subsequent analyses. We describe the implementation of a QA protocol for functional magnet resonance imaging (fMRI) data based on the regular measurement of an MRI phantom and an extensive variety of currently published QA statistics. The protocol is implemented in the MACS (Marburg-Münster Affective Disorders Cohort Study, http://for2107.de/), a two-center research consortium studying the neurobiological foundations of affective disorders. Between February 2015 and October 2016, 1214 phantom measurements have been acquired using a standard fMRI protocol. Using 444 healthy control subjects which have been measured between 2014 and 2016 in the cohort, we investigate the extent of between-site differences in contrast to the dependence on subject-specific covariates (age and sex) for structural MRI, fMRI, and diffusion tensor imaging (DTI) data. We show that most of the presented QA statistics differ severely not only between the two scanners used for the cohort but also between experimental settings (e.g. hardware and software changes), demonstrate that some of these statistics depend on external variables (e.g. time of day, temperature), highlight their strong dependence on proper handling of the MRI phantom, and show how the use of a phantom holder may balance this dependence. Site effects, however, do not only exist for the phantom data, but also for human MRI data. Using T1-weighted structural images, we show that total intracranial (TIV), grey matter (GMV), and white matter (WMV) volumes significantly differ between the MR scanners, showing large effect sizes. Voxel-based morphometry (VBM) analyses show that these structural differences observed between scanners are most pronounced in the bilateral basal ganglia, thalamus, and posterior regions. Using DTI data, we also show that fractional anisotropy (FA) differs between sites in almost all regions assessed. When pooling data from multiple centers, our data show that it is a necessity to account not only for inter-site differences but also for hardware and software changes of the scanning equipment. Also, the strong dependence of the QA statistics on the reliable placement of the MRI phantom shows that the use of a phantom holder is recommended to reduce the variance of the QA statistics and thus to increase the probability of detecting potential scanner malfunctions. Copyright © 2018 Elsevier Inc. All rights reserved.

A national analytical quality assurance program: Developing guidelines and analytical tools for the forest inventory and analysis program

Treesearch

Phyllis C. Adams; Glenn A. Christensen

2012-01-01

A rigorous quality assurance (QA) process assures that the data and information provided by the Forest Inventory and Analysis (FIA) program meet the highest possible standards of precision, completeness, representativeness, comparability, and accuracy. FIA relies on its analysts to check the final data quality prior to release of a State’s data to the national FIA...

Guidance for Quality Assurance Project Plans, EPA QA/G-5

EPA Pesticide Factsheets

provides guidance to EPA employees and other organizations involved in developing Quality Assurance (QA) Project Plans that address the specifications listed in EPA Requirements for QA Project Plans (QA/R-5)

SU-C-BRD-07: The Radiological Physics Center (RPC): 45 Years of Improving Radiotherapy Dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Followill, D; Lowenstein, J; Molineu, A

Purpose: The RPC, established in 1968 has contributed to the development, conduct, and QA of NCI funded multi-institutional cooperative group clinical trials and institutions, primarily in the USA/Canada and 242 other countries, participating in trials. Methods: The RPC QA program components were designed to audit the radiation dose calculation chain from the NIST traceable reference beam calibration, to inclusion of dosimetry parameters used to calculate tumor doses, to the delivery of the radiation dose. The QA program included: 1) remote TLD/OSLD audit of machine output, 2) on-site dosimetry review visits, 3) credentialing for advanced technologies, and 4) review of patientmore » treatment records. The RPC presented and published their findings to the radiation oncology community. Results: The number of institutions monitored by the RPC increased from around 1200 in the late 90s, to ∼2000 in 2013. There were over 4000 megavoltage therapy machines and ∼28,000 therapy beams in the 1991 institutions monitored by the RPC by the end of 2013. Within the 14,000 photon, electron and proton beam outputs remotely monitored with TLD/OSLD annually, between 10-20% of the institutions have one or more beams outside the RPC 5% criterion. Dosimetry site visits to photon and proton centers continue to result in 2-4 recommendations affecting key dosimetry parameters that impact patient treatment times. One in four patient treatment records reviewed by the RPC have their dose data corrected by >5% before trial groups use them for outcomes analysis. Twelve of fourteen clinically active proton centers are approved to participate in NCI funded clinical trials. The RPC published 222 peer reviewed articles since 1972. Conclusion: Findings from the RPC suggest that human errors continue to play a role in radiotherapy discrepancies and without the RPC independent QA program, the number of undetected errors and time elapsed before their discovery would have been greater. Work supported by MGH C06 CA059267 and grants CA10953, CA081647 awarded by NCI, DHHS.« less

Catching errors with patient-specific pretreatment machine log file analysis.

PubMed

Rangaraj, Dharanipathy; Zhu, Mingyao; Yang, Deshan; Palaniswaamy, Geethpriya; Yaddanapudi, Sridhar; Wooten, Omar H; Brame, Scott; Mutic, Sasa

2013-01-01

A robust, efficient, and reliable quality assurance (QA) process is highly desired for modern external beam radiation therapy treatments. Here, we report the results of a semiautomatic, pretreatment, patient-specific QA process based on dynamic machine log file analysis clinically implemented for intensity modulated radiation therapy (IMRT) treatments delivered by high energy linear accelerators (Varian 2100/2300 EX, Trilogy, iX-D, Varian Medical Systems Inc, Palo Alto, CA). The multileaf collimator machine (MLC) log files are called Dynalog by Varian. Using an in-house developed computer program called "Dynalog QA," we automatically compare the beam delivery parameters in the log files that are generated during pretreatment point dose verification measurements, with the treatment plan to determine any discrepancies in IMRT deliveries. Fluence maps are constructed and compared between the delivered and planned beams. Since clinical introduction in June 2009, 912 machine log file analyses QA were performed by the end of 2010. Among these, 14 errors causing dosimetric deviation were detected and required further investigation and intervention. These errors were the result of human operating mistakes, flawed treatment planning, and data modification during plan file transfer. Minor errors were also reported in 174 other log file analyses, some of which stemmed from false positives and unreliable results; the origins of these are discussed herein. It has been demonstrated that the machine log file analysis is a robust, efficient, and reliable QA process capable of detecting errors originating from human mistakes, flawed planning, and data transfer problems. The possibility of detecting these errors is low using point and planar dosimetric measurements. Copyright © 2013 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

SU-F-J-51: A Cone-Based Scintillator Detector for IGRT QA for Scattered and Scanning Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oesten, H; Clasie, B; Jee, K

Purpose: IGRT commissioning and QA are critical components for precise delivery of proton treatment beams to patients. In order to ensure high quality IGRT, a new cone-based scintillator detector was evaluated for our QA activities for double-scattered and scanning proton modalities. This allows a routine evaluation of the gantry-angle dependent position offset between the radiation and imaging. Methods: The cone-based scintillator detector (XRV-124, Logos Systems, Int’l CA, USA) features a unique configuration of measuring stereotactic paths of proton and x-ray beams in a single setup with arbitrary gantry angles. For the beams-eye-view (BEV) analysis of x-ray crosshair images, a cylindricalmore » representation of the cone image was newly developed. The calibration accuracy was evaluated using different CT resolutions for a range of 55 – 95mm in patient’s cranial direction and ±9mm in the lateral direction. Energy-dependent spot sizes (σ) of pencil beams were characterized and compared to measurements by the MatriXX detector (IBA, Germany). Iso-centric deviations between radiation and x-ray imaging were characterized as a function of gantry angle. Results: The position calibration of the detector was successfully verified with a reproducible positioning by x-ray imaging. The measurements were reproducible within clinical tolerances (±1mm). The spot size vs. energy at zero gantry angle measured with the scintillating cone detector agreed with the MatriXX detector measurements within 17%. Conclusion: The new approach to investigate the accuracy of IGRT and pencil beam properties could successfully be implemented into the QA program. The system will improve efficiency in our QA activities for proton treatments.« less

The importance of quality control in validating concentrations of contaminants of emerging concern in source and treated drinking water samples.

PubMed

Batt, Angela L; Furlong, Edward T; Mash, Heath E; Glassmeyer, Susan T; Kolpin, Dana W

2017-02-01

A national-scale survey of 247 contaminants of emerging concern (CECs), including organic and inorganic chemical compounds, and microbial contaminants, was conducted in source and treated drinking water samples from 25 treatment plants across the United States. Multiple methods were used to determine these CECs, including six analytical methods to measure 174 pharmaceuticals, personal care products, and pesticides. A three-component quality assurance/quality control (QA/QC) program was designed for the subset of 174 CECs which allowed us to assess and compare performances of the methods used. The three components included: 1) a common field QA/QC protocol and sample design, 2) individual investigator-developed method-specific QA/QC protocols, and 3) a suite of 46 method comparison analytes that were determined in two or more analytical methods. Overall method performance for the 174 organic chemical CECs was assessed by comparing spiked recoveries in reagent, source, and treated water over a two-year period. In addition to the 247 CECs reported in the larger drinking water study, another 48 pharmaceutical compounds measured did not consistently meet predetermined quality standards. Methodologies that did not seem suitable for these analytes are overviewed. The need to exclude analytes based on method performance demonstrates the importance of additional QA/QC protocols. Published by Elsevier B.V.

WE-AB-201-04: The Recommendations of MPPG #5 and Practical Implementation Strategies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smilowitz, J.

Treatment planning systems (TPS) are a cornerstone of modern radiation therapy. Errors in their commissioning or use can have a devastating impact on many patients. To support safe and high quality care, medical physicists must conduct efficient and proper commissioning, good clinical integration, and ongoing quality assurance (QA) of the TPS. AAPM Task Group 53 and related publications have served as seminal benchmarks for TPS commissioning and QA over the past two decades. Over the same time, continuing innovations have made the TPS even more complex and more central to the clinical process. Medical goals are now expressed in termsmore » of the dose and margins around organs and tissues that are delineated from multiple imaging modalities (CT, MR and PET); and even temporally resolved (i.e., 4D) imaging. This information is passed on to optimization algorithms to establish accelerator movements that are programmed directly for IMRT, VMAT and stereotactic treatments. These advances have made commissioning and QA of the TPS much more challenging. This education session reviews up-to-date experience and guidance on this subject; including the recently published AAPM Medical Physics Practice Guideline (MPPG) #5 “Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams”. Treatment Planning System Commissioning and QA: Challenges and Opportunities (Greg Salomons) This session will provide some key background and review publications describing prominent incidents relating to TPS commissioning and QA. Traditional approaches have been hardware and feature oriented. They aim to establish a functional configuration and establish specifications for regular testing of features (like dose calculation) to assure stable operation and detect failures. With the advent of more complex systems, more patient-specific testing has also been adopted. A number of actual TPS defects will be presented along with heuristics for identifying similar defects in the future. Finally, the Gamma test has become a popular metric for reporting TPS Commissioning and QA results. It simplifies complex testing into a numerical index, but noisy data and casual application can make it misleading. A brief review of the issues around the use of the Gamma test will be presented. TPS commissioning and QA: A process orientation and application of control charts (Michael Sharpe) A framework for commissioning a treatment planning system will be presented, focusing on preparations, practical aspects of configuration, priorities, specifications, and establishing performance. The complexity of the modern TPS make modular testing of features inadequate, and modern QA tools can provide “too much information” about the performance of techniques like IMRT and VMAT. We have adopted a process orientation and quality tools, like control charts, for ongoing TPS QA and assessment of patient-specific tests. The trending nature of these tools reveals the overall performance of the TPS system, and quantifies the variations that arise from individual plans, discrete calculations, and experimentation based on discrete measurements. Examples demonstrating application of these tools to TPS QA will be presented. TPS commissioning and QA: Incorporating the entire planning process (Sasa Mutic) The TPS and its features do not perform in isolation. Instead, the features and modules are key components in a complex process that begins with CT Simulation and extends to treatment delivery, along with image guidance and verification. Most importantly, the TPS is used by people working in a multi-disciplinary environment. It is very difficult to predict the outcomes of human interactions with software. Therefore, an interdisciplinary approach to training, commissioning and QA will be presented, along with an approach to the physics chart check and end-to-end testing as a tool for TPS QA. The role of standardization and automation in QA will also be discussed. The recommendations of MPPG #5 and practical implementation strategies (Jennifer Smilowitz) The recently published recommendations from Task Group No. 244, Medical Physics Practice Guideline on Commissioning and QA of Treatment Planning Dose Calculations: Megavoltage Photon and Electron Beams will be presented. The recommendations focus on the validation of commissioning data and dose calculations. Tolerance values for non-IMRT beam configurations are summarized based on established criteria and data collected by the IROC. More stringent evaluation criteria for IMRT dose calculations are suggested to test the limitations of the TPS dose algorithms for advanced delivery conditions. The MPPG encourages users to create a suite of validation tests for dose calculation for various conditions for static photon beams, heterogeneities, IMRT/VMAT and electron beams. This test suite is intended to be used for subsequent testing, including TPS software upgrades. In the past, the recommendations of some reports have not been widely implemented due to practical limitations. Implementation strategies, tools and processes developed by multiple centers for efficient and “do-able” MPPG #5 testing will be presented, as well as a discussion on the overall validation experience. Learning Objectives: Identify some of the key documents relevant for TPS commissioning and QA Understand strategies for testing TPS software Gain a practical knowledge of the Gamma test criteria Increase familiarity with the process of commissioning a TPS Learn about the use of Control Charts for TPS QA Review the role of the TPS in the overall planning process Increase awareness of the link between TPS QA and chart checking Gain an increased appreciation for the importance of interdisciplinary communication Understand the new recommendations from MPPG #5 on TPS Dose Algorithm Commissioning and QC/QA Learn practical implementation processes and tools for MPPG #5 validation recommendations.« less

SU-E-T-468: Implementation of the TG-142 QA Process for Seven Linacs with Enhanced Beam Conformance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woollard, J; Ayan, A; DiCostanzo, D

2015-06-15

Purpose: To develop a TG-142 compliant QA process for 7 Varian TrueBeam linear accelerators (linacs) with enhanced beam conformance and dosimetrically matched beam models. To ensure consistent performance of all 7 linacs, the QA process should include a common set of baseline values for use in routine QA on all linacs. Methods: The TG 142 report provides recommended tests, tolerances and frequencies for quality assurance of medical accelerators. Based on the guidance provided in the report, measurement tests were developed to evaluate each of the applicable parameters listed for daily, monthly and annual QA. These tests were then performed onmore » each of our 7 new linacs as they came on line at our institution. Results: The tolerance values specified in TG-142 for each QA test are either absolute tolerances (i.e. ±2mm) or require a comparison to a baseline value. The results of our QA tests were first used to ensure that all 7 linacs were operating within the suggested tolerance values provided in TG −142 for those tests with absolute tolerances and that the performance of the linacs was adequately matched. The QA test results were then used to develop a set of common baseline values for those QA tests that require comparison to a baseline value at routine monthly and annual QA. The procedures and baseline values were incorporated into a spreadsheets for use in monthly and annual QA. Conclusion: We have developed a set of procedures for daily, monthly and annual QA of our linacs that are consistent with the TG-142 report. A common set of baseline values was developed for routine QA tests. The use of this common set of baseline values for comparison at monthly and annual QA will ensure consistent performance of all 7 linacs.« less

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

MO-A-16A-01: QA Procedures and Metrics: In Search of QA Usability

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sathiaseelan, V; Thomadsen, B

Radiation therapy has undergone considerable changes in the past two decades with a surge of new technology and treatment delivery methods. The complexity of radiation therapy treatments has increased and there has been increased awareness and publicity about the associated risks. In response, there has been proliferation of guidelines for medical physicists to adopt to ensure that treatments are delivered safely. Task Group recommendations are copious, and clinical physicists' hours are longer, stretched to various degrees between site planning and management, IT support, physics QA, and treatment planning responsibilities.Radiation oncology has many quality control practices in place to ensure themore » delivery of high-quality, safe treatments. Incident reporting systems have been developed to collect statistics about near miss events at many radiation oncology centers. However, tools are lacking to assess the impact of these various control measures. A recent effort to address this shortcoming is the work of Ford et al (2012) who recently published a methodology enumerating quality control quantification for measuring the effectiveness of safety barriers. Over 4000 near-miss incidents reported from 2 academic radiation oncology clinics were analyzed using quality control quantification, and a profile of the most effective quality control measures (metrics) was identified.There is a critical need to identify a QA metric to help the busy clinical physicists to focus their limited time and resources most effectively in order to minimize or eliminate errors in the radiation treatment delivery processes. In this symposium the usefulness of workflows and QA metrics to assure safe and high quality patient care will be explored.Two presentations will be given:Quality Metrics and Risk Management with High Risk Radiation Oncology ProceduresStrategies and metrics for quality management in the TG-100 Era Learning Objectives: Provide an overview and the need for QA usability metrics: Different cultures/practices affecting the effectiveness of methods and metrics. Show examples of quality assurance workflows, Statistical process control, that monitor the treatment planning and delivery process to identify errors. To learn to identify and prioritize risks and QA procedures in radiation oncology. Try to answer the question: Can a quality assurance program aided by quality assurance metrics help minimize errors and ensure safe treatment delivery. Should such metrics be institution specific.« less

Exploring the Learning Mechanism of Web-Based Question-Answering Systems and Their Design

ERIC Educational Resources Information Center

Zhang, Yin

2010-01-01

In recent years, a number of models concerning question-answering (QA) systems have been put forward. But many of them stress technology and neglect the research of QA itself. In this paper, we analyse the essence of QA and discuss the relationship between technology and QA. On that basis, we propose that when designing web-based QA systems, more…

23 CFR 650.313 - Inspection procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Quality control and quality assurance. Assure systematic quality control (QC) and quality assurance (QA... periodic field review of inspection teams, periodic bridge inspection refresher training for program managers and team leaders, and independent review of inspection reports and computations. (h) Follow-up on...

Supporting Teen Parents: A Q&A with the Young Families Committee of NOAPPP

ERIC Educational Resources Information Center

Prevention Researcher, 2004

2004-01-01

Many professionals who work with youth have adolescent parents within their clientele yet don't have the demand to create special programs for these youth. Information regarding ways to assist teen parents in the normal course of the day, without developing a teen parent program, is difficult to find. Questions about supporting teen parents were…

The Skateboard Factory: Curriculum by Design--Oasis Skateboard Factory Q&A with Craig Morrison

ERIC Educational Resources Information Center

Pearson, George

2012-01-01

Since its opening three years ago, Oasis Skateboard Factory (OSF), founded by teacher Craig Morrison, has attracted considerable media exposure and received a Ken Spencer Award from the CEA for its innovative program. OSF is one of three programs offered by Oasis Alternative Secondary School, one of 22 alternative secondary schools of the Toronto…

Taxonomy-Based Approaches to Quality Assurance of Ontologies

PubMed Central

Perl, Yehoshua; Ochs, Christopher

2017-01-01

Ontologies are important components of health information management systems. As such, the quality of their content is of paramount importance. It has been proven to be practical to develop quality assurance (QA) methodologies based on automated identification of sets of concepts expected to have higher likelihood of errors. Four kinds of such sets (called QA-sets) organized around the themes of complex and uncommonly modeled concepts are introduced. A survey of different methodologies based on these QA-sets and the results of applying them to various ontologies are presented. Overall, following these approaches leads to higher QA yields and better utilization of QA personnel. The formulation of additional QA-set methodologies will further enhance the suite of available ontology QA tools. PMID:29158885

Clinical introduction of a linac head-mounted 2D detector array based quality assurance system in head and neck IMRT.

PubMed

Korevaar, Erik W; Wauben, David J L; van der Hulst, Peter C; Langendijk, Johannes A; Van't Veld, Aart A

2011-09-01

IMRT QA is commonly performed in a phantom geometry but the clinical interpretation of the results in a 2D phantom plane is difficult. The main objective of our work is to move from film measurement based QA to 3D dose reconstruction in a patient CT scan. In principle, this could be achieved using a dose reconstruction method from 2D detector array measurements as available in the COMPASS system (IBA Dosimetry). The first step in the clinical introduction of this system instead of the currently used film QA procedures is to test the reliability of the dose reconstruction. In this paper we investigated the validation of the method in a homogeneous phantom with the film QA procedure as a reference. We tested whether COMPASS QA results correctly identified treatment plans that did or did not fulfil QA requirements in head and neck (H&N) IMRT. A total number of 24 treatments were selected from an existing database with more than 100 film based H&N IMRT QA results. The QA results were classified as either good, just acceptable or clinically rejected (mean gamma index <0.4, 0.4-0.5 or >0.5, respectively with 3%/3mm criteria). Film QA was repeated and compared to COMPASS QA with a MatriXX detector measurement performed on the same day. Good agreement was found between COMPASS reconstructed dose and film measured dose in a phantom (mean gamma 0.83±0.09, 1SD with 1%/1mm criteria, 0.33±0.04 with 3%/3mm criteria). COMPASS QA results correlated well with film QA, identifying the same patients with less good QA results. Repeated measurements with film and COMPASS showed changes in delivery after a modified MLC calibration, also visible in a standard MLC check in COMPASS. The time required for QA reduced by half by using COMPASS instead of film. Agreement of COMPASS QA results with film based QA supports its clinical introduction for a phantom geometry. A standard MLC calibration check is sensitive to <1mm changes that could be significant in H&N IMRT. These findings offer opportunities to further investigate the method based on a 2D detector array to 3D dose reconstruction in a patient anatomy. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

WE-AB-206-00: Diagnostic QA/QC Hands-On Workshop

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environmentmore » with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.« less

Quality assurance for gamma knives

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jones, E.D.; Banks, W.W.; Fischer, L.E.

1995-09-01

This report describes and summarizes the results of a quality assurance (QA) study of the Gamma Knife, a nuclear medical device used for the gamma irradiation of intracranial lesions. Focus was on the physical aspects of QA and did not address issues that are essentially medical, such as patient selection or prescription of dose. A risk-based QA assessment approach was used. Sample programs for quality control and assurance are included. The use of the Gamma Knife was found to conform to existing standards and guidelines concerning radiation safety and quality control of external beam therapies (shielding, safety reviews, radiation surveys,more » interlock systems, exposure monitoring, good medical physics practices, etc.) and to be compliant with NRC teletherapy regulations. There are, however, current practices for the Gamma Knife not covered by existing, formalized regulations, standards, or guidelines. These practices have been adopted by Gamma Knife users and continue to be developed with further experience. Some of these have appeared in publications or presentations and are slowly finding their way into recommendations of professional organizations.« less

Quality assurance and quality control for thermal/optical analysis of aerosol samples for organic and elemental carbon.

PubMed

Chow, Judith C; Watson, John G; Robles, Jerome; Wang, Xiaoliang; Chen, L-W Antony; Trimble, Dana L; Kohl, Steven D; Tropp, Richard J; Fung, Kochy K

2011-12-01

Accurate, precise, and valid organic and elemental carbon (OC and EC, respectively) measurements require more effort than the routine analysis of ambient aerosol and source samples. This paper documents the quality assurance (QA) and quality control (QC) procedures that should be implemented to ensure consistency of OC and EC measurements. Prior to field sampling, the appropriate filter substrate must be selected and tested for sampling effectiveness. Unexposed filters are pre-fired to remove contaminants and acceptance tested. After sampling, filters must be stored in the laboratory in clean, labeled containers under refrigeration (<4 °C) to minimize loss of semi-volatile OC. QA activities include participation in laboratory accreditation programs, external system audits, and interlaboratory comparisons. For thermal/optical carbon analyses, periodic QC tests include calibration of the flame ionization detector with different types of carbon standards, thermogram inspection, replicate analyses, quantification of trace oxygen concentrations (<100 ppmv) in the helium atmosphere, and calibration of the sample temperature sensor. These established QA/QC procedures are applicable to aerosol sampling and analysis for carbon and other chemical components.

Analysis of Qa-1bPeptide Binding Specificity and the Capacity of Cd94/Nkg2a to Discriminate between Qa-1–Peptide Complexes

PubMed Central

Kraft, Jennifer R.; Vance, Russell E.; Pohl, Jan; Martin, Amy M.; Raulet, David H.; Jensen, Peter E.

2000-01-01

The major histocompatibility complex class Ib protein, Qa-1b, serves as a ligand for murine CD94/NKG2A natural killer (NK) cell inhibitory receptors. The Qa-1b peptide-binding site is predominantly occupied by a single nonameric peptide, Qa-1 determinant modifier (Qdm), derived from the leader sequence of H-2D and L molecules. Five anchor residues were identified in this study by measuring the peptide-binding affinities of substituted Qdm peptides in experiments with purified recombinant Qa-1b. A candidate peptide-binding motif was determined by sequence analysis of peptides eluted from Qa-1 that had been folded in the presence of random peptide libraries or pools of Qdm derivatives randomized at specific anchor positions. The results indicate that Qa-1b can bind a diverse repertoire of peptides but that Qdm has an optimal primary structure for binding Qa-1b. Flow cytometry experiments with Qa-1b tetramers and NK target cell lysis assays demonstrated that CD94/NKG2A discriminates between Qa-1b complexes containing peptides with substitutions at nonanchor positions P4, P5, or P8. Our findings suggest that it may be difficult for viruses to generate decoy peptides that mimic Qdm and raise the possibility that competitive replacement of Qdm with other peptides may provide a novel mechanism for activation of NK cells. PMID:10974028

John F. Kennedy Space Center, Safety, Reliability, Maintainability and Quality Assurance, Survey and Audit Program

NASA Technical Reports Server (NTRS)

1994-01-01

This document is the product of the KSC Survey and Audit Working Group composed of civil service and contractor Safety, Reliability, and Quality Assurance (SR&QA) personnel. The program described herein provides standardized terminology, uniformity of survey and audit operations, and emphasizes process assessments rather than a program based solely on compliance. The program establishes minimum training requirements, adopts an auditor certification methodology, and includes survey and audit metrics for the audited organizations as well as the auditing organization.

QA/QC in the laboratory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hood, F.C.

1992-05-01

Quality assurance and quality control (QA/QC) of analytical chemistry laboratory activities are essential to the validity and usefulness of resultant data. However, in themselves, conventional QA/QC measures will not always ensure that fraudulent data are not generated. Conventional QA/QC measures are based on the assumption that work will be done in good faith; to assure against fraudulent practices, QA/QC measures must be tailored to specific analyses protocols in anticipation of intentional misapplication of those protocols. Application of specific QA/QC measures to ensure against fraudulent practices result in an increased administrative burden being placed on the analytical process; accordingly, in keepingmore » with graded QA philosophy, data quality objectives must be used to identify specific points of concern for special control to minimize the administrative impact.« less

QA/QC in the laboratory. Session F

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hood, F.C.

1992-05-01

Quality assurance and quality control (QA/QC) of analytical chemistry laboratory activities are essential to the validity and usefulness of resultant data. However, in themselves, conventional QA/QC measures will not always ensure that fraudulent data are not generated. Conventional QA/QC measures are based on the assumption that work will be done in good faith; to assure against fraudulent practices, QA/QC measures must be tailored to specific analyses protocols in anticipation of intentional misapplication of those protocols. Application of specific QA/QC measures to ensure against fraudulent practices result in an increased administrative burden being placed on the analytical process; accordingly, in keepingmore » with graded QA philosophy, data quality objectives must be used to identify specific points of concern for special control to minimize the administrative impact.« less

Neurodegeneration Alters Metabolic Profile and Sirt 1 Signaling in High-Fat-Induced Obese Mice.

PubMed

Lima, Leandro Ceotto Freitas; Saliba, Soraya Wilke; Andrade, João Marcus Oliveira; Cunha, Maria Luisa; Cassini-Vieira, Puebla; Feltenberger, John David; Barcelos, Lucíola Silva; Guimarães, André Luiz Sena; de-Paula, Alfredo Mauricio Batista; de Oliveira, Antônio Carlos Pinheiro; Santos, Sérgio Henrique Sousa

2017-07-01

Different factors may contribute to the development of neurodegenerative diseases. Among them, metabolic syndrome (MS), which has reached epidemic proportions, has emerged as a potential element that may be involved in neurodegeneration. Furthermore, studies have shown the importance of the sirtuin family in neuronal survival and MS, which opens the possibility of new pharmacological targets. This study investigates the influence of sirtuin metabolic pathways by examining the functional capacities of glucose-induced obesity in an excitotoxic state induced by a quinolinic acid (QA) animal model. Mice were divided into two groups that received different diets for 8 weeks: one group received a regular diet, and the other group received a high-fat diet (HF) to induce MS. The animals were submitted to a stereotaxic surgery and subdivided into four groups: Standard (ST), Standard-QA (ST-QA), HF and HF-QA. The QA groups were given a 250 nL quinolinic acid injection in the right striatum and PBS was injected in the other groups. Obese mice presented with a weight gain of 40 % more than the ST group beyond acquiring an insulin resistance. QA induced motor impairment and neurodegeneration in both ST-QA and HF-QA, although no difference was observed between these groups. The HF-QA group showed a reduction in adiposity when compared with the groups that received PBS. Therefore, the HF-QA group demonstrated a commitment-dependent metabolic pathway. The results suggest that an obesogenic diet does not aggravate the neurodegeneration induced by QA. However, the excitotoxicity induced by QA promotes a sirtuin pathway impairment that contributes to metabolic changes.

MO-G-BRE-02: A Survey of IMRT QA Practices for More Than 800 Institutions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pulliam, K; Kerns, J; Howell, R

Purpose: A wide range of techniques and measurement devices are employed for IMRT QA, causing a large variation of accepted action limits and potential follow up for failing plans. Such procedures are not well established or accepted in the medical physics community. To achieve the goal of proving insight into current IMRT QA practices, we created an electronic IMRT QA survey. The survey was open to a variety of the most common QA devices and assessed the type of comparison to measurement, action limits, delivery methods, and clinical action for failing QA plans. Methods: We conducted an online survey throughmore » the Radiological Physics Center's (RPC) annual survey with the goal of ascertaining elements of routine patient-specific IMRT QA. A total of 874 institutions responded to the survey. The questions ranged from asking for action limits, dosimeter type(s) used, delivery techniques, and actions taken when a plan fails IMRT QA. Results: The most common (52%) planar gamma criteria was 3%/3 mm with a 95% of pixels passing criteria. The most common QA device were diode arrays (48%). The most common first response to a plan failing QA was to re-measure at the same point the point dose (89%), second was to re-measure at a new point (13%), and third was to analyze the plan in relative instead of absolute mode (10%) (Does not add to 100% as not all institutions placed a response for each QA follow-up option). Some institutions, however, claimed that they had never observed a plan failure. Conclusion: The survey provided insights into the way the community currently performs IMRT QA. This information will help in the push to standardize action limits among dosimeters.« less

Investigation of the Asphalt Pavement Analyzer (APA) testing program in Nebraska.

DOT National Transportation Integrated Search

2008-03-01

The asphalt pavement analyzer (APA) has been widely used to evaluate hot-mix asphalt (HMA) rutting potential in mix : design and quality control-quality assurance (QC-QA) applications, because the APA testing and its data analyses are : relatively si...

CAUSES OF PROBLEMS IN ANALYZING PE SAMPLES

EPA Science Inventory

The U.S. EPA's Environmental Monitoring Systems Laboratory in Las Vegas (EMSL-LV), is responsible for overseeing quality assurance of EPA's Superfund Contract Laboratory Program. n part, this oversight role involves examining QA data provided by the labs in order to investigate p...

NATIONAL QA STANDARD FOR ENVIRONMENTAL PROGRAMS FOR HAZARDOUS WASTE MANAGEMENT ACTIVITIES

EPA Science Inventory

The clean-up of Federally-owned facilities contaminated by mixtures of hazardous chemical and radioactive wastes involves critical decisions based on environmental data. ederal agencies are currently using several different standards or sets of requirements, including U.S. Enviro...

Commissioning and comprehensive evaluation of the ArcCHECK cylindrical diode array for VMAT pretreatment delivery QA.

PubMed

Chaswal, Vibha; Weldon, Michael; Gupta, Nilendu; Chakravarti, Arnab; Rong, Yi

2014-07-08

We present commissioning and comprehensive evaluation for ArcCHECK as a QA equipment for volumetric-modulated arc therapy (VMAT), using the 6 MV photon beam with and without the flattening filter, and the SNC patient software (version 6.2). In addition to commissioning involving absolute dose calibration, array calibration, and PMMA density verification, ArcCHECK was evaluated for its response dependency on linac dose rate, instantaneous dose rate, radiation field size, beam angle, and couch insertion. Scatter dose characterization, consistency and symmetry of response, and dosimetry accuracy evaluation for fixed aperture arcs and clinical VMAT patient plans were also investigated. All the evaluation tests were performed with the central plug inserted and the homogeneous PMMA density value. Results of gamma analysis demonstrated an overall agreement between ArcCHECK-measured and TPS-calculated reference doses. The diode based field size dependency was found to be within 0.5% of the reference. The dose rate-based dependency was well within 1% of the TPS reference, and the angular dependency was found to be ± 3% of the reference, as tested for BEV angles, for both beams. Dosimetry of fixed arcs, using both narrow and wide field widths, resulted in clinically acceptable global gamma passing rates on the 3%/3mm level and 10% threshold. Dosimetry of narrow arcs showed an improvement over published literature. The clinical VMAT cases demonstrated high level of dosimetry accuracy in gamma passing rates.

Quality assurance guides health reform in Jordan.

PubMed

Abubaker, W; Abdulrahman, M

1996-01-01

In November 1995, a World Bank mission went to Jordan to conduct a study of the health sector. The study recommended three strategies to reform the health sector: decentralization of Ministry of Health (MOH) management; improvement of clinical practices, quality of care, and consumer satisfaction; and adoption of treatment protocols and standards. The MOH chose quality assurance (QA) methods and quality management (QM) techniques to accomplish these reforms. The Monitoring and QA Directorate oversees QA applications within MOH. It also institutes and develops the capacity of local QA units in the 12 governorates. The QA units implement and monitor day-to-day QA activities. The QM approach encompasses quality principles: establish objectives; use a systematic approach; teach lessons learned and applicable research; use QA training to teach quality care, quality improvement, and patient satisfaction; educate health personnel about QM approaches; use assessment tools and interviews; measure the needs and expectations of local health providers and patients; ensure feedback on QA improvement projects; ensure valid and reliable data; monitor quality improvement efforts; standardize systemic data collection and outcomes; and establish and disseminate QA standards and performance improvement efforts. The Jordan QA Project has helped with the successful institutionalization of a QA system at both the central and local levels. The bylaws of the QA councils and committees require team participation in the decision-making process. Over the last two years, the M&QA Project has adopted 21 standards for nursing, maternal and child health care centers, pharmacies, and medications. The Balqa pilot project has developed 44 such protocols. Quality improvement (COUGH) studies have examined hyper-allergy, analysis of patient flow rate, redistribution of nurses, vaccine waste, and anemic pregnant women. There are a considerable number of on-going clinical and non-clinical COUGH studies. Four epidemiological studies are examining maternal mortality, causes of death, morbidity, and perinatal mortality.

Optimization and quality assurance of an image-guided radiation therapy system for intensity-modulated radiation therapy radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsai, Jen-San, E-mail: jen-san.tsai@verizon.net; Micaily, Bizhan; Miyamoto, Curtis

2012-10-01

To develop a quality assurance (QA) of XVI cone beam system (XVIcbs) for its optimal imaging-guided radiotherapy (IGRT) implementation, and to construe prostate tumor margin required for intensity-modulated radiation therapy (IMRT) if IGRT is unavailable. XVIcbs spatial accuracy was explored with a humanoid phantom; isodose conformity to lesion target with a rice phantom housing a soap as target; image resolution with a diagnostic phantom; and exposure validation with a Radcal ion chamber. To optimize XVIcbs, rotation flexmap on coincidency between gantry rotational axis and that of XVI cone beam scan was investigated. Theoretic correlation to image quality of XVIcbs rotationalmore » axis stability was elaborately studied. Comprehensive QA of IGRT using XVIcbs has initially been explored and then implemented on our general IMRT treatments, and on special IMRT radiotherapies such as head and neck (H and N), stereotactic radiation therapy (SRT), stereotactic radiosurgery (SRS), and stereotactic body radiotherapy (SBRT). Fifteen examples of prostate setup accounted for 350 IGRT cone beam system were analyzed. IGRT accuracy results were in agreement {+-} 1 mm. Flexmap 0.25 mm met the manufacturer's specification. Films confirmed isodose coincidence with target (soap) via XVIcbs, otherwise not. Superficial doses were measured from 7.2-2.5 cGy for anatomic diameters 15-33 cm, respectively. Image quality was susceptible to rotational stability or patient movement. IGRT using XVIcbs on general IMRT treatments such as prostate, SRT, SRS, and SBRT for setup accuracy were verified; and subsequently coordinate shifts corrections were recorded. The 350 prostate IGRT coordinate shifts modeled to Gaussian distributions show central peaks deviated off the isocenter by 0.6 {+-} 3.0 mm, 0.5 {+-} 4.5 mm in the X(RL)- and Z(SI)-coordinates, respectively; and 2.0 {+-} 3.0 mm in the Y(AP)-coordinate as a result of belly and bladder capacity variations. Sixty-eight percent of confidence was within {+-} 4.5 mm coordinates shifting. IGRT using XVIcbs is critical to IMRT for prostate and H and N, especially SRT, SRS, and SBRT. To optimize this modality of IGRT, a vigilant QA program is indispensable. Prostate IGRT reveals treatment accuracy as subject to coordinates' adjustments; otherwise a 4.5-mm margin is required to allow for full dose coverage of the clinical target volume, notwithstanding toxicity to normal tissues.« less

A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography.

PubMed

Steiding, Christian; Kolditz, Daniel; Kalender, Willi A

2014-03-01

Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, and an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations was also verified. The maximum percentage interscan variation of repeated measurements was less than 4% and 1.7% on average for all investigated quality criteria. The NPS-based image noise differed by less than 5% from the conventional standard deviation approach and spatially selective 10% MTF values were well comparable to subjective results obtained with 3D resolution pattern. Determining only transverse spatial resolution and global noise behavior in the central field of measurement turned out to be insufficient. The proposed framework transfers QA routines employed in conventional CT in an advanced version to CBCT for fully automated and time-efficient evaluation of technical equipment. With the modular phantom design, a routine as well as an expert version for assessing IQ is provided. The QA program can be used for arbitrary CT units to evaluate 3D imaging characteristics automatically.

A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Steiding, Christian; Kolditz, Daniel; Kalender, Willi A., E-mail: willi.kalender@imp.uni-erlangen.de

Purpose: Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. Methods: The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, andmore » an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. Results: The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations was also verified. The maximum percentage interscan variation of repeated measurements was less than 4% and 1.7% on average for all investigated quality criteria. The NPS-based image noise differed by less than 5% from the conventional standard deviation approach and spatially selective 10% MTF values were well comparable to subjective results obtained with 3D resolution pattern. Determining only transverse spatial resolution and global noise behavior in the central field of measurement turned out to be insufficient. Conclusions: The proposed framework transfers QA routines employed in conventional CT in an advanced version to CBCT for fully automated and time-efficient evaluation of technical equipment. With the modular phantom design, a routine as well as an expert version for assessing IQ is provided. The QA program can be used for arbitrary CT units to evaluate 3D imaging characteristics automatically.« less

Is there a necessity for individual blood water corrections when conductivity-based access blood flow measurements are made?

PubMed

Huang, Shih-Han S; Heidenheim, Paul A; Gallo, Kerri; Jayakumar, Saumya; Lindsay, Robert M

2011-01-01

Access blood water flow rate (Qaw) can be measured during hemodialysis using an online effective ionic dialysance (EID) methodology. Fresenius employ this methodology in their 2008K dialysis machine. The machine computer converts Qaw to an access blood flow rate (Fresenius Qa) using a generic blood water constant (BWC). We wished to validate this BWC. 18 patients had Fresenius Qa measurements using the EID and these were compared with a 'gold standard' ultrasound dilution methodology (Transonic Qa). Qa values were also obtained by removing the BWC from Fresenius Qa values to obtain the Qaw and recorrecting it with individualized patient factors using hematocrit and total protein values (HctTp Qa). The measurements were repeated after 1 h. There were no significant differences between Fresenius and Transonic, nor between HctTp and Transonic Qa values (p > 0.17). There were strong correlations between both sets of values (r > 0.856; p < 0.001). There was a significant correlation between the pairs of Transonic Qa values (r = 0.823; p < 0.007), but not for Fresenius Qa pairs (r = 0.573; p > 0.07). It was surmised that the BWC was not valid post-dialysis. The generic BWC is comparable to individualized blood water correction factors when Qa measures are made early in dialysis and prior to ultrafiltration treatment. Copyright © 2011 S. Karger AG, Basel.

Field spectrometer (S191H) preprocessor tape quality test program design document

NASA Technical Reports Server (NTRS)

Campbell, H. M.

1976-01-01

Program QA191H performs quality assurance tests on field spectrometer data recorded on 9-track magnetic tape. The quality testing involves the comparison of key housekeeping and data parameters with historic and predetermined tolerance limits. Samples of key parameters are processed during the calibration period and wavelength cal period, and the results are printed out and recorded on an historical file tape.

Analytical methods manual for the Mineral Resource Surveys Program, U.S. Geological Survey

USGS Publications Warehouse

Arbogast, Belinda F.

1996-01-01

The analytical methods validated by the Mineral Resource Surveys Program, Geologic Division, is the subject of this manual. This edition replaces the methods portion of Open-File Report 90-668 published in 1990. Newer methods may be used which have been approved by the quality assurance (QA) project and are on file with the QA coordinator.This manual is intended primarily for use by laboratory scientists; this manual can also assist laboratory users to evaluate the data they receive. The analytical methods are written in a step by step approach so that they may be used as a training tool and provide detailed documentation of the procedures for quality assurance. A "Catalog of Services" is available for customer (submitter) use with brief listings of:the element(s)/species determined,method of determination,reference to cite,contact person,summary of the technique,and analyte concentration range.For a copy please contact the Branch office at (303) 236-1800 or fax (303) 236-3200.

CMU OAQA at TREC 2015 LiveQA: Discovering the Right Answer with Clues

DTIC Science & Technology

2015-11-20

QA) system that was evaluated in the TREC 2015 LiveQA Challenge. This system answers real-user questions freshly submitted to the Yahoo ! Answers...questions on the Yahoo ! Answers site 1, which have not yet received a human answer. As per the requirements for this track, participants must deploy their... Yahoo ! Answers. We also designed and im- plemented a new data model and novel relevance ranking methods for LiveQA. During the official run, our QA web

Relationship between hydroxycinnamic acids and the resistance of apple cultivars to rosy apple aphid.

PubMed

Berrueta, Luis A; Sasía-Arriba, Andrea; Miñarro, Marcos; Antón, María J; Alonso-Salces, Rosa M; Micheletti, Diego; Gallo, Blanca; Dapena, Enrique

2018-09-01

The phenolic profiles of apple cultivars from the SERIDA Asturian cider apple breeding program, including parents and progenies, were determined by ultrahigh-performance liquid chromatography-diode array detector-electrospray ionization-quadrupole time of flight/mass spectrometer in order to study the relationship between phenols and the resistance of apple tree cultivars to rosy apple aphid (RAA). A pattern recognition technique named partial least square discriminant analysis (PLS-DA) was used to classify apple cultivars based on resistance to RAA, resistant and susceptible, reaching scores with accuracy higher than 97% and 91% respectively. Hydroxycinnamic acids, particularly 4-caffeoylquinic acid (4-CQA) and 4-p-coumaroylquinic acid (4-pCoQA), were identified as the major player in RAA resistance by the PLS-DA model. Indeed, the isomerisation 5-CQA → 4-CQA is favoured in resistant cultivars, whereas the isomerisation 5-pCoQA → 4-pCoQA is favoured in susceptible cultivars. As a result, resistant cultivars accumulate higher amounts of 4-CQA than susceptible ones, and the opposite occurs for 4-pCoQA. Also, minor isomerisations of 5-CQA to 1-CQA or 3-CQA show opposite behaviour for resistant and susceptible cultivars. Cultivar resistance to RAA is concluded to be related with the phenylpropanoid pathway, the isomerisation reactions being the key metabolic reaction for a cultivar to be resistant or susceptible to RAA. Copyright © 2018 Elsevier B.V. All rights reserved.

Using the CER Hub to ensure data quality in a multi-institution smoking cessation study.

PubMed

Walker, Kari L; Kirillova, Olga; Gillespie, Suzanne E; Hsiao, David; Pishchalenko, Valentyna; Pai, Akshatha Kalsanka; Puro, Jon E; Plumley, Robert; Kudyakov, Rustam; Hu, Weiming; Allisany, Art; McBurnie, MaryAnn; Kurtz, Stephen E; Hazlehurst, Brian L

2014-01-01

Comparative effectiveness research (CER) studies involving multiple institutions with diverse electronic health records (EHRs) depend on high quality data. To ensure uniformity of data derived from different EHR systems and implementations, the CER Hub informatics platform developed a quality assurance (QA) process using tools and data formats available through the CER Hub. The QA process, implemented here in a study of smoking cessation services in primary care, used the 'emrAdapter' tool programmed with a set of quality checks to query large samples of primary care encounter records extracted in accord with the CER Hub common data framework. The tool, deployed to each study site, generated error reports indicating data problems to be fixed locally and aggregate data sharable with the central site for quality review. Across the CER Hub network of six health systems, data completeness and correctness issues were prevalent in the first iteration and were considerably improved after three iterations of the QA process. A common issue encountered was incomplete mapping of local EHR data values to those defined by the common data framework. A highly automated and distributed QA process helped to ensure the correctness and completeness of patient care data extracted from EHRs for a multi-institution CER study in smoking cessation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Quality Assurance and Improvement Practice in Mental Health Agencies: Roles, Activities, Targets and Contributions

PubMed Central

McMillen, Curtis; Zayas, Luis E.; Books, Samantha; Lee, Madeline

2009-01-01

Accompanying the rise in the number of mental health agency personnel tasked with quality assurance and improvement (QA/I) responsibilities is an increased need to understand the nature of the work these professionals undertake. Four aspects of the work of quality assurance and improvement (QA/I) professionals in mental health were explored in this qualitative study: their perceived roles, their major activities, their QA/I targets, and their contributions. In-person interviews were conducted with QA/I professionals at 16 mental health agencies. Respondents perceived their roles at varying levels of complexity, focused on different targets, and used different methods to conduct their work. Few targets of QA/I work served as indicators of high quality care. Most QA/I professionals provided concrete descriptions of how they had improved agency services, while others could describe none. Accreditation framed much of agency QA/I work, perhaps to its detriment. PMID:18688707

A structural basis for antigen presentation by the MHC class Ib molecule, Qa-1b.

PubMed

Zeng, Li; Sullivan, Lucy C; Vivian, Julian P; Walpole, Nicholas G; Harpur, Christopher M; Rossjohn, Jamie; Clements, Craig S; Brooks, Andrew G

2012-01-01

The primary function of the monomorphic MHC class Ib molecule Qa-1(b) is to present peptides derived from the leader sequences of other MHC class I molecules for recognition by the CD94-NKG2 receptors expressed by NK and T cells. Whereas the mode of peptide presentation by its ortholog HLA-E, and subsequent recognition by CD94-NKG2A, is known, the molecular basis of Qa-1(b) function is unclear. We have assessed the interaction between Qa-1(b) and CD94-NKG2A and shown that they interact with an affinity of 17 μM. Furthermore, we have determined the structure of Qa-1(b) bound to the leader sequence peptide, Qdm (AMAPRTLLL), to a resolution of 1.9 Å and compared it with that of HLA-E. The crystal structure provided a basis for understanding the restricted peptide repertoire of Qa-1(b). Whereas the Qa-1(b-AMAPRTLLL) complex was similar to that of HLA-E, significant sequence and structural differences were observed between the respective Ag-binding clefts. However, the conformation of the Qdm peptide bound by Qa-1(b) was very similar to that of peptide bound to HLA-E. Although a number of conserved innate receptors can recognize heterologous ligands from other species, the structural differences between Qa-1(b) and HLA-E manifested in CD94-NKG2A ligand recognition being species specific despite similarities in peptide sequence and conformation. Collectively, our data illustrate the structural homology between Qa-1(b) and HLA-E and provide a structural basis for understanding peptide repertoire selection and the specificity of the interaction of Qa-1(b) with CD94-NKG2 receptors.

Improving spot-scanning proton therapy patient specific quality assurance with HPlusQA, a second-check dose calculation engine.

PubMed

Mackin, Dennis; Li, Yupeng; Taylor, Michael B; Kerr, Matthew; Holmes, Charles; Sahoo, Narayan; Poenisch, Falk; Li, Heng; Lii, Jim; Amos, Richard; Wu, Richard; Suzuki, Kazumichi; Gillin, Michael T; Zhu, X Ronald; Zhang, Xiaodong

2013-12-01

The purpose of this study was to validate the use of HPlusQA, spot-scanning proton therapy (SSPT) dose calculation software developed at The University of Texas MD Anderson Cancer Center, as second-check dose calculation software for patient-specific quality assurance (PSQA). The authors also showed how HPlusQA can be used within the current PSQA framework. The authors compared the dose calculations of HPlusQA and the Eclipse treatment planning system with 106 planar dose measurements made as part of PSQA. To determine the relative performance and the degree of correlation between HPlusQA and Eclipse, the authors compared calculated with measured point doses. Then, to determine how well HPlusQA can predict when the comparisons between Eclipse calculations and the measured dose will exceed tolerance levels, the authors compared gamma index scores for HPlusQA versus Eclipse with those of measured doses versus Eclipse. The authors introduce the αβγ transformation as a way to more easily compare gamma scores. The authors compared measured and calculated dose planes using the relative depth, z∕R × 100%, where z is the depth of the measurement and R is the proton beam range. For relative depths than less than 80%, both Eclipse and HPlusQA calculations were within 2 cGy of dose measurements on average. When the relative depth was greater than 80%, the agreement between the calculations and measurements fell to 4 cGy. For relative depths less than 10%, the Eclipse and HPlusQA dose discrepancies showed a negative correlation, -0.21. Otherwise, the correlation between the dose discrepancies was positive and as large as 0.6. For the dose planes in this study, HPlusQA correctly predicted when Eclipse had and had not calculated the dose to within tolerance 92% and 79% of the time, respectively. In 4 of 106 cases, HPlusQA failed to predict when the comparison between measurement and Eclipse's calculation had exceeded the tolerance levels of 3% for dose and 3 mm for distance-to-agreement. The authors found HPlusQA to be reasonably effective (79% ± 10%) in determining when the comparison between measured dose planes and the dose planes calculated by the Eclipse treatment planning system had exceeded the acceptable tolerance levels. When used as described in this study, HPlusQA can reduce the need for patient specific quality assurance measurements by 64%. The authors believe that the use of HPlusQA as a dose calculation second check can increase the efficiency and effectiveness of the QA process.

The unusually strong hydrogen bond between the carbonyl of Q(A) and His M219 in the Rhodobacter sphaeroides reaction center is not essential for efficient electron transfer from Q(A)(-) to Q(B).

PubMed

Breton, Jacques; Lavergne, Jérôme; Wakeham, Marion C; Nabedryk, Eliane; Jones, Michael R

2007-06-05

In native reaction centers (RCs) from photosynthetic purple bacteria the primary quinone (QA) and the secondary quinone (QB) are interconnected via a specific His-Fe-His bridge. In Rhodobacter sphaeroides RCs the C4=O carbonyl of QA forms a very strong hydrogen bond with the protonated Npi of His M219, and the Ntau of this residue is in turn coordinated to the non-heme iron atom. The second carbonyl of QA is engaged in a much weaker hydrogen bond with the backbone N-H of Ala M260. In previous work, a Trp side chain was introduced by site-directed mutagenesis at the M260 position in the RC of Rb. sphaeroides, resulting in a complex that is completely devoid of QA and therefore nonfunctional. A photochemically competent derivative of the AM260W mutant was isolated that contains a Cys side chain at the M260 position (denoted AM260(W-->C)). In the present work, the interactions between the carbonyl groups of QA and the protein in the AM260(W-->C) suppressor mutant have been characterized by light-induced FTIR difference spectroscopy of the photoreduction of QA. The QA-/QA difference spectrum demonstrates that the strong interaction between the C4=O carbonyl of QA and His M219 is lost in the mutant, and the coupled CO and CC modes of the QA- semiquinone are also strongly perturbed. In parallel, a band assigned to the perturbation of the C5-Ntau mode of His M219 upon QA- formation in the native RC is lacking in the spectrum of the mutant. Furthermore, a positive band between 2900 and 2400 cm-1 that is related to protons fluctuating within a network of highly polarizable hydrogen bonds in the native RC is reduced in amplitude in the mutant. On the other hand, the QB-/QB FTIR difference spectrum is essentially the same as for the native RC. The kinetics of electron transfer from QA- to QB were measured by the flash-induced absorption changes at 780 nm. Compared to native RCs the absorption transients are slowed by a factor of about 2 for both the slow phase (in the hundreds of microseconds range) and fast phase (microseconds to tens of microseconds range) in AM260(W-->C) RCs. We conclude that the unusually strong hydrogen bond between the carbonyl of QA and His M219 in the Rb. sphaeroides RC is not obligatory for efficient electron transfer from QA- to QB.

Test/QA Plan For Verification Of Anaerobic Digester For Energy Production And Pollution Prevention

EPA Science Inventory

The ETV-ESTE Program conducts third-party verification testing of commercially available technologies that improve the environmental conditions in the U.S. A stakeholder committee of buyers and users of such technologies guided the development of this test on anaerobic digesters...

EVALUATING TREATMENT TECHNOLOGIES - QA APPROACHES IN THE USA AND GERMANY

EPA Science Inventory

The US EPA and the German Federal Ministry of Education and Research entered into a Bilateral Agreement in 1990 to gain a better understanding of each country's efforts in developing and demonstrating remedial technologies. Under Phase II of the Agreement, SITe Program quality ma...

75 FR 18575 - Mandatory Reporting of Greenhouse Gases: Injection and Geologic Sequestration of Carbon Dioxide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... perfluorocarbon QA/QC quality assurance/quality control R&D research and development RFA Regulatory Flexibility... Climate Change.'' Joint Global Change Research Institute, Battelle Pacific Northwest Division. PNWD-3602... research, demonstration, and deployment programs throughout the world, are building confidence that...

Quality Assurance Specifications for Planetary Protection Assays

NASA Astrophysics Data System (ADS)

Baker, Amy

As the European Space Agency planetary protection (PP) activities move forward to support the ExoMars and other planetary missions, it will become necessary to increase staffing of labo-ratories that provide analyses for these programs. Standardization of procedures, a comprehen-sive quality assurance program, and unilateral training of personnel will be necessary to ensure that the planetary protection goals and schedules are met. The PP Quality Assurance/Quality Control (QAQC) program is designed to regulate and monitor procedures performed by labora-tory personnel to ensure that all work meets data quality objectives through the assembly and launch process. Because personnel time is at a premium and sampling schedules are often de-pendent on engineering schedules, it is necessary to have flexible staffing to support all sampling requirements. The most productive approach to having a competent and flexible work force is to establish well defined laboratory procedures and training programs that clearly address the needs of the program and the work force. The quality assurance specification for planetary protection assays has to ensure that labora-tories and associated personnel can demonstrate the competence to perform assays according to the applicable standard AD4. Detailed subjects included in the presentation are as follows: • field and laboratory control criteria • data reporting • personnel training requirements and certification • laboratory audit criteria. Based upon RD2 for primary and secondary validation and RD3 for data quality objectives, the QAQC will provide traceable quality assurance safeguards by providing structured laboratory requirements for guidelines and oversight including training and technical updates, standardized documentation, standardized QA/QC checks, data review and data archiving.

MO-PIS-Exhibit Hall-01: Tools for TG-142 Linac Imaging QA I

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clements, M; Wiesmeyer, M

2014-06-15

Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The therapy topic this year is solutions for TG-142 recommendations for linear accelerator imaging QA. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Automated Imaging QA for TG-142 with RIT Presentation Time: 2:45 – 3:15 PM This presentation will discuss software tools for automated imaging QA and phantom analysis for TG-142.more » All modalities used in radiation oncology will be discussed, including CBCT, planar kV imaging, planar MV imaging, and imaging and treatment coordinate coincidence. Vendor supplied phantoms as well as a variety of third-party phantoms will be shown, along with appropriate analyses, proper phantom setup procedures and scanning settings, and a discussion of image quality metrics. Tools for process automation will be discussed which include: RIT Cognition (machine learning for phantom image identification), RIT Cerberus (automated file system monitoring and searching), and RunQueueC (batch processing of multiple images). In addition to phantom analysis, tools for statistical tracking, trending, and reporting will be discussed. This discussion will include an introduction to statistical process control, a valuable tool in analyzing data and determining appropriate tolerances. An Introduction to TG-142 Imaging QA Using Standard Imaging Products Presentation Time: 3:15 – 3:45 PM Medical Physicists want to understand the logic behind TG-142 Imaging QA. What is often missing is a firm understanding of the connections between the EPID and OBI phantom imaging, the software “algorithms” that calculate the QA metrics, the establishment of baselines, and the analysis and interpretation of the results. The goal of our brief presentation will be to establish and solidify these connections. Our talk will be motivated by the Standard Imaging, Inc. phantom and software solutions. We will present and explain each of the image quality metrics in TG-142 in terms of the theory, mathematics, and algorithms used to implement them in the Standard Imaging PIPSpro software. In the process, we will identify the regions of phantom images that are analyzed by each algorithm. We then will discuss the process of the creation of baselines and typical ranges of acceptable values for each imaging quality metric.« less

Raman spectroscopy characterization of two-dimensional materials

NASA Astrophysics Data System (ADS)

Liang, Fang; Xu, Hejun; Wu, Xing; Wang, Chaolun; Luo, Chen; Zhang, Jian

2018-03-01

Not Available Project supported by the National Natural Science Foundation of China (Grant Nos. 11504111, 61574060, and 61574056), the Projects of Science and Technology Commission of Shanghai Municipality of China (Grant Nos. 15JC1401800 and 14DZ2260800), the Program for Professor of Special Appointment (Eastern Scholar), Shanghai Rising-Star Program, China (Grant No. 17QA1401400), and the Fundamental Research Funds for the Central Universities of China.

CTC Sentinel. Volume 2, Issue 6, June 2009

DTIC Science & Technology

2009-06-01

Pakistan also makes it easier for al-Qa`ida to manage local perceptions and deny involvement in controversial terrorist attacks within the country...Combating Terrorism Center (CTC) at West Point, where he manages the Harmony Program and is developing the CTC’s South Asian research program. Prior to...operational art. Police operational art is defined as the capacity to go beyond managing single tactical incidents to influencing the effects of multiple

In-Plant Technical Assistance for Software

DTIC Science & Technology

1986-09-29

engineer who has had a few programming courses (or send him to a few), and then he will be your software engineer." ( Pressman , 1982.)* Generally, It...1984. Program Office/AFCMD Interface. AFSCR 800-42, November 1982. Pressman , Roger S., Software Engineering. McGraw-Hill, New York, 1982. Dennis...B.M.C., Norton AFB Darrah Whitlock QA Specialist, Plans & Eval. Branch Rockwell-Anaheim AFPRO Lt. Col. Barry Prins HQ/AFCMD Kirtland AFB Stan

Quality assurance in MR image guided adaptive brachytherapy for cervical cancer: Final results of the EMBRACE study dummy run.

PubMed

Kirisits, Christian; Federico, Mario; Nkiwane, Karen; Fidarova, Elena; Jürgenliemk-Schulz, Ina; de Leeuw, Astrid; Lindegaard, Jacob; Pötter, Richard; Tanderup, Kari

2015-12-01

Upfront quality assurance (QA) is considered essential when starting a multicenter clinical trial in radiotherapy. Despite the long experience gained for external beam radiotherapy (EBRT) trials, there are only limited audit QA methods for brachytherapy (BT) and none include the specific aspects of image guided adaptive brachytherapy (IGABT). EMBRACE is a prospective multicenter trial aiming to assess the impact of (MRI)-based IGABT in locally advanced cervical cancer. An EMBRACE dummy run was designed to identify sources and magnitude of uncertainties and errors considered important for the evaluation of clinical, and dosimetric parameters and their relation to outcome. Contouring, treatment planning and dose reporting was evaluated and scored with a categorical scale of 1-10. Active feedback to centers was provided to improve protocol compliance and reporting. A second dummy run was required in case of major deviations (score <7) for any item. Overall 27/30 centers passed the dummy run. 16 centers had to repeat the dummy run in order to clarify major inconsistencies to the protocol. The most pronounced variations were related to contouring for both EBRT and BT. Centers with experience in IGABT (>30 cases) had better performance as compared to centers with limited experience. The comprehensive dummy run designed for the EMBRACE trial has been a feasible tool for QA in IGABT of cervix cancer. It should be considered for future IGABT trials and could serve as the basis for continuous quality checks for brachytherapy centers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

SU-F-T-251: The Quality Assurance for the Heavy Patient Load Department in the Developing Country: The Primary Experience of An Entire Workflow QA Process Management in Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xie, J; Wang, J; Peng, J

Purpose: To implement an entire workflow quality assurance (QA) process in the radiotherapy department and to reduce the error rates of radiotherapy based on the entire workflow management in the developing country. Methods: The entire workflow QA process management starts from patient registration to the end of last treatment including all steps through the entire radiotherapy process. Error rate of chartcheck is used to evaluate the the entire workflow QA process. Two to three qualified senior medical physicists checked the documents before the first treatment fraction of every patient. Random check of the treatment history during treatment was also performed.more » A total of around 6000 patients treatment data before and after implementing the entire workflow QA process were compared from May, 2014 to December, 2015. Results: A systemic checklist was established. It mainly includes patient’s registration, treatment plan QA, information exporting to OIS(Oncology Information System), documents of treatment QAand QA of the treatment history. The error rate derived from the chart check decreases from 1.7% to 0.9% after our the entire workflow QA process. All checked errors before the first treatment fraction were corrected as soon as oncologist re-confirmed them and reinforce staff training was accordingly followed to prevent those errors. Conclusion: The entire workflow QA process improved the safety, quality of radiotherapy in our department and we consider that our QA experience can be applicable for the heavily-loaded radiotherapy departments in developing country.« less

Effect of mutations in the qa gene cluster of Neurospora crassa on the enzyme catabolic dehydroquinase.

PubMed Central

Jacobson, J W; Hautala, J A; Case, M E; Giles, N H

1975-01-01

Catabolic dehydroquinase, which functions in the inducible quinic acid catabolic pathway of Neurospora crassa, has been purified from wild type (74-A) and three mutants in the qa gene cluster. The mutant strains were: 105c, a temperature-sensitive constitutive mutant in the qa-1 regulatory locus; M-16, a qa-3 mutant deficient in quinate dehydrogenase activity; and 237, a leaky qa-2 mutant which possess very low levels of catabolic dehydroquinase activity. The enzymes purified from strains 74-A, 105c, and M-16 are identical with respect to behavior during purification, specific activity, electrophoretic behavior, stability, molecular weight, subunit structure, immunological cross-reactivity, and amino acid content. The mutant enzyme from strain 237 is 1,500-fold less active and appears to have a slightly different amino acid content. It is identical by a number of the other criteria listed above and is presumed to be a mutant at or near the enzyme active site. These data demonstrate that the qa-1 gene product is not involved in the posttranslational expression of enzyme activity. The biochemical identity of catabolic dehydroquinase isolated from strains 105c and M-16 with that from wild type also demonstrates that neither the inducer, quinic acid, nor other enzymes encoded in the qa gene cluster are necessary for the expression of activity. Therefore the combined genetic and biochemical data on the qa system continue to support the hypothesis that the qa-1 regulatory protein acts as a positive initiator of qa enzyme synthesis. Images PMID:126226

A tool to include gamma analysis software into a quality assurance program.

PubMed

Agnew, Christina E; McGarry, Conor K

2016-03-01

To provide a tool to enable gamma analysis software algorithms to be included in a quality assurance (QA) program. Four image sets were created comprising two geometric images to independently test the distance to agreement (DTA) and dose difference (DD) elements of the gamma algorithm, a clinical step and shoot IMRT field and a clinical VMAT arc. The images were analysed using global and local gamma analysis with 2 in-house and 8 commercially available software encompassing 15 software versions. The effect of image resolution on gamma pass rates was also investigated. All but one software accurately calculated the gamma passing rate for the geometric images. Variation in global gamma passing rates of 1% at 3%/3mm and over 2% at 1%/1mm was measured between software and software versions with analysis of appropriately sampled images. This study provides a suite of test images and the gamma pass rates achieved for a selection of commercially available software. This image suite will enable validation of gamma analysis software within a QA program and provide a frame of reference by which to compare results reported in the literature from various manufacturers and software versions. Copyright © 2015. Published by Elsevier Ireland Ltd.

Detection of Pathogenic Protozoa in the Diagnostic Laboratory: Result Reproducibility, Specimen Pooling, and Competency Assessment▿

PubMed Central

Libman, M. D.; Gyorkos, T. W.; Kokoskin, E.; MacLean, J. D.

2008-01-01

Stool microscopy as performed in clinical parasitology laboratories is a complex procedure with subjective interpretation. Quality assurance (QA) programs often emphasize proficiency testing as an assessment tool. We describe a result reproducibility assessment tool, which can form part of a broader QA program, and which is based on the blinded resubmission of selected clinical samples, using concordance between the reports of the initial and resubmitted specimen as an indicator. Specimens preserved in sodium acetate-acetic acid-formalin can be stored for several months for use in such a program. The presence of multiple protozoa in one specimen does not affect concordance. Some dilution of specimens occurs in this process, and this may explain poor concordance when specimens with low protozoal concentrations are resubmitted. Evaluation of this tool in a large parasitology laboratory revealed concordance rates for pathogenic protozoa (Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Dientamoeba fragilis) of about 80%, which may be considered for use as a benchmark value. We also used this tool to demonstrate that when pairs of specimens from one patient are pooled to create a single specimen, concordance between the results of the individual and pooled specimens is high. PMID:18448690

SU-E-T-100: Designing a QA Tool for Enhance Dynamic Wedges Based On Dynalog Files

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yousuf, A; Hussain, A

2014-06-01

Purpose: A robust quality assurance (QA) program for computer controlled enhanced dynamic wedge (EDW) has been designed and tested. Calculations to perform such QA test is based upon the EDW dynamic log files generated during dose delivery. Methods: Varian record and verify system generates dynamic log (dynalog) files during dynamic dose delivery. The system generated dynalog files contain information such as date and time of treatment, energy, monitor units, wedge orientation, and type of treatment. It also contains the expected calculated segmented treatment tables (STT) and the actual delivered STT for the treatment delivery as a verification record. These filesmore » can be used to assess the integrity and precision of the treatment plan delivery. The plans were delivered with a 6 MV beam from a Varian linear accelerator. For available EDW angles (10°, 15°, 20°, 25°, 30°, 45°, and 60°) Varian STT values were used to manually calculate monitor units for each segment. It can also be used to calculate the EDW factors. Independent verification of fractional MUs per segment was performed against those generated from dynalog files. The EDW factors used to calculate MUs in TPS were dosimetrically verified in solid water phantom with semiflex chamber on central axis. Results: EDW factors were generated from the STT provided by Varian and verified against practical measurements. The measurements were in agreement of the order of 1 % to the calculated EDW data. Variation between the MUs per segment obtained from dynalog files and those manually calculated was found to be less than 2%. Conclusion: An efficient and easy tool to perform routine QA procedure of EDW is suggested. The method can be easily implemented in any institution without a need for expensive QA equipment. An error of the order of ≥2% can be easily detected.« less

SU-E-T-75: A Simple Technique for Proton Beam Range Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burgdorf, B; Kassaee, A; Garver, E

2015-06-15

Purpose: To develop a measurement-based technique to verify the range of proton beams for quality assurance (QA). Methods: We developed a simple technique to verify the proton beam range with in-house fabricated devices. Two separate devices were fabricated; a clear acrylic rectangular cuboid and a solid polyvinyl chloride (PVC) step wedge. For efficiency in our clinic, we used the rectangular cuboid for double scattering (DS) beams and the step wedge for pencil beam scanning (PBS) beams. These devices were added to our QA phantom to measure dose points along the distal fall-off region (between 80% and 20%) in addition tomore » dose at mid-SOBP (spread out Bragg peak) using a two-dimensional parallel plate chamber array (MatriXX™, IBA Dosimetry, Schwarzenbruck, Germany). This method relies on the fact that the slope of the distal fall-off is linear and does not vary with small changes in energy. Using a multi-layer ionization chamber (Zebra™, IBA Dosimetry), percent depth dose (PDD) curves were measured for our standard daily QA beams. The range (energy) for each beam was then varied (i.e. ±2mm and ±5mm) and additional PDD curves were measured. The distal fall-off of all PDD curves was fit to a linear equation. The distal fall-off measured dose for a particular beam was used in our linear equation to determine the beam range. Results: The linear fit of the fall-off region for the PDD curves, when varying the range by a few millimeters for a specific QA beam, yielded identical slopes. The calculated range based on measured point dose(s) in the fall-off region using the slope resulted in agreement of ±1mm of the expected beam range. Conclusion: We developed a simple technique for accurately verifying the beam range for proton therapy QA programs.« less

Automation of a Linear Accelerator Dosimetric Quality Assurance Program

NASA Astrophysics Data System (ADS)

Lebron Gonzalez, Sharon H.

According to the American Society of Radiation Oncology, two-thirds of all cancer patients will receive radiation therapy during their illness with the majority of the treatments been delivered by a linear accelerator (linac). Therefore, quality assurance (QA) procedures must be enforced in order to deliver treatments with a machine in proper conditions. The overall goal of this project is to automate the linac's dosimetric QA procedures by analyzing and accomplishing various tasks. First, the photon beam dosimetry (i.e. total scatter correction factor, infinite percentage depth dose (PDD) and profiles) were parameterized. Parameterization consists of defining the parameters necessary for the specification of a dosimetric quantity model creating a data set that is portable and easy to implement for different applications including: beam modeling data input into a treatment planning system (TPS), comparing measured and TPS modelled data, the QA of a linac's beam characteristics, and the establishment of a standard data set for comparison with other data, etcetera. Second, this parameterization model was used to develop a universal method to determine the radiation field size of flattened (FF), flattening-filter-free (FFF) and wedge beams which we termed the parameterized gradient method (PGM). Third, the parameterized model was also used to develop a profile-based method for assessing the beam quality of photon FF and FFF beams using an ionization chamber array. The PDD and PDD change was also predicted from the measured profile. Lastly, methods were created to automate the multileaf collimator (MLC) calibration and QA procedures as well as the acquisition of the parameters included in monthly and annual photon dosimetric QA. A two field technique was used for the calculation of the MLC leaf relative offsets using an electronic portal imaging device (EPID). A step-and-shoot technique was used to accurately acquire the radiation field size, flatness, symmetry, output and beam quality specifiers in a single delivery to an ionization chamber array for FF and FFF beams.

Poster - Thur Eve - 29: Detecting changes in IMRT QA using statistical process control.

PubMed

Drever, L; Salomons, G

2012-07-01

Statistical process control (SPC) methods were used to analyze 239 measurement based individual IMRT QA events. The selected IMRT QA events were all head and neck (H&N) cases with 70Gy in 35 fractions, and all prostate cases with 76Gy in 38 fractions planned between March 2009 and 2012. The results were used to determine if the tolerance limits currently being used for IMRT QA were able to indicate if the process was under control. The SPC calculations were repeated for IMRT QA of the same type of cases that were planned after the treatment planning system was upgraded from Eclipse version 8.1.18 to version 10.0.39. The initial tolerance limits were found to be acceptable for two of the three metrics tested prior to the upgrade. After the upgrade to the treatment planning system the SPC analysis found that the a priori limits were no longer capable of indicating control for 2 of the 3 metrics analyzed. The changes in the IMRT QA results were clearly identified using SPC, indicating that it is a useful tool for finding changes in the IMRT QA process. Routine application of SPC to IMRT QA results would help to distinguish unintentional trends and changes from the random variation in the IMRT QA results for individual plans. © 2012 American Association of Physicists in Medicine.

A Method to Exchange Air Nitrogen Emission Reductions for Watershed Nitrogen Load Reductions

EPA Science Inventory

Presentation of the method developed for the Chesapeake Bay Program to estimate changes in nitrogen loading to Chesapeake due to changes in Bay State state-level nitrogen oxide emissions to support air-water trading by the Bay States. Type for SticsUnder AMAD Application QAPP, QA...

Inferring random component distributions from environmental measurements for quality assurance

USDA-ARS?s Scientific Manuscript database

Environmental measurement programs can add value by providing not just accurate data, but also a measure of that accuracy. While quality assurance (QA) has been recognized as necessary since almost the beginning of automated weather measurement, it has received less attention than the data proper. M...

Test/QA Plan for Verification of Radio Frequency Identification (RFID) for Tracking Hazardous Waste Shipments across International Borders

EPA Science Inventory

The verification test will be conducted under the auspices of the U.S. Environmental Protection Agency (EPA) through the Environmental Technology Verification (ETV) Program. It will be performed by Battelle, which is managing the ETV Advanced Monitoring Systems (AMS) Center throu...

Legal Perspective: Q&A with Daniel F. Goldstein

ERIC Educational Resources Information Center

Betts, Kristen

2013-01-01

For students with disabilities to have the same opportunities to succeed as their nondisabled peers, access to educational technology and digital content is critical. It is essential that higher education boards, administrators, faculty, and administrative staff understand why accessibility must be on the forefront of our educational programs,…

QUALITY ASSURANCE: THE THREAD THAT WEAVES TOGETHER THE FABRIC OF DIVERSE DISCIPLINES

EPA Science Inventory

Mature Quality Assurance (QA) programs do not call for high quality! However, they most often demand known quality. We can intuitively sense quality in our daily lives.

Protection of the environment is, in part, dependent on the quality of data used in decision making. Wh...

Quality Assurance and Quality Control Practices for Rehabilitation of Sewer and Water Mains

EPA Science Inventory

As part of the US Environmental Protection Agency (EPA)’s Aging Water Infrastructure Research Program, several areas of research are being pursued, including a review of quality assurance and quality control (QA/QC) practices and acceptance testing during the installation of reha...

Quality Assurance and Quality Control Practices For Rehabilitation of Sewer and Water Mains

EPA Science Inventory

As part of the US Environmental Protection Agency (EPA)’s Aging Water Infrastructure Research Program, several areas of research are being pursued including a review of quality assurance and quality control (QA/QC) practices and acceptance testing during the installation of rehab...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--QA ANALYTICAL RESULTS FOR PARTICULATE MATTER IN BLANK SAMPLES

EPA Science Inventory

The Particulate Matter in Blank Samples data set contains the analytical results for measurements of two particle sizes in 12 samples. Filters were pre-weighed, loaded into impactors, kept unexposed in the laboratory, unloaded and post-weighed. Positive weight gains for laborat...

Improving spot-scanning proton therapy patient specific quality assurance with HPlusQA, a second-check dose calculation engine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mackin, Dennis; Li, Yupeng; Taylor, Michael B.

Purpose: The purpose of this study was to validate the use of HPlusQA, spot-scanning proton therapy (SSPT) dose calculation software developed at The University of Texas MD Anderson Cancer Center, as second-check dose calculation software for patient-specific quality assurance (PSQA). The authors also showed how HPlusQA can be used within the current PSQA framework.Methods: The authors compared the dose calculations of HPlusQA and the Eclipse treatment planning system with 106 planar dose measurements made as part of PSQA. To determine the relative performance and the degree of correlation between HPlusQA and Eclipse, the authors compared calculated with measured point doses.more » Then, to determine how well HPlusQA can predict when the comparisons between Eclipse calculations and the measured dose will exceed tolerance levels, the authors compared gamma index scores for HPlusQA versus Eclipse with those of measured doses versus Eclipse. The authors introduce the αβγ transformation as a way to more easily compare gamma scores.Results: The authors compared measured and calculated dose planes using the relative depth, z/R × 100%, where z is the depth of the measurement and R is the proton beam range. For relative depths than less than 80%, both Eclipse and HPlusQA calculations were within 2 cGy of dose measurements on average. When the relative depth was greater than 80%, the agreement between the calculations and measurements fell to 4 cGy. For relative depths less than 10%, the Eclipse and HPlusQA dose discrepancies showed a negative correlation, −0.21. Otherwise, the correlation between the dose discrepancies was positive and as large as 0.6. For the dose planes in this study, HPlusQA correctly predicted when Eclipse had and had not calculated the dose to within tolerance 92% and 79% of the time, respectively. In 4 of 106 cases, HPlusQA failed to predict when the comparison between measurement and Eclipse's calculation had exceeded the tolerance levels of 3% for dose and 3 mm for distance-to-agreement.Conclusions: The authors found HPlusQA to be reasonably effective (79%± 10%) in determining when the comparison between measured dose planes and the dose planes calculated by the Eclipse treatment planning system had exceeded the acceptable tolerance levels. When used as described in this study, HPlusQA can reduce the need for patient specific quality assurance measurements by 64%. The authors believe that the use of HPlusQA as a dose calculation second check can increase the efficiency and effectiveness of the QA process.« less

Clinical implementation and error sensitivity of a 3D quality assurance protocol for prostate and thoracic IMRT

PubMed Central

Cotter, Christopher; Turcotte, Julie Catherine; Crawford, Bruce; Sharp, Gregory; Mah'D, Mufeed

2015-01-01

This work aims at three goals: first, to define a set of statistical parameters and plan structures for a 3D pretreatment thoracic and prostate intensity‐modulated radiation therapy (IMRT) quality assurance (QA) protocol; secondly, to test if the 3D QA protocol is able to detect certain clinical errors; and third, to compare the 3D QA method with QA performed with single ion chamber and 2D gamma test in detecting those errors. The 3D QA protocol measurements were performed on 13 prostate and 25 thoracic IMRT patients using IBA's COMPASS system. For each treatment planning structure included in the protocol, the following statistical parameters were evaluated: average absolute dose difference (AADD), percent structure volume with absolute dose difference greater than 6% (ADD6), and 3D gamma test. To test the 3D QA protocol error sensitivity, two prostate and two thoracic step‐and‐shoot IMRT patients were investigated. Errors introduced to each of the treatment plans included energy switched from 6 MV to 10 MV, multileaf collimator (MLC) leaf errors, linac jaws errors, monitor unit (MU) errors, MLC and gantry angle errors, and detector shift errors. QA was performed on each plan using a single ion chamber and 2D array of ion chambers for 2D and 3D QA. Based on the measurements performed, we established a uniform set of tolerance levels to determine if QA passes for each IMRT treatment plan structure: maximum allowed AADD is 6%; maximum 4% of any structure volume can be with ADD6 greater than 6%, and maximum 4% of any structure volume may fail 3D gamma test with test parameters 3%/3 mm DTA. Out of the three QA methods tested the single ion chamber performed the worst by detecting 4 out of 18 introduced errors, 2D QA detected 11 out of 18 errors, and 3D QA detected 14 out of 18 errors. PACS number: 87.56.Fc PMID:26699299

Commissioning and comprehensive evaluation of the ArcCHECK cylindrical diode array for VMAT pretreatment delivery QA

PubMed Central

Chaswal, Vibha; Weldon, Michael; Gupta, Nilendu; Chakravarti, Arnab

2014-01-01

We present commissioning and comprehensive evaluation for ArcCHECK as a QA equipment for volumetric‐modulated arc therapy (VMAT), using the 6 MV photon beam with and without the flattening filter, and the SNC patient software (version 6.2). In addition to commissioning involving absolute dose calibration, array calibration, and PMMA density verification, ArcCHECK was evaluated for its response dependency on linac dose rate, instantaneous dose rate, radiation field size, beam angle, and couch insertion. Scatter dose characterization, consistency and symmetry of response, and dosimetry accuracy evaluation for fixed aperture arcs and clinical VMAT patient plans were also investigated. All the evaluation tests were performed with the central plug inserted and the homogeneous PMMA density value. Results of gamma analysis demonstrated an overall agreement between ArcCHECK‐measured and TPS‐calculated reference doses. The diode based field size dependency was found to be within 0.5% of the reference. The dose rate‐based dependency was well within 1% of the TPS reference, and the angular dependency was found to be ± 3% of the reference, as tested for BEV angles, for both beams. Dosimetry of fixed arcs, using both narrow and wide field widths, resulted in clinically acceptable global gamma passing rates on the 3%/3 mm level and 10% threshold. Dosimetry of narrow arcs showed an improvement over published literature. The clinical VMAT cases demonstrated high level of dosimetry accuracy in gamma passing rates. PACS numbers: 87.56.Fc, 87.55.kh, 87.55.Qr PMID:25207411

SU-F-BRD-13: Quantum Annealing Applied to IMRT Beamlet Intensity Optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nazareth, D; Spaans, J

Purpose: We report on the first application of quantum annealing (QA) to the process of beamlet intensity optimization for IMRT. QA is a new technology, which employs novel hardware and software techniques to address various discrete optimization problems in many fields. Methods: We apply the D-Wave Inc. proprietary hardware, which natively exploits quantum mechanical effects for improved optimization. The new QA algorithm, running on this hardware, is most similar to simulated annealing, but relies on natural processes to directly minimize the free energy of a system. A simple quantum system is slowly evolved into a classical system, representing the objectivemore » function. To apply QA to IMRT-type optimization, two prostate cases were considered. A reduced number of beamlets were employed, due to the current QA hardware limitation of ∼500 binary variables. The beamlet dose matrices were computed using CERR, and an objective function was defined based on typical clinical constraints, including dose-volume objectives. The objective function was discretized, and the QA method was compared to two standard optimization Methods: simulated annealing and Tabu search, run on a conventional computing cluster. Results: Based on several runs, the average final objective function value achieved by the QA was 16.9 for the first patient, compared with 10.0 for Tabu and 6.7 for the SA. For the second patient, the values were 70.7 for the QA, 120.0 for Tabu, and 22.9 for the SA. The QA algorithm required 27–38% of the time required by the other two methods. Conclusion: In terms of objective function value, the QA performance was similar to Tabu but less effective than the SA. However, its speed was 3–4 times faster than the other two methods. This initial experiment suggests that QA-based heuristics may offer significant speedup over conventional clinical optimization methods, as quantum annealing hardware scales to larger sizes.« less

Evaluation of the implementation of new traceability and food safety requirements in the pig industry in eastern Australia.

PubMed

Hernández-Jover, M; Schembri, N; Toribio, J-A; Holyoake, P K

2009-10-01

To evaluate the implementation and barriers to adoption, among pig producers, of a newly introduced traceability and food safety system in Australia. Implementation of the PigPass national vendor declaration (NVD) linked to an on-farm quality assurance (QA) program was evaluated in May and December 2007 at saleyards and abattoirs in New South Wales, Victoria and Queensland. Four focus group discussions with saleyard producers were held between April and July 2007. Implementation of the PigPass system in terms of accurate completion of the form and QA accreditation was higher at the export abattoir than at the regional saleyard at the first audit (P < 0.01). Implementation increased at the second audit at the abattoirs, but little change with time was observed at saleyards. Approximately half of the producers at saleyards used photocopied PigPass forms, made at least one error (>64%), and many vendors did not appear to be QA-accredited. During focus groups, producers expressed the view that PigPass implementation improved animal and product traceability. They identified the associated costs and a perceived lack of support by information providers as obstacles for adoption. Improvement in the implementation of PigPass among producers marketing pigs at export abattoirs was observed during the 8-month period of the study. There is a need for a more uniform message to producers from government agencies on the importance of the PigPass NVD and QA and extension and education targeted toward producers supplying pigs to saleyards and domestic abattoirs to ensure compliance with the traceability requirements.

Methods for Streamlining Intervention Fidelity Checklists: An Example from the Chronic Disease Self-Management Program

PubMed Central

Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Belza, Basia; Post, Lindsey; Ory, Marcia G.

2015-01-01

Maintaining intervention fidelity should be part of any programmatic quality assurance (QA) plan and is often a licensure requirement. However, fidelity checklists designed by original program developers are often lengthy, which makes compliance difficult once programs become widely disseminated in the field. As a case example, we used Stanford’s original Chronic Disease Self-Management Program (CDSMP) fidelity checklist of 157 items to demonstrate heuristic procedures for generating shorter fidelity checklists. Using an expert consensus approach, we sought feedback from active master trainers registered with the Stanford University Patient Education Research Center about which items were most essential to, and also feasible for, assessing fidelity. We conducted three sequential surveys and one expert group-teleconference call. Three versions of the fidelity checklist were created using different statistical and methodological criteria. In a final group-teleconference call with seven national experts, there was unanimous agreement that all three final versions (e.g., a 34-item version, a 20-item version, and a 12-item version) should be made available because the purpose and resources for administering a checklist might vary from one setting to another. This study highlights the methodology used to generate shorter versions of a fidelity checklist, which has potential to inform future QA efforts for this and other evidence-based programs (EBP) for older adults delivered in community settings. With CDSMP and other EBP, it is important to differentiate between program fidelity as mandated by program developers for licensure, and intervention fidelity tools for providing an “at-a-glance” snapshot of the level of compliance to selected program indicators. PMID:25964941

The role of Imaging and Radiation Oncology Core for precision medicine era of clinical trial

PubMed Central

Rosen, Mark

2017-01-01

Imaging and Radiation Oncology Core (IROC) services have been established for the quality assurance (QA) of imaging and radiotherapy (RT) for NCI’s Clinical Trial Network (NCTN) for any trials that contain imaging or RT. The randomized clinical trial is the gold standard for evidence-based medicine. QA ensures data quality, preventing noise from inferior treatments obscuring clinical trial outcome. QA is also found to be cost-effective. IROC has made great progress in multi-institution standardization and is expected to lead QA standardization, QA science in imaging and RT and to advance quality data analysis with big data in the future. The QA in the era of precision medicine is of paramount importance, when individualized decision making may depend on the quality and accuracy of RT and imaging. PMID:29218265

SU-F-T-262: Commissioning Varian Portal Dosimetry for EPID-Based Patient Specific QA in a Non-Aria Environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmidt, M; Knutson, N; University of Rhode Island, Kingston, RI

2016-06-15

Purpose: Development of an in-house program facilitates a workflow that allows Electronic Portal Imaging Device (EPID) patient specific quality assurance (QA) measurements to be acquired and analyzed in the Portal Dosimetry Application (Varian Medical Systems, Palo Alto, CA) using a non-Aria Record and Verify (R&V) system (MOSAIQ, Elekta, Crawley, UK) to deliver beams in standard clinical treatment mode. Methods: Initial calibration of an in-house software tool includes characterization of EPID dosimetry parameters by importing DICOM images of varying delivered MUs to determine linear mapping factors in order to convert image pixel values to Varian-defined Calibrated Units (CU). Using this information,more » the Portal Dose Image Prediction (PDIP) algorithm was commissioned by converting images of various field sizes to output factors using the Eclipse Scripting Application Programming Interface (ESAPI) and converting a delivered configuration fluence to absolute dose units. To verify the algorithm configuration, an integrated image was acquired, exported directly from the R&V client, automatically converted to a compatible, calibrated dosimetric image, and compared to a PDIP calculated image using Varian’s Portal Dosimetry Application. Results: For two C-Series and one TrueBeam Varian linear accelerators, gamma comparisons (global 3% / 3mm) of PDIP algorithm predicted dosimetric images and images converted via the inhouse system demonstrated agreement for ≥99% of all pixels, exceeding vendor-recommended commissioning guidelines. Conclusion: Combinations of a programmatic image conversion tool and ESAPI allow for an efficient and accurate method of patient IMRT QA incorporating a 3rd party R&V system.« less

Answerers' Motivations and Strategies for Providing Information and Social Support in Social Q&A an Investigation of Health Question Answering

ERIC Educational Resources Information Center

Oh, Sanghee

2010-01-01

Social Q&A allows people to ask and answer questions for each other and to solve problems in everyday life collaboratively. The purpose of the current study is to understand the motivations and strategies of answerers in social Q&A. Thus, three research questions were investigated: (1) Why do answerers participate and contribute in social Q&A? (2)…

Alternative splicing of class Ib major histocompatibility complex transcripts in vivo leads to the expression of soluble Qa-2 molecules in murine blood.

PubMed Central

Tabaczewski, P; Shirwan, H; Lewis, K; Stroynowski, I

1994-01-01

Class Ib Qa-2 molecules are expressed in tissue culture cells as approximately 40-kDa membrane-bound, glycophosphatidylinositol-linked antigens and as approximately 39-kDa soluble polypeptides. Recently, alternative splicing events which delete exon 5 from a portion of Qa-2 transcripts were demonstrated to give rise to truncated secreted Qa-2 molecules in transfected cell lines. To determine whether this mechanism operates in vivo and to find out whether Qa-2 can be detected in soluble form in circulation, murine blood samples were analyzed. Critical to these experiments was preparation of an anti-peptide antiserum against an epitope encoded by a junction of exon 4 and exon 6. We find that supernatants of splenocytes cultured in vitro as well as serum or plasma contain two forms of soluble Qa-2 molecules. One form corresponds to a secreted molecule translated from transcripts from which exon 5 has been deleted; the other is derived from membrane-bound antigens or their precursors. The levels of both soluble forms of Qa-2 are inducible upon stimulation of the immune system, suggesting an immunoregulatory role for these molecules or for the mechanism leading to the reduction of cell-associated Qa-2 antigens in vivo. Images PMID:8127900

SU-E-T-77: Comparison of 2D and 3D Gamma Analysis in Patient-Specific QA for Prostate VMAT Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clemente, F; Perez, C

2014-06-01

Purpose: Patient-specific QA procedures for IMRT and VMAT are traditionally performed by comparing TPS calculations with measured single point values and plane dose distributions by means of gamma analysis. New QA devices permit us to calculate 3D dose distributions on patient anatomy as redundant secondary check and reconstruct it from measurements taken with 2D and 3D detector arrays. 3D dose calculations allow us to perform DVH-based comparisons with clinical relevance, as well as 3D gamma analysis. One of these systems (Compass, IBA Dosimetry) combines traditional 2D with new anatomical-based 3D gamma analysis. This work shows the ability of this systemmore » by comparing 2D and 3D gamma analysis in pre-treatment QA for several VMAT prostate plans. Methods: Compass is capable of calculating dose as secondary check from DICOM TPS data and reconstructing it from measurements taken by a 2D ion chamber array (MatriXX Evolution, IBA Dosimetry). Both 2D and 3D gamma tests are available to compare calculated and reconstructed dose in Compass with TPS RT Dose. Results: 15 VMAT prostate plans have been measured with Compass. Dose is reconstructed with Compass for these plans. 2D gamma comparisons can be done for any plane from dose matrix. Mean gamma passing rates for isocenter planes (axial, coronal, sagittal) are (99.7±0.2)%, (99.9±0.1)%, (99.9±0.1)% for reconstructed dose planes. 3D mean gamma passing rates are (98.5±1.7)% for PTVs, (99.1±1.5)% for rectum, (100.0±0.0)% for bladder, (99.6±0.7)% for femoral heads and (98.1±4.1)% for penile bulb. Conclusion: Compass is a powerful tool to perform a complete pre-treatment QA analysis, from 2D techniques to 3D DVH-based techniques with clinical relevance. All reported values for VMAT prostate plans are in good agreement with TPS values. This system permits us to ensure the accuracy in the delivery of VMAT treatments completing a full patient-specific QA program.« less

[Development of quality assurance/quality control web system in radiotherapy].

PubMed

Okamoto, Hiroyuki; Mochizuki, Toshihiko; Yokoyama, Kazutoshi; Wakita, Akihisa; Nakamura, Satoshi; Ueki, Heihachi; Shiozawa, Keiko; Sasaki, Koji; Fuse, Masashi; Abe, Yoshihisa; Itami, Jun

2013-12-01

Our purpose is to develop a QA/QC (quality assurance/quality control) web system using a server-side script language such as HTML (HyperText Markup Language) and PHP (Hypertext Preprocessor), which can be useful as a tool to share information about QA/QC in radiotherapy. The system proposed in this study can be easily built in one's own institute, because HTML can be easily handled. There are two desired functions in a QA/QC web system: (i) To review the results of QA/QC for a radiotherapy machine, manuals, and reports necessary for routinely performing radiotherapy through this system. By disclosing the results, transparency can be maintained, (ii) To reveal a protocol for QA/QC in one's own institute using pictures and movies relating to QA/QC for simplicity's sake, which can also be used as an educational tool for junior radiation technologists and medical physicists. By using this system, not only administrators, but also all staff involved in radiotherapy, can obtain information about the conditions and accuracy of treatment machines through the QA/QC web system.

A method for evaluating treatment quality using in vivo EPID dosimetry and statistical process control in radiation therapy.

PubMed

Fuangrod, Todsaporn; Greer, Peter B; Simpson, John; Zwan, Benjamin J; Middleton, Richard H

2017-03-13

Purpose Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) programmes, that to date generally focus on the pre-treatment stage. The purpose of this paper is to provide a method for an individual patient treatment QA evaluation and identification of a "quality gap" for continuous quality improvement. Design/methodology/approach A statistical process control (SPC) was applied to evaluate treatment delivery using in vivo electronic portal imaging device (EPID) dosimetry. A moving range control chart was constructed to monitor the individual patient treatment performance based on a control limit generated from initial data of 90 intensity-modulated radiotherapy (IMRT) and ten volumetric-modulated arc therapy (VMAT) patient deliveries. A process capability index was used to evaluate the continuing treatment quality based on three quality classes: treatment type-specific, treatment linac-specific, and body site-specific. Findings The determined control limits were 62.5 and 70.0 per cent of the χ pass-rate for IMRT and VMAT deliveries, respectively. In total, 14 patients were selected for a pilot study the results of which showed that about 1 per cent of all treatments contained errors relating to unexpected anatomical changes between treatment fractions. Both rectum and pelvis cancer treatments demonstrated process capability indices were less than 1, indicating the potential for quality improvement and hence may benefit from further assessment. Research limitations/implications The study relied on the application of in vivo EPID dosimetry for patients treated at the specific centre. Sampling patients for generating the control limits were limited to 100 patients. Whilst the quantitative results are specific to the clinical techniques and equipment used, the described method is generally applicable to IMRT and VMAT treatment QA. Whilst more work is required to determine the level of clinical significance, the authors have demonstrated the capability of the method for both treatment specific QA and continuing quality improvement. Practical implications The proposed method is a valuable tool for assessing the accuracy of treatment delivery whilst also improving treatment quality and patient safety. Originality/value Assessing in vivo EPID dosimetry with SPC can be used to improve the quality of radiation treatment for cancer patients.

Near Real Time Operational Satellite Ocean Color Products From NOAA OSPO CoastWatch Okeanos System:: Status and Challenges

NASA Astrophysics Data System (ADS)

Banghua Yan, B.

2016-02-01

Near real-time (NRT) ocean color (OC) satellite operation products are generated and distributed in NOAA Okeanos Operational Product System, by using the CWAPS including the Multi-Sensor Level (MSL) 12 and the chlorophyll-a frontal algorithms. Current OC operational products include daily chlorophyll concentration (anomaly), water turbidity, remote sensing reflectance and chlorophyll frontal products from Moderate-resolution Imaging Spectroradiometer (MODIS)/Aqua. The products have been widely applied to USA local and state ecosystem research, ecosystem observations, and fisheries managements for coastal and regional forecasting of ocean water quality, phytoplankton concentrations, and primary production. Users of the products have the National Ocean Service, National Marine Fisheries Service, National Weather Service, and Oceanic and Atmospheric Research. Recently, the OC products are being extended to S-NPP VIIRS to provide global NRT ocean color products to user community suh as National Weatrher Service for application for Global Data Assimilation System and Real-Time Ocean Forecast System. However, there remain some challenges in application of the products due to certain product quality and coverage issues. Recent efforts were made to provide a comprehensive web-based Quality Assurance (QA) tool for monitoring OC products quality in near real time mode, referring to http://www.ospo.noaa.gov/Products/ocean/color_new/color.htm. The new QA monitoring tool includes but not limited to the following advanced features applicable for MODIS/Aqua and NPP/VIIRS OC products: 1) Monitoring product quality in NRT mode; 2) Monitoring the availability and quality of OC products with time; 3) Detecting anomalous OC products due to low valid pixels and other quality issues. As an example, potential application and challenges of the ocean color products to oceanic oil spill detection are investigated. It is thus expected that the Okeanos ocean color operational system in combination with the new QA monitoring tool will more efficiently ensure availability and quality of satellite operational OC products from Okeanos system to the user community. The QA tool also will provide much useful information of OC products quality and statistics to the OC user community.

SU-E-T-60: A Plan Quality Index in IMRT QA That Is Independent of the Acceptance Criteria

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, D; Kang, S; Kim, T

2015-06-15

Purpose: In IMRT QA, plan quality evaluation is made based on pass rate under preset acceptance criteria, mostly using gamma-values. This method is convenient but, its Result highly depends on what the acceptance criteria are and suffers from the lack of sensitivity in judging how good the plan is. In this study, we introduced a simple but effective plan quality index of IMRT QA based on dose difference only to supplement such shortcomings, and investigated its validity. Methods: The proposed index is a single value which is calculated mainly based on point-by-point comparison between planned and measured dose distributions, andmore » it becomes “1” in an ideal case. A systematic evaluation was performed with one-dimensional test dose distributions. For 3 hypothetical dose profiles, various displacements (in both dose and space) were introduced, the proposed index was calculated for each case, and the behavior of obtained indices was analyzed and compared with that of gamma evaluation. In addition, the feasibility of the index was assessed with clinical IMRT/VMAT/SBRT QA cases for different sites (prostate, head & neck, liver, lung, spine, and abdomen). Results: The proposed index showed more robust correlation with the amount of induced displacement compared to the gamma evaluation method. No matter what the acceptance criteria are (e.g., whether 3%/3mm or 2%/2mm), it was possible to clearly rank every case with the proposed index while it was difficult to do with the gamma evaluation method. Conclusion: IMRT plan quality can be evaluated quantitatively by the proposed index. It is considered that the proposed index would provide useful information for better judging the level of goodness of each plan and its Result is independent of the acceptance criteria. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning.« less

Technical Note: A new phantom design for routine testing of Doppler ultrasound.

PubMed

Grice, J V; Pickens, D R; Price, R R

2016-07-01

The objective of this project is to demonstrate the principle and operation for a simple, inexpensive, and highly portable Doppler ultrasound quality assurance (QA) phantom intended for routine QA testing. A prototype phantom has been designed, fabricated, and evaluated. The phantom described here is powered by gravity alone, requires no external equipment for operation, and produces a stable fluid velocity useful for quality assurance. Many commercially available Doppler ultrasound testing systems can suffer from issues such as a lengthy setup, prohibitive cost, nonportable size, or difficulty in use. This new phantom design aims to address some of these problems and create a phantom appropriate for assessing Doppler ultrasound stability. The phantom was fabricated using a 3D printer. The basic design of the phantom is to provide gravity-powered flow of a Doppler fluid between two reservoirs. The printed components were connected with latex tubing and then seated in a tissue mimicking gel. Spectral Doppler waveforms were sampled to evaluate variations in the data, and the phantom was evaluated using high frame rate video to find an alternate measure of mean fluid velocity flowing in the phantom. The current system design maintains stable flow from one reservoir to the other for approximately 7 s. Color Doppler imaging of the phantom was found to be qualitatively consistent with laminar flow. Using pulsed spectral Doppler, the average fluid velocity from a sample volume approximately centered in the synthetic vessel was measured to be 56 cm/s with a standard deviation of 3.2 cm/s across 118 measurements. An independent measure of the average fluid velocity was measured to be 51.9 cm/s with a standard deviation of 0.7 cm/s over 4 measurements. The developed phantom provides stable fluid flow useful for frequent clinical Doppler ultrasound testing and attempts to address several obstacles facing Doppler phantom testing. Such an ultrasound phantom can make routine testing more approachable for institutions that wish to initiate a Doppler QA program or complement a previously existing QA program.

New Directions for Higher Education: Q&A with Matthew Sigelman on Reading the Labor Market

ERIC Educational Resources Information Center

DiSalvio, Philip

2014-01-01

In April 2013, "NEJHE" launched its "New Directions for Higher Education" series to examine emerging issues, trends and ideas that have an impact on higher education policies, programs and practices. In this installment, DiSalvio interviews Matthew Sigelman, CEO of Burning Glass Technologies, a Boston-based labor market…

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--QA ANALYTICAL RESULTS FOR METALS IN SPIKE SAMPLES

EPA Science Inventory

The Metals in Spike Samples data set contains the analytical results of measurements of up to 11 metals in 15 control samples (spikes) from 11 households. Measurements were made in spiked samples of dust, food, and dermal wipe residue. Spiked samples were used to assess recover...

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--QA ANALYTICAL RESULTS FOR METALS IN REPLICATE SAMPLES

EPA Science Inventory

The Metals in Replicate Samples data set contains the analytical results of measurements of up to 2 metals in 172 replicate (duplicate) samples from 86 households. Measurements were made in samples of blood. Duplicate samples for a small percentage of the total number of sample...

New Directions for Higher Education: Q&A with ACE's Molly Corbett Broad on Attainment

ERIC Educational Resources Information Center

DiSalvio, Philip

2013-01-01

In April 2013, the "New England Journal of Higher Education" ("NEJHE") launched its "New Directions for Higher Education" series to examine emerging issues, trends, and ideas that have an impact on higher education policies, programs and practices. In this installment of the series, DiSalvio speaks with American…

New Directions for Higher Education: Q&A with Muriel Howard on Public Higher Ed

ERIC Educational Resources Information Center

DiSalvio, Philip

2014-01-01

Nearly a year ago, "NEJHE" launched its "New Directions for Higher Education" series to examine emerging issues, trends, and ideas that have an impact on higher education policies, programs, and practices. In this installment, DiSalvio interviews Muriel A. Howard, president of the American Association of State Colleges and…

SU-F-P-04: Implementation of Dose Monitoring Software: Successes and Pitfalls

DOE Office of Scientific and Technical Information (OSTI.GOV)

Och, J

2016-06-15

Purpose: to successfully install a dose monitoring software (DMS) application to assist in CT protocol and dose management. Methods: Upon selecting the DMS, we began our implementation of the application. A working group composed of Medical Physics, Radiology Administration, Information Technology, and CT technologists was formed. On-site training in the application was supplied by the vendor. The decision was made to apply the process for all the CT protocols on all platforms at all facilities. Protocols were painstakingly mapped to the correct masters, and the system went ‘live’. Results: We are routinely using DMS as a tool in our Clinicalmore » Performance CT QA program. It is useful in determining the effectiveness of revisions to existing protocols, and establishing performance baselines for new units. However, the implementation was not without difficulty. We identified several pitfalls and obstacles which frustrated progress. Including: Training deficiencies, Nomenclature problems, Communication, DICOM variability. Conclusion: Dose monitoring software can be a potent tool for QA. However, implementation of the program can be problematic and requires planning, organization and commitment.« less

Transforming an EPA QA/R-2 quality management plan into an ISO 9002 quality management system.

PubMed

Kell, R A; Hedin, C M; Kassakhian, G H; Reynolds, E S

2001-01-01

The Environmental Protection Agency's (EPA) Office of Emergency and Remedial Response (OERR) requires environmental data of known quality to support Superfund hazardous waste site projects. The Quality Assurance Technical Support (QATS) Program is operated by Shaw Environmental and Infrastructure, Inc. to provide EPA's Analytical Operations Center (AOC) with performance evaluation samples, reference materials, on-site laboratory auditing capabilities, data audits (including electronic media data audits), methods development, and other support services. The new QATS contract awarded in November 2000 required that the QATS Program become ISO 9000 certified. In a first for an EPA contractor, the QATS staff and management successfully transformed EPA's QA/R-2 type Quality Management Plan into a Quality Management System (QMS) that complies with the requirements of the internationally recognized ISO 9002 standard and achieved certification in the United States, Canada, and throughout Europe. The presentation describes how quality system elements of ISO 9002 were implemented on an already existing quality system. The psychological and organizational challenges of the culture change in QATS' day-to-day operations will be discussed for the benefit of other ISO 9000 aspirants.

Tolerance design of patient-specific range QA using the DMAIC framework in proton therapy.

PubMed

Rah, Jeong-Eun; Shin, Dongho; Manger, Ryan P; Kim, Tae Hyun; Oh, Do Hoon; Kim, Dae Yong; Kim, Gwe-Ya

2018-02-01

To implement the DMAIC (Define-Measure-Analyze-Improve-Control) can be used for customizing the patient-specific QA by designing site-specific range tolerances. The DMAIC framework (process flow diagram, cause and effect, Pareto chart, control chart, and capability analysis) were utilized to determine the steps that need focus for improving the patient-specific QA. The patient-specific range QA plans were selected according to seven treatment site groups, a total of 1437 cases. The process capability index, C pm was used to guide the tolerance design of patient site-specific range. For prostate field, our results suggested that the patient range measurements were capable at the current tolerance level of ±1 mm in clinical proton plans. For other site-specific ranges, we analyzed that the tolerance tends to be overdesigned to insufficient process capability calculated by the patient-specific QA data. The customized tolerances were calculated for treatment sites. Control charts were constructed to simulate the patient QA time before and after the new tolerances were implemented. It is found that the total simulation QA time was decreased on average of approximately 20% after establishing new site-specific range tolerances. We simulated the financial impact of this project. The QA failure for whole process in proton therapy would lead up to approximately 30% increase in total cost. DMAIC framework can be used to provide an effective QA by setting customized tolerances. When tolerance design is customized, the quality is reasonably balanced with time and cost demands. © 2017 American Association of Physicists in Medicine.

Two roles for CD4 cells in the control of the generation of cytotoxic T lymphocytes.

PubMed

Cassell, D; Forman, J

1991-01-01

The generation of CTL against Qa-1 Ag in C57BL/6 (B6) (Qa-1b) and B6.Tlaa (Qa-1a) congenic strains requires in vivo priming with the Qa-1 alloantigen together with a helper Ag, such as H-Y. The primed precursors obtained from these female mice generate Qa-1-specific CTL activity upon culture in vitro. Although the presence of the H-Y helper Ag is not required for the in vitro sensitization, no response occurs in the absence of CD4 cells. Addition of unprimed B6.Tlaa CD4 cells from Qa-1 incompatible radiation bone marrow chimeras (B6.Tlaa----B6), that are presumably tolerant to Qa-1b, provide helper activity for Qa-1b-specific CTL. This indicates that although CD4 cells are obligatory for the Qa-1 response, they need not be specific for alloantigens on the APC to generate helper activity in in vitro cultures. Addition of unirradiated B6 CD8-depleted spleen cells to CD4-depleted B6.Tlaa anti-B6 cultures in the presence of either B6.Tlaa CD4 cells or rIL-2 prevents the generation of Qa-1 specific CTL. This inhibition is not due to an anti-idiotypic Ts cell since B6.Tlaa----B6 chimeric cells do not suppress an anti-Qa-1b response. Rather, this finding is consistent with that of a veto cell mechanism. To determine whether CD4 cells themselves exhibit veto activity, highly purified CD4 populations were tested for their ability to inhibit the generation of Qa-1-specific CTL. CD4 cells precultured for 2 to 3 days with Con A and rIL-2 specifically inhibit CTL activity whereas resting cells do not, similar to that noted for CD8 veto cells. The relative efficiency of activated CD4 cells is greater than that of resting NK cells but is less than that of activated CD8 or NK cells. Thus, CD4 cells not only provide helper activity for CTL precursors, but also act as veto cells to prevent the generation of CTL activity.

Evaluation of a laboratory quality assurance pilot programme for malaria diagnostics in low-transmission areas of Kenya, 2013.

PubMed

Wanja, Elizabeth; Achilla, Rachel; Obare, Peter; Adeny, Rose; Moseti, Caroline; Otieno, Victor; Morang'a, Collins; Murigi, Ephantus; Nyamuni, John; Monthei, Derek R; Ogutu, Bernhards; Buff, Ann M

2017-05-25

One objective of the Kenya National Malaria Strategy 2009-2017 is scaling access to prompt diagnosis and effective treatment. In 2013, a quality assurance (QA) pilot was implemented to improve accuracy of malaria diagnostics at selected health facilities in low-transmission counties of Kenya. Trends in malaria diagnostic and QA indicator performance during the pilot are described. From June to December 2013, 28 QA officers provided on-the-job training and mentoring for malaria microscopy, malaria rapid diagnostic tests and laboratory QA/quality control (QC) practices over four 1-day visits at 83 health facilities. QA officers observed and recorded laboratory conditions and practices and cross-checked blood slides for malaria parasite presence, and a portion of cross-checked slides were confirmed by reference laboratories. Eighty (96%) facilities completed the pilot. Among 315 personnel at pilot initiation, 13% (n = 40) reported malaria diagnostics training within the previous 12 months. Slide positivity ranged from 3 to 7%. Compared to the reference laboratory, microscopy sensitivity ranged from 53 to 96% and positive predictive value from 39 to 53% for facility staff and from 60 to 96% and 52 to 80%, respectively, for QA officers. Compared to reference, specificity ranged from 88 to 98% and negative predictive value from 98 to 99% for health-facility personnel and from 93 to 99% and 99%, respectively, for QA officers. The kappa value ranged from 0.48-0.66 for facility staff and 0.57-0.84 for QA officers compared to reference. The only significant test performance improvement observed for facility staff was for specificity from 88% (95% CI 85-90%) to 98% (95% CI 97-99%). QA/QC practices, including use of positive-control slides, internal and external slide cross-checking and recording of QA/QC activities, all increased significantly across the pilot (p < 0.001). Reference material availability also increased significantly; availability of six microscopy job aids and seven microscopy standard operating procedures increased by a mean of 32 percentage points (p < 0.001) and 38 percentage points (p < 0.001), respectively. Significant gains were observed in malaria QA/QC practices over the pilot. However, these advances did not translate into improved accuracy of malaria diagnostic performance perhaps because of the limited duration of the QA pilot implementation.

The role of metadata and strategies to detect and control temporal data bias in environmental monitoring of soil contamination.

PubMed

Desaules, André

2012-11-01

It is crucial for environmental monitoring to fully control temporal bias, which is the distortion of real data evolution by varying bias through time. Temporal bias cannot be fully controlled by statistics alone but requires appropriate and sufficient metadata, which should be under rigorous and continuous quality assurance and control (QA/QC) to reliably document the degree of consistency of the monitoring system. All presented strategies to detect and control temporal data bias (QA/QC, harmonisation/homogenisation/standardisation, mass balance approach, use of tracers and analogues and control of changing boundary conditions) rely on metadata. The Will Rogers phenomenon, due to subsequent reclassification, is a particular source of temporal data bias introduced to environmental monitoring here. Sources and effects of temporal data bias are illustrated by examples from the Swiss soil monitoring network. The attempt to make a comprehensive compilation and assessment of required metadata for soil contamination monitoring reveals that most metadata are still far from being reliable. This leads to the conclusion that progress in environmental monitoring means further development of the concept of environmental metadata for the sake of temporal data bias control as a prerequisite for reliable interpretations and decisions.

Association of vascular access flow with short-term and long-term mortality in chronic haemodialysis patients: a retrospective cohort study.

PubMed

Wu, Chung-Kuan; Wu, Chia-Lin; Lin, Chia-Hsun; Leu, Jyh-Gang; Kor, Chew-Teng; Tarng, Der-Cherng

2017-09-24

To investigate the impact of vascular access flow (Qa) on vascular and all-cause mortality in chronic haemodialysis (HD) patients. Observational cohort study. Single centre. Adult chronic HD patients at the HD unit of Shin Kong Wu Ho-Su Memorial Hospital between 1 January 2003 and 31 December 2003 were recruited. Patients were excluded if they had arteriovenous fistula or arteriovenous graft failure within 3 months before the date of Qa measurement, were aged <18 years and had Qa levels of ≥2000mL/min. A total of 378 adult chronic HD patients were eventually enrolled for the study. The selected patients were evaluated with Qa and cardiac index (CI). They were divided into four groups according to three Qa cut-off points (500, 1000 and 1500 mL/min). Short-term and long-term vascular (cardiovascular or cerebrovascular) and all-cause mortality. Qa was positively correlated with CI ( r =0.48, p<0.001). A Qa level of <1000 mL/min was independently associated with 1-year all-cause mortality (adjusted OR, 6.04; 95% CI 1.64 to 22.16; p=0.007). Kaplan-Meier analysis revealed that the cumulative incidence rates of all-cause and vascular mortality were significantly higher in the patients with a Qa level of <1000 mL/min (log-rank test; all p<0.01). Furthermore, a Qa level of <1000 mL/min was independently associated with long-term all-cause mortality (adjusted HR, 1.62; 95% CI 1.11 to 2.37; p=0.013); however, the risk of vascular mortality did not significantly increase after adjustment for confounders. Qa is moderately correlated with cardiac function, and a Qa level of <1000 mL/min is an independent risk factor for both short-term and long-term all-cause mortality in chronic HD patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Conformational heterogeneity of the bacteriopheophytin electron acceptor HA in reaction centers from Rhodopseudomonas viridis revealed by Fourier transform infrared spectroscopy and site-directed mutagenesis.

PubMed

Breton, J; Bibikova, M; Oesterhelt, D; Nabedryk, E

1999-08-31

The light-induced Fourier transform infrared (FTIR) difference spectra corresponding to the photoreduction of either the HA bacteriopheophytin electron acceptor (HA-/HA spectrum) or the QA primary quinone (QA-/QA spectrum) in photosynthetic reaction centers (RCs) of Rhodopseudomonas viridis are reported. These spectra have been compared for wild-type (WT) RCs and for two site-directed mutants in which the proposed interactions between the carbonyls on ring V of HA and the RC protein have been altered. In the mutant EQ(L104), the putative hydrogen bond between the protein and the 9-keto C=O of HA should be affected by changing Glu L104 to a Gln. In the mutant WF(M250), the van der Waals interactions between Trp M250 and the 10a-ester C=O of HA should be modified. The characteristic effects of both mutations on the FTIR spectra support the proposed interactions and allow the IR modes of the 9-keto and 10a-ester C=O of HA and HA- to be assigned. Comparison of the HA-/HA and QA-/QA spectra leads us to conclude that the QA-/QA IR signals in the spectral range above 1700 cm-1 are largely dominated by contributions from the electrostatic response of the 10a-ester C=O mode of HA upon QA photoreduction. A heterogeneity in the conformation of the 10a-ester C=O mode of HA in WT RCs, leading to three distinct populations of HA, appears to be related to differences in the hydrogen-bonding interactions between the carbonyls of ring V of HA and the RC protein. The possibility that this structural heterogeneity is related to the observed multiexponential kinetics of electron transfer and the implications for primary processes are discussed. The effect of 1H/2H exchange on the QA-/QA spectra of the WT and mutant RCs shows that neither Glu L104 nor any other exchangeable carboxylic residue changes appreciably its protonation state upon QA reduction.

WE-G-BRA-02: SafetyNet: Automating Radiotherapy QA with An Event Driven Framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hadley, S; Kessler, M; Litzenberg, D

2015-06-15

Purpose: Quality assurance is an essential task in radiotherapy that often requires many manual tasks. We investigate the use of an event driven framework in conjunction with software agents to automate QA and eliminate wait times. Methods: An in house developed subscription-publication service, EventNet, was added to the Aria OIS to be a message broker for critical events occurring in the OIS and software agents. Software agents operate without user intervention and perform critical QA steps. The results of the QA are documented and the resulting event is generated and passed back to EventNet. Users can subscribe to those eventsmore » and receive messages based on custom filters designed to send passing or failing results to physicists or dosimetrists. Agents were developed to expedite the following QA tasks: Plan Revision, Plan 2nd Check, SRS Winston-Lutz isocenter, Treatment History Audit, Treatment Machine Configuration. Results: Plan approval in the Aria OIS was used as the event trigger for plan revision QA and Plan 2nd check agents. The agents pulled the plan data, executed the prescribed QA, stored the results and updated EventNet for publication. The Winston Lutz agent reduced QA time from 20 minutes to 4 minutes and provided a more accurate quantitative estimate of radiation isocenter. The Treatment Machine Configuration agent automatically reports any changes to the Treatment machine or HDR unit configuration. The agents are reliable, act immediately, and execute each task identically every time. Conclusion: An event driven framework has inverted the data chase in our radiotherapy QA process. Rather than have dosimetrists and physicists push data to QA software and pull results back into the OIS, the software agents perform these steps immediately upon receiving the sentinel events from EventNet. Mr Keranen is an employee of Varian Medical Systems. Dr. Moran’s institution receives research support for her effort for a linear accelerator QA project from Varian Medical Systems. Other quality projects involving her effort are funded by Blue Cross Blue Shield of Michigan, Breast Cancer Research Foundation, and the NIH.« less

Assessing the quality of pharmacist answers to telephone drug information questions.

PubMed

Woodward, C T; Stevenson, J G; Poremba, A

1990-04-01

A quality assurance (QA) program is described in which frontline pharmacists were asked test drug information questions via anonymous telephone calls. The program was instituted at a university hospital that began providing decentralized pharmaceutical services in 1985. Questions were developed on the basis of a pilot study conducted to determine the types and complexity of drug information questions received by frontline pharmacists at the hospital. Data on departmental clinical productivity were used to determine the number of questions that would be posed during each shift in the various service areas. The questions were posed during a 10-day period; the pharmacists were aware of the program, but the callers did not identify their affiliation with it. In response to 105 questions asked, 86 were judged to have been answered correctly, 13 answers were deemed incomplete, and 6 were judged incorrect. Pharmacists were more likely to respond incorrectly to complex questions and questions posed during the night shift. As a result of the audit, staff members with advanced clinical knowledge were asked to help less experienced pharmacists, the position of assistant director for drug information and staff development was created, and educational programs were instituted. The QA audit has been repeated twice. Posing test drug information questions via anonymous telephone calls is effective in assessing the quality of drug information provided by pharmacists in patient-care areas.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bodnarczuk, M.

How does one assure that both quality and creativity are obtained in basic research environments QA theoreticians have attempted to develop workable definitions of quality, but in more reflective moments, these definitions often fail to capture the deeper essence of the idea of quality.'' This paper asserts that creativity (as a product of the human mind) is a concrete interface between perfunctory definitions of quality (conformance to specifications) and more philosophical speculations about the nature of quality- related ultimates'' like elegance or beauty. In addition, we describe the distinction between creative ideas and creative acts and highlight one of themore » major inhibitors of creativity, fear. Finally we show that highly creative people often have an irreverent attitude toward boundaries and established authority, and discuss how one can allow for this when designing a QA program in a basic research environment.« less

SU-G-TeP4-02: A Method for Evaluating the Direct Impact of Failed IMRT QAs On Patient Dose

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geneser, S; Butkus, M

Purpose: We developed a method to calculate patient doses corresponding to IMRT QA measurements in order to determine and assess the actual dose delivered for plans with failed (or borderline) IMRT QA. This work demonstrates the feasibility of automatically computing delivered patient dose from portal dosimetry measurements in the Varian TPS system, which would provide a valuable and clinically viable IMRT QA tool for physicists and physicians. Methods: IMRT QA fluences were measured using portal dosimetry, processed using in-house matlab software, and imported back into Eclipse to calculate dose on the planning CT. To validate the proposed workflow, the Eclipsemore » calculated portal dose for a 5-field sliding window prostate boost plan was processed as described above. The resulting dose was compared to the planned dose and found to be within 0.5 Gy. Two IMRT QA results for the prostate boost plan (one that failed and one that passed) were processed and the resulting patient doses were evaluated. Results: The max dose difference between IMRT QA #1 and the original planned and approved dose is 4.5 Gy, while the difference between the planned and IMRT QA #2 dose is 4.0 Gy. The inferior portion of the PTV is slightly underdosed in both plans, and the superior portion is slightly overdosed. The patient dose resulting from IMRT QA #1 and #2 differs by only 0.5 Gy. With this new information, it may be argued that the evaluated plan alteration to obtain passing gamma analysis produced clinically irrelevant differences. Conclusion: Evaluation of the delivered QA dose on the planning CT provides valuable information about the clinical relevance of failed or borderline IMRT QAs. This particular workflow demonstrates the feasibility of pushing the measured IMRT QA portal dosimetry results directly back onto the patient planning CT within the Varian system.« less

SU-F-T-567: Sensitivity and Reproducibility of the Portal Imaging Panel for Routine FFF QC and Patient Plan Dose Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Willett, A; Gilmore, M; Rowbottom, C

2016-06-15

Purpose: The purpose of this work was to see if the EPID is a viable alternative to other QA devices for routine FFF QA and plan dose measurements. Methods: Sensitivity measurements were made to assess response to small changes in field size and beam steering. QA plans were created where field size was varied from baseline values (5–5.5cm, 20–20.5cm). Beam steering was adjusted by altering values in service mode (Symmetry 0–3%). Plans were measured using the Varian portal imager (aS1200 DMI panel), QA3 (Sun Nuclear), and Starcheck Maxi (PTW). FFF beam parameters as stated in Fogliata et al were calculated.more » Constancy measurements were taken using all 3 QC devices to measure a MLC defined 20×20cm field. Two clinical SABR patient plans were measured on a Varian Edge linac, using the Portal Dosimetry module in ARIA, and results compared with analysis made using Delta4 (ScandiDos). Results: The EPID and the Starcheck performed better at detecting clinically relevant changes in field size with the QA3 performing better when detecting similar changes in beam symmetry. Consistency measurements with the EPID and Starcheck were equivalent, with comparable standard deviations. Clinical plan measurements on the EPID compared well with Delta4 results at 3%/1mm. Conclusion: Our results show that for FFF QA measurements such as field size and symmetry, using the EPID is a viable alternative to other QA devices. The EPID could potentially be used for QC measurements with a focus on geometric accuracy, such as MLC positional QA, due to its high resolution compared to other QA devices (EPID 0.34mm, Starcheck 3mm, QA3 5mm). Good agreement between Delta4 and portal dosimetry also indicated the EPID may be a suitable alternative for measurement of clinical plans.« less

Identification of the protein components displaying immunomodulatory activity in aged garlic extract.

PubMed

Chandrashekar, P M; Venkatesh, Y P

2009-07-30

Traditionally, garlic (Allium sativum L.; Alliaceae) has been known to boost the immune system. Aged garlic has more potent immunomodulatory effects than raw garlic. These effects have been attributed to the transformed organosulfur compounds; the identity of the immunomodulatory proteins in aged garlic extract (AGE) is not known. The major aims are to examine the changes occurring in the protein fraction during ageing of garlic and to identify the immunomodulatory proteins. Changes occurring in garlic during ageing have been examined by protein quantitation and gel electrophoresis. Purification and identification of the immunomodulatory proteins have been achieved by Q-Sepharose chromatography and mitogenic activity. Only two major proteins (12-14 kDa range by SDS-PAGE) are observed in AGE. The purified protein components QA-1, QA-2, and QA-3 display immunomodulatory and mannose-binding activity; QA-2 shows the highest mitogenic activity. The identity of QA-2 and QA-1 proteins with the garlic lectins ASA I and ASA II, respectively, has been confirmed by hemagglutination analysis. QA-3 exhibits mitogenic activity, but no hemagglutination activity. The immunomodulatory activity of AGE is also contributed by immunomodulatory proteins. The major immunomodulatory proteins have been identified as the well-known garlic lectins.

Commercial grade item (CGI) dedication of MDR relays for nuclear safety related applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Das, R.K.; Julka, A.; Modi, G.

1994-08-01

MDR relays manufactured by Potter and Brumfield (P and B) have been used in various safety related applications in commercial nuclear power plants. These include emergency safety features (ESF) actuation systems, emergency core cooling systems (ECCS) actuation, and reactor protection systems. The MDR relays manufactured prior to May 1990 showed signs of generic failure due to corrosion and outgassing of coil varnish. P and B has made design changes to correct these problems in relays manufactured after May 1990. However, P and B does not manufacture the relays under any 10CFR50 Appendix B quality assurance (QA) program. They manufacture themore » relays under their commercial QA program and supply these as commercial grade items. This necessitates CGI Dedication of these relays for use in nuclear-safety-related applications. This paper presents a CGI dedication program that has been used to dedicate the MDR relays manufactured after May 1990. The program is in compliance with current Nuclear Regulatory Commission (NRC) and Electric Power Research Institute (EPRI) guidelines and applicable industry standards; it specifies the critical characteristics of the relays, provides the tests and analysis required to verify the critical characteristics, the acceptance criteria for the test results, performs source verification to qualify P and B for its control of the critical characteristics, and provides documentation. The program provides reasonable assurance that the new MDR relays will perform their intended safety functions.« less

GEOSPATIAL IT/IM QA CHECKLIST

EPA Science Inventory

Quality assurance (QA) of information technology (IT) and Information Management (IM) systems help to ensure that the end product is of known quality and integrity. As the complexity of IT & IM processes increase, so does the need for regular QA evaluation.

The areas revi...

Quality control of CT systems by automated monitoring of key performance indicators: a two-year study.

PubMed

Nowik, Patrik; Bujila, Robert; Poludniowski, Gavin; Fransson, Annette

2015-07-08

The purpose of this study was to develop a method of performing routine periodical quality controls (QC) of CT systems by automatically analyzing key performance indicators (KPIs), obtainable from images of manufacturers' quality assurance (QA) phantoms. A KPI pertains to a measurable or determinable QC parameter that is influenced by other underlying fundamental QC parameters. The established KPIs are based on relationships between existing QC parameters used in the annual testing program of CT scanners at the Karolinska University Hospital in Stockholm, Sweden. The KPIs include positioning, image noise, uniformity, homogeneity, the CT number of water, and the CT number of air. An application (MonitorCT) was developed to automatically evaluate phantom images in terms of the established KPIs. The developed methodology has been used for two years in clinical routine, where CT technologists perform daily scans of the manufacturer's QA phantom and automatically send the images to MonitorCT for KPI evaluation. In the cases where results were out of tolerance, actions could be initiated in less than 10 min. 900 QC scans from two CT scanners have been collected and analyzed over the two-year period that MonitorCT has been active. Two types of errors have been registered in this period: a ring artifact was discovered with the image noise test, and a calibration error was detected multiple times with the CT number test. In both cases, results were outside the tolerances defined for MonitorCT, as well as by the vendor. Automated monitoring of KPIs is a powerful tool that can be used to supplement established QC methodologies. Medical physicists and other professionals concerned with the performance of a CT system will, using such methods, have access to comprehensive data on the current and historical (trend) status of the system such that swift actions can be taken in order to ensure the quality of the CT examinations, patient safety, and minimal disruption of service.

MO-E-9A-01: Risk Based Quality Management: TG100 In Action

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huq, M; Palta, J; Dunscombe, P

2014-06-15

One of the goals of quality management in radiation therapy is to gain high confidence that patients will receive the prescribed treatment correctly. To accomplish these goals professional societies such as the American Association of Physicists in Medicine (AAPM) has published many quality assurance (QA), quality control (QC), and quality management (QM) guidance documents. In general, the recommendations provided in these documents have emphasized on performing device-specific QA at the expense of process flow and protection of the patient against catastrophic errors. Analyses of radiation therapy incidents find that they are most often caused by flaws in the overall therapymore » process, from initial consult through final treatment, than by isolated hardware or computer failures detectable by traditional physics QA. This challenge is shared by many intrinsically hazardous industries. Risk assessment tools and analysis techniques have been developed to define, identify, and eliminate known and/or potential failures, problems, or errors, from a system, process and/or service before they reach the customer. These include, but are not limited to, process mapping, failure modes and effects analysis (FMEA), fault tree analysis (FTA), and establishment of a quality management program that best avoids the faults and risks that have been identified in the overall process. These tools can be easily adapted to radiation therapy practices because of their simplicity and effectiveness to provide efficient ways to enhance the safety and quality of treatment processes. Task group 100 (TG100) of AAPM has developed a risk-based quality management program that uses these tools. This session will be devoted to a discussion of these tools and how these tools can be used in a given radiotherapy clinic to develop a risk based QM program. Learning Objectives: Learn how to design a process map for a radiotherapy process. Learn how to perform a FMEA analysis for a given process. Learn what Fault tree analysis is all about. Learn how to design a quality management program based upon the information obtained from process mapping, FMEA and FTA.« less

Quality Assurance and Improvement in Head and Neck Cancer Surgery: From Clinical Trials to National Healthcare Initiatives.

PubMed

Simon, Christian; Caballero, Carmela

2018-05-24

It is without question in the best interest of our patients, if we can identify ways to improve the quality of care we deliver to them. Great progress has been made within the last 25 years in terms of development and implementation of quality-assurance (QA) platforms and quality improvement programs for surgery in general, and within this context for head and neck surgery. As of now, we have successfully identified process indicators that impact outcome of our patients and the quality of care we deliver as surgeons. We have developed risk calculators to determine the risk for complications of individual surgical patients. We have created perioperative guidelines for complex head and neck procedures. We have in Europe and North America created audit registries that can gather and analyze data from institutions across the world to better understand which processes need change to obtain good outcomes and improve quality of care. QA platforms can be tested within the clearly defined environment of prospective clinical trials. If positive, such programs could be rolled out within national healthcare systems, if feasible. Testing quality programs in clinical trials could be a versatile tool to help head neck cancer patients benefit directly from such initiatives on a global level.

Proteoglycans as Target for an Innovative Therapeutic Approach in Chondrosarcoma: Preclinical Proof of Concept.

PubMed

Peyrode, Caroline; Weber, Valérie; Voissière, Aurélien; Maisonial-Besset, Aurélie; Vidal, Aurélien; Auzeloux, Philippe; Gaumet, Vincent; Borel, Michèle; Dauplat, Marie-Mélanie; Quintana, Mercedes; Degoul, Françoise; Rédini, Françoise; Chezal, Jean-Michel; Miot-Noirault, Elisabeth

2016-11-01

To date, surgery remains the only option for the treatment of chondrosarcoma, which is radio- and chemoresistant due in part to its large extracellular matrix (ECM) and poor vascularity. In case of unresectable locally advanced or metastatic diseases with a poor prognosis, improving the management of chondrosarcoma still remains a challenge. Our team developed an attractive approach of improvement of the therapeutic index of chemotherapy by targeting proteoglycan (PG)-rich tissues using a quaternary ammonium (QA) function conjugated to melphalan (Mel). First of all, we demonstrated the crucial role of the QA carrier for binding to aggrecan by surface plasmon resonance. In the orthotopic model of Swarm rat chondrosarcoma, an in vivo biodistribution study of Mel and its QA derivative (Mel-QA), radiolabeled with tritium, showed rapid radioactivity accumulation in healthy cartilaginous tissues and tumor after [ 3 H]-Mel-QA injection. The higher T/M ratio of the QA derivative suggests some advantage of QA-active targeting of chondrosarcoma. The antitumoral effects were characterized by tumor volume assessment, in vivo 99m Tc-NTP 15-5 scintigraphic imaging of PGs, 1 H-HRMAS NMR spectroscopy, and histology. The conjugation of a QA function to Mel did not hamper its in vivo efficiency and strongly improved the tolerability of Mel leading to a significant decrease of side effects (hematologic analyses and body weight monitoring). Thus, QA conjugation leads to a significant improvement of the therapeutic index, which is essential in oncology and enable repeated cycles of chemotherapy in patients with chondrosarcoma. Mol Cancer Ther; 15(11); 2575-85. ©2016 AACR. ©2016 American Association for Cancer Research.

Quercetin-3-O-α-l-arabinopyranoside protects against retinal cell death via blue light-induced damage in human RPE cells and Balb-c mice.

PubMed

Kim, Jun; Jin, Hong Lan; Jang, Dae Sik; Jeong, Kwang Won; Choung, Se-Young

2018-04-25

Age-related macular degeneration (AMD) is among the increasing number of diseases causing irreversible blindness in the elderly. Dry AMD is characterized by the accumulation of lipofuscin in retinal pigment epithelium (RPE) cells. N-Retinylidene-N-retinylethanolamine (A2E), a component of lipofuscin, is oxidized to oxo-A2E under blue light illumination, leading to retinal cell death. The aim of this study was to investigate the protective effect and mechanism of quercetin-3-O-α-l-arabinopyranoside (QA) against blue light (BL)-induced damage in both RPE cells and mice models. Treatment by QA inhibited A2E uptake in RPE cells, as determined by a decrease in fluorescence intensity. QA also protected A2E-laden RPE cells against BL-induced apoptosis. QA inhibited C3 complement activation and poly (ADP-ribose) polymerase (PARP) cleavage, as determined by western blotting. QA showed an inhibitory effect on AP1 and NF-kB activity as estimated in a reporter gene assay. In addition, QA activated the gene expression of aryl hydrocarbon receptor target genes (CYP1A1, CYP1B1) in TCDD-treated RPE cells. In the mice model, oral administration of QA protected against retinal degeneration induced by BL exposure as determined by histological analyses (thickness of retinal layers and immunostaining for caspase-3). In addition, QA inhibited apoptosis and inflammation via inhibition of NF-kB p65 translocation, C3 activation, and PARP cleavage. Collectively, these results revealed the protective mechanism of QA against BL-induced retinal damage both in vitro and in vivo.

Technical Note: Response time evolution of XR-QA2 GafChromic™ film models.

PubMed

Aldelaijan, Saad; Tomic, Nada; Papaconstadopoulos, Pavlos; Schneider, James; Seuntjens, Jan; Shih, Shelley; Lewis, David; Devic, Slobodan

2018-01-01

To evaluate the response of the newest XR-QA2 GafChromic™ film model in terms of postexposure signal growth and energy response in comparison with the older XR-QA (Version 2) model. Pieces of film were irradiated to air kerma in air values up to 12 cGy with several beam qualities (5.3-8.25 mm Al) commonly used for CT scanning. Film response was scored in terms of net reflectance from scanned film images at various points in time postirradiation ranging from 1 to 7 days and 5 months postexposure. To reconstruct the measurement signal changes with postirradiation delay, we irradiated one film piece and then scanned it at different point times starting from 2" min and up to 3 days postexposure. For all beam qualities and dose range investigated, it appears that the XR-QA2 film signal completely saturated after 15 h. Compared to 15 h postirradiation scanning time, the observed variation in net reflectance were 3%, 2%, and 1% for film scanned 2" min, 20 min, and 3 h after exposure, respectively, which is well within the measurement uncertainty of the XR-QA2 based reference radiochromic film dosimetry system. A comparison between the XR-QA (Version 2) and the XR-QA2 film response after several months (relative to their responses after 24 h) show differences in up to 8% and 1% for each film model respectively. The replacement of cesium bromide in the older XR-QA (Version 2) film model with bismuth oxide in the newer XR-QA2 film, while keeping the same single sensitive layer structure, lead to a significantly more stable postexposure response. © 2017 American Association of Physicists in Medicine.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 06: Patient-specific QA Procedure for Gated VMAT SABR Treatments using 10x Beam in Flattening-Filter Free Mode

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mestrovic, Ante; Chitsazzadeh, Shadi; Wells, Derek

2016-08-15

Purpose: To develop a highly sensitive patient specific QA procedure for gated VMAT stereotactic ablative radiotherapy (SABR) treatments. Methods: A platform was constructed to attach the translational stage of a Quasar respiratory motion phantom to a pinpoint ion chamber insert and move the ion chamber inside the ArcCheck. The Quasar phantom controller uses a patient-specific breathing pattern to translate the ion chamber in a superior-inferior direction inside the ArcCheck. With this system the ion chamber is used to QA the correct phase of the gated delivery and the ArcCheck diodes are used to QA the overall dose distribution. This novelmore » approach requires a single plan delivery for a complete QA of a gated plan. The sensitivity of the gating QA procedure was investigated with respect to the following parameters: PTV size, exhale duration, baseline drift, gating window size. Results: The difference between the measured dose to a point in the penumbra and the Eclipse calculated dose was under 2% for small residual motions. The QA procedure was independent of PTV size and duration of exhale. Baseline drift and gating window size, however, significantly affected the penumbral dose measurement, with differences of up to 30% compared to Eclipse. Conclusion: This study described a highly sensitive QA procedure for gated VMAT SABR treatments. The QA outcome was dependent on the gating window size and baseline drift. Analysis of additional patient breathing patterns is currently undergoing to determine a clinically relevant gating window size and an appropriate tolerance level for this procedure.« less

Simultaneous Analysis and Quality Assurance for Diffusion Tensor Imaging

PubMed Central

Lauzon, Carolyn B.; Asman, Andrew J.; Esparza, Michael L.; Burns, Scott S.; Fan, Qiuyun; Gao, Yurui; Anderson, Adam W.; Davis, Nicole; Cutting, Laurie E.; Landman, Bennett A.

2013-01-01

Diffusion tensor imaging (DTI) enables non-invasive, cyto-architectural mapping of in vivo tissue microarchitecture through voxel-wise mathematical modeling of multiple magnetic resonance imaging (MRI) acquisitions, each differently sensitized to water diffusion. DTI computations are fundamentally estimation processes and are sensitive to noise and artifacts. Despite widespread adoption in the neuroimaging community, maintaining consistent DTI data quality remains challenging given the propensity for patient motion, artifacts associated with fast imaging techniques, and the possibility of hardware changes/failures. Furthermore, the quantity of data acquired per voxel, the non-linear estimation process, and numerous potential use cases complicate traditional visual data inspection approaches. Currently, quality inspection of DTI data has relied on visual inspection and individual processing in DTI analysis software programs (e.g. DTIPrep, DTI-studio). However, recent advances in applied statistical methods have yielded several different metrics to assess noise level, artifact propensity, quality of tensor fit, variance of estimated measures, and bias in estimated measures. To date, these metrics have been largely studied in isolation. Herein, we select complementary metrics for integration into an automatic DTI analysis and quality assurance pipeline. The pipeline completes in 24 hours, stores statistical outputs, and produces a graphical summary quality analysis (QA) report. We assess the utility of this streamlined approach for empirical quality assessment on 608 DTI datasets from pediatric neuroimaging studies. The efficiency and accuracy of quality analysis using the proposed pipeline is compared with quality analysis based on visual inspection. The unified pipeline is found to save a statistically significant amount of time (over 70%) while improving the consistency of QA between a DTI expert and a pool of research associates. Projection of QA metrics to a low dimensional manifold reveal qualitative, but clear, QA-study associations and suggest that automated outlier/anomaly detection would be feasible. PMID:23637895

TU-FG-201-04: Computer Vision in Autonomous Quality Assurance of Linear Accelerators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, H; Jenkins, C; Yu, S

Purpose: Routine quality assurance (QA) of linear accelerators represents a critical and costly element of a radiation oncology center. Recently, a system was developed to autonomously perform routine quality assurance on linear accelerators. The purpose of this work is to extend this system and contribute computer vision techniques for obtaining quantitative measurements for a monthly multi-leaf collimator (MLC) QA test specified by TG-142, namely leaf position accuracy, and demonstrate extensibility for additional routines. Methods: Grayscale images of a picket fence delivery on a radioluminescent phosphor coated phantom are captured using a CMOS camera. Collected images are processed to correct formore » camera distortions, rotation and alignment, reduce noise, and enhance contrast. The location of each MLC leaf is determined through logistic fitting and a priori modeling based on knowledge of the delivered beams. Using the data collected and the criteria from TG-142, a decision is made on whether or not the leaf position accuracy of the MLC passes or fails. Results: The locations of all MLC leaf edges are found for three different picket fence images in a picket fence routine to 0.1mm/1pixel precision. The program to correct for image alignment and determination of leaf positions requires a runtime of 21– 25 seconds for a single picket, and 44 – 46 seconds for a group of three pickets on a standard workstation CPU, 2.2 GHz Intel Core i7. Conclusion: MLC leaf edges were successfully found using techniques in computer vision. With the addition of computer vision techniques to the previously described autonomous QA system, the system is able to quickly perform complete QA routines with minimal human contribution.« less

SU-E-T-255: Development of a Michigan Quality Assurance (MQA) Database for Clinical Machine Operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roberts, D

Purpose: A unified database system was developed to allow accumulation, review and analysis of quality assurance (QA) data for measurement, treatment, imaging and simulation equipment in our department. Recording these data in a database allows a unified and structured approach to review and analysis of data gathered using commercial database tools. Methods: A clinical database was developed to track records of quality assurance operations on linear accelerators, a computed tomography (CT) scanner, high dose rate (HDR) afterloader and imaging systems such as on-board imaging (OBI) and Calypso in our department. The database was developed using Microsoft Access database and visualmore » basic for applications (VBA) programming interface. Separate modules were written for accumulation, review and analysis of daily, monthly and annual QA data. All modules were designed to use structured query language (SQL) as the basis of data accumulation and review. The SQL strings are dynamically re-written at run time. The database also features embedded documentation, storage of documents produced during QA activities and the ability to annotate all data within the database. Tests are defined in a set of tables that define test type, specific value, and schedule. Results: Daily, Monthly and Annual QA data has been taken in parallel with established procedures to test MQA. The database has been used to aggregate data across machines to examine the consistency of machine parameters and operations within the clinic for several months. Conclusion: The MQA application has been developed as an interface to a commercially available SQL engine (JET 5.0) and a standard database back-end. The MQA system has been used for several months for routine data collection.. The system is robust, relatively simple to extend and can be migrated to a commercial SQL server.« less

Simultaneous analysis and quality assurance for diffusion tensor imaging.

PubMed

Lauzon, Carolyn B; Asman, Andrew J; Esparza, Michael L; Burns, Scott S; Fan, Qiuyun; Gao, Yurui; Anderson, Adam W; Davis, Nicole; Cutting, Laurie E; Landman, Bennett A

2013-01-01

Diffusion tensor imaging (DTI) enables non-invasive, cyto-architectural mapping of in vivo tissue microarchitecture through voxel-wise mathematical modeling of multiple magnetic resonance imaging (MRI) acquisitions, each differently sensitized to water diffusion. DTI computations are fundamentally estimation processes and are sensitive to noise and artifacts. Despite widespread adoption in the neuroimaging community, maintaining consistent DTI data quality remains challenging given the propensity for patient motion, artifacts associated with fast imaging techniques, and the possibility of hardware changes/failures. Furthermore, the quantity of data acquired per voxel, the non-linear estimation process, and numerous potential use cases complicate traditional visual data inspection approaches. Currently, quality inspection of DTI data has relied on visual inspection and individual processing in DTI analysis software programs (e.g. DTIPrep, DTI-studio). However, recent advances in applied statistical methods have yielded several different metrics to assess noise level, artifact propensity, quality of tensor fit, variance of estimated measures, and bias in estimated measures. To date, these metrics have been largely studied in isolation. Herein, we select complementary metrics for integration into an automatic DTI analysis and quality assurance pipeline. The pipeline completes in 24 hours, stores statistical outputs, and produces a graphical summary quality analysis (QA) report. We assess the utility of this streamlined approach for empirical quality assessment on 608 DTI datasets from pediatric neuroimaging studies. The efficiency and accuracy of quality analysis using the proposed pipeline is compared with quality analysis based on visual inspection. The unified pipeline is found to save a statistically significant amount of time (over 70%) while improving the consistency of QA between a DTI expert and a pool of research associates. Projection of QA metrics to a low dimensional manifold reveal qualitative, but clear, QA-study associations and suggest that automated outlier/anomaly detection would be feasible.

The NCI Thesaurus quality assurance life cycle.

PubMed

de Coronado, Sherri; Wright, Lawrence W; Fragoso, Gilberto; Haber, Margaret W; Hahn-Dantona, Elizabeth A; Hartel, Francis W; Quan, Sharon L; Safran, Tracy; Thomas, Nicole; Whiteman, Lori

2009-06-01

The National Cancer Institute Enterprise Vocabulary Services (NCI EVS) uses a wide range of quality assurance (QA) techniques to maintain and extend NCI Thesaurus (NCIt). NCIt is a reference terminology and biomedical ontology used in a growing number of NCI and other systems that extend from translational and basic research through clinical care to public information and administrative activities. Both automated and manual QA techniques are employed throughout the editing and publication cycle, which includes inserting and editing NCIt in NCI Metathesaurus. NCI EVS conducts its own additional periodic and ongoing content QA. External reviews, and extensive evaluation by and interaction with EVS partners and other users, have also played an important part in the QA process. There have always been tensions and compromises between meeting the needs of dependent systems and providing consistent and well-structured content; external QA and feedback have been important in identifying and addressing such issues. Currently, NCI EVS is exploring new approaches to broaden external participation in the terminology development and QA process.

Quality assurance of the gene ontology using abstraction networks.

PubMed

Ochs, Christopher; Perl, Yehoshua; Halper, Michael; Geller, James; Lomax, Jane

2016-06-01

The gene ontology (GO) is used extensively in the field of genomics. Like other large and complex ontologies, quality assurance (QA) efforts for GO's content can be laborious and time consuming. Abstraction networks (AbNs) are summarization networks that reveal and highlight high-level structural and hierarchical aggregation patterns in an ontology. They have been shown to successfully support QA work in the context of various ontologies. Two kinds of AbNs, called the area taxonomy and the partial-area taxonomy, are developed for GO hierarchies and derived specifically for the biological process (BP) hierarchy. Within this framework, several QA heuristics, based on the identification of groups of anomalous terms which exhibit certain taxonomy-defined characteristics, are introduced. Such groups are expected to have higher error rates when compared to other terms. Thus, by focusing QA efforts on anomalous terms one would expect to find relatively more erroneous content. By automatically identifying these potential problem areas within an ontology, time and effort will be saved during manual reviews of GO's content. BP is used as a testbed, with samples of three kinds of anomalous BP terms chosen for a taxonomy-based QA review. Additional heuristics for QA are demonstrated. From the results of this QA effort, it is observed that different kinds of inconsistencies in the modeling of GO can be exposed with the use of the proposed heuristics. For comparison, the results of QA work on a sample of terms chosen from GO's general population are presented.

Pilot program to assess proposed basic quality assurance requirements in the medical use of byproduct materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kaplan, E.; Nelson, K.; Meinhold, C.B.

1991-10-01

In January 1990, the Nuclear Regulatory Commission (NRC) proposed amendments to 10 CFR Part 35 that would require medical licensees using byproduct material to establish and implement a basic quality assurance program. A 60-day real-world trial of the proposed rules was initiated to obtain information beyond that generally found through standard public comment procedures. Volunteers from randomly selected institutions had opportunities to review the details of the proposed regulations and to implement these rules on a daily basis during the trial. The participating institutions were then asked to evaluate the proposed regulations based on their personal experiences. The pilot projectmore » sought to determine whether medical institutions could develop written quality assurance programs that would meet the eight performance-based objectives of proposed Section 35.35. In addition, the NRC wanted to learn from these volunteers if they had any recommendations on how the rule could be revised to minimized its cost and to clarify its objectives without decreasing its effectiveness. It was found that licensees could develop acceptable QA programs under a performance-based approach, that most licensee programs did meet the proposed objectives, and that most written QA plans would require consultations with NRC or Agreement State personnel before they would fully meet all objectives of proposed Section 35.35. This report describes the overall pilot program. The methodology used to select and assemble the group of participating licensees is presented. The various workshops and evaluation questionnaires are discussed, and detailed findings are presented. 7 refs.« less

Underground Test Area Fiscal Year 2014 Annual Quality Assurance Report Nevada National Security Site, Nevada, Revision 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krenzien, Susan

2015-01-01

This report is required by the Underground Test Area (UGTA) Quality Assurance Plan (QAP) and identifies the UGTA quality assurance (QA) activities from October 1, 2013, through September 30, 2014 (fiscal year [FY] 2014). All UGTA organizations—U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO); Desert Research Institute (DRI); Lawrence Livermore National Laboratory (LLNL); Los Alamos National Laboratory (LANL); National Security Technologies, LLC (NSTec); Navarro-Intera, LLC (N-I); and the U.S. Geological Survey (USGS)—conducted QA activities in FY 2014. The activities included conducting oversight assessments for QAP compliance, identifying findings and completing corrective actions, evaluating laboratory performance,more » and publishing documents. UGTA Activity participants conducted 25 assessments on topics including safe operations, QAP compliance, activity planning, and sampling. These assessments are summarized in Section 2.0. Corrective actions tracked in FY 2014 are presented in Appendix A. Laboratory performance was evaluated based on three approaches: (1) established performance evaluation programs (PEPs), (2) interlaboratory comparisons, or (3) data review. The results of the laboratory performance evaluations, and interlaboratory comparison results are summarized in Section 4.0. The UGTA Activity published three public documents and a variety of other publications in FY 2014. The titles, dates, and main authors are identified in Section 5.0. The Contract Managers, Corrective Action Unit (CAU) Leads, Preemptive Review (PER) Committee members, and Topical Committee members are listed by name and organization in Section 6.0. Other activities that affected UGTA quality are discussed in Section 7.0. Section 8.0 provides the FY 2014 UGTA QA program conclusions, and Section 9.0 lists the references not identified in Section 5.0.« less

SU-F-T-295: MLCs Performance and Patient-Specific IMRT QA Using Log File Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Osman, A; American University of Biuret Medical Center, Biuret; Maalej, N

2016-06-15

Purpose: To analyze the performance of the multi-leaf collimators (MLCs) from the log files recorded during the intensity modulated radiotherapy (IMRT) treatment and to construct the relative fluence maps and do the gamma analysis to compare the planned and executed MLCs movement. Methods: We developed a program to extract and analyze the data from dynamic log files (dynalog files) generated from sliding window IMRT delivery treatments. The program extracts the planned and executed (actual or delivered) MLCs movement, calculates and compares the relative planned and executed fluences. The fluence maps were used to perform the gamma analysis (with 3% dosemore » difference and 3 mm distance to agreement) for 3 IMR patients. We compared our gamma analysis results with those obtained from portal dose image prediction (PDIP) algorithm performed using the EPID. Results: For 3 different IMRT patient treatments, the maximum difference between the planned and the executed MCLs positions was 1.2 mm. The gamma analysis results of the planned and delivered fluences were in good agreement with the gamma analysis from portal dosimetry. The maximum difference for number of pixels passing the gamma criteria (3%/3mm) was 0.19% with respect to portal dosimetry results. Conclusion: MLC log files can be used to verify the performance of the MLCs. Patientspecific IMRT QA based on MLC movement log files gives similar results to EPID dosimetry results. This promising method for patient-specific IMRT QA is fast, does not require dose measurements in a phantom, can be done before the treatment and for every fraction, and significantly reduces the IMRT workload. The author would like to thank King Fahd University of petroleum and Minerals for the support.« less

MO-FG-210-00: US Guided Systems for Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-01: Commissioning An US System for Brachytherapy: An Overview of Physics, Instrumentation, and Techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, Z.

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-02: Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Libby, B.

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

MO-FG-210-03: Intraoperative Ultrasonography-Guided Positioning of Plaque Brachytherapy in the Treatment of Choroidal Melanoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lamb, J.

2015-06-15

Ultrasound (US) is one of the most widely used imaging modalities in medical practice. Since US imaging offers real-time imaging capability, it has becomes an excellent option to provide image guidance for brachytherapy (IGBT). (1) The physics and the fundamental principles of US imaging are presented, and the typical steps required to commission an US system for IGBT is provided for illustration. (2) Application of US for prostate HDR brachytherapy, including partial prostate treatments using MR-ultrasound co-registration to enable a focused treatment on the disease within the prostate is also presented. Prostate HDR with US image guidance planning can benefitmore » from real time visualization of the needles, and fusion of the ultrasound images with T2 weighted MR allows the focusing of the treatment to the specific areas of disease within the prostate, so that the entire gland need not be treated. Finally, (3) ultrasound guidance for an eye plaque program is presented. US can be a key component of placement and QA for episcleral plaque brachytherapy for ocular cancer, and the UCLA eye plaque program with US for image guidance is presented to demonstrate the utility of US verification of plaque placement in improving the methods and QA in episcleral plaque brachytherapy. Learning Objectives: To understand the physics of an US system and the necessary aspects of commissioning US for image guided brachytherapy (IGBT). To understand real time planning of prostate HDR using ultrasound, and its application in partial prostate treatments using MR-ultrasound fusion to focus treatment on disease within the prostate. To understand the methods and QA in applying US for localizing the target and the implant during a episcleral plaque brachytherapy procedures.« less

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--QA ANALYTICAL RESULTS FOR METALS IN BLANK SAMPLES

EPA Science Inventory

The Metals in Blank Samples data set contains the analytical results of measurements of up to 27 metals in 52 blank samples. Measurements were made in blank samples of dust, indoor air, food, water, and dermal wipe residue. Blank samples were used to assess the potential for sa...

International Disability Educational Alliance (IDEAnet)

DTIC Science & Technology

2008-03-01

Rehabilitation in Amman, Jordan. ....................34 Page 5 of 213 D2: Deliver professional education to 70 Iraqi physical therapists and 20...and Orthotic Center P&O: prosthetics and orthotics PT: physical therapists /physiotherapists PWDs: people with disabilities QI/QA: Quality...training program for physical therapists /physiotherapists (PTs) with previous clinical experience (see Appendix N for physical therapy modules). The

New Directions for Higher Education: Q&A with Richard Ekman on Challenges, Misconceptions Facing Independent Colleges

ERIC Educational Resources Information Center

DiSalvio, Philip

2014-01-01

In April 2013, "NEJHE" launched its "New Directions for Higher Education series" to examine emerging issues, trends and ideas that have an impact on higher education policies, programs and practices. In this installment, DiSalvio interviews Richard Ekman, president of the Council of Independent Colleges (CIC), an association of…

New Directions for Higher Education: Q&A with Ed Dept's Studley on College Ratings, Feds

ERIC Educational Resources Information Center

DiSalvio, Philip

2014-01-01

In April 2013, "NEJHE" launched its "New Directions for Higher Education" series to examine emerging issues, trends and ideas that have an impact on higher education policies, programs, and practices. In this installment, Philip DiSalvio interviews U.S. Department of Education Deputy Under Secretary Jamienne S. Studley, who…

New Directions for Higher Education: Q&A with AAC&U President Carol Geary Schneider on Liberal Education

ERIC Educational Resources Information Center

DiSalvio, Philip

2013-01-01

In April 2013, the "New England Journal of Higher Education" ("NEJHE") launched its "New Directions for Higher Education" series to examine emerging issues, trends, and ideas that have an impact on higher education policies, programs, and practices. In this series feature Philip DiSalvio, dean of the College of…

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR SAMPLING WEIGHT CALCULATION (IIT-A-9.0)

EPA Science Inventory

The purpose of this SOP is to describe the procedures undertaken to calculate sampling weights. The sampling weights are needed to obtain weighted statistics of the study data. This SOP uses data that have been properly coded and certified with appropriate QA/QC procedures by th...

Software for Information Storage and Retrieval Tested, Evaluated and Compared: Part VI--Various Additional Programs.

ERIC Educational Resources Information Center

Sieverts, Eric G.; And Others

1993-01-01

Reports on tests evaluating nine microcomputer software packages designed for information storage and retrieval: BRS-Search, dtSearch, InfoBank, Micro-OPC, Q&A, STN-PFS, Strix, TINman, and ZYindex. Tables and narrative evaluations detail results related to security, hardware, user features, search capability, indexing, input, maintenance of files,…

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PERFORMANCE OF COMPUTER SOFTWARE: VERIFICATION AND VALIDATION (UA-D-2.0)

EPA Science Inventory

The purpose of this SOP is to define the procedures used for the initial and periodic verification and validation of computer programs used during the Arizona NHEXAS project and the "Border" study. Keywords: Computers; Software; QA/QC.

The National Human Exposure Assessment Sur...

New Directions for Higher Education: Q&A with AGB Prez Richard Legon on Challenges Facing Higher Ed Boards

ERIC Educational Resources Information Center

DiSalvio, Philip

2013-01-01

In April, the "New England Journal of Higher Education ("NEJHE") launched its "New Directions for Higher Education" series to examine emerging issues, trends and ideas that have an impact on higher education policies, programs and practices. In this installment, Philip DiSalvio interviews Richard Legon, president of the…

New Directions for Higher Education: Q&A with Education Scholar Adrianna Kezar on the Changing Faculty

ERIC Educational Resources Information Center

DiSalvio, Philip

2014-01-01

In April 2013, "NEJHE" launched its "New Directions for Higher Education" series to examine emerging issues, trends and ideas that have an impact on higher education policies, programs, and practices. In this installment, DiSalvio interviews Adrianna Kezar, professor of higher education at the University of Southern California…

Rhetoric and Reality: The Irish Experience of Quality Assurance

ERIC Educational Resources Information Center

Fitzsimons, Camilla

2017-01-01

This paper shares the Irish adult educator's experiences of Quality Assurance (QA). Educators are found to be largely supportive of QA but contradictions emerge. These include philosophical tensions, inconsistent moderation and incongruence between the stated values of QA and a more powerful government-led employability discourse.

FINDING THE BALANCE - QUALITY ASSURANCE REQUIREMENTS VS. RESEARCH NEEDS

EPA Science Inventory

Investigators often misapply quality assurance (QA) procedures and may consider QA as a hindrance to developing test plans for sampling and analysis. If used properly, however, QA is the driving force for collecting the right kind and proper amount of data. Researchers must use Q...

FINDING THE BALANCE - QUALITY ASSURANCE REQUIREMENTS VS. RESEARCH NEEDS

EPA Science Inventory

Investigators often misapply quality assurance (QA) procedures and may consider QA as a hindrance to developing test plans for
sampling and analysis. If used properly, however, QA is the driving force for collecting the right kind and proper amount of data.
Researchers must...

ETD QA CORE TEAM: AN ELOQUENT SOLUTION TO A COMPLEX PROBLEM

EPA Science Inventory

ETD QA CORE TEAM: AN ELOQUENT SOLUTION TO A COMPLEX PROBLEMThomas J. Hughes, QA and Records Manager, Experimental Toxicology Division (ETD), National Health and Environmental Effects Research Laboratory (NHEERL), ORD, U.S. EPA, RTP, NC 27709

ETD is the largest health divis...

QUALITY SCIENCE AND QUALITY ASSURANCE: OBSERVATIONS OR AN ENVIRONMENTAL SCIENTIST

EPA Science Inventory

--

ABSTRACT
The purpose of this manuscript is to examine the relationship between quality science (QS) and quality assurance (QA). Many research scientists definitely want to do QS, but are afraid or do not want to do QA because they are intimidated by the QA proc...

Test/QA Plan for Verification of Semi-Continuous Ambient Air Monitoring Systems - Second Round

EPA Science Inventory

Test/QA Plan for Verification of Semi-Continuous Ambient Air Monitoring Systems - Second Round. Changes reflect performance of second round of testing at new location and with various changes to personnel. Additional changes reflect general improvements to the Version 1 test/QA...

40 CFR 98.424 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Suppliers of Carbon Dioxide § 98.424 Monitoring and QA/QC... determine quantity in accordance with this paragraph. (i) Reporters that supply CO2 in containers using...

40 CFR 98.424 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Suppliers of Carbon Dioxide § 98.424 Monitoring and QA/QC... determine quantity in accordance with this paragraph. (i) Reporters that supply CO2 in containers using...

40 CFR 98.334 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Zinc Production § 98.334 Monitoring and QA/QC requirements. If..., belt weigh feeders, weighed purchased quantities in shipments or containers, combination of bulk...

40 CFR 98.94 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electronics Manufacturing § 98.94 Monitoring and QA/QC requirements. (a) For calendar year 2011 monitoring, you may follow the provisions in paragraphs (a)(1) through...

40 CFR 98.424 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Suppliers of Carbon Dioxide § 98.424 Monitoring and QA/QC... determine quantity in accordance with this paragraph. (i) Reporters that supply CO2 in containers using...

40 CFR 98.334 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Zinc Production § 98.334 Monitoring and QA/QC requirements. If..., belt weigh feeders, weighed purchased quantities in shipments or containers, combination of bulk...

40 CFR 98.334 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Zinc Production § 98.334 Monitoring and QA/QC requirements. If..., belt weigh feeders, weighed purchased quantities in shipments or containers, combination of bulk...

40 CFR 98.94 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electronics Manufacturing § 98.94 Monitoring and QA/QC requirements. (a) For calendar year 2011 monitoring, you may follow the provisions in paragraphs (a)(1) through...

40 CFR 98.424 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Suppliers of Carbon Dioxide § 98.424 Monitoring and QA/QC... determine quantity in accordance with this paragraph. (i) Reporters that supply CO2 in containers using...

40 CFR 98.94 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electronics Manufacturing § 98.94 Monitoring and QA/QC requirements. (a) For calendar year 2011 monitoring, you may follow the provisions in paragraphs (a)(1) through...

40 CFR 98.334 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Zinc Production § 98.334 Monitoring and QA/QC requirements. If..., belt weigh feeders, weighed purchased quantities in shipments or containers, combination of bulk...

40 CFR 98.94 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Electronics Manufacturing § 98.94 Monitoring and QA/QC...-specific heel factors for each container type for each gas used, according to the procedures in paragraphs...

STRATEGIC PLAN FOR GEOGRAPHIC INFORMATION SYSTEM (GIS) QUALITY ASSURANCE IN THE EPA

EPA Science Inventory

The EPA GIS-QA Team was created to fill the gap between the EPA Quality Assurance (QA) and Geographic Information Systems (GIS) communities. All EPA Offices and Regions were invited to participate. Currently, the EPA GIS-QA Team consists of members from the EPA Regional Offices...

Quality assurance in European pharmacy education and training*

PubMed Central

Guimarāes Morais, Jose A.; Cavaco, Afonso M.; Rombaut, Bart; Rouse, Michael J.; Atkinson, Jeffrey

A survey of quality assurance (QA) systems in European faculties of pharmacy was carried out under the auspices of the European Association of Faculties of Pharmacy PHARMINE consortium. A questionnaire based on the quality criteria of the International Pharmaceutical Federation and the Accreditation Council for Pharmacy Education (USA) was sent out to European faculties. Replies were obtained from 28 countries. Just above half has a working QA system. QA scores were high concerning matters such as complete curriculum and training, use of European Credit Transfer System, students’ representation and promotion of professional behavior. QA scores were low concerning matters such as evaluation of achievement of mission and goals, and financial resources. The PHARMINE consortium now has a basis upon which to elaborate and promote QA in European pharmacy faculties. PMID:24198856

Designing a biocidal reverse osmosis membrane coating: Synthesis and biofouling properties

DOE PAGES

Hibbs, Michael R.; McGrath, Lucas K.; Kang, Seoktae; ...

2015-12-04

In this study, a biocidal coating was developed in order to reduce biofouling on a reverse osmosis (RO) membrane using a quaternary ammonium (QA) functionalized polymer. The synthesis of a series of polysulfone (PS) ionomers with QA groups is described, and a method for spraying these QA ionomers as an alcoholic solution, which dried into water insoluble coatings. Contact angle and streaming potential were used to analyze the coating's hydrophilicity and surface charge. Both PS-QA1 and the commercial RO membrane had an apparent contact angle of 68° that increased to 126° for PS-QA12 corresponding to alkyl chain length. A negativelymore » charged particle-probe was used to measure coated and uncoated RO membrane interaction forces. Measured interaction forces correlated strongly with the length of alkyl chains or hydrophobicity of the coated surfaces. Uncoated RO membranes and ones coated with PS-QA were exposed to suspensions of Escherichia coli cells. All four PS-QA coatings showed significant biotoxicity and killed 100% of the E. coli cells, but uncoated RO membranes had metabolically active biofilms. However, coatings tested in a RO crossflow system showed a flux reduction that is attributed to mass transfer resistance due to excessively thick films.« less

Designing a biocidal reverse osmosis membrane coating: Synthesis and biofouling properties

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hibbs, Michael R.; McGrath, Lucas K.; Kang, Seoktae

In this study, a biocidal coating was developed in order to reduce biofouling on a reverse osmosis (RO) membrane using a quaternary ammonium (QA) functionalized polymer. The synthesis of a series of polysulfone (PS) ionomers with QA groups is described, and a method for spraying these QA ionomers as an alcoholic solution, which dried into water insoluble coatings. Contact angle and streaming potential were used to analyze the coating's hydrophilicity and surface charge. Both PS-QA1 and the commercial RO membrane had an apparent contact angle of 68° that increased to 126° for PS-QA12 corresponding to alkyl chain length. A negativelymore » charged particle-probe was used to measure coated and uncoated RO membrane interaction forces. Measured interaction forces correlated strongly with the length of alkyl chains or hydrophobicity of the coated surfaces. Uncoated RO membranes and ones coated with PS-QA were exposed to suspensions of Escherichia coli cells. All four PS-QA coatings showed significant biotoxicity and killed 100% of the E. coli cells, but uncoated RO membranes had metabolically active biofilms. However, coatings tested in a RO crossflow system showed a flux reduction that is attributed to mass transfer resistance due to excessively thick films.« less

SU-F-T-459: ArcCHECK Machine QA : Highly Efficient Quality Assurance Tool for VMAT, SRS & SBRT Linear Accelerator Delivery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mhatre, V; Patwe, P; Dandekar, P

Purpose: Quality assurance (QA) of complex linear accelerators is critical and highly time consuming. ArcCHECK Machine QA tool is used to test geometric and delivery aspects of linear accelerator. In this study we evaluated the performance of this tool. Methods: Machine QA feature allows user to perform quality assurance tests using ArcCHECK phantom. Following tests were performed 1) Gantry Speed 2) Gantry Rotation 3) Gantry Angle 4)MLC/Collimator QA 5)Beam Profile Flatness & Symmetry. Data was collected on trueBEAM stX machine for 6 MV for a period of one year. The Gantry QA test allows to view errors in gantry angle,more » rotation & assess how accurately the gantry moves around the isocentre. The MLC/Collimator QA tool is used to analyze & locate the differences between leaf bank & jaw position of linac. The flatness & Symmetry test quantifies beam flatness & symmetry in IEC-y & x direction. The Gantry & Flatness/Symmetry test can be performed for static & dynamic delivery. Results: The Gantry speed was 3.9 deg/sec with speed maximum deviation around 0.3 deg/sec. The Gantry Isocentre for arc delivery was 0.9mm & static delivery was 0.4mm. The maximum percent positive & negative difference was found to be 1.9 % & – 0.25 % & maximum distance positive & negative diff was 0.4mm & – 0.3 mm for MLC/Collimator QA. The Flatness for Arc delivery was 1.8 % & Symmetry for Y was 0.8 % & X was 1.8 %. The Flatness for gantry 0°,270°,90° & 180° was 1.75,1.9,1.8 & 1.6% respectively & Symmetry for X & Y was 0.8,0.6% for 0°, 0.6,0.7% for 270°, 0.6,1% for 90° & 0.6,0.7% for 180°. Conclusion: ArcCHECK Machine QA is an useful tool for QA of Modern linear accelerators as it tests both geometric & delivery aspects. This is very important for VMAT, SRS & SBRT treatments.« less

SU-E-J-199: A Software Tool for Quality Assurance of Online Replanning with MR-Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, G; Ahunbay, E; Li, X

2015-06-15

Purpose: To develop a quality assurance software tool, ArtQA, capable of automatically checking radiation treatment plan parameters, verifying plan data transfer from treatment planning system (TPS) to record and verify (R&V) system, performing a secondary MU calculation considering the effect of magnetic field from MR-Linac, and verifying the delivery and plan consistency, for online replanning. Methods: ArtQA was developed by creating interfaces to TPS (e.g., Monaco, Elekta), R&V system (Mosaiq, Elekta), and secondary MU calculation system. The tool obtains plan parameters from the TPS via direct file reading, and retrieves plan data both transferred from TPS and recorded during themore » actual delivery in the R&V system database via open database connectivity and structured query language. By comparing beam/plan datasets in different systems, ArtQA detects and outputs discrepancies between TPS, R&V system and secondary MU calculation system, and delivery. To consider the effect of 1.5T transverse magnetic field from MR-Linac in the secondary MU calculation, a method based on modified Clarkson integration algorithm was developed and tested for a series of clinical situations. Results: ArtQA is capable of automatically checking plan integrity and logic consistency, detecting plan data transfer errors, performing secondary MU calculations with or without a transverse magnetic field, and verifying treatment delivery. The tool is efficient and effective for pre- and post-treatment QA checks of all available treatment parameters that may be impractical with the commonly-used visual inspection. Conclusion: The software tool ArtQA can be used for quick and automatic pre- and post-treatment QA check, eliminating human error associated with visual inspection. While this tool is developed for online replanning to be used on MR-Linac, where the QA needs to be performed rapidly as the patient is lying on the table waiting for the treatment, ArtQA can be used as a general QA tool in radiation oncology practice. This work is partially supported by Elekta Inc.« less

Design of a fused phantom for quantitative evaluation of brain metabolites and enhanced quality assurance testing for magnetic resonance imaging and spectroscopy.

PubMed

Song, Kyu-Ho; Kim, Sang-Young; Lee, Do-Wan; Jung, Jin-Young; Lee, Jung-Hoon; Baek, Hyeon-Man; Choe, Bo-Young

2015-11-30

Magnetic resonance imaging and spectroscopy (MRI-MRS) is a useful tool for the identification and evaluation of chemical changes in anatomical regions. Quality assurance (QA) is performed in either images or spectra using QA phantom. Therefore, consistent and uniform technical MRI-MRS QA is crucial. Here we developed an MRI-MRS fused phantom along with the inserts for metabolite quantification to simultaneously optimize QA parameters for both MRI and MRS. T1- and T2-weighted images were obtained and MRS was performed with point-resolved spectroscopy. Using the fused phantom, the results of measuring MRI factors were: geometric distortion, <2% and ± 2 mm; image intensity uniformity, 83.09 ± 1.33%; percent-signal ghosting, 0.025 ± 0.004; low-contrast object detectability, 27.85 ± 0.80. In addition, the signal-to-noise ratio of N-acetyl-aspartate was consistently high (42.00 ± 5.66). In previous studies, MR phantoms could not obtain information from both images and spectra in the MR scanner simultaneously. Here we designed and developed a phantom for accurate and consistent QA within the acceptance range. It is important to take into account variations in the QA value using the MRI-MRS phantom, when comparing to other clinical or research MR scanners. The MRI-MRS QA factors obtained simultaneously using the phantom can facilitate evaluation of both images and spectra, and provide guidelines for obtaining MRI and MRS QA factors simultaneously. Copyright © 2015 Elsevier B.V. All rights reserved.

A framework for institutionalizing quality assurance.

PubMed

Silimperi, Diana R; Franco, Lynne Miller; Veldhuyzen van Zanten, Tisna; MacAulay, Catherine

2002-12-01

To develop a framework to support the institutionalization of quality assurance (QA). The framework for institutionalizing QA consists of a model of eight essential elements and a 'roadmap' for the process of institutionalization. The essential elements are the building blocks required for implementing and sustaining QA activities. Core QA activities include defining, measuring and improving quality. The essential elements are grouped under three categories: the internal enabling environment (internal to the organization or system), organizing for quality, and support functions. The enabling environment contains the essential elements of leadership, policy, core values, and resources. Organizing for quality includes the structure for implementing QA. Three essential elements are primarily support functions: capacity building, communication and information, and rewarding quality. The model can be applied at the level of an organization or a system. The paper also describes the process of institutionalizing QA, starting from a state of preawareness, passing through four phases (awareness, experiential, expansion, and consolidation), and culminating in a state of maturity. The process is not linear; an organization may regress, vacillate between phases, or even remain stagnant. Some phases (e.g. awareness and experiential) may occur simultaneously. The framework has been introduced in nearly a dozen countries in Latin America and Africa. The conceptual model has been used to support strategic planning and directing Ministry of Health work plans, and also as a resource for determining the elements necessary to strengthen and sustain QA. The next step will be the development and evaluation of an assessment tool to monitor developmental progress in the institutionalization of QA.

SU-E-T-627: Failure Modes and Effect Analysis for Monthly Quality Assurance of Linear Accelerator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xie, J; Xiao, Y; Wang, J

2014-06-15

Purpose: To develop and implement a failure mode and effect analysis (FMEA) on routine monthly Quality Assurance (QA) tests (physical tests part) of linear accelerator. Methods: A systematic failure mode and effect analysis method was performed for monthly QA procedures. A detailed process tree of monthly QA was created and potential failure modes were defined. Each failure mode may have many influencing factors. For each factor, a risk probability number (RPN) was calculated from the product of probability of occurrence (O), the severity of effect (S), and detectability of the failure (D). The RPN scores are in a range ofmore » 1 to 1000, with higher scores indicating stronger correlation to a given influencing factor of a failure mode. Five medical physicists in our institution were responsible to discuss and to define the O, S, D values. Results: 15 possible failure modes were identified and all RPN scores of all influencing factors of these 15 failue modes were from 8 to 150, and the checklist of FMEA in monthly QA was drawn. The system showed consistent and accurate response to erroneous conditions. Conclusion: The influencing factors of RPN greater than 50 were considered as highly-correlated factors of a certain out-oftolerance monthly QA test. FMEA is a fast and flexible tool to develop an implement a quality management (QM) frame work of monthly QA, which improved the QA efficiency of our QA team. The FMEA work may incorporate more quantification and monitoring fuctions in future.« less

Effects of quisqualic acid on retinal ZENK expression induced by imposed defocus in the chick eye.

PubMed

Bitzer, Michaela; Schaeffel, Frank

2004-02-01

Expression of the transcription factor ZENK in glucagon amacrine cells of the chicken retina is enhanced after treatment with positive spectacle lenses and reduced after treatment with negative lenses. ZENK may, therefore, have an important role in emmetropization. To learn more about its regulation, we have studied its expression after retinal intoxication with quisqualic acid (QA, a glutamatergic excitotoxin). Lenses of either +7 or -7 D power were placed in front of the eyes of young chickens 6 days after intravitreal QA injections. By this time, QA had caused severe damage to the retina. After 2 hours of lens wearing, changes in ZENK immunoreactivity were measured by means of double staining. In another experiment, lenses were worn for 4 days to study the residual function of emmetropization. QA injections caused a massive loss of cells in the inner nuclear layer and the ganglion cell layer but left the numbers of glucagon cells unchanged. Four of six QA-injected eyes became more myopic in response to wearing positive lenses, and all eyes with negative lenses also became myopic. QA caused a general reduction in ZENK expression, and there was no clear evidence that ZENK expression was still controlled by the sign of imposed defocus. After severe destruction of the inner retina by QA, retinal image processing appeared to be reduced to blur detection with no sign, causing myopia with both types of lenses. QA must remove synaptic input to the glucagon cells, which is necessary to transmit the information on the sign of imposed defocus.

The April 1994 and October 1994 radon intercomparisons at EML

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisenne, I.M.; George, A.C.; Perry, P.M.

1995-10-01

Quality assurance/quality control (QA/QC) are the backbone of many commercial and research processes and programs. QA/QC research tests the state of a functioning system, be it the production of manufactured goods or the ability to make accurate and precise measurements. The quality of the radon measurements in the US have been tested under controlled conditions in semi-annual radon gas intercomparison exercises sponsored by the Environmental Measurements Laboratory (EML) since 1981. The two Calendar Year 1994 radon gas intercomparison exercises were conducted in the EML exposure chamber. Thirty-two groups including US Federal facilities, USDOE contractors, national and state laboratories, universities andmore » foreign institutions participated in these exercises. The majority of the participant`s results were within {+-}10% of the EML value at radon concentrations of 570 and 945 Bq m{sup {minus}3}.« less

ICPP environmental monitoring report CY-1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1996-04-01

Summarized in this report are the data collected through Environmental Monitoring programs conducted at the Idaho Chemical Processing Plant (ICPP) by the Environmental Protection Department. The ICPP is responsible for complying with all applicable Federal, State, Local and DOE Rules, Regulations and Orders. Radiological effluent and emissions are regulated by the DOE in accordance with the Derived Concentration Guides (DCGs). The State of Idaho regulates nonradiological waste resulting from the ICPP operations including airborne, liquid, and solid waste. The Environmental Department updated the Quality Assurance (QA) Project Plan for Environmental Monitoring activities during the third quarter of 1992. QA activitiesmore » have resulted in the ICPP`s implementation of the Environmental Protection Agency (EPA) rules and guidelines pertaining to the collection, analyses, and reporting of environmentally related samples. Where no EPA methods for analyses existed for radionuclides, Lockheed Idaho Technologies Company (LITCO) methods were used.« less

ICPP environmental monitoring report CY-1994

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-05-01

Summarized in this report are the data collected through Environmental Monitoring programs conducted at the Idaho Chemical Processing Plant (ICPP) by the Environmental Protection Department. The ICPP is responsible for complying with all applicable Federal, State, Local and DOE Rules, Regulations and Orders. Radiological effluent and emissions are regulated by the DOE in accordance with the Derived Concentration Guides (DCGs) as presented in DOE Order 5400.5. The State of Idaho regulates nonradiological waste resulting from the ICPP operations including airborne, liquid, and solid waste. The Environmental Department updated the Quality Assurance (QA) Project Plan for Environmental Monitoring activities during themore » third quarter of 1992. QA activities have resulted in the ICPP`s implementation of the Environmental Protection Agency (EPA) rules and guidelines pertaining to the collection, analyses, and reporting of environmentally related samples. Where no EPA methods for analyses existed for radionuclides, LITCO methods were used.« less

Summary of development and recommendations for a quality assurance program for the procurement and manufacture of urban mass transit operating equipment and systems

NASA Technical Reports Server (NTRS)

Witkin, S. A.

1976-01-01

A viable quality program for the urban mass transit industry, and a management approach to ensure compliance with the program are outlined. Included are: (1) a set of guidelines for quality assurance to be imposed on transit authorities, and a management approach to ensure compliance with them; (2) a management approach to be used by the transit authorities (properties) for assuring compliance with the QA guidelines; and (3) quality assurance guidelines to be imposed by properties and umta for procurement of hardware and systems.

A VIRTUAL TECHNICAL SYSTEMS AUDIT OF RESEARCH QUALITY ASSURANCE AND RECORD MANAGEMENT SYSTEMS IN ORD, U.S EPA

EPA Science Inventory

NHEERL conducts technical systems audits (TSAs) on its research projects. The findings are reported by the QA Manager (QAM) to the Director of QA (DQA) as Exemplary Findings (things the QA Team liked); Corrective Actions (things that must be corrected immediately); and Areas for...

Evaluation of a Standardized Method of Quality Assurance in Mental Health Records: A Pilot Study

ERIC Educational Resources Information Center

Bradshaw, Kelsey M.; Donohue, Bradley; Fayeghi, Jasmine; Lee, Tiffany; Wilks, Chelsey R.; Ross, Brendon

2016-01-01

The widespread adoption of research-supported treatments by mental health providers has facilitated empirical development of quality assurance (QA) methods. Research in this area has focused on QA systems aimed at assuring the integrity of research-supported treatment implementation, while examination of QA systems to assure appropriate…

Evolution of Internal Quality Assurance at One University--A Case Study

ERIC Educational Resources Information Center

O'Sullivan, David

2017-01-01

Purpose: Quality assurance (QA) at one University has evolved over the past 15 years through emerging National and European standards, various leadership initiatives and through the engagement of key stakeholders in co-designing and implementing internal QA processes. In 2000, the QA process was focussed mainly on quality review (QR) that involved…

40 CFR 98.474 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 22 2013-07-01 2013-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Injection of Carbon Dioxide § 98.474 Monitoring and QA/QC.... (2) You must determine the quarterly mass or volume of contents in all containers if you receive CO2...

40 CFR 98.474 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 21 2014-07-01 2014-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Injection of Carbon Dioxide § 98.474 Monitoring and QA/QC.... (2) You must determine the quarterly mass or volume of contents in all containers if you receive CO2...

40 CFR 98.474 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 22 2012-07-01 2012-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Injection of Carbon Dioxide § 98.474 Monitoring and QA/QC.... (2) You must determine the quarterly mass or volume of contents in all containers if you receive CO2...

40 CFR 98.424 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Monitoring and QA/QC requirements. 98... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Suppliers of Carbon Dioxide § 98.424 Monitoring and QA/QC... containers shall measure the mass in each CO2 container using weigh bills, scales, or load cells and sum the...

A practical implementation of physics quality assurance for photon adaptive radiotherapy.

PubMed

Cai, Bin; Green, Olga L; Kashani, Rojano; Rodriguez, Vivian L; Mutic, Sasa; Yang, Deshan

2018-03-14

The fast evolution of technology in radiotherapy (RT) enabled the realization of adaptive radiotherapy (ART). However, the new characteristics of ART pose unique challenges for efficiencies and effectiveness of quality assurance (QA) strategies. In this paper, we discuss the necessary QAs for ART and introduce a practical implementation. A previously published work on failure modes and effects analysis (FMEA) of ART is introduced first to explain the risks associated with ART sub-processes. After a brief discussion of QA challenges, we review the existing QA strategies and tools that might be suitable for each ART step. By introducing the MR-guided online ART QA processes developed at our institute, we demonstrate a practical implementation. The limitations and future works to develop more robust and efficient QA strategies are discussed at the end. Copyright © 2018. Published by Elsevier GmbH.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saleh, Z; Tang, X; Song, Y

Purpose: To investigate the long term stability and viability of using EPID-based daily output QA via in-house and vendor driven protocol, to replace conventional QA tools and improve QA efficiency. Methods: Two Varian TrueBeam machines (TB1&TB2) equipped with electronic portal imaging devices (EPID) were employed in this study. Both machines were calibrated per TG-51 and used clinically since Oct 2014. Daily output measurement for 6/15 MV beams were obtained using SunNuclear DailyQA3 device as part of morning QA. In addition, in-house protocol was implemented for EPID output measurement (10×10 cm fields, 100 MU, 100cm SID, output defined over an ROImore » of 2×2 cm around central axis). Moreover, the Varian Machine Performance Check (MPC) was used on both machines to measure machine output. The EPID and DailyQA3 based measurements of the relative machine output were compared and cross-correlated with monthly machine output as measured by an A12 Exradin 0.65cc Ion Chamber (IC) serving as ground truth. The results were correlated using Pearson test. Results: The correlations among DailyQA3, in-house EPID and Varian MPC output measurements, with the IC for 6/15 MV were similar for TB1 (0.83–0.95) and TB2 (0.55–0.67). The machine output for the 6/15MV beams on both machines showed a similar trend, namely an increase over time as indicated by all measurements, requiring a machine recalibration after 6 months. This drift is due to a known issue with pressurized monitor chamber which tends to leak over time. MPC failed occasionally but passed when repeated. Conclusion: The results indicate that the use of EPID for daily output measurements has the potential to become a viable and efficient tool for daily routine LINAC QA, thus eliminating weather (T,P) and human setup variability and increasing efficiency of the QA process.« less

SU-F-T-489: 4-Years Experience of QA in TomoTherapy MVCT: What Do We Look Out For?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, F; Chan, K

2016-06-15

Purpose: To evaluate the QA results of TomoTherapy MVCT from March 2012 to February 2016, and to identify issues that may affect consistency in HU numbers and reconstructed treatment dose in MVCT. Methods: Monthly QA was performed on our TomoHD system. Phantom with rod inserts of various mass densities was imaged in MVCT and compared to baseline to evaluate HU number consistency. To evaluate treatment dose reconstructed by delivered sinogram and MVCT, a treatment plan was designed on a humanoid skull phantom. The phantom was imaged with MVCT and treatment plan was delivered to obtain the sinogram. The dose reconstructedmore » with the Planned Adaptive software was compared to the dose in the original plan. The QA tolerance for HU numbers was ±30 HU, and ±2% for discrepancy between original plan dose and reconstructed dose. Tolerances were referenced to AAPM TG148. Results: Several technical modifications or maintenance activities to the system have been identified which affected QA Results: 1) Upgrade in console system software which added a weekly HU calibration procedure; 2) Linac or MLC replacement leading to change in Accelerator Output Machine (AOM) parameters; 3) Upgrade in planning system algorithm affecting MVCT dose reconstruction. These events caused abrupt changes in QA results especially for the reconstructed dose. In the past 9 months, when no such modifications were done to the system, reconstructed dose was consistent with maximum deviation from baseline less than 0.6%. The HU number deviated less than 5HU. Conclusion: Routine QA is essential for MVCT, especially if the MVCT is used for daily dose reconstruction to monitor delivered dose to patients. Several technical events which may affect consistency of this are software changes, linac or MLC replacement. QA results reflected changes which justify re-calibration or system adjustment. In normal circumstances, the system should be relatively stable and quarterly QA may be sufficient.« less

Comparison of Transcutaneous Electrical Nerve Stimulation and Cryotherapy for Increasing Quadriceps Activation in Patients With Knee Pathologies.

PubMed

Gabler, Conrad M; Lepley, Adam S; Uhl, Tim L; Mattacola, Carl G

2016-08-01

Proper neuromuscular activation of the quadriceps muscle is essential for maintaining quadriceps (quad) strength and lower-extremity function. Quad activation (QA) failure is a common characteristic observed in patients with knee pathologies, defined as an inability to voluntarily activate the entire alpha-motor-neuron pool innervating the quad. One of the more popular techniques used to assess QA is the superimposed burst (SIB) technique, a force-based technique that uses a supramaximal, percutaneous electrical stimulation to activate all of the motor units in the quad during a maximal, voluntary isometric contraction. Central activation ratio (CAR) is the formula used to calculate QA level (CAR = voluntary force/SIB force) with the SIB technique. People who can voluntarily activate 95% or more (CAR = 0.95-1.0) of their motor units are defined as being fully activated. Therapeutic exercises aimed at improving quad strength in patients with knee pathologies are limited in their effectiveness due to a failure to fully activate the muscle. Within the past decade, several disinhibitory interventions have been introduced to treat QA failure in patients with knee pathologies. Transcutaneous electrical nerve stimulation (TENS) and cryotherapy are sensory-targeted modalities traditionally used to treat pain, but they have been shown to be 2 of the most successful treatments for increasing QA levels in patients with QA failure. Both modalities are hypothesized to positively affect voluntary QA by disinhibiting the motor-neuron pool of the quad. In essence, these modalities provide excitatory afferent stimuli to the spinal cord, which thereby overrides the inhibitory afferent signaling that arises from the involved joint. However, it remains unknown whether 1 is more effective than the other for restoring QA levels in patients with knee pathologies. By knowing the capabilities of each disinhibitory modality, clinicians can tailor treatments based on the rehabilitation goals of their patients. Focused Clinical Question: Is TENS or cryotherapy the more effective disinhibitory modality for treating QA failure (quantified via CAR) in patients with knee pathologies?

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

PubMed Central

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

2015-01-01

Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of these strategies in outpatient DCSS units require further policy attention. PMID:26673175

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals.

PubMed

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S

2015-05-20

Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of these strategies in outpatient DCSS units require further policy attention. © 2015 by Kerman University of Medical Sciences.

MO-FG-202-09: Virtual IMRT QA Using Machine Learning: A Multi-Institutional Validation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Valdes, G; Scheuermann, R; Solberg, T

Purpose: To validate a machine learning approach to Virtual IMRT QA for accurately predicting gamma passing rates using different QA devices at different institutions. Methods: A Virtual IMRT QA was constructed using a machine learning algorithm based on 416 IMRT plans, in which QA measurements were performed using diode-array detectors and a 3%local/3mm with 10% threshold. An independent set of 139 IMRT measurements from a different institution, with QA data based on portal dosimetry using the same gamma index and 10% threshold, was used to further test the algorithm. Plans were characterized by 90 different complexity metrics. A weighted poisonmore » regression with Lasso regularization was trained to predict passing rates using the complexity metrics as input. Results: In addition to predicting passing rates with 3% accuracy for all composite plans using diode-array detectors, passing rates for portal dosimetry on per-beam basis were predicted with an error <3.5% for 120 IMRT measurements. The remaining measurements (19) had large areas of low CU, where portal dosimetry has larger disagreement with the calculated dose and, as such, large errors were expected. These beams need to be further modeled to correct the under-response in low dose regions. Important features selected by Lasso to predict gamma passing rates were: complete irradiated area outline (CIAO) area, jaw position, fraction of MLC leafs with gaps smaller than 20 mm or 5mm, fraction of area receiving less than 50% of the total CU, fraction of the area receiving dose from penumbra, weighted Average Irregularity Factor, duty cycle among others. Conclusion: We have demonstrated that the Virtual IMRT QA can predict passing rates using different QA devices and across multiple institutions. Prediction of QA passing rates could have profound implications on the current IMRT process.« less

Q&A on the For-Profit College "90-10 Rule"

ERIC Educational Resources Information Center

Project on Student Debt, 2012

2012-01-01

The "90-10" Rule is a federal law barring for-profit colleges from receiving more than 90% of their revenues from Department of Education federal student aid. It is modeled on the Department of Veterans Affairs' long-standing "85-15" Rule, which prohibits more than 85% of a program's students from receiving VA funding. It prevents for-profit…

TEST/QA PLAN FOR THE VERIFICATION TESTING OF ALTERNATIVES OR REFORMULATED LIQUID FUELS, FUEL ADDITIVES, FUEL EMULSONS, AND LUBRICANTS FOR HIGHWAY AND NONROAD USE HEAVY DUTY DIESEL ENGINES AND LIGHT DUTY GASOLINE ENGINES AND VEHICLES

EPA Science Inventory

The U.S. Environmental Protection Agency established the Environmental Technology Verification Program to accelerate the development and commercialization of improved environmental technology through third party verification and reporting of product performance. Research Triangl...

New Directions for Higher Education: Q&A with CAEL's Tate on Prior Learning, Competency-Based Ed

ERIC Educational Resources Information Center

DiSalvio, Philip

2014-01-01

In April 2013, "NEJHE" launched its New Directions for Higher Education series to examine emerging issues, trends and ideas that have an impact on higher education policies, programs and practices. In this installment, DiSalvio interviews Pamela Tate, president and CEO of the Council for Adult and Experiential Learning (CAEL). Topics…

Engaging Families in Partnership Programs to Promote Student Success: Q&A for Dr. Joyce L. Epstein. REL Mid-Atlantic Educator Effectiveness Webinar Series

ERIC Educational Resources Information Center

Regional Educational Laboratory Mid-Atlantic, 2015

2015-01-01

In this webinar, Dr. Joyce Epstein, Director of the Center on School, Family, and Community Partnerships and the National Network of Partnership Schools, discussed what the research says about effective family engagement. The webinar and PowerPoint presentation are also available. A brief list of resources is included.

The Center for HIV/AIDS Vaccine Immunology (CHAVI) Multi-site Quality Assurance Program for Cryopreserved Human Peripheral Blood Mononuclear Cells

PubMed Central

Sarzotti-Kelsoe, Marcella; Needham, Leila K.; Rountree, Wes; Bainbridge, John; Gray, Clive M.; Fiscus, Susan A.; Ferrari, Guido; Stevens, Wendy S.; Stager, Susan L.; Binz, Whitney; Louzao, Raul; Long, Kristy O.; Mokgotho, Pauline; Moodley, Niranjini; Mackay, Melanie; Kerkau, Melissa; McMillion, Takesha; Kirchherr, Jennifer; Soderberg, Kelly A.; Haynes, Barton F.; Denny, Thomas N.

2014-01-01

The Center for HIV/AIDS Vaccine Immunology (CHAVI) consortium was established to determine the host and virus factors associated with HIV transmission, infection and containment of virus replication, with the goal of advancing the development of an HIV protective vaccine. Studies to meet this goal required the use of cryopreserved Peripheral Blood Mononuclear Cell (PBMC) specimens, and therefore it was imperative that a quality assurance (QA) oversight program be developed to monitor PBMC samples obtained from study participants at multiple international sites. Nine site-affiliated laboratories in Africa and the USA collected and processed PBMCs, and cryopreserved PBMC were shipped to CHAVI repositories in Africa and the USA for long-term storage. A three-stage program was designed, based on Good Clinical Laboratory Practices (GCLP), to monitor PBMC integrity at each step of this process. The first stage evaluated the integrity of fresh PBMCs for initial viability, overall yield, and processing time at the site-affiliated laboratories (Stage 1); for the second stage, the repositories determined post-thaw viability and cell recovery of cryopreserved PBMC, received from the site-affiliated laboratories (Stage 2); the third stage assessed the long-term specimen storage at each repository (Stage 3). Overall, the CHAVI PBMC QA oversight program results highlight the relative importance of each of these stages to the ultimate goal of preserving specimen integrity from peripheral blood collection to long-term repository storage. PMID:24910414

MO-E-217A-01: Contrast-Enhanced Spectral Mammography - Physical Aspects and QA.

PubMed

Yaffe, M; Hill, M

2012-06-01

To describe the current state of dual energy contrast-enhanced digital mammography, to discuss those aspects of its operation that require evaluation or monitoring and to propose elements of a program for quality assurance of such systems. The principles of dual-energy contrast imaging will be discussed and tools and techniques for assessment of performance will be described. Many of the elements affecting image quality and dose performance in digital mammography (eg noise, system linearity, consistency of x-ray output and detector performance, artifacts) remain important. In addition, the ability to register images can influence the resultant image quality. The maintenance of breast compression thickness during the imaging procedure and calibration of the system to allow quantification of iodine in the breast represent new challenges to quality assurance. CESM provides a means of acquiring new information regarding tumor angiogenesis and may reveal some cancers that will not be detectable on digital mammography. It may also better demonstrate the extent of disease. The medical physicist must understand the dependence of image quality on physical factors. Implementation of a relevant QA program will be required if the promise of this new modality is to be delivered. © 2012 American Association of Physicists in Medicine.

Doxycycline and its quaternary ammonium derivative for adjuvant therapies of chondrosarcoma.

PubMed

Miladi, Imen; Vivier, Magali; Dauplat, Marie-Mélanie; Chatard, Morgane; Besse, Sophie; Vidal, Aurélien; Chassain, Karine; Jean, Betty; Forestier, Christiane; Chezal, Jean-Michel; Rédini, Francoise; Degoul, Francoise; Miot-Noirault, Elisabeth

2017-09-01

This study was conducted during the development of innovative treatment targeting the microenvironment of chondrosarcoma. In this context, MMP inhibitors were conjugated with a quaternary ammonium (QA) function as a targeting ligand to proteoglycans of chondrosarcoma extracellular matrix. Here we report the proof of concept of this strategy applied to the MMP13 inhibitor, doxycycline (Dox). A quaternary ammonium derivative of the MMP13 inhibitor doxycycline (QA-Dox) was synthesized, and its anticancer activity was evaluated in the Swarm rat chondrosarcoma (SRC) model compared with the parent drug doxycycline, in vitro and in vivo. In vivo, dox and QA-Dox efficiency was assessed at equimolar doses according to a q4dx4 schedule by monitoring tumour volume by MRI and PG-targeted scintigraphy. Molecular mechanism (MMP13 expression, proteoglycan level) and histology studies were performed on tumours. The link of QA targeting function to Dox maintained the MMP13 inhibitory activity in vitro. Interestingly, the bacteriostatic activity was lost. SRC cells incubated with both drugs were blocked in S and G2 M phases. Tumour growth inhibition (confirmed by histology) was observed for both Dox and QA-Dox. Undesirable blood effects (leukocyte decrease) were reduced when Dox was targeted to tumour tissue using the QA function. In the SRC model, the MMP13 inhibitor Dox and its QA derivative are promising as adjuvant therapies for chondrosarcoma management.

Statistical process control analysis for patient quality assurance of intensity modulated radiation therapy

NASA Astrophysics Data System (ADS)

Lee, Rena; Kim, Kyubo; Cho, Samju; Lim, Sangwook; Lee, Suk; Shim, Jang Bo; Huh, Hyun Do; Lee, Sang Hoon; Ahn, Sohyun

2017-11-01

This study applied statistical process control to set and verify the quality assurances (QA) tolerance standard for our hospital's characteristics with the criteria standards that are applied to all the treatment sites with this analysis. Gamma test factor of delivery quality assurances (DQA) was based on 3%/3 mm. Head and neck, breast, prostate cases of intensity modulated radiation therapy (IMRT) or volumetric arc radiation therapy (VMAT) were selected for the analysis of the QA treatment sites. The numbers of data used in the analysis were 73 and 68 for head and neck patients. Prostate and breast were 49 and 152 by MapCHECK and ArcCHECK respectively. C p value of head and neck and prostate QA were above 1.0, C pml is 1.53 and 1.71 respectively, which is close to the target value of 100%. C pml value of breast (IMRT) was 1.67, data values are close to the target value of 95%. But value of was 0.90, which means that the data values are widely distributed. C p and C pml of breast VMAT QA were respectively 1.07 and 2.10. This suggests that the VMAT QA has better process capability than the IMRT QA. Consequently, we should pay more attention to planning and QA before treatment for breast Radiotherapy.

Test/QA plan for the validation of the verification protocol for high speed pesticide spray drift reduction technologies for row and field crops

EPA Science Inventory

This test/QA plan for evaluation the generic test protocol for high speed wind tunnel, representing aerial application, pesticide spray drift reduction technologies (DRT) for row and field crops is in conformance with EPA Requirements for Quality Assurance Project Plans (EPA QA/R...

Test/QA plan for the validation of the verification protocol for low speed pesticide spray drift reduction technologies for row and field crops

EPA Science Inventory

This test/QA plan for evaluation the generic test protocol for high speed wind tunnel, representing aerial application, pesticide spray drift reduction technologies (DRT) for row and field crops is in conformance with EPA Requirements for Quality Assurance Project Plans (EPA QA/R...

owl-qa | Informatics Technology for Cancer Research (ITCR)

Cancer.gov

owl-qa is an OWL-based QA tool for cancer study CDEs. The tool uses the combination of the NCI Thesaurus and additional disjointness axioms to detect potential errors and duplications in the data element definitions. The tool comprises three modules: Data Integration and Services Module; Compositional Expression Transformation Module; and OWL-based Quality Assurance Module.

A CHRONOLOGICAL HISTORY OF QUALITY ASSURANCE IN THE US EPA OFFICE OF RESEARCH AND DEVELOPMENT

EPA Science Inventory

The US EPA Office of Research and Development (ORD) has a fairly long, eventful, and largely successful QA history, in spite of the fact that the Agency' s QA focus has been elsewhere. For most of the past decade, we QA professionals in ORD have had little opportunity other than ...

Factors associated with malaria microscopy diagnostic performance following a pilot quality-assurance programme in health facilities in malaria low-transmission areas of Kenya, 2014.

PubMed

Odhiambo, Fredrick; Buff, Ann M; Moranga, Collins; Moseti, Caroline M; Wesongah, Jesca Okwara; Lowther, Sara A; Arvelo, Wences; Galgalo, Tura; Achia, Thomas O; Roka, Zeinab G; Boru, Waqo; Chepkurui, Lily; Ogutu, Bernhards; Wanja, Elizabeth

2017-09-13

Malaria accounts for ~21% of outpatient visits annually in Kenya; prompt and accurate malaria diagnosis is critical to ensure proper treatment. In 2013, formal malaria microscopy refresher training for microscopists and a pilot quality-assurance (QA) programme for malaria diagnostics were independently implemented to improve malaria microscopy diagnosis in malaria low-transmission areas of Kenya. A study was conducted to identify factors associated with malaria microscopy performance in the same areas. From March to April 2014, a cross-sectional survey was conducted in 42 public health facilities; 21 were QA-pilot facilities. In each facility, 18 malaria thick blood slides archived during January-February 2014 were selected by simple random sampling. Each malaria slide was re-examined by two expert microscopists masked to health-facility results. Expert results were used as the reference for microscopy performance measures. Logistic regression with specific random effects modelling was performed to identify factors associated with accurate malaria microscopy diagnosis. Of 756 malaria slides collected, 204 (27%) were read as positive by health-facility microscopists and 103 (14%) as positive by experts. Overall, 93% of slide results from QA-pilot facilities were concordant with expert reference compared to 77% in non-QA pilot facilities (p < 0.001). Recently trained microscopists in QA-pilot facilities performed better on microscopy performance measures with 97% sensitivity and 100% specificity compared to those in non-QA pilot facilities (69% sensitivity; 93% specificity; p < 0.01). The overall inter-reader agreement between QA-pilot facilities and experts was κ = 0.80 (95% CI 0.74-0.88) compared to κ = 0.35 (95% CI 0.24-0.46) between non-QA pilot facilities and experts (p < 0.001). In adjusted multivariable logistic regression analysis, recent microscopy refresher training (prevalence ratio [PR] = 13.8; 95% CI 4.6-41.4), ≥5 years of work experience (PR = 3.8; 95% CI 1.5-9.9), and pilot QA programme participation (PR = 4.3; 95% CI 1.0-11.0) were significantly associated with accurate malaria diagnosis. Microscopists who had recently completed refresher training and worked in a QA-pilot facility performed the best overall. The QA programme and formal microscopy refresher training should be systematically implemented together to improve parasitological diagnosis of malaria by microscopy in Kenya.

Quinolinic acid induces neuritogenesis in SH-SY5Y neuroblastoma cells independently of NMDA receptor activation.

PubMed

Hernandez-Martinez, Juan-Manuel; Forrest, Caroline M; Darlington, L Gail; Smith, Robert A; Stone, Trevor W

2017-03-01

Glutamate and nicotinamide adenine dinucleotide (NAD + ) have been implicated in neuronal development and several types of cancer. The kynurenine pathway of tryptophan metabolism includes quinolinic acid (QA) which is both a selective agonist at N-methyl-D-aspartate (NMDA) receptors and also a precursor for the formation of NAD + . The effect of QA on cell survival and differentiation has therefore been examined on SH-SY5Y human neuroblastoma cells. Retinoic acid (RA, 10 μm) induced differentiation of SH-SY5Y cells into a neuronal phenotype showing neurite growth. QA (50-150 nm) also caused a concentration-dependent increase in the neurite/soma ratio, indicating differentiation. Both RA and QA increased expression of the neuronal marker β3-tubulin in whole-cell homogenates and in the neuritic fraction assessed using a neurite outgrowth assay. Expression of the neuronal proliferation marker doublecortin revealed that, unlike RA, QA did not decrease the number of mitotic cells. QA-induced neuritogenesis coincided with an increase in the generation of reactive oxygen species. Neuritogenesis was prevented by diphenylene-iodonium (an inhibitor of NADPH oxidase) and superoxide dismutase, supporting the involvement of reactive oxygen species. NMDA itself did not promote neuritogenesis and the NMDA antagonist dizocilpine (MK-801) did not prevent quinolinate-induced neuritogenesis, indicating that the effects of QA were independent of NMDA receptors. Nicotinamide caused a significant increase in the neurite/soma ratio and the expression of β3-tubulin in the neuritic fraction. Taken together, these results suggest that QA induces neuritogenesis by promoting oxidizing conditions and affecting the availability of NAD + , independently of NMDA receptors. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

DOE Office of Scientific and Technical Information (OSTI.GOV)

St James, S; Bloch, C; Saini, J

Purpose: Proton pencil beam scanning is used clinically across the United States. There are no current guidelines on tolerances for daily QA specific to pencil beam scanning, specifically related to the individual spot properties (spot width). Using a stochastic method to determine tolerances has the potential to optimize tolerances on individual spots and decrease the number of false positive failures in daily QA. Individual and global spot tolerances were evaluated. Methods: As part of daily QA for proton pencil beam scanning, a field of 16 spots (corresponding to 8 energies) is measured using an array of ion chambers (Matrixx, IBA).more » Each individual spot is fit to two Gaussian functions (x,y). The spot width (σ) in × and y are recorded (32 parameters). Results from the daily QA were retrospectively analyzed for 100 days of data. The deviations of the spot widths were histogrammed and fit to a Gaussian function. The stochastic spot tolerance was taken to be the mean ± 3σ. Using these results, tolerances were developed and tested against known deviations in spot width. Results: The individual spot tolerances derived with the stochastic method decreased in 30/32 instances. Using the previous tolerances (± 20% width), the daily QA would have detected 0/20 days of the deviation. Using a tolerance of any 6 spots failing the stochastic tolerance, 18/20 days of the deviation would have been detected. Conclusion: Using a stochastic method we have been able to decrease daily tolerances on the spot widths for 30/32 spot widths measured. The stochastic tolerances can lead to detection of deviations that previously would have been picked up on monthly QA and missed by daily QA. This method could be easily extended for evaluation of other QA parameters in proton spot scanning.« less

Specific Reactions of Different Striatal Neuron Types in Morphology Induced by Quinolinic Acid in Rats

PubMed Central

Mu, Shuhua; Wu, Jiajia; Chen, Si; OuYang, Lisi; Lei, Wanlong

2014-01-01

Huntington's disease (HD) is a neurological degenerative disease and quinolinic acid (QA) has been used to establish HD model in animals through the mechanism of excitotoxicity. Yet the specific pathological changes and the underlying mechanisms are not fully elucidated. We aimed to reveal the specific morphological changes of different striatal neurons in the HD model. Sprague-Dawley (SD) rats were subjected to unilaterally intrastriatal injections of QA to mimic the HD model. Behavioral tests, histochemical and immunhistochemical stainings as well as Western blots were applied in the present study. The results showed that QA-treated rats had obvious motor and cognitive impairments when compared with the control group. Immunohistochemical detection showed a great loss of NeuN+ neurons and Darpp32+ projection neurons in the transition zone in the QA group when compared with the control group. The numbers of parvalbumin (Parv)+ and neuropeptide Y (NPY)+ interneurons were both significantly reduced while those of calretinin (Cr)+ and choline acetyltransferase (ChAT)+ were not changed notably in the transition zone in the QA group when compared to the controls. Parv+, NPY+ and ChAT+ interneurons were not significantly increased in fiber density while Cr+ neurons displayed an obvious increase in fiber density in the transition zone in QA-treated rats. The varicosity densities of Parv+, Cr+ and NPY+ interneurons were all raised in the transition zone after QA treatment. In conclusion, the present study revealed that QA induced obvious behavioral changes as well as a general loss of striatal projection neurons and specific morphological changes in different striatal interneurons, which may help further explain the underlying mechanisms and the specific functions of various striatal neurons in the pathological process of HD. PMID:24632560

SU-E-T-760: Tolerance Design for Site-Specific Range in Proton Patient QA Process Using the Six Sigma Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lah, J; Shin, D; Kim, G

Purpose: To show how tolerance design and tolerancing approaches can be used to predict and improve the site-specific range in patient QA process in implementing the Six Sigma. Methods: In this study, patient QA plans were selected according to 6 site-treatment groups: head &neck (94 cases), spine (76 cases), lung (89 cases), liver (53 cases), pancreas (55 cases), and prostate (121 cases), treated between 2007 and 2013. We evaluated a model of the Six Sigma that determines allowable deviations in design parameters and process variables in patient-specific QA, where possible, tolerance may be loosened, then customized if it necessary tomore » meet the functional requirements. A Six Sigma problem-solving methodology is known as DMAIC phases, which are used stand for: Define a problem or improvement opportunity, Measure process performance, Analyze the process to determine the root causes of poor performance, Improve the process by fixing root causes, Control the improved process to hold the gains. Results: The process capability for patient-specific range QA is 0.65 with only ±1 mm of tolerance criteria. Our results suggested the tolerance level of ±2–3 mm for prostate and liver cases and ±5 mm for lung cases. We found that customized tolerance between calculated and measured range reduce that patient QA plan failure and almost all sites had failure rates less than 1%. The average QA time also improved from 2 hr to less than 1 hr for all including planning and converting process, depth-dose measurement and evaluation. Conclusion: The objective of tolerance design is to achieve optimization beyond that obtained through QA process improvement and statistical analysis function detailing to implement a Six Sigma capable design.« less

Development of quality measures for monitoring and improving care in gastroenterology.

PubMed

Germansky, Katharine A; Leffler, Daniel A

2011-06-01

Over the past decade, most quality assurance (QA) efforts in gastroenterology have been aimed at endoscopy. Endoscopic quality improvement was the rational area to begin QA work in gastroenterology due to the relatively acute nature of complications and the high volume of procedures performed. While endoscopy is currently the focus of most quality assurance (QA) measures in gastroenterology, more recent efforts have begun to address clinical gastroenterology practices both in the outpatient and inpatient settings. Clinical outpatient and inpatient gastroenterology is laden with areas where standardization could benefit patient care. While data and experience in clinical gastroenterology QA is relatively limited, it is clear that inconsistent use of guidelines and practice variations in gastroenterology can lead to lower quality care. In this review, we review a variety of areas in clinical gastroenterology where existing guidelines and published data suggest both the need and practicality of active QA measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Pre-trial quality assurance processes for an intensity-modulated radiation therapy (IMRT) trial: PARSPORT, a UK multicentre Phase III trial comparing conventional radiotherapy and parotid-sparing IMRT for locally advanced head and neck cancer.

PubMed

Clark, C H; Miles, E A; Urbano, M T Guerrero; Bhide, S A; Bidmead, A M; Harrington, K J; Nutting, C M

2009-07-01

The purpose of this study was to compare conventional radiotherapy with parotid gland-sparing intensity-modulated radiation therapy (IMRT) using the PARSPORT trial. The validity of such a trial depends on the radiotherapy planning and delivery meeting a defined standard across all centres. At the outset, many of the centres had little or no experience of delivering IMRT; therefore, quality assurance processes were devised to ensure consistency and standardisation of all processes for comparison within the trial. The pre-trial quality assurance (QA) programme and results are described. Each centre undertook exercises in target volume definition and treatment planning, completed a resource questionnaire and produced a process document. Additionally, the QA team visited each participating centre. Each exercise had to be accepted before patients could be recruited into the trial. 10 centres successfully completed the quality assurance exercises. A range of treatment planning systems, linear accelerators and delivery methods were used for the planning exercises, and all the plans created reached the standard required for participation in this multicentre trial. All 10 participating centres achieved implementation of a comprehensive and robust IMRT programme for treatment of head and neck cancer.

A topic clustering approach to finding similar questions from large question and answer archives.

PubMed

Zhang, Wei-Nan; Liu, Ting; Yang, Yang; Cao, Liujuan; Zhang, Yu; Ji, Rongrong

2014-01-01

With the blooming of Web 2.0, Community Question Answering (CQA) services such as Yahoo! Answers (http://answers.yahoo.com), WikiAnswer (http://wiki.answers.com), and Baidu Zhidao (http://zhidao.baidu.com), etc., have emerged as alternatives for knowledge and information acquisition. Over time, a large number of question and answer (Q&A) pairs with high quality devoted by human intelligence have been accumulated as a comprehensive knowledge base. Unlike the search engines, which return long lists of results, searching in the CQA services can obtain the correct answers to the question queries by automatically finding similar questions that have already been answered by other users. Hence, it greatly improves the efficiency of the online information retrieval. However, given a question query, finding the similar and well-answered questions is a non-trivial task. The main challenge is the word mismatch between question query (query) and candidate question for retrieval (question). To investigate this problem, in this study, we capture the word semantic similarity between query and question by introducing the topic modeling approach. We then propose an unsupervised machine-learning approach to finding similar questions on CQA Q&A archives. The experimental results show that our proposed approach significantly outperforms the state-of-the-art methods.

TU-E-BRB-03: Overview of Proposed TG-132 Recommendations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brock, K.

2015-06-15

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will alsomore » discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.« less

One fish, two fish, we QC fish: controlling data quality among more than 50 organizations over a four-year period.

PubMed

Riddick, L; Simbanin, C

2001-01-01

EPA is conducting a National Study of Chemical Residues in Lake Fish Tissue. The study involves five analytical laboratories, multiple sampling teams from each of the 47 participating states, several tribes, all 10 EPA Regions and several EPA program offices, with input from other federal agencies. To fulfill study objectives, state and tribal sampling teams are voluntarily collecting predator and bottom-dwelling fish from approximately 500 randomly selected lakes over a 4-year period. The fish will be analyzed for more than 300 pollutants. The long-term nature of the study, combined with the large number of participants, created several QA challenges: (1) controlling variability among sampling activities performed by different sampling teams from more than 50 organizations over a 4-year period; (2) controlling variability in lab processes over a 4-year period; (3) generating results that will meet the primary study objectives for use by OW statisticians; (4) generating results that will meet the undefined needs of more than 50 participating organizations; and (5) devising a system for evaluating and defining data quality and for reporting data quality assessments concurrently with the data to ensure that assessment efforts are streamlined and that assessments are consistent among organizations. This paper describes the QA program employed for the study and presents an interim assessment of the program's effectiveness.

Canadian Forces Training and Mental Preparation for Adversity: Empirical Review of Stoltz ’Adversity Quotient (AQ) Training for Optimal Response to Adversity’, A Review of the AQ Literature and Supporting Studies

DTIC Science & Technology

2002-07-01

canadiennes. Enfin, nous faisons des recommandations aux FC sur la mise en ceuvre duS processus de d6veloppement du QA comme mesure proactive. Un examen...critique des ouvrages lies au QA et A d’autres sujets connexes a montr6 que le concept du QA est fond6 sur un certain nombre de thdories sens~es sur la...rdsilience. Cependant, m~me si le cadre th~orique et le programme de d6veloppement du QA pourraicnt 8tre valides dans un contexte industriel

Estimation of Eye Lens Dose During Brain Scans Using Gafchromic Xr-QA2 Film in Various Multidetector CT Scanners.

PubMed

Akhilesh, Philomina; Kulkarni, Arti R; Jamhale, Shramika H; Sharma, S D; Kumar, Rajesh; Datta, D

2017-04-25

The purpose of this study was to estimate eye lens dose during brain scans in 16-, 64-, 128- and 256-slice multidetector computed tomography (CT) scanners in helical acquisition mode and to test the feasibility of using radiochromic film as eye lens dosemeter during CT scanning. Eye lens dose measurements were performed using Gafchromic XR-QA2 film on a polystyrene head phantom designed with outer dimensions equivalent to the head size of a reference Indian man. The response accuracy of XR-QA2 film was validated by using thermoluminescence dosemeters. The eye lens dose measured using XR-QA2 film on head phantom for plain brain scanning in helical mode ranged from 43.8 to 45.8 mGy. The XR-QA2 film measured dose values were in agreement with TLD measured dose values within a maximum variation of 8.9%. The good correlation between the two data sets confirms the viability of using XR-QA2 film for eye lens dosimetry. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Study of arteriovenous fistula function by the temperature gradient method using the Twister™ device.

PubMed

Roca-Tey, Ramon; Samon, Rosa; Ibrik, Omar; Roda, Amparo; González-Oliva, Juan C; Viladoms, Jordi

2012-01-01

Periodic blood flow (QA) measurement is the preferred way for arteriovenous fistula (AVF) surveillance in chronic hemodialysis (HD) patients. Objectives. 1) Assess the efficacy of the temperature gradient method (TGM) on the QA determinations using the Twister™ device and to compare the functional results with the Delta-H method. 2) Evaluate the effect of blood pressure on the AVF function. Patients and method. We measured the QA non invasively in 30 AVF (24 radial and 6 brachial; mean duration 53.4 +/- 78.5 months) during HD in 30 stable patients (mean age 59.9 +/- 14.1 years, males 60 %, females 40 %; mean time on HD 37.4 +/- 40.6 months, diabetic nephropathy 20 %) by the TGM, described and validated by Wijnen et al (Kidney Int 2007;72:736). The QA was calculated from the temperature values obtained by means of the blood temperature monitor (BTM), integrated into the Fresenius Medical Care 4008-S machine, at normal and reverse configurations of the HD blood lines, with no need for a thermal bolus. The Twister™ device was used for reversing the blood lines without the need to disconnect them from the AVF lines nor to stop the blood pump. The QA was measured within the first hour of two consecutive HD sessions (the values were averaged). The mean arterial pressure MAP (diastolic pressure + 1/3 pulse pressure) was calculated simultaneous with the QA. In addition, the AVF blood flow was also determined during the same week in all patients by the Delta-H method using the Crit-Line III Monitor (ABF-mode, HemaMetrics, USA) during HD (manually switching lines). The mean QA was 1132.5 +/- 515.4 ml/min (range, 446-2233 ml/min). The mean coefficient of variation for duplicate QA measurements was 6.8 +/- 4.7 %; the MAP was not different when the reproducibility tests were performed (96.1 +/- 13.7 versus 96.6 +/- 12.8 mmHg, p = .72). No significant difference was found when comparing the mean QA between diabetic (n = 6, 966.4 +/- 340.7 ml/min) and nondiabetic (n = 24, 1174.4 +/- 548.3 ml/min) patients (p = .39). The mean QA was similar for patients with mean MAP < 100 mmHg (n = 18, 1101.0 +/- 552.7 ml/min) and for patients with mean MAP >_ 100 mmHg (n = 12, 1180.4 +/- 473.3 ml/min) (p = .69). No correlation was found between the mean QA and: age (r = 0.09, p = .62), time on HD (r = 0.06, p = .76), MAP (r = -0.21, p = .27), Kt/V index (r = 0.12, p = .51), distance between needles (r = - 0.17, p = .37) and AVF duration (r = -0.01, p = .96). The mean time required to measure QA with the TGM using the Twister™ device (5.9+/- 1.9 min) was significantly shorter compared with the Delta-H technique (26.8 +/- 1.9 min) or with the TGM (n = 35, 8.9 +/- 3.5 min, manually reversing lines) reported by Wijnen et al (Kidney Int 2007;72:736).) (for both comparisons, p < .001). The mean QA obtained by the TGM was not different when compared to mean ABF determined by the Delta-H method (1138.4 +/- 502.3 ml/min) (p=.83).The calculated values of AVF blood flow obtained by TGM were highly correlated with those determined by the Delta-H technique (r = 0.963, p < .001). 1) The TGM is a valuable and reproducible indicator of QA during HD. 2) The Twister™ device is useful to reduce the time for QA measurement by the TGM. 3) The AVF blood flow values obtained by the TGM and the Delta-H technique correlated highly with each other. 4) It has been shown the lack of relationship between the AVF function and the patient's blood pressure.

Installation Restoration Program Phase 1: Records Search of Hanscom Air Force Base, Massachusetts

DTIC Science & Technology

1984-08-01

Engineer o Kevin R. Boyer, P.E., Project Manager and Civil Engineer o Alfred N. Wickline, Records Search Team Leader and Soil Scientist o Claudia A...INVESTIGATION TEAM :I.., 𔃾 44. ’m4, Use or disclosure of proposal data is subject to the restriction on the Title page of this Proposal. KEVIN R... KEVIN R. BOYER, P.E. Page 2 of 3 While working under the USEPA’s Field Investigation Team (FIT) program, Mr. Boyer was part of a quality assurance (QA

Development of reference practices for the calibration and validation of atmospheric composition satellites

NASA Astrophysics Data System (ADS)

Lambert, Jean-Christopher; Bojkov, Bojan

The Committee on Earth Observation Satellites (CEOS)/Working Group on Calibration and Validation (WGCV) is developing a global data quality strategy for the Global Earth Obser-vation System of Systems (GEOSS). In this context, CEOS WGCV elaborated the GEOSS Quality Assurance framework for Earth Observation (QA4EO, http://qa4eo.org). QA4EO en-compasses a documentary framework and a set of ten guidelines, which describe the top-level approach of QA activities and key requirements that drive the QA process. QA4EO is appli-cable virtually to all Earth Observation data. Calibration and validation activities are a cornerstone of the GEOSS data quality strategy. Proper uncertainty assessment of the satellite measurements and their derived data products is essential, and needs to be continuously monitored and traceable to standards. As a practical application of QA4EO, CEOS WGCV has undertaken to establish a set of best practices, methodologies and guidelines for satellite calibration and validation. The present paper reviews current developments of best practices and guidelines for the vali-dation of atmospheric composition satellites. Aimed as a community effort, the approach is to start with current practices that could be improved with time. The present review addresses current validation capabilities, achievements, caveats, harmonization efforts, and challenges. Terminologies and general principles of validation are reminded. Going beyond elementary def-initions of validation like the assessment of uncertainties, the specific GEOSS context requires considering also the validation of individual service components and against user requirements.

Quinolinic acid injection in mouse medial prefrontal cortex affects reversal learning abilities, cortical connectivity and hippocampal synaptic plasticity

PubMed Central

Latif-Hernandez, Amira; Shah, Disha; Ahmed, Tariq; Lo, Adrian C.; Callaerts-Vegh, Zsuzsanna; Van der Linden, Annemie; Balschun, Detlef; D’Hooge, Rudi

2016-01-01

Intracerebral injection of the excitotoxic, endogenous tryptophan metabolite, quinolinic acid (QA), constitutes a chemical model of neurodegenerative brain disease. Complementary techniques were combined to examine the consequences of QA injection into medial prefrontal cortex (mPFC) of C57BL6 mice. In accordance with the NMDAR-mediated synapto- and neurotoxic action of QA, we found an initial increase in excitability and an augmentation of hippocampal long-term potentiation, converting within two weeks into a reduction and impairment, respectively, of these processes. QA-induced mPFC excitotoxicity impaired behavioral flexibility in a reversal variant of the hidden-platform Morris water maze (MWM), whereas regular, extended MWM training was unaffected. QA-induced mPFC damage specifically affected the spatial-cognitive strategies that mice use to locate the platform during reversal learning. These behavioral and cognitive defects coincided with changes in cortical functional connectivity (FC) and hippocampal neuroplasticity. FC between various cortical regions was assessed by resting-state fMRI (rsfMRI) methodology, and mice that had received QA injection into mPFC showed increased FC between various cortical regions. mPFC and hippocampus (HC) are anatomically as well as functionally linked as part of a cortical network that controls higher-order cognitive functions. Together, these observations demonstrate the central functional importance of rodent mPFC as well as the validity of QA-induced mPFC damage as a preclinical rodent model of the early stages of neurodegeneration. PMID:27819338

Tunneling and speedup in quantum optimization for permutation-symmetric problems

DOE PAGES

Muthukrishnan, Siddharth; Albash, Tameem; Lidar, Daniel A.

2016-07-21

Tunneling is often claimed to be the key mechanism underlying possible speedups in quantum optimization via quantum annealing (QA), especially for problems featuring a cost function with tall and thin barriers. We present and analyze several counterexamples from the class of perturbed Hamming weight optimization problems with qubit permutation symmetry. We first show that, for these problems, the adiabatic dynamics that make tunneling possible should be understood not in terms of the cost function but rather the semiclassical potential arising from the spin-coherent path-integral formalism. We then provide an example where the shape of the barrier in the final costmore » function is short and wide, which might suggest no quantum advantage for QA, yet where tunneling renders QA superior to simulated annealing in the adiabatic regime. However, the adiabatic dynamics turn out not be optimal. Instead, an evolution involving a sequence of diabatic transitions through many avoided-level crossings, involving no tunneling, is optimal and outperforms adiabatic QA. We show that this phenomenon of speedup by diabatic transitions is not unique to this example, and we provide an example where it provides an exponential speedup over adiabatic QA. In yet another twist, we show that a classical algorithm, spin-vector dynamics, is at least as efficient as diabatic QA. Lastly, in a different example with a convex cost function, the diabatic transitions result in a speedup relative to both adiabatic QA with tunneling and classical spin-vector dynamics.« less

Tunneling and speedup in quantum optimization for permutation-symmetric problems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muthukrishnan, Siddharth; Albash, Tameem; Lidar, Daniel A.

Tunneling is often claimed to be the key mechanism underlying possible speedups in quantum optimization via quantum annealing (QA), especially for problems featuring a cost function with tall and thin barriers. We present and analyze several counterexamples from the class of perturbed Hamming weight optimization problems with qubit permutation symmetry. We first show that, for these problems, the adiabatic dynamics that make tunneling possible should be understood not in terms of the cost function but rather the semiclassical potential arising from the spin-coherent path-integral formalism. We then provide an example where the shape of the barrier in the final costmore » function is short and wide, which might suggest no quantum advantage for QA, yet where tunneling renders QA superior to simulated annealing in the adiabatic regime. However, the adiabatic dynamics turn out not be optimal. Instead, an evolution involving a sequence of diabatic transitions through many avoided-level crossings, involving no tunneling, is optimal and outperforms adiabatic QA. We show that this phenomenon of speedup by diabatic transitions is not unique to this example, and we provide an example where it provides an exponential speedup over adiabatic QA. In yet another twist, we show that a classical algorithm, spin-vector dynamics, is at least as efficient as diabatic QA. Lastly, in a different example with a convex cost function, the diabatic transitions result in a speedup relative to both adiabatic QA with tunneling and classical spin-vector dynamics.« less

"Remember to Hand out Medals": Peer Rating and Expertise in a Question-and-Answer Study Group

ERIC Educational Resources Information Center

Ponti, Marisa

2015-01-01

This article reports on an exploratory study of giving medals as part of a peer rating system in a question-and-answer (Q&A) study group on Python, a programming language. There are no professional teachers tutoring learners. The study aimed to understand whether and how medals, awarded to responses in a peer-based learning environment, can…

Size Effect of the 2-D Bodies on the Geothermal Gradient and Q-A Plot

NASA Astrophysics Data System (ADS)

Thakur, M.; Blackwell, D. D.

2009-12-01

Using numerical models we have investigated some of the criticisms on the Q-A plot of related to the effect of size of the body on the slope and reduced heat flow. The effects of horizontal conduction depend on the relative difference of radioactivity between the body and the country rock (assuming constant thermal conductivity). Horizontal heat transfer due to different 2-D bodies was numerically studied in order to quantify resulting temperature differences at the Moho and errors on the predication of Qr (reduced heat flow). Using the two end member distributions of radioactivity, the step model (thickness 10km) and exponential model, different 2-D models of horizontal scale (width) ranging from 10 -500 km were investigated. Increasing the horizontal size of the body tends to move observations closer towards the 1-D solution. A temperature difference of 50 oC is produced (for the step model) at Moho between models of width 10 km versus 500 km. In other words the 1-D solution effectively provides large scale averaging in terms of heat flow and temperature field in the lithosphere. For bodies’ ≤ 100 km wide the geotherms at shallower levels are affected, but at depth they converge and are 50 oC lower than that of the infinite plate model temperature. In case of 2-D bodies surface heat flow is decreased due to horizontal transfer of heat, which will shift the Q-A point vertically downward on the Q-A plot. The smaller the size of the body, the more will be the deviation from the 1-D solution and the more will be the movement of Q-A point downwards on a Q-A plot. On the Q-A plot, a limited points of bodies of different sizes with different radioactivity contrast (for the step and exponential model), exactly reproduce the reduced heat flow Qr. Thus the size of the body can affect the slope on a Q-A plot but Qr is not changed. Therefore, Qr ~ 32 mWm-2 obtained from the global terrain average Q-A plot represents the best estimate of stable continental mantle heat flow.

SU-G-206-01: A Fully Automated CT Tool to Facilitate Phantom Image QA for Quantitative Imaging in Clinical Trials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wahi-Anwar, M; Lo, P; Kim, H

Purpose: The use of Quantitative Imaging (QI) methods in Clinical Trials requires both verification of adherence to a specified protocol and an assessment of scanner performance under that protocol, which are currently accomplished manually. This work introduces automated phantom identification and image QA measure extraction towards a fully-automated CT phantom QA system to perform these functions and facilitate the use of Quantitative Imaging methods in clinical trials. Methods: This study used a retrospective cohort of CT phantom scans from existing clinical trial protocols - totaling 84 phantoms, across 3 phantom types using various scanners and protocols. The QA system identifiesmore » the input phantom scan through an ensemble of threshold-based classifiers. Each classifier - corresponding to a phantom type - contains a template slice, which is compared to the input scan on a slice-by-slice basis, resulting in slice-wise similarity metric values for each slice compared. Pre-trained thresholds (established from a training set of phantom images matching the template type) are used to filter the similarity distribution, and the slice with the most optimal local mean similarity, with local neighboring slices meeting the threshold requirement, is chosen as the classifier’s matched slice (if it existed). The classifier with the matched slice possessing the most optimal local mean similarity is then chosen as the ensemble’s best matching slice. If the best matching slice exists, image QA algorithm and ROIs corresponding to the matching classifier extracted the image QA measures. Results: Automated phantom identification performed with 84.5% accuracy and 88.8% sensitivity on 84 phantoms. Automated image quality measurements (following standard protocol) on identified water phantoms (n=35) matched user QA decisions with 100% accuracy. Conclusion: We provide a fullyautomated CT phantom QA system consistent with manual QA performance. Further work will include parallel component to automatically verify image acquisition parameters and automated adherence to specifications. Institutional research agreement, Siemens Healthcare; Past recipient, research grant support, Siemens Healthcare; Consultant, Toshiba America Medical Systems; Consultant, Samsung Electronics; NIH Grant support from: U01 CA181156.« less

Analysis of the kinetics of P+ HA- recombination in membrane-embedded wild-type and mutant Rhodobacter sphaeroides reaction centers between 298 and 77 K indicates that the adjacent negatively charged QA ubiquinone modulates the free energy of P+ HA- and may influence the rate of the protein dielectric response.

PubMed

Gibasiewicz, Krzysztof; Pajzderska, Maria; Dobek, Andrzej; Brettel, Klaus; Jones, Michael R

2013-09-26

Time-resolved spectroscopic studies of recombination of the P(+)HA(-) radical pair in photosynthetic reaction centers (RCs) from Rhodobacter sphaeroides give an opportunity to study protein dynamics triggered by light and occurring over the lifetime of P(+)HA(-). The state P(+)HA(-) is formed after the ultrafast light-induced electron transfer from the primary donor pair of bacteriochlorophylls (P) to the acceptor bacteriopheophytin (HA). In order to increase the lifetime of this state, and thus increase the temporal window for the examination of protein dynamics, it is possible to block forward electron transfer from HA(-) to the secondary electron acceptor QA. In this contribution, the dynamics of P(+)HA(-) recombination were compared at a range of temperatures from 77 K to room temperature, electron transfer from HA(-) to QA being blocked either by prereduction of QA or by genetic removal of QA. The observed P(+)HA(-) charge recombination was significantly slower in the QA-deficient RCs, and in both types of complexes, lowering the temperature from RT to 77 K led to a slowing of charge recombination. The effects are explained in the frame of a model in which charge recombination occurs via competing pathways, one of which is thermally activated and includes transient formation of a higher-energy state, P(+)BA(-). An internal electrostatic field supplied by the negative charge on QA increases the free energy levels of the state P(+)HA(-), thus decreasing its energetic distance to the state P(+)BA(-). In addition, the dielectric response of the protein environment to the appearance of the state P(+)HA(-) is accelerated from ∼50-100 ns in the QA-deficient mutant RCs to ∼1-16 ns in WT RCs with a negatively charged QA(-). In both cases, the temperature dependence of the protein dynamics is weak.

SU-F-T-285: Evaluation of a Patient DVH-Based IMRT QA System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhen, H; Redler, G; Chu, J

2016-06-15

Purpose: To evaluate the clinical performance of a patient DVH-based QA system for prostate VMAT QA. Methods: Mobius3D(M3D) is a QA software with an independent beam model and dose engine. The MobiusFX(MFX) add-on predicts patient dose using treatment machine log files. We commissioned the Mobius beam model in two steps. First, the stock beam model was customized using machine commissioning data, then verified against the TPS with 12 simple phantom plans and 7 clinical 3D plans. Secondly, the Dosimetric Leaf Gap(DLG) in the Mobius model was fine-tuned for VMAT treatment based on ion chamber measurements for 6 clinical VMAT plans.more » Upon successful commissioning, we retrospectively performed IMRT QA for 12 VMAT plans with the Mobius system as well as the ArcCHECK-3DVH system. Selected patient DVH values (PTV D95, D50; Bladder D2cc, Dmean; Rectum D2cc) were compared between TPS, M3D, MFX, and 3DVH. Results: During the first commissioning step, TPS and M3D calculated target Dmean for 3D plans agree within 0.7%±0.7%, with 3D gamma passing rates of 98%±2%. In the second commissioning step, the Mobius DLG was adjusted by 1.2mm from the stock value, reducing the average difference between MFX calculation and ion chamber measurement from 3.2% to 0.1%. In retrospective prostate VMAT QA, 5 of 60 MFX calculated DVH values have a deviation greater than 5% compared to TPS. One large deviation at high dose level was identified as a potential QA failure. This echoes the 3DVH QA result, which identified 2 instances of large DVH deviation on the same structure. For all DVH’s evaluated, M3D and MFX show high level of agreement (0.1%±0.2%), indicating that the observed deviation is likely from beam modelling differences rather than delivery errors. Conclusion: Mobius system provides a viable solution for DVH based VMAT QA, with the capability of separating TPS and delivery errors.« less

Experience with Quality Assurance in Two Store-and-Forward Telemedicine Networks.

PubMed

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent; Venugopal, Raghu; Oakley, Amanda

2015-01-01

Despite the increasing use of telemedicine around the world, little has been done to incorporate quality assurance (QA) into these operations. The purpose of the present study was to examine the feasibility of QA in store-and-forward teleconsulting using a previously published framework. During a 2-year study period, we examined the feasibility of using QA tools in two mature telemedicine networks [Médecins Sans Frontières (MSF) and New Zealand Teledermatology (NZT)]. The tools included performance reporting to assess trends, automated follow-up of patients to obtain outcomes data, automated surveying of referrers to obtain user feedback, and retrospective assessment of randomly selected cases to assess quality. In addition, the senior case coordinators in each network were responsible for identifying potential adverse events from email reports received from users. During the study period, there were 149 responses to the patient follow-up questions relating to the 1241 MSF cases (i.e., 12% of cases), and there were 271 responses to the follow-up questions relating to the 639 NZT cases (i.e., 42% of cases). The collection of user feedback reports was combined with the collection of patient follow-up data, thus producing the same response rates. The outcomes data suggested that the telemedicine advice proved useful for the referring doctor in the majority of cases and was likely to benefit the patient. The user feedback was overwhelmingly positive, over 90% of referrers in the two networks finding the advice received to be of educational benefit. The feedback also suggested that the teleconsultation had provided cost savings in about 20% of cases, either to the patient/family, or to the hospital/clinic treating the patient. Various problems were detected by regular monitoring, and certain adverse events were identified from email reports by the users. A single aberrant quality reading was detected by using a process control chart. The present study demonstrates that a QA program is feasible in store-and-forward telemedicine, and shows that it was useful in two different networks, because certain problems were detected (and then solved) that would not have been identified until much later. It seems likely that QA could be used much more widely in telemedicine generally to benefit patient care.

Feasibility study of using statistical process control to customized quality assurance in proton therapy.

PubMed

Rah, Jeong-Eun; Shin, Dongho; Oh, Do Hoon; Kim, Tae Hyun; Kim, Gwe-Ya

2014-09-01

To evaluate and improve the reliability of proton quality assurance (QA) processes and, to provide an optimal customized tolerance level using the statistical process control (SPC) methodology. The authors investigated the consistency check of dose per monitor unit (D/MU) and range in proton beams to see whether it was within the tolerance level of the daily QA process. This study analyzed the difference between the measured and calculated ranges along the central axis to improve the patient-specific QA process in proton beams by using process capability indices. The authors established a customized tolerance level of ±2% for D/MU and ±0.5 mm for beam range in the daily proton QA process. In the authors' analysis of the process capability indices, the patient-specific range measurements were capable of a specification limit of ±2% in clinical plans. SPC methodology is a useful tool for customizing the optimal QA tolerance levels and improving the quality of proton machine maintenance, treatment delivery, and ultimately patient safety.

Beyond Information Retrieval—Medical Question Answering

PubMed Central

Lee, Minsuk; Cimino, James; Zhu, Hai Ran; Sable, Carl; Shanker, Vijay; Ely, John; Yu, Hong

2006-01-01

Physicians have many questions when caring for patients, and frequently need to seek answers for their questions. Information retrieval systems (e.g., PubMed) typically return a list of documents in response to a user’s query. Frequently the number of returned documents is large and makes physicians’ information seeking “practical only ‘after hours’ and not in the clinical settings”. Question answering techniques are based on automatically analyzing thousands of electronic documents to generate short-text answers in response to clinical questions that are posed by physicians. The authors address physicians’ information needs and described the design, implementation, and evaluation of the medical question answering system (MedQA). Although our long term goal is to enable MedQA to answer all types of medical questions, currently, we currently implement MedQA to integrate information retrieval, extraction, and summarization techniques to automatically generate paragraph-level text for definitional questions (i.e., “What is X?”). MedQA can be accessed at http://www.dbmi.columbia.edu/~yuh9001/research/MedQA.html. PMID:17238385

Quinic acid is a biologically active component of the Uncaria tomentosa extract C-Med 100.

PubMed

Akesson, Christina; Lindgren, Hanna; Pero, Ronald W; Leanderson, Tomas; Ivars, Fredrik

2005-01-01

We have previously reported that the C-Med 100 extract of the plant Uncaria tomentosa induces prolonged lymphocyte half life and hence increased spleen cell number in mice receiving the extract in their drinking water. Further, the extract induces cell proliferation arrest and inhibits activation of the transcriptional regulator nuclear factor kappaB (NF-kappaB) in vitro. We now report that mice exposed to quinic acid (QA), a component of this extract, had significantly increased number of spleen cells, thus recapitulating the in vivo biological effect of C-Med 100 exposure. Commercially supplied QA (H(+) form) did not, however, inhibit cell proliferation in vitro, while the ammonia-treated QA (QAA) was a potent inhibitor. Both QA and QAA inhibited NF-kappaB activity in exposed cells at similar concentrations. Thus, our present data identify QA as a candidate component for both in vivo and in vitro biological effects of the C-Med 100 extract.

Automating linear accelerator quality assurance.

PubMed

Eckhause, Tobias; Al-Hallaq, Hania; Ritter, Timothy; DeMarco, John; Farrey, Karl; Pawlicki, Todd; Kim, Gwe-Ya; Popple, Richard; Sharma, Vijeshwar; Perez, Mario; Park, SungYong; Booth, Jeremy T; Thorwarth, Ryan; Moran, Jean M

2015-10-01

The purpose of this study was 2-fold. One purpose was to develop an automated, streamlined quality assurance (QA) program for use by multiple centers. The second purpose was to evaluate machine performance over time for multiple centers using linear accelerator (Linac) log files and electronic portal images. The authors sought to evaluate variations in Linac performance to establish as a reference for other centers. The authors developed analytical software tools for a QA program using both log files and electronic portal imaging device (EPID) measurements. The first tool is a general analysis tool which can read and visually represent data in the log file. This tool, which can be used to automatically analyze patient treatment or QA log files, examines the files for Linac deviations which exceed thresholds. The second set of tools consists of a test suite of QA fields, a standard phantom, and software to collect information from the log files on deviations from the expected values. The test suite was designed to focus on the mechanical tests of the Linac to include jaw, MLC, and collimator positions during static, IMRT, and volumetric modulated arc therapy delivery. A consortium of eight institutions delivered the test suite at monthly or weekly intervals on each Linac using a standard phantom. The behavior of various components was analyzed for eight TrueBeam Linacs. For the EPID and trajectory log file analysis, all observed deviations which exceeded established thresholds for Linac behavior resulted in a beam hold off. In the absence of an interlock-triggering event, the maximum observed log file deviations between the expected and actual component positions (such as MLC leaves) varied from less than 1% to 26% of published tolerance thresholds. The maximum and standard deviations of the variations due to gantry sag, collimator angle, jaw position, and MLC positions are presented. Gantry sag among Linacs was 0.336 ± 0.072 mm. The standard deviation in MLC position, as determined by EPID measurements, across the consortium was 0.33 mm for IMRT fields. With respect to the log files, the deviations between expected and actual positions for parameters were small (<0.12 mm) for all Linacs. Considering both log files and EPID measurements, all parameters were well within published tolerance values. Variations in collimator angle, MLC position, and gantry sag were also evaluated for all Linacs. The performance of the TrueBeam Linac model was shown to be consistent based on automated analysis of trajectory log files and EPID images acquired during delivery of a standardized test suite. The results can be compared directly to tolerance thresholds. In addition, sharing of results from standard tests across institutions can facilitate the identification of QA process and Linac changes. These reference values are presented along with the standard deviation for common tests so that the test suite can be used by other centers to evaluate their Linac performance against those in this consortium.

Cation Effects on the Electron-Acceptor Side of Photosystem II.

PubMed

Khan, Sahr; Sun, Jennifer S; Brudvig, Gary W

2015-06-18

The normal pathway of electron transfer on the electron-acceptor side of photosystem II (PSII) involves electron transfer from quinone A, QA, to quinone B, QB. It is possible to redirect electrons from QA(-) to water-soluble Co(III) complexes, which opens a new avenue for harvesting electrons from water oxidation by immobilization of PSII on electrode surfaces. Herein, the kinetics of electron transfer from QA(-) to [Co(III)(terpy)2](3+) (terpy = 2,2';6',2″-terpyridine) are investigated with a spectrophotometric assay revealing that the reaction follows Michaelis-Menten saturation kinetics, is inhibited by cations, and is not affected by variation of the QA reduction potential. A negatively charged site on the stromal surface of the PSII protein complex, composed of glutamic acid residues near QA, is hypothesized to bind cations, especially divalent cations. The cations are proposed to tune the redox properties of QA through electrostatic interactions. These observations may thus explain the molecular basis of the effect of divalent cations like Ca(2+), Sr(2+), Mg(2+), and Zn(2+) on the redox properties of the quinones in PSII, which has previously been attributed to long-range conformational changes propagated from divalent cations binding to the Ca(II)-binding site in the oxygen-evolving complex on the lumenal side of the PSII complex.

Utilizing a structural meta-ontology for family-based quality assurance of the BioPortal ontologies.

PubMed

Ochs, Christopher; He, Zhe; Zheng, Ling; Geller, James; Perl, Yehoshua; Hripcsak, George; Musen, Mark A

2016-06-01

An Abstraction Network is a compact summary of an ontology's structure and content. In previous research, we showed that Abstraction Networks support quality assurance (QA) of biomedical ontologies. The development of an Abstraction Network and its associated QA methodologies, however, is a labor-intensive process that previously was applicable only to one ontology at a time. To improve the efficiency of the Abstraction-Network-based QA methodology, we introduced a QA framework that uses uniform Abstraction Network derivation techniques and QA methodologies that are applicable to whole families of structurally similar ontologies. For the family-based framework to be successful, it is necessary to develop a method for classifying ontologies into structurally similar families. We now describe a structural meta-ontology that classifies ontologies according to certain structural features that are commonly used in the modeling of ontologies (e.g., object properties) and that are important for Abstraction Network derivation. Each class of the structural meta-ontology represents a family of ontologies with identical structural features, indicating which types of Abstraction Networks and QA methodologies are potentially applicable to all of the ontologies in the family. We derive a collection of 81 families, corresponding to classes of the structural meta-ontology, that enable a flexible, streamlined family-based QA methodology, offering multiple choices for classifying an ontology. The structure of 373 ontologies from the NCBO BioPortal is analyzed and each ontology is classified into multiple families modeled by the structural meta-ontology. Copyright © 2016 Elsevier Inc. All rights reserved.

DeepQA: improving the estimation of single protein model quality with deep belief networks.

PubMed

Cao, Renzhi; Bhattacharya, Debswapna; Hou, Jie; Cheng, Jianlin

2016-12-05

Protein quality assessment (QA) useful for ranking and selecting protein models has long been viewed as one of the major challenges for protein tertiary structure prediction. Especially, estimating the quality of a single protein model, which is important for selecting a few good models out of a large model pool consisting of mostly low-quality models, is still a largely unsolved problem. We introduce a novel single-model quality assessment method DeepQA based on deep belief network that utilizes a number of selected features describing the quality of a model from different perspectives, such as energy, physio-chemical characteristics, and structural information. The deep belief network is trained on several large datasets consisting of models from the Critical Assessment of Protein Structure Prediction (CASP) experiments, several publicly available datasets, and models generated by our in-house ab initio method. Our experiments demonstrate that deep belief network has better performance compared to Support Vector Machines and Neural Networks on the protein model quality assessment problem, and our method DeepQA achieves the state-of-the-art performance on CASP11 dataset. It also outperformed two well-established methods in selecting good outlier models from a large set of models of mostly low quality generated by ab initio modeling methods. DeepQA is a useful deep learning tool for protein single model quality assessment and protein structure prediction. The source code, executable, document and training/test datasets of DeepQA for Linux is freely available to non-commercial users at http://cactus.rnet.missouri.edu/DeepQA/ .

SU-E-CAMPUS-T-04: Statistical Process Control for Patient-Specific QA in Proton Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

LAH, J; SHIN, D; Kim, G

Purpose: To evaluate and improve the reliability of proton QA process, to provide an optimal customized level using the statistical process control (SPC) methodology. The aim is then to suggest the suitable guidelines for patient-specific QA process. Methods: We investigated the constancy of the dose output and range to see whether it was within the tolerance level of daily QA process. This study analyzed the difference between the measured and calculated ranges along the central axis to suggest the suitable guidelines for patient-specific QA in proton beam by using process capability indices. In this study, patient QA plans were classifiedmore » into 6 treatment sites: head and neck (41 cases), spinal cord (29 cases), lung (28 cases), liver (30 cases), pancreas (26 cases), and prostate (24 cases). Results: The deviations for the dose output and range of daily QA process were ±0.84% and ±019%, respectively. Our results show that the patient-specific range measurements are capable at a specification limit of ±2% in all treatment sites except spinal cord cases. In spinal cord cases, comparison of process capability indices (Cp, Cpm, Cpk ≥1, but Cpmk ≤1) indicated that the process is capable, but not centered, the process mean deviates from its target value. The UCL (upper control limit), CL (center line) and LCL (lower control limit) for spinal cord cases were 1.37%, −0.27% and −1.89%, respectively. On the other hands, the range differences in prostate cases were good agreement between calculated and measured values. The UCL, CL and LCL for prostate cases were 0.57%, −0.11% and −0.78%, respectively. Conclusion: SPC methodology has potential as a useful tool to customize an optimal tolerance levels and to suggest the suitable guidelines for patient-specific QA in clinical proton beam.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gaballa, H; O’Brien, M; Riegel, A

Purpose: To develop a daily quality assurance (QA) device that can test the 6DoF (degrees of freedom) couch repositioning accuracy, prior to SBRT treatment deliveries, with an accuracy of ±0.3 degrees and ±0.3 mm. Methods: A daily QA phantom is designed with a focus on the derived center of projections of its markers, rather than tracking its individual markers one at a time. This approach can be the most favorable to address the intended machining accuracy of the QA phantom and the CBCT spatial resolution limitations, primarily 1 mm min slice thickness, simultaneously. With the current design, ±0.1 mm congruencemore » of the resultant center of gravity of the markers with reference CT (0.6 mm minimum slice thickness) vs CBCT (1.0 mm minimum slice thickness) can be achieved. If successful, the QA device should be qualified to test 6DoF couch performance with a gauged accuracy of ±0.3 degrees/±0.3 mm. Testing is performed for the Varian True Beam 2.0 6DoF system. Results: Once the QA phantom is constructed and tested, agreement of the center of gravity of the reference CT scan and the CBCT scan of ±0.1 mm is achieved. This has translated into a consistent 3D-3D match on the treatment machine, CT vs CBCT, with a repetitive ±0.1 mm variation, thus exceeding our expectations. We have deployed the phantom for daily QA on one of our accelerators, and found that the QA time has increased by only 10 minutes. Conclusion: A 6DoF phantom has been designed (patent pending) and built with a realistic work flow in mind where the daily couch accuracy QA checks taking less than 10 minutes. Current developments include integration with the Varian’s Machine Performance Check consistency module.« less

A means to estimate thermal and kinetic parameters of coal dust layer from hot surface ignition tests.

PubMed

Park, Haejun; Rangwala, Ali S; Dembsey, Nicholas A

2009-08-30

A method to estimate thermal and kinetic parameters of Pittsburgh seam coal subject to thermal runaway is presented using the standard ASTM E 2021 hot surface ignition test apparatus. Parameters include thermal conductivity (k), activation energy (E), coupled term (QA) of heat of reaction (Q) and pre-exponential factor (A) which are required, but rarely known input values to determine the thermal runaway propensity of a dust material. Four different dust layer thicknesses: 6.4, 12.7, 19.1 and 25.4mm, are tested, and among them, a single steady state dust layer temperature profile of 12.7 mm thick dust layer is used to estimate k, E and QA. k is calculated by equating heat flux from the hot surface layer and heat loss rate on the boundary assuming negligible heat generation in the coal dust layer at a low hot surface temperature. E and QA are calculated by optimizing a numerically estimated steady state dust layer temperature distribution to the experimentally obtained temperature profile of a 12.7 mm thick dust layer. Two unknowns, E and QA, are reduced to one from the correlation of E and QA obtained at criticality of thermal runaway. The estimated k is 0.1 W/mK matching the previously reported value. E ranges from 61.7 to 83.1 kJ/mol, and the corresponding QA ranges from 1.7 x 10(9) to 4.8 x 10(11)J/kg s. The mean values of E (72.4 kJ/mol) and QA (2.8 x 10(10)J/kg s) are used to predict the critical hot surface temperatures for other thicknesses, and good agreement is observed between measured and experimental values. Also, the estimated E and QA ranges match the corresponding ranges calculated from the multiple tests method and values reported in previous research.

SU-D-BRC-02: Application of Six Sigma Approach to Improve the Efficiency of Patient-Specific QA in Proton Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

LAH, J; Shin, D; Manger, R

Purpose: To show how the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) can be used for improving and optimizing the efficiency of patient-specific QA process by designing site-specific range tolerances. Methods: The Six Sigma tools (process flow diagram, cause and effect, capability analysis, Pareto chart, and control chart) were utilized to determine the steps that need focus for improving the patient-specific QA process. The patient-specific range QA plans were selected according to 7 treatment site groups, a total of 1437 cases. The process capability index, Cpm was used to guide the tolerance design of patient site-specific range. We also analyzed the financial impactmore » of this project. Results: Our results suggested that the patient range measurements were non-capable at the current tolerance level of ±1 mm in clinical proton plans. The optimized tolerances were calculated for treatment sites. Control charts for the patient QA time were constructed to compare QA time before and after the new tolerances were implemented. It is found that overall processing time was decreased by 24.3% after establishing new site-specific range tolerances. The QA failure for whole process in proton therapy would lead up to a 46% increase in total cost. This result can also predict how costs are affected by changes in adopting the tolerance design. Conclusion: We often believe that the quality and performance of proton therapy can easily be improved by merely tightening some or all of its tolerance requirements. This can become costly, however, and it is not necessarily a guarantee of better performance. The tolerance design is not a task to be undertaken without careful thought. The Six Sigma DMAIC can be used to improve the QA process by setting optimized tolerances. When tolerance design is optimized, the quality is reasonably balanced with time and cost demands.« less

Practice Patterns Analysis of Ocular Proton Therapy Centers: The International OPTIC Survey.

PubMed

Hrbacek, Jan; Mishra, Kavita K; Kacperek, Andrzej; Dendale, Remi; Nauraye, Catherine; Auger, Michel; Herault, Joel; Daftari, Inder K; Trofimov, Alexei V; Shih, Helen A; Chen, Yen-Lin E; Denker, Andrea; Heufelder, Jens; Horwacik, Tomasz; Swakoń, Jan; Hoehr, Cornelia; Duzenli, Cheryl; Pica, Alessia; Goudjil, Farid; Mazal, Alejandro; Thariat, Juliette; Weber, Damien C

2016-05-01

To assess the planning, treatment, and follow-up strategies worldwide in dedicated proton therapy ocular programs. Ten centers from 7 countries completed a questionnaire survey with 109 queries on the eye treatment planning system (TPS), hardware/software equipment, image acquisition/registration, patient positioning, eye surveillance, beam delivery, quality assurance (QA), clinical management, and workflow. Worldwide, 28,891 eye patients were treated with protons at the 10 centers as of the end of 2014. Most centers treated a vast number of ocular patients (1729 to 6369). Three centers treated fewer than 200 ocular patients. Most commonly, the centers treated uveal melanoma (UM) and other primary ocular malignancies, benign ocular tumors, conjunctival lesions, choroidal metastases, and retinoblastomas. The UM dose fractionation was generally within a standard range, whereas dosing for other ocular conditions was not standardized. The majority (80%) of centers used in common a specific ocular TPS. Variability existed in imaging registration, with magnetic resonance imaging (MRI) rarely being used in routine planning (20%). Increased patient to full-time equivalent ratios were observed by higher accruing centers (P=.0161). Generally, ophthalmologists followed up the post-radiation therapy patients, though in 40% of centers radiation oncologists also followed up the patients. Seven centers had a prospective outcomes database. All centers used a cyclotron to accelerate protons with dedicated horizontal beam lines only. QA checks (range, modulation) varied substantially across centers. The first worldwide multi-institutional ophthalmic proton therapy survey of the clinical and technical approach shows areas of substantial overlap and areas of progress needed to achieve sustainable and systematic management. Future international efforts include research and development for imaging and planning software upgrades, increased use of MRI, development of clinical protocols, systematic patient-centered data acquisition, and publishing guidelines on QA, staffing, treatment, and follow-up parameters by dedicated ocular programs to ensure the highest level of care for ocular patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Never audit alone--the case for audit teams.

PubMed

Adams, N H

1999-01-01

On-site audits, conducted by technical and quality assurance (QA) experts at the data-gathering location, are the core of an effective QA program. However, inadequate resources for such audits are the bane of a QA program and, frequently, the proposed solution is to send only one auditor to the study site. There are several reasons why audits should be performed by more than one person: 1. Audits of EPA projects frequently involve hazardous chemicals or other environmental hazards. They also often involve working after normal work hours in remote locations with dangerous equipment. It is unsafe to work alone under such conditions. 2. Skills: Many of EPA's projects are multidisciplinary, involving multiple measurements systems, several environmental media, and complex automated data collection and analysis systems. It is unlikely that one auditor would have the requisite skills to assess all of these operations. 3. Separateness: Two auditors can provide two (sometimes differing) perspectives on problems encountered during an audit. Two auditors can provide complementary expertise and work experience. Two auditors can provide twice the surveillance power. 4. Support: The operations that need to be assessed are sometimes in different parts of a site, requiring two auditing devices or considerable commuting time. Also, auditors are occasionally diverted by managers wishing to show their best efforts rather than the whole operation; if two auditors are on-site, one can interview managers while the other talks with technical staff. If there is a dispute, one auditor can support the other in verifying observations. 5. Savings: Although sending one auditor is perceived to be a cost-saving measure, it may be more economical to send two auditors. Time on site (lodging, food) is decreased, more of the project is assessed in one visit, less pre-audit training is required, and report preparation is accelerated. In summary, sending more than one auditor on a field audit is smarter, safer and more effective, and can be less expensive in the long run.

A technique for pediatric total skin electron irradiation.

PubMed

Bao, Qinan; Hrycushko, Brian A; Dugas, Joseph P; Hager, Frederick H; Solberg, Timothy D

2012-03-20

Total skin electron irradiation (TSEI) is a special radiotherapy technique which has generally been used for treating adult patients with mycosis fungoides. Recently, two infants presented with leukemia cutis isolated to the skin requiring TSEI. This work discusses the commissioning and quality assurance (QA) methods for implementing a modified Stanford technique using a rotating harness system to position sedated pediatric patients treated with electrons to the total skin. Commissioning of pediatric TSEI consisted of absolute calibration, measurement of dosimetric parameters, and subsequent verification in a pediatric patient sized cylindrical phantom using radiographic film and optically stimulated luminance (OSL) dosimeters. The depth of dose penetration under TSEI treatment condition was evaluated using radiographic film sandwiched in the phantom and demonstrated a 2 cm penetration depth with the maximum dose located at the phantom surface. Dosimetry measurements on the cylindrical phantom and in-vivo measurements from the patients suggested that, the factor relating the skin and calibration point doses (i.e., the B-factor) was larger for the pediatric TSEI treatments as compared to adult TSEI treatments. Custom made equipment, including a rotating plate and harness, was fabricated and added to a standard total body irradiation stand and tested to facilitate patient setup under sedated condition. A pediatric TSEI QA program, consisting of daily output, energy, flatness, and symmetry measurements as well as in-vivo dosimetry verification for the first cycle was developed. With a long interval between pediatric TSEI cases, absolute dosimetry was also repeated as part of the QA program. In-vivo dosimetry for the first two infants showed that a dose of ± 10% of the prescription dose can be achieved over the entire patient body. Though pediatric leukemia cutis and the subsequent need for TSEI are rare, the ability to commission the technique on a modified TBI stand is appealing for clinical implementation and has been successfully used for the treatment of two pediatric patients at our institution.

A technique for pediatric total skin electron irradiation

PubMed Central

2012-01-01

Background Total skin electron irradiation (TSEI) is a special radiotherapy technique which has generally been used for treating adult patients with mycosis fungoides. Recently, two infants presented with leukemia cutis isolated to the skin requiring TSEI. This work discusses the commissioning and quality assurance (QA) methods for implementing a modified Stanford technique using a rotating harness system to position sedated pediatric patients treated with electrons to the total skin. Methods and Results Commissioning of pediatric TSEI consisted of absolute calibration, measurement of dosimetric parameters, and subsequent verification in a pediatric patient sized cylindrical phantom using radiographic film and optically stimulated luminance (OSL) dosimeters. The depth of dose penetration under TSEI treatment condition was evaluated using radiographic film sandwiched in the phantom and demonstrated a 2 cm penetration depth with the maximum dose located at the phantom surface. Dosimetry measurements on the cylindrical phantom and in-vivo measurements from the patients suggested that, the factor relating the skin and calibration point doses (i.e., the B-factor) was larger for the pediatric TSEI treatments as compared to adult TSEI treatments. Custom made equipment, including a rotating plate and harness, was fabricated and added to a standard total body irradiation stand and tested to facilitate patient setup under sedated condition. A pediatric TSEI QA program, consisting of daily output, energy, flatness, and symmetry measurements as well as in-vivo dosimetry verification for the first cycle was developed. With a long interval between pediatric TSEI cases, absolute dosimetry was also repeated as part of the QA program. In-vivo dosimetry for the first two infants showed that a dose of ± 10% of the prescription dose can be achieved over the entire patient body. Conclusion Though pediatric leukemia cutis and the subsequent need for TSEI are rare, the ability to commission the technique on a modified TBI stand is appealing for clinical implementation and has been successfully used for the treatment of two pediatric patients at our institution. PMID:22433063

Practice Patterns Analysis of Ocular Proton Therapy Centers: The International OPTIC Survey

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hrbacek, Jan, E-mail: Jan.hrbacek@psi.ch; Mishra, Kavita K.; Kacperek, Andrzej

Purpose: To assess the planning, treatment, and follow-up strategies worldwide in dedicated proton therapy ocular programs. Methods and Materials: Ten centers from 7 countries completed a questionnaire survey with 109 queries on the eye treatment planning system (TPS), hardware/software equipment, image acquisition/registration, patient positioning, eye surveillance, beam delivery, quality assurance (QA), clinical management, and workflow. Results: Worldwide, 28,891 eye patients were treated with protons at the 10 centers as of the end of 2014. Most centers treated a vast number of ocular patients (1729 to 6369). Three centers treated fewer than 200 ocular patients. Most commonly, the centers treated uvealmore » melanoma (UM) and other primary ocular malignancies, benign ocular tumors, conjunctival lesions, choroidal metastases, and retinoblastomas. The UM dose fractionation was generally within a standard range, whereas dosing for other ocular conditions was not standardized. The majority (80%) of centers used in common a specific ocular TPS. Variability existed in imaging registration, with magnetic resonance imaging (MRI) rarely being used in routine planning (20%). Increased patient to full-time equivalent ratios were observed by higher accruing centers (P=.0161). Generally, ophthalmologists followed up the post–radiation therapy patients, though in 40% of centers radiation oncologists also followed up the patients. Seven centers had a prospective outcomes database. All centers used a cyclotron to accelerate protons with dedicated horizontal beam lines only. QA checks (range, modulation) varied substantially across centers. Conclusions: The first worldwide multi-institutional ophthalmic proton therapy survey of the clinical and technical approach shows areas of substantial overlap and areas of progress needed to achieve sustainable and systematic management. Future international efforts include research and development for imaging and planning software upgrades, increased use of MRI, development of clinical protocols, systematic patient-centered data acquisition, and publishing guidelines on QA, staffing, treatment, and follow-up parameters by dedicated ocular programs to ensure the highest level of care for ocular patients.« less

WE-AB-206-03: Workshop

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, Z.

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environmentmore » with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.« less

WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zagzebski, J.

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environmentmore » with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.« less

Physical Property Analysis and Report for Sediments at 100-BC-5 Operable Unit, Boreholes C7505, C7506, C7507, and C7665

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lindberg, Michael J.

2010-09-28

Between October 14, 2009 and February 22, 2010 sediment samples were received from 100-BC Decision Unit for geochemical studies. This is an analytical data report for sediments received from CHPRC at the 100 BC 5 OU. The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site. The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures and/or nationally recognized test procedures. The data sets include the sample identification numbers, analytical results, estimated quantification limits (EQL), and quality control data. The preparatory and analytical quality control requirements, calibrationmore » requirements, acceptance criteria, and failure actions are defined in the on-line QA plan 'Conducting Analytical Work in Support of Regulatory Programs' (CAW). This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL.« less

Satellite Surveillance: Domestic Issues

DTIC Science & Technology

2008-06-27

agents . Satellite imagery undergirded U.S. strategic planning for a quarter century and a series of arms control agreements with the Soviet Union. In...individual agencies; another would be to have one agency serve as the executive agent for a program. See Remarks and Q&A by the Principal Deputy...Antonio, Texas, October 23, 2007. as the executive agent of what it termed a new Domestic Applications Office (DAO). This recommendation was based on the

Quality assurance of the SCOPE 1 trial in oesophageal radiotherapy.

PubMed

Wills, Lucy; Maggs, Rhydian; Lewis, Geraint; Jones, Gareth; Nixon, Lisette; Staffurth, John; Crosby, Tom

2017-11-15

SCOPE 1 was the first UK based multi-centre trial involving radiotherapy of the oesophagus. A comprehensive radiotherapy trials quality assurance programme was launched with two main aims: 1. To assist centres, where needed, to adapt their radiotherapy techniques in order to achieve protocol compliance and thereby enable their participation in the trial. 2. To support the trial's clinical outcomes by ensuring the consistent planning and delivery of radiotherapy across all participating centres. A detailed information package was provided and centres were required to complete a benchmark case in which the delineated target volumes and organs at risk, dose distribution and completion of a plan assessment form were assessed prior to recruiting patients into the trial. Upon recruiting, the quality assurance (QA) programme continued to monitor the outlining and planning of radiotherapy treatments. Completion of a questionnaire was requested in order to gather information about each centre's equipment and techniques relating to their trial participation and to assess the impact of the trial nationally on standard practice for radiotherapy of the oesophagus. During the trial, advice was available for individual planning issues, and was circulated amongst the SCOPE 1 community in response to common areas of concern using bulletins. 36 centres were supported through QA processes to enable their participation in SCOPE1. We discuss the issues which have arisen throughout this process and present details of the benchmark case solutions, centre questionnaires and on-trial protocol compliance. The range of submitted benchmark case GTV volumes was 29.8-67.8cm 3 ; and PTV volumes 221.9-513.3 cm 3 . For the dose distributions associated with these volumes, the percentage volume of the lungs receiving 20Gy (V20Gy) ranged from 20.4 to 33.5%. Similarly, heart V40Gy ranged from 16.1 to 33.0%. Incidence of incorrect outlining of OAR volumes increased from 50% of centres at benchmark case, to 64% on trial. Sixty-five percent of centres, who returned the trial questionnaire, stated that their standard practice had changed as a result of their participation in the SCOPE1 trial. The SCOPE 1 QA programme outcomes lend support to the trial's clinical conclusions. The range of patient planning outcomes for the benchmark case indicated, at the outset of the trial, the significant degree of variation present in UK oesophageal radiotherapy planning outcomes, despite the presence of a protocol. This supports the case for increasingly detailed definition of practice by means of consensus protocols, training and peer review. The incidence of minor inconsistencies of technique highlights the potential for improved QA systems and the need for sufficient resource for this to be addressed within future trials. As indicated in questionnaire responses, the QA exercise as a whole has contributed to greater consistency of oesophageal radiotherapy in the UK via the adoption into standard practice of elements of the protocol. The SCOPE1 trial is an International Standard Randomized Controlled Trial, ISRCTN47718479 .

An audit of a hospital-based Doppler ultrasound quality control protocol using a commercial string Doppler phantom.

PubMed

Cournane, S; Fagan, A J; Browne, J E

2014-05-01

Results from a four-year audit of a Doppler quality assurance (QA) program using a commercially available Doppler string phantom are presented. The suitability of the phantom was firstly determined and modifications were made to improve the reliability and quality of the measurements. QA of Doppler ultrasound equipment is very important as data obtained from these systems is used in patient management. It was found that if the braided-silk filament of the Doppler phantom was exchanged with an O-ring rubber filament and the velocity range below 50 cm/s was avoided for Doppler quality control (QC) measurements, then the maximum velocity accuracy (MVA) error and intrinsic spectral broadening (ISB) results obtained using this device had a repeatability of 18 ± 3.3% and 19 ± 3.5%, respectively. A consistent overestimation of the MVA of between 12% and 56% was found for each of the tested ultrasound systems. Of more concern was the variation of the overestimation within each respective transducer category: MVA errors of the linear, curvilinear and phased array probes were in the range 12.3-20.8%, 32.3-53.8% and 27-40.7%, respectively. There is a dearth of QA data for Doppler ultrasound; it would be beneficial if a multicentre longitudinal study was carried out using the same Doppler ultrasound test object to evaluate sensitivity to deterioration in performance measurements. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thorne, N; Kassaee, A

Purpose: To develop an algorithm which can calculate the Full Width Half Maximum (FWHM) of a Proton Pencil Beam from a 2D dimensional ion chamber array (IBA Matrixx) with limited spatial resolution ( 7.6 mm inter chamber distance). The algorithm would allow beam FWHM measurements to be taken during daily QA without an appreciable time increase. Methods: Combinations of 147 MeV single spot beams were delivered onto an IBA Matrixx and concurrently on EBT3 films for a standard. Data were collected around the Bragg Peak region and evaluated by a custom MATLAB script based on our algorithm using a leastmore » squared analysis. A set of artificial data, modified with random noise, was also processed to test for robustness. Results: The Matlab script processed Matixx data shows acceptable agreement (within 5%) with film measurements with no single measurement differing by more than 1.8 mm. In cases where the spots show some degree of asymmetry, the algorithm is able to resolve the differences. The algorithm was able to process artificial data with noise up to 15% of the maximum value. Time assays of each measurement took less than 3 minutes to perform, indicating that such measurements may be efficiently added to daily QA treatment. Conclusion: The developed algorithm can be implemented in daily QA program for Proton Pencil Beam scanning beams (PBS) with Matrixx to extract spot size and position information. The developed algorithm may be extended to small field sizes in photon clinic.« less

Quality control and quality assurance in genotypic data for genome-wide association studies

PubMed Central

Laurie, Cathy C.; Doheny, Kimberly F.; Mirel, Daniel B.; Pugh, Elizabeth W.; Bierut, Laura J.; Bhangale, Tushar; Boehm, Frederick; Caporaso, Neil E.; Cornelis, Marilyn C.; Edenberg, Howard J.; Gabriel, Stacy B.; Harris, Emily L.; Hu, Frank B.; Jacobs, Kevin; Kraft, Peter; Landi, Maria Teresa; Lumley, Thomas; Manolio, Teri A.; McHugh, Caitlin; Painter, Ian; Paschall, Justin; Rice, John P.; Rice, Kenneth M.; Zheng, Xiuwen; Weir, Bruce S.

2011-01-01

Genome-wide scans of nucleotide variation in human subjects are providing an increasing number of replicated associations with complex disease traits. Most of the variants detected have small effects and, collectively, they account for a small fraction of the total genetic variance. Very large sample sizes are required to identify and validate findings. In this situation, even small sources of systematic or random error can cause spurious results or obscure real effects. The need for careful attention to data quality has been appreciated for some time in this field, and a number of strategies for quality control and quality assurance (QC/QA) have been developed. Here we extend these methods and describe a system of QC/QA for genotypic data in genome-wide association studies. This system includes some new approaches that (1) combine analysis of allelic probe intensities and called genotypes to distinguish gender misidentification from sex chromosome aberrations, (2) detect autosomal chromosome aberrations that may affect genotype calling accuracy, (3) infer DNA sample quality from relatedness and allelic intensities, (4) use duplicate concordance to infer SNP quality, (5) detect genotyping artifacts from dependence of Hardy-Weinberg equilibrium (HWE) test p-values on allelic frequency, and (6) demonstrate sensitivity of principal components analysis (PCA) to SNP selection. The methods are illustrated with examples from the ‘Gene Environment Association Studies’ (GENEVA) program. The results suggest several recommendations for QC/QA in the design and execution of genome-wide association studies. PMID:20718045

Diabetes care may be improved with Steno Quality Assurance Tool--a self-assessment tool in diabetes management.

PubMed

Bjerre-Christensen, Ulla; Nielsen, Annemette Anker; Binder, Christian; Hansen, Jes B; Eldrup, Ebbe

2014-08-01

To evaluate if improvements in the quality of diabetes care in Indian clinics can be obtained by simple self-surveillance PC-based software. Nineteen Indian diabetes clinics were introduced to the principles of quality assurance (QA), and to a software program, the Steno Quality Assurance Tool (SQAT). Data was entered for an initial 3 months period. Subsequently data were analyzed by the users, who designed plans to improve indicator status and set goals for the upcoming period. A second data entry period followed after 7-9 months. QA data was analyzed from 4487 T2DM patients (baseline) and 4440 (follow-up). The average examination frequency per clinic of the following indicators increased significantly: lipid examination (72-87%) (p=0.007), foot examination (80-94%) (p=0.02), HbA1c investigation (59-77%) (p=0.006), and urine albumin excretion investigation (72-87%) (p=0.006). Outcome parameters also improved significantly: mean (SD) fasting and post prandial BG reduced from 144(16) to 132(16)mg/dl (p=0.02) and 212(24)-195(29)mg/dl (p=0.03), respectively. Systolic BP reduced from 139(6) to 133(4) (p=0.0008)mmHg and diastolic BP from 83(3) to 81(3)mmHg (p=0.002). Quality of diabetes care can be improved by applying SQAT, a QA self-surveillance software that enables documentation of changes in process and outcome indicators. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Quality Assurance for Essential Climate Variables

NASA Astrophysics Data System (ADS)

Folkert Boersma, K.; Muller, Jan-Peter

2015-04-01

Satellite data are of central interest to the QA4ECV project. Satellites have revolutionized the Earth's observation system of climate change and air quality over the past three decades, providing continuous data for the entire Earth. However, many users of these data are lost in the fog as to the quality of these satellite data. Because of this, the European Union expressed in its 2013 FP7 Space Research Call a need for reliable, traceable, and understandable quality information on satellite data records that could serve as a blueprint contribution to a future Copernicus Climate Change Service. The potential of satellite data to benefit climate change and air quality services is too great to be ignored. QA4ECV therefore bridges the gap between end-users of satellite data and the satellite data products. We are developing an internationally acceptable Quality Assurance (QA) framework that provides understandable and traceable quality information for satellite data used in climate and air quality services. Such a framework should deliver the historically linked long-term data sets that users need, in a format that they can readily use. QA4ECV has approached more than 150 users and suppliers of satellite data to collect their needs and expectations. The project will use their response as a guideline for developing user-friendly tools to obtain information on the completeness, accuracy, and fitness-for-purpose of the satellite datasets. QA4ECV collaborates with 4 joint FP7 Space projects in reaching out to scientists, policy makers, and other end-users of satellite data to improve understanding of the special challenges -and also opportunities- of working with satellite data for climate and air quality purposes. As a demonstration of its capacity, QA4ECV will generate multi-decadal climate data records for 3 atmospheric ECV precursors (nitrogen dioxide, formaldehyde, and carbon monoxide) and 3 land ECVs (albedo, leaf area index and absorbed photosynthetically active radiation), with full uncertainty metrics for every pixel. Multi-use tools and SI/community reference standards will be developed. But QA4ECV is not only about satellites. It is also about exploiting independent reference data obtained from in situ networks, and applying these data with the right, traceable methodologies for quality assurance of the satellite ECVs. The QA4ECV project started in January 2014, as a partnership between 17 research institutes from 7 different European countries working together for a period of 4 years. All QA4ECV partners are closely involved in projects improving, validating, and using satellite data. We hope that QA4ECV will be a major step forward in providing quality assured long-term climate data records that are relevant for policy and climate change assessments. A detailed description of the project can be found at http://qa4ecv.eu.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, S; Mazur, T; Li, H

Purpose: The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(ά)) to the passing rates of 2D dose measurementbased QA (P(Dm)). Methods: 3D volumetric primary fluencies are calculated by forward-projecting the beam apertures and modulated by beam MU values at all gantry angles. We first introduce simulated machine parameter errors (MU, MLC positions, jaw, gantry and collimator) to the plan. Using passing rates of voxel intensity differences (P(Ir)) and 3D gamma analysis (P(γ)), calculatedmore » 3D fluencies, calculated 3D delivered dose, and measured 2D planar dose in phantom from the original plan are then compared with those from corresponding plans with errors, respectively. The correlations of these three groups of resultant passing rates, i.e. 3D fluence-based QA (P(ά,Ir) and P(ά,γ)), calculated 3D dose (P(Dc,Ir) and P(Dc,γ)), and 2D dose measurement-based QA (P(Dm,Ir) and P(Dm,γ)), will be investigated. Results: 20 treatment plans with 5 different types of errors were tested. Spearman’s correlations were found between P(ά,Ir) and P(Dc,Ir), and also between P(ά,γ) and P(Dc,γ), with averaged p-value 0.037, 0.065, and averaged correlation coefficient ρ-value 0.942, 0.871 respectively. Using Matrixx QA for IMRT plans, Spearman’s correlations were also obtained between P(ά,Ir) and P(Dm,Ir) and also between P(ά,γ) and P(Dm,γ), with p-value being 0.048, 0.071 and ρ-value being 0.897, 0.779 respectively. Conclusion: The demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans. Together with advantages of high detection sensitivity and better visualization of machine parameter errors, this study further demonstrates the accuracy and feasibility of 3D fluence based-QA in pre-treatment QA and daily QA. Research reported in this study is supported by the Agency for Healthcare Research and Quality (AHRQ) under award 1R01HS0222888. The senior author received research grants from ViewRay Inc. and Varian Medical System.« less

Quinolizidine Alkaloid Biosynthesis in Lupins and Prospects for Grain Quality Improvement

PubMed Central

Frick, Karen M.; Kamphuis, Lars G.; Siddique, Kadambot H. M.; Singh, Karam B.; Foley, Rhonda C.

2017-01-01

Quinolizidine alkaloids (QAs) are toxic secondary metabolites found within the genus Lupinus, some species of which are commercially important grain legume crops including Lupinus angustifolius (narrow-leafed lupin, NLL), L. luteus (yellow lupin), L. albus (white lupin), and L. mutabilis (pearl lupin), with NLL grain being the most largely produced of the four species in Australia and worldwide. While QAs offer the plants protection against insect pests, the accumulation of QAs in lupin grain complicates its use for food purposes as QA levels must remain below the industry threshold (0.02%), which is often exceeded. It is not well understood what factors cause grain QA levels to exceed this threshold. Much of the early work on QA biosynthesis began in the 1970–1980s, with many QA chemical structures well-characterized and lupin cell cultures and enzyme assays employed to identify some biosynthetic enzymes and pathway intermediates. More recently, two genes associated with these enzymes have been characterized, however, the QA biosynthetic pathway remains only partially elucidated. Here, we review the research accomplished thus far concerning QAs in lupin and consider some possibilities for further elucidation and manipulation of the QA pathway in lupin crops, drawing on examples from model alkaloid species. One breeding strategy for lupin is to produce plants with high QAs in vegetative tissues while low in the grain in order to confer insect resistance to plants while keeping grain QA levels within industry regulations. With the knowledge achieved on alkaloid biosynthesis in other plant species in recent years, and the recent development of genomic and transcriptomic resources for NLL, there is considerable scope to facilitate advances in our knowledge of QAs, leading to the production of improved lupin crops. PMID:28197163

Quinolizidine Alkaloid Biosynthesis in Lupins and Prospects for Grain Quality Improvement.

PubMed

Frick, Karen M; Kamphuis, Lars G; Siddique, Kadambot H M; Singh, Karam B; Foley, Rhonda C

2017-01-01

Quinolizidine alkaloids (QAs) are toxic secondary metabolites found within the genus Lupinus , some species of which are commercially important grain legume crops including Lupinus angustifolius (narrow-leafed lupin, NLL), L. luteus (yellow lupin), L. albus (white lupin), and L. mutabilis (pearl lupin), with NLL grain being the most largely produced of the four species in Australia and worldwide. While QAs offer the plants protection against insect pests, the accumulation of QAs in lupin grain complicates its use for food purposes as QA levels must remain below the industry threshold (0.02%), which is often exceeded. It is not well understood what factors cause grain QA levels to exceed this threshold. Much of the early work on QA biosynthesis began in the 1970-1980s, with many QA chemical structures well-characterized and lupin cell cultures and enzyme assays employed to identify some biosynthetic enzymes and pathway intermediates. More recently, two genes associated with these enzymes have been characterized, however, the QA biosynthetic pathway remains only partially elucidated. Here, we review the research accomplished thus far concerning QAs in lupin and consider some possibilities for further elucidation and manipulation of the QA pathway in lupin crops, drawing on examples from model alkaloid species. One breeding strategy for lupin is to produce plants with high QAs in vegetative tissues while low in the grain in order to confer insect resistance to plants while keeping grain QA levels within industry regulations. With the knowledge achieved on alkaloid biosynthesis in other plant species in recent years, and the recent development of genomic and transcriptomic resources for NLL, there is considerable scope to facilitate advances in our knowledge of QAs, leading to the production of improved lupin crops.

Smartphone application for mechanical quality assurance of medical linear accelerators

NASA Astrophysics Data System (ADS)

Kim, Hwiyoung; Lee, Hyunseok; In Park, Jong; Choi, Chang Heon; Park, So-Yeon; Kim, Hee Jung; Kim, Young Suk; Ye, Sung-Joon

2017-06-01

Mechanical quality assurance (QA) of medical linear accelerators consists of time-consuming and human-error-prone procedures. We developed a smartphone application system for mechanical QA. The system consists of two smartphones: one attached to a gantry for obtaining real-time information on the mechanical parameters of the medical linear accelerator, and another displaying real-time information via a Bluetooth connection with the former. Motion sensors embedded in the smartphone were used to measure gantry and collimator rotations. Images taken by the smartphone’s high-resolution camera were processed to evaluate accuracies of jaw-positioning, crosshair centering and source-to-surface distance (SSD). The application was developed using Android software development kit and OpenCV library. The accuracy and precision of the system was validated against an optical rotation stage and digital calipers, prior to routine QA measurements of five medical linear accelerators. The system accuracy and precision in measuring angles and lengths were determined to be 0.05  ±  0.05° and 0.25  ±  0.14 mm, respectively. The mean absolute errors (MAEs) in QA measurements of gantry and collimator rotation were 0.05  ±  0.04° and 0.05  ±  0.04°, respectively. The MAE in QA measurements of light field was 0.39  ±  0.36 mm. The MAEs in QA measurements of crosshair centering and SSD were 0.40  ±  0.35 mm and 0.41  ±  0.32 mm, respectively. In conclusion, most routine mechanical QA procedures could be performed using the smartphone application system with improved precision and within a shorter time-frame, while eliminating potential human errors.

Smartphone application for mechanical quality assurance of medical linear accelerators.

PubMed

Kim, Hwiyoung; Lee, Hyunseok; Park, Jong In; Choi, Chang Heon; Park, So-Yeon; Kim, Hee Jung; Kim, Young Suk; Ye, Sung-Joon

2017-06-07

Mechanical quality assurance (QA) of medical linear accelerators consists of time-consuming and human-error-prone procedures. We developed a smartphone application system for mechanical QA. The system consists of two smartphones: one attached to a gantry for obtaining real-time information on the mechanical parameters of the medical linear accelerator, and another displaying real-time information via a Bluetooth connection with the former. Motion sensors embedded in the smartphone were used to measure gantry and collimator rotations. Images taken by the smartphone's high-resolution camera were processed to evaluate accuracies of jaw-positioning, crosshair centering and source-to-surface distance (SSD). The application was developed using Android software development kit and OpenCV library. The accuracy and precision of the system was validated against an optical rotation stage and digital calipers, prior to routine QA measurements of five medical linear accelerators. The system accuracy and precision in measuring angles and lengths were determined to be 0.05  ±  0.05° and 0.25  ±  0.14 mm, respectively. The mean absolute errors (MAEs) in QA measurements of gantry and collimator rotation were 0.05  ±  0.04° and 0.05  ±  0.04°, respectively. The MAE in QA measurements of light field was 0.39  ±  0.36 mm. The MAEs in QA measurements of crosshair centering and SSD were 0.40  ±  0.35 mm and 0.41  ±  0.32 mm, respectively. In conclusion, most routine mechanical QA procedures could be performed using the smartphone application system with improved precision and within a shorter time-frame, while eliminating potential human errors.

Quality Assurance in Stem Cell Banking: Emphasis on Embryonic and Induced Pluripotent Stem Cell Banking.

PubMed

Kallur, Therése; Blomberg, Pontus; Stenfelt, Sonya; Tryggvason, Kristian; Hovatta, Outi

2017-01-01

For quality assurance (QA) in stem cell banking, a planned system is needed to ensure that the banked products, stem cells, meet the standards required for research, clinical use, and commercial biotechnological applications. QA is process oriented, avoids, or minimizes unacceptable product defects, and particularly encompasses the management and operational systems of the bank, as well as the ethical and legal frameworks. Quality control (QC ) is product oriented and therefore ensures the stem cells of a bank are what they are expected to be. Testing is for controlling, not assuring, product quality, and is therefore a part of QC , not QA. Like QA, QC is essential for banking cells for quality research and translational application (Schwartz et al., Lancet 379:713-720, 2012). Human embryonic stem cells (hESCs), as cells derived from donated supernumerary embryos from in vitro fertilization (IVF) therapy, are different from other stem cell types in resulting from an embryo that has had two donors . This imposes important ethical and legal constraints on the utility of the cells, which, together with quite specific culture conditions, require special attention in the QA system. Importantly, although the origin and derivation of induced pluripotent stem cells (iPSCs ) differ from that of hESCs, many of the principles of QA for hESC banking are applicable to iPSC banking (Stacey et al., Cell Stem Cell 13:385-388, 2013). Furthermore, despite differences between the legal and regulatory frameworks for hESC and iPSC banking between different countries, the requirements for QA are being harmonized (Stacey et al., Cell Stem Cell 13:385-388, 2013; International Stem Cell Banking Initiative, Stem Cell Rev 5:301-314, 2009).

77 FR 73732 - In the Matter of the Amendment of the Designation of al-Qa'ida in Iraq, aka Jam'at al Tawhid wa...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

...-Qa'ida in Iraq, aka Jam'at al Tawhid wa'al-Jihad, aka The Monotheism and Jihad Group, aka The al-Zarqawi Network, aka al-Tawhid, aka Tanzim Qa`idat al-Jihad fi Bilad al-Rafidayn, aka The Organization of... Group of Jihad in Iraq, aka al-Qaida Group of Jihad in the Land of the Two Rivers, aka The Organization...

Quantitative Approach to Failure Mode and Effect Analysis for Linear Accelerator Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Daniel, Jennifer C., E-mail: jennifer.odaniel@duke.edu; Yin, Fang-Fang

Purpose: To determine clinic-specific linear accelerator quality assurance (QA) TG-142 test frequencies, to maximize physicist time efficiency and patient treatment quality. Methods and Materials: A novel quantitative approach to failure mode and effect analysis is proposed. Nine linear accelerator-years of QA records provided data on failure occurrence rates. The severity of test failure was modeled by introducing corresponding errors into head and neck intensity modulated radiation therapy treatment plans. The relative risk of daily linear accelerator QA was calculated as a function of frequency of test performance. Results: Although the failure severity was greatest for daily imaging QA (imaging vsmore » treatment isocenter and imaging positioning/repositioning), the failure occurrence rate was greatest for output and laser testing. The composite ranking results suggest that performing output and lasers tests daily, imaging versus treatment isocenter and imaging positioning/repositioning tests weekly, and optical distance indicator and jaws versus light field tests biweekly would be acceptable for non-stereotactic radiosurgery/stereotactic body radiation therapy linear accelerators. Conclusions: Failure mode and effect analysis is a useful tool to determine the relative importance of QA tests from TG-142. Because there are practical time limitations on how many QA tests can be performed, this analysis highlights which tests are the most important and suggests the frequency of testing based on each test's risk priority number.« less

Comparison of four commercial devices for RapidArc and sliding window IMRT QA

PubMed Central

Chandraraj, Varatharaj; Manickam, Ravikumar; Esquivel, Carlos; Supe, Sanjay S.; Papanikolaou, Nikos

2011-01-01

For intensity‐modulated radiation therapy, evaluation of the measured dose against the treatment planning calculated dose is essential in the context of patient‐specific quality assurance. The complexity of volumetric arc radiotherapy delivery attributed to its dynamic and synchronization nature require new methods and potentially new tools for the quality assurance of such techniques. In the present study, we evaluated and compared the dosimetric performance of EDR2 film and three other commercially available quality assurance devices: IBA I'MatriXX array, PTW Seven29 array and the Delta 4 array. The evaluation of these dosimetric systems was performed for RapidArc and IMRT deliveries using a Varian NovalisTX linear accelerator. The plans were generated using the Varian Eclipse treatment planning system. Our results showed that all four QA techniques yield equivalent results. All patient QAs passed our institutional clinical criteria of gamma index based on a 3% dose difference and 3 mm distance to agreement. In addition, the Bland‐Altman analysis was performed which showed that all the calculated gamma values of all three QA devices were within 5% from those of the film. The results showed that the four QA systems used in this patient‐specific IMRT QA analysis are equivalent. We concluded that the dosimetric systems under investigation can be used interchangeably for routine patient specific QA. PACS numbers: 87.55.Qr, 87.56.Fc

Synergistic effect of quercetin and quinic acid by alleviating structural degeneration in the liver, kidney and pancreas tissues of STZ-induced diabetic rats: a mechanistic study.

PubMed

Arya, Aditya; Al-Obaidi, Mazen M Jamil; Shahid, Nayiar; Bin Noordin, Mohamed Ibrahim; Looi, Chung Yeng; Wong, Won Fen; Khaing, Si Lay; Mustafa, Mohd Rais

2014-09-01

The aim of this study was to investigate the synergistic effects of quercetin (QE) and quinic acid (QA) on a STZ-induced diabetic rat model to determine their potential role in alleviating diabetes and its associated complications. In our study design, diabetic rats were treated with single and combined doses of QE and QA for 45days to analyse their effects on liver, kidney and pancreas tissues. The study result showed that QE and QA treated groups down-regulated hyperglycaemia and oxidative stress by up-regulating insulin and C-peptide levels. Moreover, histological observations of the liver, kidney and pancreas of diabetic rats treated with single and combined doses of QE and QA showed a significant improvement in the structural degeneration. Interestingly, the combination dose of QE and QA (50 mg/kg) exhibited maximum inhibition of the pro-apoptotic protein Bax expression and demonstrate enhancement of the anti-apoptotic protein Bcl-2 expression in the kidney tissues, suggesting a protective role in the kidneys of diabetic rats. Taken together, these results indicates the synergistic effects of QE and QA in ameliorating hyperglycaemia, hyperlipidemia and insulin resistance in diabetic rats and therefore, open a new window of research on the combinatorial therapy of flavonoids. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quality control of CT systems by automated monitoring of key performance indicators: a two‐year study

PubMed Central

Bujila, Robert; Poludniowski, Gavin; Fransson, Annette

2015-01-01

The purpose of this study was to develop a method of performing routine periodical quality controls (QC) of CT systems by automatically analyzing key performance indicators (KPIs), obtainable from images of manufacturers' quality assurance (QA) phantoms. A KPI pertains to a measurable or determinable QC parameter that is influenced by other underlying fundamental QC parameters. The established KPIs are based on relationships between existing QC parameters used in the annual testing program of CT scanners at the Karolinska University Hospital in Stockholm, Sweden. The KPIs include positioning, image noise, uniformity, homogeneity, the CT number of water, and the CT number of air. An application (MonitorCT) was developed to automatically evaluate phantom images in terms of the established KPIs. The developed methodology has been used for two years in clinical routine, where CT technologists perform daily scans of the manufacturer's QA phantom and automatically send the images to MonitorCT for KPI evaluation. In the cases where results were out of tolerance, actions could be initiated in less than 10 min. 900 QC scans from two CT scanners have been collected and analyzed over the two‐year period that MonitorCT has been active. Two types of errors have been registered in this period: a ring artifact was discovered with the image noise test, and a calibration error was detected multiple times with the CT number test. In both cases, results were outside the tolerances defined for MonitorCT, as well as by the vendor. Automated monitoring of KPIs is a powerful tool that can be used to supplement established QC methodologies. Medical physicists and other professionals concerned with the performance of a CT system will, using such methods, have access to comprehensive data on the current and historical (trend) status of the system such that swift actions can be taken in order to ensure the quality of the CT examinations, patient safety, and minimal disruption of service PACS numbers: 87.57.C‐, 87.57.N‐, 87.57.Q‐ PMID:26219012

Contribution of two ζ-carotene desaturases to the poly-cis desaturation pathway in the cyanobacterium Nostoc PCC 7120.

PubMed

Breitenbach, Jürgen; Bruns, Marius; Sandmann, Gerhard

2013-07-01

The presence of two completely unrelated ζ-carotene desaturases CrtQa and CrtQb in some Nostoc strains is unique. CrtQb is the ζ-carotene desaturase, which was acquired by almost all cyanobacteria. The additional CrtQa can be regarded as an evolutionary relict of the CrtI desaturase present in non-photosynthetic bacteria. By reconstruction of the carotene desaturation pathway, we showed that both enzymes from Nostoc PCC 7120 were active. However, they differed in their preferred utilization of ζ-carotene Z isomers. CrtQa converted ζ-carotene isomers that were poorly metabolized by CrtQb. In this respect, CrtQa complemented the reactions of CrtQb, which is an advantage avoiding dead ends in the poly-cis desaturation pathway. In addition to ζ-carotene desaturation, CrtQa still possesses the Z to E isomerase function of the ancestral desaturase CrtI. Biochemical characterization showed that CrtQb is an enzyme with one molecule of tightly bound FAD and acts as a dehydrogenase transferring hydrogen to oxidized plastoquinone.

Feasibility study of using statistical process control to customized quality assurance in proton therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rah, Jeong-Eun; Oh, Do Hoon; Shin, Dongho

Purpose: To evaluate and improve the reliability of proton quality assurance (QA) processes and, to provide an optimal customized tolerance level using the statistical process control (SPC) methodology. Methods: The authors investigated the consistency check of dose per monitor unit (D/MU) and range in proton beams to see whether it was within the tolerance level of the daily QA process. This study analyzed the difference between the measured and calculated ranges along the central axis to improve the patient-specific QA process in proton beams by using process capability indices. Results: The authors established a customized tolerance level of ±2% formore » D/MU and ±0.5 mm for beam range in the daily proton QA process. In the authors’ analysis of the process capability indices, the patient-specific range measurements were capable of a specification limit of ±2% in clinical plans. Conclusions: SPC methodology is a useful tool for customizing the optimal QA tolerance levels and improving the quality of proton machine maintenance, treatment delivery, and ultimately patient safety.« less

Australasian brachytherapy audit: results of the 'end-to-end' dosimetry pilot study.

PubMed

Haworth, Annette; Wilfert, Lisa; Butler, Duncan; Ebert, Martin A; Todd, Stephen; Bucci, Joseph; Duchesne, Gillian M; Joseph, David; Kron, Tomas

2013-08-01

We present the results of a pilot study to test the feasibility of a brachytherapy dosimetry audit. The feasibility study was conducted at seven sites from four Australian states in both public and private centres. A purpose-built cylindrical water phantom was imaged using the local imaging protocol and a treatment plan was generated to deliver 1 Gy to the central (1 of 3) thermoluminescent dosimeter (TLD) from six dwell positions. All centres completed the audit, consisting of three consecutive irradiations, within a 2-h time period, with the exception of one centre that uses a pulsed dose rate brachytherapy unit. All TLD results were within 4.5% of the predicted value, with the exception of one subset where the dwell position step size was incorrectly applied. While the limited data collected in the study demonstrated considerable heterogeneity in clinical practice, the study proved a brachytherapy dosimetry audit to be feasible. Future studies should include verification of source strength using a Standard Dosimetry Laboratory calibrated chamber, a phantom that more closely mimics the clinical situation, a more comprehensive review of safety and quality assurance (QA) procedures including source dwell time and position accuracy, and a review of patient treatment QA procedures such as applicator position verification. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

Land 3D-seismic data: Preprocessing quality control utilizing survey design specifications, noise properties, normal moveout, first breaks, and offset

USGS Publications Warehouse

Raef, A.

2009-01-01

The recent proliferation of the 3D reflection seismic method into the near-surface area of geophysical applications, especially in response to the emergence of the need to comprehensively characterize and monitor near-surface carbon dioxide sequestration in shallow saline aquifers around the world, justifies the emphasis on cost-effective and robust quality control and assurance (QC/QA) workflow of 3D seismic data preprocessing that is suitable for near-surface applications. The main purpose of our seismic data preprocessing QC is to enable the use of appropriate header information, data that are free of noise-dominated traces, and/or flawed vertical stacking in subsequent processing steps. In this article, I provide an account of utilizing survey design specifications, noise properties, first breaks, and normal moveout for rapid and thorough graphical QC/QA diagnostics, which are easy to apply and efficient in the diagnosis of inconsistencies. A correlated vibroseis time-lapse 3D-seismic data set from a CO2-flood monitoring survey is used for demonstrating QC diagnostics. An important by-product of the QC workflow is establishing the number of layers for a refraction statics model in a data-driven graphical manner that capitalizes on the spatial coverage of the 3D seismic data. ?? China University of Geosciences (Wuhan) and Springer-Verlag GmbH 2009.

TU-E-BRB-00: Deformable Image Registration: Is It Right for Your Clinic

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2015-06-15

Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will alsomore » discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.« less

Chemical Reactivity Testing for the National Spent Nuclear Fuel Program. Quality Assurance Project Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Newsom, H.C.

This quality assurance project plan (QAPjP) summarizes requirements used by Lockheed Martin Energy Systems, Incorporated (LMES) Development Division at Y-12 for conducting chemical reactivity testing of Department of Energy (DOE) owned spent nuclear fuel, sponsored by the National Spent Nuclear Fuel Program (NSNFP). The requirements are based on the NSNFP Statement of Work PRO-007 (Statement of Work for Laboratory Determination of Uranium Hydride Oxidation Reaction Kinetics.) This QAPjP will utilize the quality assurance program at Y-12, QA-101PD, revision 1, and existing implementing procedures for the most part in meeting the NSNFP Statement of Work PRO-007 requirements, exceptions will be noted.

40 CFR 98.252 - GHGs to report.

Code of Federal Regulations, 2011 CFR

2011-07-01

... follow the calculation methodologies from § 98.253(f) and the monitoring and QA/QC methods, missing data..., monitoring and QA/QC methods, missing data procedures, reporting requirements, and recordkeeping requirements...

40 CFR 98.252 - GHGs to report.

Code of Federal Regulations, 2013 CFR

2013-07-01

... follow the calculation methodologies from § 98.253(f) and the monitoring and QA/QC methods, missing data..., monitoring and QA/QC methods, missing data procedures, reporting requirements, and recordkeeping requirements...

40 CFR 98.252 - GHGs to report.

Code of Federal Regulations, 2012 CFR

2012-07-01

... follow the calculation methodologies from § 98.253(f) and the monitoring and QA/QC methods, missing data..., monitoring and QA/QC methods, missing data procedures, reporting requirements, and recordkeeping requirements...

SU-F-T-232: Monthly Quality Assurance in External Beam Radiation Therapy Using a Single System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding, K; Ji, T; Department of Radiation Oncology, The First Hospital, China Medical University, Shenyang, Liaoning

Purpose: Monthly quality assurance (QA) is time consuming for external beam radiation therapy, taking as long as 6–8 hours for each machine. It is due to the use and setup of multiple devices for different QA procedures. We have developed a single system with rotational capability for the measurement of both optical light and radiation which significantly reduces the time spent on Monthly QA. Methods: A single system using mirrors, a phosphor screen and a CCD camera is housed on a cylindrical motor so that it can rotate 360 degrees. For monthly QA, the system is placed on the patientmore » couch of the medical accelerator with the plane of the phosphor screen at isocenter for all measurements. For optical QA such as optical distance indicator, room laser and light field, the optical image is collected directly with the camera. For radiation QA such as beam profile, MLC speed, picket-fence test, collimator rotation, table rotation and gantry rotation, a brass build-up plate is attached to the top of the phosphor screen. Two brass plates with islands of different thickness were designed for photon energy and electron energy constancy checks. Flex map, distortion map and uniformity map were developed to calibrate the motor bearing, camera/lens distortion, and the phosphor screen’s measured response across the field. Results: Following the TG142 guidelines for monthly QA with our system, the overall run time is reduced from 6–8 hours to 1.5 hours. Our system’s rotating design allows for quick testing of the gantry radiation isocenter test that is also independent of the sag of the gantry and the EPID. Conclusion: Our system significantly shortens the time needed for monthly QA by unifying the tests with a single system. Future work will be focused on extending the technology to Brachytherapy, IMRT and proton therapy QAs. This work is funded in part by a sponsor research grant from JPLC who owns the Raven technology. John Wong is a co-founder of JPLC.« less

Validation of serum markers for blood-brain barrier disruption in traumatic brain injury.

PubMed

Blyth, Brian J; Farhavar, Arash; Gee, Christopher; Hawthorn, Brendan; He, Hua; Nayak, Akshata; Stöcklein, Veit; Bazarian, Jeffrey J

2009-09-01

The blood-brain barrier (BBB), which prevents the entry into the central nervous system (CNS) of most water-soluble molecules over 500 Da, is often disrupted after trauma. Post-traumatic BBB disruption may have important implications for prognosis and therapy. Assessment of BBB status is not routine in clinical practice because available techniques are invasive. The gold-standard measure, the cerebrospinal fluide (CSF)-serum albumin quotient (Q(A)), requires the measurement of albumin in CSF and serum collected contemporaneously. Accurate, less invasive techniques are necessary. The objective of this study was to evaluate the relationship between Q(A) and serum concentrations of monomeric transthyretin (TTR) or S100B. Nine subjects with severe traumatic brain injury (TBI; Glasgow Coma Scale [GCS] score < or =8) and 11 subjects with non-traumatic headache who had CSF collected by ventriculostomy or lumbar puncture (LP) were enrolled. Serum and CSF were collected at the time of LP for headache subjects and at 12, 24, and 48 h after ventriculostomy for TBI subjects. The Q(A) was calculated for all time points at which paired CSF and serum samples were available. Serum S100B and TTR levels were also measured. Pearson's correlation coefficient and area under the receiver operating characteristic (ROC) curve were used to determine the relationship between the serum proteins and QA. Seven TBI subjects had abnormal Q(A)'s indicating BBB dysfunction. The remaining TBI and control subjects had normal BBB function. No significant relationship between TTR and QA was found. A statistically significant linear correlation between serum S100B and Q(A) was present (r = 0.432, p = 0.02). ROC analysis demonstrated a significant relationship between Q(A) and serum S100B concentrations at 12 h after TBI (AUC = 0.800; SE 0.147, 95% CI 0.511-1.089). Using an S100B concentration cutoff of 0.027 ng=ml, specificity for abnormal Q(A) was 90% or higher at each time point. We conclude that serum S100B concentrations accurately indicate BBB dysfunction at 12 h after TBI.

AmeriFlux Data Processing: Integrating automated and manual data management across software technologies and an international network to generate timely data products

NASA Astrophysics Data System (ADS)

Christianson, D. S.; Beekwilder, N.; Chan, S.; Cheah, Y. W.; Chu, H.; Dengel, S.; O'Brien, F.; Pastorello, G.; Sandesh, M.; Torn, M. S.; Agarwal, D.

2017-12-01

AmeriFlux is a network of scientists who independently collect eddy covariance and related environmental observations at over 250 locations across the Americas. As part of the AmeriFlux Management Project, the AmeriFlux Data Team manages standardization, collection, quality assurance / quality control (QA/QC), and distribution of data submitted by network members. To generate data products that are timely, QA/QC'd, and repeatable, and have traceable provenance, we developed a semi-automated data processing pipeline. The new pipeline consists of semi-automated format and data QA/QC checks. Results are communicated via on-line reports as well as an issue-tracking system. Data processing time has been reduced from 2-3 days to a few hours of manual review time, resulting in faster data availability from the time of data submission. The pipeline is scalable to the network level and has the following key features. (1) On-line results of the format QA/QC checks are available immediately for data provider review. This enables data providers to correct and resubmit data quickly. (2) The format QA/QC assessment includes an automated attempt to fix minor format errors. Data submissions that are formatted in the new AmeriFlux FP-In standard can be queued for the data QA/QC assessment, often with minimal delay. (3) Automated data QA/QC checks identify and communicate potentially erroneous data via online, graphical quick views that highlight observations with unexpected values, incorrect units, time drifts, invalid multivariate correlations, and/or radiation shadows. (4) Progress through the pipeline is integrated with an issue-tracking system that facilitates communications between data providers and the data processing team in an organized and searchable fashion. Through development of these and other features of the pipeline, we present solutions to challenges that include optimizing automated with manual processing, bridging legacy data management infrastructure with various software tools, and working across interdisciplinary and international science cultures. Additionally, we discuss results from community member feedback that helped refine QA/QC communications for efficient data submission and revision.

Cost Effective, Ultra Sensitive Groundwater Monitoring for Site Remediation and Management: Standard Operating Procedures with QA/QC

DTIC Science & Technology

2015-05-01

in consultation with the site management . 4.0 DATA TYPES AND QUALITY CONTROL A sampling plan must account for the collection, handling, and...GUIDANCE DOCUMENT Cost-Effective, Ultra-Sensitive Groundwater Monitoring for Site Remediation and Management : Standard Operating Procedures...Groundwater Monitoring for Site Remediation and Management 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Halden, R.U., Roll, I.B. 5d

Precipitation-Frequency and Discharge-Frequency Relations for Basins Less than 32 Square Miles in Kansas

USGS Publications Warehouse

Perry, Charles A.

2008-01-01

Precipitation-frequency and discharge-frequency relations for small drainage basins with areas less than 32 square miles in Kansas were evaluated to reduce the uncertainty of discharge-frequency estimates. Gaged-discharge records were used to develop discharge-frequency equations for the ratio of discharge to drainage area (Q/A) values using data from basins with variable soil permeability, channel slope, and mean annual precipitation. Soil permeability and mean annual precipitation are the dominant basin characteristics in the multiple linear regression analyses. In addition, 28 discharge measurements at ungaged sites by indirect surveying methods and by velocity meters also were used in this analysis to relate precipitation-recurrence interval to discharge-recurrence interval. Precipitation-recurrence interval for each of these discharge measurements were estimated from weather-radar estimates of precipitation and from nearby raingages. Time of concentration for each basin for each of the ungaged sites was computed and used to determine the precipitation-recurrence interval based on precipitation depth and duration. The ratio of discharge/drainage area (Q/A) value for each event was then assigned to that precipitation-recurrence interval. The relation between the ratio of discharge/drainage area (Q/A) and precipitation-recurrence interval for all 28 measured events resulted in a correlation coefficient of 0.79. Using basins less than 5.4 mi2 only, the correlation decreases to 0.74. However, when basins greater than 5.4 and less than 32 mi2 are examined the relation improves to a correlation coefficient of 0.95. There were a sufficient number of discharge and radar-measured precipitation events for both the 5-year (8 events) and the 100-year (11 events) recurrence intervals to examine the effect of basin characteristics on the Q/A values for basins less than 32 mi2. At the 5-year precipitation-/discharge-recurrence interval, channel slope was a significant predictor (r=0.99) of Q/A. Permeability (r=0.68) also had a significant effect on Q/A values for the 5-year recurrence interval. At the 100-year recurrence interval, permeability, channel slope, and mean annual precipitation did not have a significant effect on Q/A; however, time of concentration was a significant factor in determining Q/A for the 100-year events with greater times of concentration resulting in lower Q/A values. Additional high-recurrence interval (5-, 10-, 25-, 50-, and 100-year) precipitation/discharge data are needed to confirm these relations suggested above. Discharge data with attendant basin-wide precipitation data from precipitation-radar estimates provides a unique opportunity to study the effects of basin characteristics on the relation between precipitation recurrence interval and discharge-recurrence interval. Discharge-frequency values from the Q/A equations, the rational method, and the Kansas discharge-frequency equations (KFFE) were compared to 28 measured weather-radar precipitation-/discharge-frequency values. The association between precipitation frequency from weather-radar estimates and the frequency of the resulting discharge was shown in these comparisons. The measured and Q/A equation computed discharges displayed the best equality from low to high discharges of the three methods. Here the slope of the line was nearly 1:1 (y=0.9844x0.9677). Comparisons with the rational method produced a slope greater than 1:1 (y=0.0722x1.235), and the KFFE equations produced a slope less than 1:1 (y=5.9103x0.7475). The Q/A equation standard error of prediction averaged 0.1346 log units for the 5.4-to 32-square-mile group and 0.0944 log units for the less than 5.4-square mile group. The KFFE standard error averaged 0.2107 log units for the less-than-30-square-mile equations. Using the Q/A equations for determining discharge frequency values for ungaged sites thus appears to be a good alternative to the other two methods because of this s

Studies on a Q/A selector for the SECRAL electron cyclotron resonance ion source.

PubMed

Yang, Y; Sun, L T; Feng, Y C; Fang, X; Lu, W; Zhang, W H; Cao, Y; Zhang, X Z; Zhao, H W

2014-08-01

Electron cyclotron resonance ion sources are widely used in heavy ion accelerators in the world because they are capable of producing high current beams of highly charged ions. However, the design of the Q/A selector system for these devices is challenging, because it must have a sufficient ion resolution while controlling the beam emittance growth. Moreover, this system has to be matched for a wide range of ion beam species with different intensities. In this paper, research on the Q/A selector system at the SECRAL (Superconducting Electron Cyclotron Resonance ion source with Advanced design in Lanzhou) platform both in experiment and simulation is presented. Based on this study, a new Q/A selector system has been designed for SECRAL II. The features of the new design including beam simulations are also presented.

Large-scale model quality assessment for improving protein tertiary structure prediction.

PubMed

Cao, Renzhi; Bhattacharya, Debswapna; Adhikari, Badri; Li, Jilong; Cheng, Jianlin

2015-06-15

Sampling structural models and ranking them are the two major challenges of protein structure prediction. Traditional protein structure prediction methods generally use one or a few quality assessment (QA) methods to select the best-predicted models, which cannot consistently select relatively better models and rank a large number of models well. Here, we develop a novel large-scale model QA method in conjunction with model clustering to rank and select protein structural models. It unprecedentedly applied 14 model QA methods to generate consensus model rankings, followed by model refinement based on model combination (i.e. averaging). Our experiment demonstrates that the large-scale model QA approach is more consistent and robust in selecting models of better quality than any individual QA method. Our method was blindly tested during the 11th Critical Assessment of Techniques for Protein Structure Prediction (CASP11) as MULTICOM group. It was officially ranked third out of all 143 human and server predictors according to the total scores of the first models predicted for 78 CASP11 protein domains and second according to the total scores of the best of the five models predicted for these domains. MULTICOM's outstanding performance in the extremely competitive 2014 CASP11 experiment proves that our large-scale QA approach together with model clustering is a promising solution to one of the two major problems in protein structure modeling. The web server is available at: http://sysbio.rnet.missouri.edu/multicom_cluster/human/. © The Author 2015. Published by Oxford University Press.

Helical tomotherapy quality assurance with ArcCHECK.

PubMed

Chapman, David; Barnett, Rob; Yartsev, Slav

2014-01-01

To design a quality assurance (QA) procedure for helical tomotherapy that measures multiple beam parameters with 1 delivery and uses a rotating gantry to simulate treatment conditions. The customized QA procedure was preprogrammed on the tomotherapy operator station. The dosimetry measurements were performed using an ArcCHECK diode array and an A1SL ion chamber inserted in the central holder. The ArcCHECK was positioned 10cm above the isocenter so that the 21-cm diameter detector array could measure the 40-cm wide tomotherapy beam. During the implementation of the new QA procedure, separate comparative measurements were made using ion chambers in both liquid and solid water, the tomotherapy onboard detector array, and a MapCHECK diode array for a period of 10 weeks. There was good agreement (within 1.3%) for the beam output and cone ratio obtained with the new procedure and the routine QA measurements. The measured beam energy was comparable (0.3%) to solid water measurement during the 10-week evaluation period, excluding 2 of the 10 measurements with unusually high background. The symmetry reading was similarly compromised for those 2 weeks, and on the other weeks, it deviated from the solid water reading by ~2.5%. The ArcCHECK phantom presents a suitable alternative for performing helical tomotherapy QA, provided the background is collected properly. The proposed weekly procedure using ArcCHECK and water phantom makes the QA process more efficient. Copyright © 2014 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Helical tomotherapy quality assurance with ArcCHECK

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chapman, David; Barnett, Rob; Yartsev, Slav, E-mail: slav.yartsev@lhsc.on.ca

2014-07-01

To design a quality assurance (QA) procedure for helical tomotherapy that measures multiple beam parameters with 1 delivery and uses a rotating gantry to simulate treatment conditions. The customized QA procedure was preprogrammed on the tomotherapy operator station. The dosimetry measurements were performed using an ArcCHECK diode array and an A1SL ion chamber inserted in the central holder. The ArcCHECK was positioned 10 cm above the isocenter so that the 21-cm diameter detector array could measure the 40-cm wide tomotherapy beam. During the implementation of the new QA procedure, separate comparative measurements were made using ion chambers in both liquidmore » and solid water, the tomotherapy onboard detector array, and a MapCHECK diode array for a period of 10 weeks. There was good agreement (within 1.3%) for the beam output and cone ratio obtained with the new procedure and the routine QA measurements. The measured beam energy was comparable (0.3%) to solid water measurement during the 10-week evaluation period, excluding 2 of the 10 measurements with unusually high background. The symmetry reading was similarly compromised for those 2 weeks, and on the other weeks, it deviated from the solid water reading by ∼2.5%. The ArcCHECK phantom presents a suitable alternative for performing helical tomotherapy QA, provided the background is collected properly. The proposed weekly procedure using ArcCHECK and water phantom makes the QA process more efficient.« less

Development and operation of a quality assurance system for deviations from standard operating procedures in a clinical cell therapy laboratory.

PubMed

McKenna, D; Kadidlo, D; Sumstad, D; McCullough, J

2003-01-01

Errors and accidents, or deviations from standard operating procedures, other policy, or regulations must be documented and reviewed, with corrective actions taken to assure quality performance in a cellular therapy laboratory. Though expectations and guidance for deviation management exist, a description of the framework for the development of such a program is lacking in the literature. Here we describe our deviation management program, which uses a Microsoft Access database and Microsoft Excel to analyze deviations and notable events, facilitating quality assurance (QA) functions and ongoing process improvement. Data is stored in a Microsoft Access database with an assignment to one of six deviation type categories. Deviation events are evaluated for potential impact on patient and product, and impact scores for each are determined using a 0- 4 grading scale. An immediate investigation occurs, and corrective actions are taken to prevent future similar events from taking place. Additionally, deviation data is collectively analyzed on a quarterly basis using Microsoft Excel, to identify recurring events or developing trends. Between January 1, 2001 and December 31, 2001 over 2500 products were processed at our laboratory. During this time period, 335 deviations and notable events occurred, affecting 385 products and/or patients. Deviations within the 'technical error' category were most common (37%). Thirteen percent of deviations had a patient and/or a product impact score > or = 2, a score indicating, at a minimum, potentially affected patient outcome or moderate effect upon product quality. Real-time analysis and quarterly review of deviations using our deviation management program allows for identification and correction of deviations. Monitoring of deviation trends allows for process improvement and overall successful functioning of the QA program in the cell therapy laboratory. Our deviation management program could serve as a model for other laboratories in need of such a program.

Anion exchange composite membrane based on octa quaternary ammonium Polyhedral Oligomeric Silsesquioxane for alkaline fuel cells

NASA Astrophysics Data System (ADS)

Elumalai, Vijayakumar; Sangeetha, Dharmalingam

2018-01-01

A series of novel composite anion exchange membranes were prepared via simple solution casting method using synthesized quaternary ammonium functionalized Polyhedral Oligomeric Silsesquioxane (QA-POSS) with Quaternary polysulfone (QPSU). QA-POSS was synthesized from prepared Cl-POSS and well characterized by FT-IR, NMR, SEM and TEM analyses to confirm the chemical modifications and cubic morphologies. The QA-POSS nano particles have dual role in the membrane providing additional ion conducting groups and reinforcing the membrane in molecular level for the overall improvement of composite membrane. Additionally, the composite membranes were characterized by XRD, SEM, Ion exchange capacity (IEC), water uptake and conductivity to ensure the suitability of its use as an electrolyte in alkaline fuel cell. Finally, membrane electrode assembly (MEA) was fabricated using Pt anode (0.25 mg/cm2), Ag cathode (0.375 mg/cm2) and various synthesized composite membranes, and then it was tested in real time fuel cell setup. The membrane with 15% QA-POSS showed the maximum power density of 321 mW/cm2. The results showed that QA-POSS possess the ability to enhance the performance of the anion exchange membrane significantly.

40 CFR 98.74 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Ammonia Manufacturing § 98.74 Monitoring and QA/QC... (c)(8) of this section. (f) [Reserved] (g) If CO2 from ammonia production is used to produce urea at...

40 CFR 98.74 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Ammonia Manufacturing § 98.74 Monitoring and QA/QC... (c)(8) of this section. (f)[Reserved] (g) If CO2 from ammonia production is used to produce urea at...

40 CFR 98.74 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Ammonia Manufacturing § 98.74 Monitoring and QA/QC... (c)(8) of this section. (f)[Reserved] (g) If CO2 from ammonia production is used to produce urea at...

40 CFR 98.74 - Monitoring and QA/QC requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Ammonia Manufacturing § 98.74 Monitoring and QA/QC... (c)(8) of this section. (f) [Reserved] (g) If CO2 from ammonia production is used to produce urea at...

Quality assurance and ergonomics in the mammography department.

PubMed

Reynolds, April

2014-01-01

Quality assurance (QA) in mammography is a system of checks that helps ensure the proper functioning of imaging equipment and processes. Ergonomics is a scientific approach to arranging the work environment to reduce the risk of work-related injuries while increasing staff productivity and job satisfaction. This article reviews both QA and ergonomics in mammography and explains how they work together to create a safe and healthy environment for radiologic technologists and their patients. QA and quality control requirements in mammography are discussed, along with ergonomic best practices in the mammography setting.

CTC Sentinel. Volume 3, Issue 7, July 2010

DTIC Science & Technology

2010-07-01

reports say they are free to operate. It has been reported that these Iran-based al-Qa`ida cells played a support role in the al-Qa`ida attacks on...how al-Qa`ida views Iran and the Shi`a. Al-Zarqawi began by saying that the Shi`a are “an insurmountable obstacle, a lurking snake, a crafty and...He even quoted a European specialist as saying that if the “Safavids had not existed, we in Europe would be reading the Quran just as the Algerians

A novel technique for VMAT QA with EPID in cine mode on a Varian TrueBeam linac

NASA Astrophysics Data System (ADS)

Liu, Bo; Adamson, Justus; Rodrigues, Anna; Zhou, Fugen; Yin, Fang-fang; Wu, Qiuwen

2013-10-01

Volumetric modulated arc therapy (VMAT) is a relatively new treatment modality for dynamic photon radiation therapy. Pre-treatment quality assurance (QA) is necessary and many efforts have been made to apply electronic portal imaging device (EPID)-based IMRT QA methods to VMAT. It is important to verify the gantry rotation speed during delivery as this is a new variable that is also modulated in VMAT. In this paper, we present a new technique to perform VMAT QA using an EPID. The method utilizes EPID cine mode and was tested on Varian TrueBeam in research mode. The cine images were acquired during delivery and converted to dose matrices after profile correction and dose calibration. A sub-arc corresponding to each cine image was extracted from the original plan and its portal image prediction was calculated. Several analyses were performed including 3D γ analysis (2D images + gantry angle axis), 2D γ analysis, and other statistical analyses. The method was applied to 21 VMAT photon plans of 3 photon energies. The accuracy of the cine image information was investigated. Furthermore, this method's sensitivity to machine delivery errors was studied. The pass rate (92.8 ± 1.4%) for 3D γ analysis was comparable to those from Delta4 system (99.9 ± 0.1%) under similar criteria (3%, 3 mm, 5% threshold and 2° angle to agreement) at 6 MV. The recorded gantry angle and start/stop MUs were found to have sufficient accuracy for clinical QA. Machine delivery errors can be detected through combined analyses of 3D γ, gantry angle, and percentage dose difference. In summary, we have developed and validated a QA technique that can simultaneously verify the gantry angle and delivered MLC fluence for VMAT treatment.This technique is efficient and its accuracy is comparable to other QA methods.

SU-E-J-78: Adaptive Planning Workflow in a Pencil Beam Scanning Proton Therapy Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blakey, M; Price, S; Robison, B

Purpose: The susceptibility of proton therapy to changes in patient setup and anatomy necessitates an adaptive planning process. With the right planning tools and clinical workflow, an adaptive plan can be created in a timely manner without adding significant workload to the treatment planning staff. Methods: In our center, a weekly QA CT is performed on most patients to assess setup, anatomy change, and tumor response. The QA CT is fused to the treatment planning CT, the contours are transferred via deformable registration, and the plan dose is recalculated on the QA CT. A physicist assesses the dose distribution, andmore » an adaptive plan is requested based on tumor coverage or OAR dose changes. After the physician confirms or alters the deformed contours, a dosimetrist develops an adaptive plan using our TPS adaptation module. The plan is assessed for robustness and is then reviewed by the physician. Patient QA is performed within three days following the first adapted treatment. Results: Of the patients who received QA CTs, 19% required at least one adaptive plan (18.5% H&N, 18.5% brain, 11.1% breast, 14.8% chestwall, 14.8% lung, 18.5% pelvis and 3.8% abdomen). Of these patients, 14% went on a break, while the remainder was treated with the previous plan during the re-planning process. Adaptive plans were performed based on tumor shrinkage, anatomy change or positioning uncertainties for 37.9%, 44.8%, and 17.3% of the patients, respectively. On average, 3 full days are required between the QA CT and the first adapted plan treatment. Conclusion: Adaptive planning is a crucial component of proton therapy and should be applied to any site when the QA CT shows significant deviation from the plan. With an efficient workflow, an adaptive plan can be applied without delaying patient treatment or burdening the dosimetry and medical physics team.« less

WE-D-BRA-06: IMRT QA with ArcCHECK: The MD Anderson Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aristophanous, M; Suh, Y; Chi, P

Purpose: The objective of this project was to report our initial IMRT QA results and experience with the SunNuclear ArcCHECK. Methods: Three thousand one-hundred and sixteen cases were treated with IMRT or VMAT at our institution between October 2013 and September 2014. All IMRT/VMAT treatment plans underwent Quality Assurance (QA) using ArcCHECK prior to therapy. For clinical evaluation, a Gamma analysis is performed following QA delivery using the SNC Patient software (Sun Nuclear Corp) at the 3%/3mm level. QA Gamma pass rates were analyzed based on categories of treatment site, technique, and type of MLCs. Our current clinical threshold formore » passing a QA (Tclin) is set at a Gamma pass rate greater than 90%. We recorded the percent of failures for each category, as well as the Gamma pass rate threshold that would Result in 95% of QAs to pass (T95). Results: Using Tclin a failure rate of 5.9% over all QAs was observed. The highest failure rate was observed for gynecological (22%) and the lowest for CNS (0.9%) treatments. T95 was 91% over all QAs and ranged from 73% (gynecological) to 96.5% (CNS) for individual treatments sites. T95 was lower for IMRT and non-HD (high definition) MLCs at 88.5% and 94.5%, respectively, compared to 92.4% and 97.1% for VMAT and HD MLC treatments, respectively. There was a statistically significant difference between the passing rates for IMRT vs. VMAT and for HD MLCs vs. non-HD MLCs (p-values << 0.01). Gynecological, IMRT, and HD MLC treatments typically include more plans with larger field sizes. Conclusion: On average, Tclin with ArcCHECK was consistent with T95, as well as the 90% action level reported in TG-119. However, significant variations between the examined categories suggest a link between field size and QA passing rates and may warrant field size-specific passing rate thresholds.« less

SU-E-T-392: Evaluation of Ion Chamber/film and Log File Based QA to Detect Delivery Errors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, C; Mason, B; Kirsner, S

2015-06-15

Purpose: Ion chamber and film (ICAF) is a method used to verify patient dose prior to treatment. More recently, log file based QA has been shown as an alternative for measurement based QA. In this study, we delivered VMAT plans with and without errors to determine if ICAF and/or log file based QA was able to detect the errors. Methods: Using two VMAT patients, the original treatment plan plus 7 additional plans with delivery errors introduced were generated and delivered. The erroneous plans had gantry, collimator, MLC, gantry and collimator, collimator and MLC, MLC and gantry, and gantry, collimator, andmore » MLC errors. The gantry and collimator errors were off by 4{sup 0} for one of the two arcs. The MLC error introduced was one in which the opening aperture didn’t move throughout the delivery of the field. For each delivery, an ICAF measurement was made as well as a dose comparison based upon log files. Passing criteria to evaluate the plans were ion chamber less and 5% and film 90% of pixels pass the 3mm/3% gamma analysis(GA). For log file analysis 90% of voxels pass the 3mm/3% 3D GA and beam parameters match what was in the plan. Results: Two original plans were delivered and passed both ICAF and log file base QA. Both ICAF and log file QA met the dosimetry criteria on 4 of the 12 erroneous cases analyzed (2 cases were not analyzed). For the log file analysis, all 12 erroneous plans alerted a mismatch in delivery versus what was planned. The 8 plans that didn’t meet criteria all had MLC errors. Conclusion: Our study demonstrates that log file based pre-treatment QA was able to detect small errors that may not be detected using an ICAF and both methods of were able to detect larger delivery errors.« less

MO-D-213-05: Sensitivity of Routine IMRT QA Metrics to Couch and Collimator Rotations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alaei, P

Purpose: To assess the sensitivity of gamma index and other IMRT QA metrics to couch and collimator rotations. Methods: Two brain IMRT plans with couch and/or collimator rotations in one or more of the fields were evaluated using the IBA MatriXX ion chamber array and its associated software (OmniPro-I’mRT). The plans were subjected to routine QA by 1) Creating a composite planar dose in the treatment planning system (TPS) with the couch/collimator rotations and 2) Creating the planar dose after “zeroing” the rotations. Plan deliveries to MatriXX were performed with all rotations set to zero on a Varian 21ex linearmore » accelerator. This in effect created TPS-created planar doses with an induced rotation error. Point dose measurements for the delivered plans were also performed in a solid water phantom. Results: The IMRT QA of the plans with couch and collimator rotations showed clear discrepancies in the planar dose and 2D dose profile overlays. The gamma analysis, however, did pass with the criteria of 3%/3mm (for 95% of the points), albeit with a lower percentage pass rate, when one or two of the fields had a rotation. Similar results were obtained with tighter criteria of 2%/2mm. Other QA metrics such as percentage difference or distance-to-agreement (DTA) histograms produced similar results. The point dose measurements did not obviously indicate the error due to location of dose measurement (on the central axis) and the size of the ion chamber used (0.6 cc). Conclusion: Relying on Gamma analysis, percentage difference, or DTA to determine the passing of an IMRT QA may miss critical errors in the plan delivery due to couch/collimator rotations. A combination of analyses for composite QA plans, or per-beam analysis, would detect these errors.« less

Neuroprotective effects of intrastriatal injection of rapamycin in a mouse model of excitotoxicity induced by quinolinic acid.

PubMed

Saliba, Soraya Wilke; Vieira, Erica Leandro Marciano; Santos, Rebeca Priscila de Melo; Candelario-Jalil, Eduardo; Fiebich, Bernd L; Vieira, Luciene Bruno; Teixeira, Antonio Lucio; de Oliveira, Antonio Carlos Pinheiro

2017-01-31

The mammalian target of rapamycin (mTOR) is a kinase involved in a variety of physiological and pathological functions. However, the exact role of mTOR in excitotoxicity is poorly understood. Here, we investigated the effects of mTOR inhibition with rapamycin against neurodegeneration, and motor impairment, as well as inflammatory profile caused by an excitotoxic stimulus. A single and unilateral striatal injection of quinolinic acid (QA) was used to induce excitotoxicity in mice. Rapamycin (250 nL of 0.2, 2, or 20 μM; intrastriatal route) was administered 15 min before QA injection. Forty-eight hours after QA administration, rotarod test was performed to evaluate motor coordination and balance. Fluoro-Jade C, Iba-1, and GFAP staining were used to evaluate neuronal cell death, microglia morphology, and astrocytes density, respectively, at this time point. Levels of cytokines and neurotrophic factors were measured by ELISA and Cytometric Bead Array 8 h after QA injection. Striatal synaptosomes were used to evaluate the release of glutamate. We first demonstrated that rapamycin prevented the motor impairment induced by QA. Moreover, mTOR inhibition also reduced the neurodegeneration and the production of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α induced by excitotoxic stimulus. The lowest dose of rapamycin also increased the production of IL-10 and prevented the reduction of astrocyte density induced by QA. By using an in vitro approach, we demonstrated that rapamycin differently alters the release of glutamate from striatal synaptosomes induced by QA, reducing or enhancing the release of this neurotransmitter at low or high concentrations, respectively. Taken together, these data demonstrated a protective effect of rapamycin against an excitotoxic stimulus. Therefore, this study provides new evidence of the detrimental role of mTOR in neurodegeneration, which might represent an important target for the treatment of neurodegenerative diseases.

PM2.5 Gravimetric Lab Training (2016 NAAMC)

EPA Pesticide Factsheets

This training focused on understanding/applying the PM2.5 FRM in 40 CFR part 50, Appendix L and the updated QA Guidance Document 2.12. it was geared primarily for monitoring and QA managers and staff.

BUILDING "BRIDGES" WITH QUALITY ASSURANCE

EPA Science Inventory

The papr describes how, rather than building "bridges" across centuries, quality assurance (QA) personnel have the opportunity to build bridges across technical disciplines, between public and private organizations, and between different QA groups. As reviewers and auditors of a...

Auditing radiation sterilization facilities

NASA Astrophysics Data System (ADS)

Beck, Jeffrey A.

The diversity of radiation sterilization systems available today places renewed emphasis on the need for thorough Quality Assurance audits of these facilities. Evaluating compliance with Good Manufacturing Practices is an obvious requirement, but an effective audit must also evaluate installation and performance qualification programs (validation_, and process control and monitoring procedures in detail. The present paper describes general standards that radiation sterilization operations should meet in each of these key areas, and provides basic guidance for conducting QA audits of these facilities.