Sample records for qa-driven guidelines generation

  1. QA-driven Guidelines Generation for Bacteriotherapy

    PubMed Central

    Pasche, Emilie; Teodoro, Douglas; Gobeill, Julien; Ruch, Patrick; Lovis, Christian

    2009-01-01

    PURPOSE We propose a question-answering (QA) driven generation approach for automatic acquisition of structured rules that can be used in a knowledge authoring tool for antibiotic prescription guidelines management. METHODS: The rule generation is seen as a question-answering problem, where the parameters of the questions are known items of the rule (e.g. an infectious disease, caused by a given bacterium) and answers (e.g. some antibiotics) are obtained by a question-answering engine. RESULTS: When looking for a drug given a pathogen and a disease, top-precision of 0.55 is obtained by the combination of the Boolean engine (PubMed) and the relevance-driven engine (easyIR), which means that for more than half of our evaluation benchmark at least one of the recommended antibiotics was automatically acquired by the rule generation method. CONCLUSION: These results suggest that such an automatic text mining approach could provide a useful tool for guidelines management, by improving knowledge update and discovery. PMID:20351908

  2. 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

  3. Strategy Guideline: Quality Management in Existing Homes - Cantilever Floor Example

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

    Taggart, J.; Sikora, J.; Wiehagen, J.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented.

  4. 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

  5. Reliability and quality assurance on the MOD 2 wind system

    NASA Technical Reports Server (NTRS)

    Mason, W. E. B.; Jones, B. G.

    1981-01-01

    The Safety, Reliability, and Quality Assurance (R&QA) approach developed for the largest wind turbine generator, the Mod 2, is described. The R&QA approach assures that the machine is not hazardous to the public or to the operating personnel, is operated unattended on a utility grid, demonstrates reliable operation, and helps establish the quality assurance and maintainability requirements for future wind turbine projects. The significant guideline consisted of a failure modes and effects analysis (FMEA) during the design phase, hardware inspections during parts fabrication, and three simple documents to control activities during machine construction and operation.

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings.

    PubMed

    Van Rie, A; Fitzgerald, D; Kabuya, G; Van Deun, A; Tabala, M; Jarret, N; Behets, F; Bahati, E

    2008-03-01

    Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories.

  14. 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.

  15. Guidelines for the creation and management of geographic data bases within a GIS environment, version 1.0

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

    Durfee, R.C.; Land, M.L.; McCord, R.A.

    1994-07-01

    A Geographic Information System (GIS) provides the ability to manage and analyze all types of geographic and environmental information. It performs these functions by providing the tools necessary to capture, access, analyze, and display spatially referenced information in graphic and tabular form. Typical data elements that can be visualized in a map might include roads, buildings, topography, streams, waste areas, monitoring wells, groundwater measurements, soil sample results, landcover, and demography. The intent of this document is to provide data management and quality assurance (QA) guidelines that will aid implementors and users of GIS technology and data bases. These guidelines shouldmore » be useful in all, phases of GIS activities, including the following: (1) project planning, (2) data collection and generation, (3) data maintenance and management, (4) QA and standards, (5) project implementation, (6) spatial analysis and data interpretation, (7) data transformation and exchange, and (8) output and reporting. The daily use of desktop GIS technologies within Martin Marietta Energy Systems, Inc. (Energy Systems), is a relatively new phenomenon, but usage is increasing rapidly. Large volumes of GIS-related data are now being collected and analyzed for the U.S. Department of Energy (DOE) Oak Ridge Reservation (ORR) and its facilities. It is very important to establish and follow good data management practices for GIS. In the absence of such practices, data-related problems will overwhelm users for many years. In comparison with traditional data processing and software life-cycle management, there is limited information on GIS QA techniques, data standards and structures, configuration control, and documentation practices. This lack of information partially results from the newness of the technology and the complexity of spatial information and geographic analysis techniques as compared to typical tabular data management.« less

  16. 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.

  17. 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...

  18. 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...

  19. 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...

  20. 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 ...

  1. Particle Acceleration by Cme-driven Shock Waves

    NASA Technical Reports Server (NTRS)

    Reames, Donald V.

    1999-01-01

    In the largest solar energetic particle (SEP) events, acceleration occurs at shock waves driven out from the Sun by coronal mass ejections (CMEs). Peak particle intensities are a strong function of CME speed, although the intensities, spectra, and angular distributions of particles escaping the shock are highly modified by scattering on Alfven waves produced by the streaming particles themselves. Element abundances vary in complex ways because ions with different values of Q/A resonate with different parts of the wave spectrum, which varies with space and time. Just recently, we have begun to model these systematic variations theoretically and to explore other consequences of proton-generated waves.

  2. 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.

  3. 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.

  4. The Observational Consequences of Proton-Generated Waves at Shocks

    NASA Technical Reports Server (NTRS)

    Reames, Donald V.

    2000-01-01

    In the largest solar energetic particle (SEP) events, acceleration takes place at shock waves driven out from the Sun by fast coronal mass ejections. Protons streaming away from strong shocks generate Alfven waves that trap particles in the acceleration region, limiting outflowing intensities but increasing the efficiency of acceleration to higher energies. Early in the events, with the shock still near the Sun, intensities at 1 AU are bounded and spectra are flattened at low energies. Elements with different charge-to-mass ratios, Q/A, differentially probe the wave spectra near shocks, producing abundance ratios that vary in space and time. An initial rise in He/H, while Fe/O declines, is a typical symptom of the non-Kolmogorov wave spectra in the largest events. Strong wave generation can cause cross-field scattering near the shock and unusually rapid reduction in anisotropies even far from the shock. At the highest energies, shock spectra steepen to form a "knee." For protons, this spectral knee can vary from approx. 10 MeV to approx. 1 GeV depending on shock conditions for wave growth. In one case, the location of the knee scales approximately as Q/A in the energy/nucleon spectra of other species.

  5. Technical aspects of quality assurance in radiation oncology

    PubMed Central

    Saw, CB; Ferenci, MS; Wanger, H

    2008-01-01

    The technical aspects of quality assurance (QA) in radiation oncology as practice in the United States will be reviewed and updated in the spirit of offering the experience to the radiation oncology communities in the Asia-Pacific region. The word “technical” is used to express the organisational components or processes and not the materials within the QA program. A comprehensive QA program in radiation oncology will have an official statement declaring the quality plan for effective patient care services it provides in a document. The QA program will include all aspects of patient care: physical, clinical, and medical aspects of the services. The document will describe the organisational structure, responsibilities, checks and procedures, and resources allocated to ensure the successful implementation of the quality of patient management. Regulatory guidelines and guidelines from accreditation agencies should be incorporated in the QA program to ensure compliance. The organisational structure will have a multidisciplinary QA committee that has the authority to evaluate continuously the effectiveness of the QA program to provide prompt corrective recommendations and to request feedback as needed to monitor the response. The continuous monitoring aspects require meetings to be held at regular intervals with the minutes of the meetings officially recorded and documented. To ensure that a QA program is effective, the program itself should be audited for quality at regular intervals at least annually. It has been recognised that the current QA program has not kept abreast with the rapid implementation of new and advanced radiation therapy technologies with the most recent in image-based radiation therapy technology. The societal bodies (ASTRO and AAPM) and federal agency (NCI) acknowledge this inadequacy and have held workshops to address this issue. The challenges for the societal bodies and federal agency are numerous that include (a) the prescriptive methodology used may not be appropriate for currently implemented new technologies, (b) resources are becoming scarce, (c) advanced radiation therapy technologies have been introduced too rapidly, (d) advances in radiation therapy technologies have become too sophisticated and specialised with each therapy modality having its own separate set of equipment, for example its own dose planning software, computer system and dose delivery systems requiring individualised QA procedures. At the present time, industrial engineers are being recruited to assist in devising a methodology that is broad-based and more process-oriented risk-based formulation of QA in radiation oncology. PMID:21611011

  6. 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

  7. 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.

  8. Comparing Shock geometry from MHD simulation to that from the Q/A-scaling analysis

    NASA Astrophysics Data System (ADS)

    Li, G.; Zhao, L.; Jin, M.

    2017-12-01

    In large SEP events, ions can be accelerated at CME-driven shocks to very high energies. Spectra of heavy ions in many large SEP events show features such as roll-overs or spectral breaks. In some events when the spectra are plotted in energy/nucleon they can be shifted relatively to each other so that the spectra align. The amount of shift is charge-to-mass ratio (Q/A) dependent and varies from event to event. In the work of Li et al. (2009), the Q/A dependences of the scaling is related to shock geometry when the CME-driven shock is close to the Sun. For events where multiple in-situ spacecraft observations exist, one may expect that different spacecraft are connected to different portions of the CME-driven shock that have different shock geometries, therefore yielding different Q/A dependence. At the same time, shock geometry can be also obtained from MHD simulations. This means we can compare shock geometry from two completely different approaches: one from MHD simulation and the other from in-situ spectral fitting. In this work, we examine this comparison for selected events.

  9. 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.

  10. Overall Quality Assurance Project Plan, Remedial Investigation/Feasibility Study Fort Sheridan, Illinois, Volume 1.

    DTIC Science & Technology

    1995-03-15

    billion volume ppm parts per million PT pole-mounted PTFE polytetrafluoro-ethylene PUF polyurethane foam PVC polyvinyl chloride QA quality assurance...and Illinois Environmental Protection Agency (IEPA) quality assurance (QA) objectives. The format of the OQAPP is based on "Interim Guidelines and...County. The till material deposited in the Fort Sheridan region has been classified as the Wadsworth Till Member of the Wedron Formation . This till

  11. Quality Assurance Results for a Commercial Radiosurgery System: A Communication.

    PubMed

    Ruschin, Mark; Lightstone, Alexander; Beachey, David; Wronski, Matt; Babic, Steven; Yeboah, Collins; Lee, Young; Soliman, Hany; Sahgal, Arjun

    2015-10-01

    The purpose of this communication is to inform the radiosurgery community of quality assurance (QA) results requiring attention in a commercial FDA-approved linac-based cone stereo-tactic radiosurgery (SRS) system. Standard published QA guidelines as per the American Association of Physics in Medicine (AAPM) were followed during the SRS system's commissioning process including end-to-end testing, cone concentricity testing, image transfer verification, and documentation. Several software and hardware deficiencies that were deemed risky were uncovered during the process and QA processes were put in place to mitigate these risks during clinical practice. In particular, the present work focuses on daily cone concentricity testing and commissioning-related findings associated with the software. Cone concentricity/alignment is measured daily using both optical light field inspection, as well as quantitative radiation field tests with the electronic portal imager. In 10 out of 36 clini-cal treatments, adjustments to the cone position had to be made to align the cone with the collimator axis to less than 0.5 mm and on two occasions the pre-adjustment measured offset was 1.0 mm. Software-related errors discovered during commissioning included incorrect transfer of the isocentre in DICOM coordinates, improper handling of non-axial image sets, and complex handling of beam data, especially for multi-target treatments. QA processes were established to mitigate the occurrence of the software errors. With proper QA processes, the reported SRS system complies with tolerances set out in established guidelines. Discussions with the vendor are ongoing to address some of the hardware issues related to cone alignment. © The Author(s) 2014.

  12. The NCS code of practice for the quality assurance and control for volumetric modulated arc therapy

    NASA Astrophysics Data System (ADS)

    Mans, Anton; Schuring, Danny; Arends, Mark P.; Vugts, Cornelia A. J. M.; Wolthaus, Jochem W. H.; Lotz, Heidi T.; Admiraal, Marjan; Louwe, Rob J. W.; Öllers, Michel C.; van de Kamer, Jeroen B.

    2016-10-01

    In 2010, the NCS (Netherlands Commission on Radiation Dosimetry) installed a subcommittee to develop guidelines for quality assurance and control for volumetric modulated arc therapy (VMAT) treatments. The report (published in 2015) has been written by Dutch medical physicists and has therefore, inevitably, a Dutch focus. This paper is a condensed version of these guidelines, the full report in English is freely available from the NCS website www.radiationdosimetry.org. After describing the transition from IMRT to VMAT, the paper addresses machine quality assurance (QA) and treatment planning system (TPS) commissioning for VMAT. The final section discusses patient specific QA issues such as the use of class solutions, measurement devices and dose evaluation methods.

  13. 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

  14. 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.

  15. 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.

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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

  2. 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

  3. Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

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

    Taggart, J.; Sikora, J.; Wiehagen, J.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling andmore » quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.« less

  4. 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.

  5. Evaluation and Quality Control for the Copernicus Seasonal Forecast Systems

    NASA Astrophysics Data System (ADS)

    Manubens, N.; Hunter, A.; Bedia, J.; Bretonnière, P. A.; Bhend, J.; Doblas-Reyes, F. J.

    2017-12-01

    The EU funded Copernicus Climate Change Service (C3S) will provide authoritative information about past, current and future climate for a wide range of users, from climate scientists to stakeholders from a wide range of sectors including insurance, energy or transport. It has been recognized that providing information about the products' quality and provenance is paramount to establish trust in the service and allow users to make best use of the available information. This presentation outlines the work being conducted within the Quality Assurance for Multi-model Seasonal Forecast Products project (QA4Seas). The aim of QA4Seas is to develop a strategy for the evaluation and quality control (EQC) of the multi-model seasonal forecasts provided by C3S. First, we present the set of guidelines the data providers must comply with, ensuring the data is fully traceable and harmonized across data sets. Second, we discuss the ongoing work on defining a provenance and metadata model that is able to encode such information, and that can be extended to describe the steps followed to obtain the final verification products such as maps and time series of forecast quality measures. The metadata model is based on the Resource Description Framework W3C standard, being thus extensible and reusable. It benefits from widely adopted vocabularies to describe data provenance and workflows, as well as from expert consensus and community-support for the development of the verification and downscaling specific ontologies. Third, we describe the open source software being developed to generate fully reproducible and certifiable seasonal forecast products, which also attaches provenance and metadata information to the verification measures and enables the user to visually inspect the quality of the C3S products. QA4Seas is seeking collaboration with similar initiatives, as well as extending the discussion to interested parties outside the C3S community to share experiences and establish global common guidelines or best practices regarding data provenance.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. Quality assurance, an administrative means to a managerial end: Part IV.

    PubMed

    Clark, G B

    1992-01-01

    This is the fourth and final part of a series of articles on laboratory quality surveillance. Part I addressed the historical background of medical quality assurance. Part II covered surveillance guidelines of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the College of American Pathologists with emphasis on quality assurance (QA) and the ten-step process. Part III focused on the JCAHO transition from QA to quality assessment and improvement. Part IV concludes the series by discussing the systematic identification of quality indicators in the total quality management and continuous quality improvement environment.

  13. 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

  14. 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.

  15. Innovation of IT metasystems by means of event-driven paradigm using QDMS

    NASA Astrophysics Data System (ADS)

    Nedic, Vladimir; Despotovic, Danijela; Cvetanovic, Slobodan; Despotovic, Milan; Eric, Milan

    2016-10-01

    Globalisation of world economy brings new and more complex demands to business systems. In order to respond to these trends, business systems apply new paradigms that are inevitable reflecting on management metasystems - quality assurance (QA), as well as on information technology (IT) metasystems. Small and medium enterprises (in particular in food industry) do not have possibilities to access external resources to the extent that could provide adequate keeping up with these trends. That raises the question how to enhance synergetic effect of interaction between existing QA and IT metasystems in order to overcome resource gap and achieve set goals by internal resources. The focus of this article is to propose a methodology for utilisation of potential of quality assurance document management system (QDMS) as prototypical platform for initiating, developing, testing and improving new functionalities that are required by IT as support for buiness system management. In that way QDMS plays a role of catalyst that not only accelerates but could also enhance selectivity of the reactions of QA and IT metasystems and direct them on finding new functionalities based on event-driven paradigm. The article tries to show the process of modelling, development and implementation of a possible approach to this problem through conceptual survey and practical solution in the food industry.

  16. 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

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

    Chen, S; Guerrero, M; Zhang, B

    Purpose: To implement a comprehensive non-measurement-based verification program for patient-specific IMRT QA Methods: Based on published guidelines, a robust IMRT QA program should assess the following components: 1) accuracy of dose calculation, 2) accuracy of data transfer from the treatment planning system (TPS) to the record-and-verify (RV) system, 3) treatment plan deliverability, and 4) accuracy of plan delivery. Results: We have implemented an IMRT QA program that consist of four components: 1) an independent re-calculation of the dose distribution in the patient anatomy with a commercial secondary dose calculation program: Mobius3D (Mobius Medical Systems, Houston, TX), with dose accuracy evaluationmore » using gamma analysis, PTV mean dose, PTV coverage to 95%, and organ-at-risk mean dose; 2) an automated in-house-developed plan comparison system that compares all relevant plan parameters such as MU, MLC position, beam iso-center position, collimator, gantry, couch, field size settings, and bolus placement, etc. between the plan and the RV system; 3) use of the RV system to check the plan deliverability and further confirm using “mode-up” function on treatment console for plans receiving warning; and 4) implementation of a comprehensive weekly MLC QA, in addition to routine accelerator monthly and daily QA. Among 1200 verifications, there were 9 cases of suspicious calculations, 5 cases of delivery failure, no data transfer errors, and no failure of weekly MLC QA. These 9 suspicious cases were due to the PTV extending to the skin or to heterogeneity correction effects, which would not have been caught using phantom measurement-based QA. The delivery failure was due to the rounding variation of MLC position between the planning system and RV system. Conclusion: A very efficient, yet comprehensive, non-measurement-based patient-specific QA program has been implemented and used clinically for about 18 months with excellent results.« less

  18. SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

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

    Zhou, Y; Tan, J; Jiang, S

    Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this systemmore » for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.« less

  19. 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

  20. 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

  1. 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/ .

  2. 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.

  3. Demonstration of Essential Reliability Services by Utility-Scale Solar

    Science.gov Websites

    Essential Reliability Services by Utility-Scale Solar Photovoltaic Power Plant: Q&A Demonstration of Essential Reliability Services by Utility-Scale Solar Photovoltaic Power Plant: Q&A Webinar Questions & Answers April 27, 2017 Is photovoltaic (PV) generation required to provide grid supportive

  4. Flow enhancement of deformable self-driven objects by countercurrent

    NASA Astrophysics Data System (ADS)

    Mashiko, Takashi; Fujiwara, Takashi

    2016-10-01

    We report numerical simulations of the mixed flows of two groups of deformable self-driven objects. The objects belonging to the group A (B) have drift coefficient D =DA (DB), where a positive (negative) value of D denotes the rightward (leftward) driving force. For co-current flows (DA ,DB > 0), the result is rather intuitive: the net flow of one group (QA) increases if the driving force of the other group is stronger than its own driving force (i.e., DB >DA), and decreases otherwise (DB

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Depressive, anxiety and hypomanic symptoms in schizophrenia may be driven by tryptophan catabolite (TRYCAT) patterning of IgA and IgM responses directed to TRYCATs.

    PubMed

    Kanchanatawan, Buranee; Sirivichayakul, Sunee; Carvalho, André F; Anderson, George; Galecki, Piotr; Maes, Michael

    2018-01-03

    The aim of this study was to delineate the associations between the tryptophan catabolite (TRYCAT) pathway and affective symptoms in schizophrenia. Towards this end we measured immunoglobulin (Ig)A and IgM responses to relatively noxious TRYCATs, namely quinolinic (QA), xanthurenic (XA), picolinic (PA) acid and 3-OH-kynurenine (3HK), and generally protective TRYCATs, namely anthranilic (AA) and kynurenic (KA) acid in 80 patients with schizophrenia and 40 healthy controls. The Hamilton Rating Scale for Depression (HDRS) and anxiety (HAMA), Young Mania Rating Scale (YMRS) as well as the Positive and Negative Symptoms Scale of Schizophrenia (PANSS) were measured. Depression, anxiety and hypomanic as well as negative and positive symptoms were associated with increased IgA responses to PA. Increased IgA responses to XA were associated with anxiety, hypomanic and negative symptoms. Moreover, depressive, anxiety, hypomanic and negative symptoms were characterized by increased IgA responses to the noxious (XA+3HK+QA+PA)/protective (AA+KA) TRYCAT ratio. All symptom dimensions were associated with increased IgM responses to QA, while depressive, anxiety, positive and negative symptoms were accompanied by lowered IgM responses to 3HK. Hypomanic symptoms were additionally accompanied by lowered IgM responses to AA, and negative symptoms by increased IgM responses to KA. In conclusion, both shared and distinct alterations in the activity of the TRYCAT pathway, as well as its regulatory factors and consequences, may underpin affective and classical psychotic symptoms of schizophrenia. Increased mucosa-generated production of noxious TRYCATs, especially PA, and specific changes in IgM-mediated regulatory activities may be associated with the different symptom dimensions of schizophrenia. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. 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

  12. 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

  13. A virtual dosimetry audit - Towards transferability of gamma index analysis between clinical trial QA groups.

    PubMed

    Hussein, Mohammad; Clementel, Enrico; Eaton, David J; Greer, Peter B; Haworth, Annette; Ishikura, Satoshi; Kry, Stephen F; Lehmann, Joerg; Lye, Jessica; Monti, Angelo F; Nakamura, Mitsuhiro; Hurkmans, Coen; Clark, Catharine H

    2017-12-01

    Quality assurance (QA) for clinical trials is important. Lack of compliance can affect trial outcome. Clinical trial QA groups have different methods of dose distribution verification and analysis, all with the ultimate aim of ensuring trial compliance. The aim of this study was to gain a better understanding of different processes to inform future dosimetry audit reciprocity. Six clinical trial QA groups participated. Intensity modulated treatment plans were generated for three different cases. A range of 17 virtual 'measurements' were generated by introducing a variety of simulated perturbations (such as MLC position deviations, dose differences, gantry rotation errors, Gaussian noise) to three different treatment plan cases. Participants were blinded to the 'measured' data details. Each group analysed the datasets using their own gamma index (γ) technique and using standardised parameters for passing criteria, lower dose threshold, γ normalisation and global γ. For the same virtual 'measured' datasets, different results were observed using local techniques. For the standardised γ, differences in the percentage of points passing with γ < 1 were also found, however these differences were less pronounced than for each clinical trial QA group's analysis. These variations may be due to different software implementations of γ. This virtual dosimetry audit has been an informative step in understanding differences in the verification of measured dose distributions between different clinical trial QA groups. This work lays the foundations for audit reciprocity between groups, particularly with more clinical trials being open to international recruitment. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 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.

  15. Analysis of dynamic behavior of multiple-stage planetary gear train used in wind driven generator.

    PubMed

    Wang, Jungang; Wang, Yong; Huo, Zhipu

    2014-01-01

    A dynamic model of multiple-stage planetary gear train composed of a two-stage planetary gear train and a one-stage parallel axis gear is proposed to be used in wind driven generator to analyze the influence of revolution speed and mesh error on dynamic load sharing characteristic based on the lumped parameter theory. Dynamic equation of the model is solved using numerical method to analyze the uniform load distribution of the system. It is shown that the load sharing property of the system is significantly affected by mesh error and rotational speed; load sharing coefficient and change rate of internal and external meshing of the system are of obvious difference from each other. The study provides useful theoretical guideline for the design of the multiple-stage planetary gear train of wind driven generator.

  16. Analysis of Dynamic Behavior of Multiple-Stage Planetary Gear Train Used in Wind Driven Generator

    PubMed Central

    Wang, Jungang; Wang, Yong; Huo, Zhipu

    2014-01-01

    A dynamic model of multiple-stage planetary gear train composed of a two-stage planetary gear train and a one-stage parallel axis gear is proposed to be used in wind driven generator to analyze the influence of revolution speed and mesh error on dynamic load sharing characteristic based on the lumped parameter theory. Dynamic equation of the model is solved using numerical method to analyze the uniform load distribution of the system. It is shown that the load sharing property of the system is significantly affected by mesh error and rotational speed; load sharing coefficient and change rate of internal and external meshing of the system are of obvious difference from each other. The study provides useful theoretical guideline for the design of the multiple-stage planetary gear train of wind driven generator. PMID:24511295

  17. 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.

  18. 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

  19. SU-E-T-148: Benchmarks and Pre-Treatment Reviews: A Study of Quality Assurance Effectiveness

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

    Lowenstein, J; Nguyen, H; Roll, J

    Purpose: To determine the impact benchmarks and pre-treatment reviews have on improving the quality of submitted clinical trial data. Methods: Benchmarks are used to evaluate a site’s ability to develop a treatment that meets a specific protocol’s treatment guidelines prior to placing their first patient on the protocol. A pre-treatment review is an actual patient placed on the protocol in which the dosimetry and contour volumes are evaluated to be per protocol guidelines prior to allowing the beginning of the treatment. A key component of these QA mechanisms is that sites are provided timely feedback to educate them on howmore » to plan per the protocol and prevent protocol deviations on patients accrued to a protocol. For both benchmarks and pre-treatment reviews a dose volume analysis (DVA) was performed using MIM softwareTM. For pre-treatment reviews a volume contour evaluation was also performed. Results: IROC Houston performed a QA effectiveness analysis of a protocol which required both benchmarks and pre-treatment reviews. In 70 percent of the patient cases submitted, the benchmark played an effective role in assuring that the pre-treatment review of the cases met protocol requirements. The 35 percent of sites failing the benchmark subsequently modified there planning technique to pass the benchmark before being allowed to submit a patient for pre-treatment review. However, in 30 percent of the submitted cases the pre-treatment review failed where the majority (71 percent) failed the DVA. 20 percent of sites submitting patients failed to correct their dose volume discrepancies indicated by the benchmark case. Conclusion: Benchmark cases and pre-treatment reviews can be an effective QA tool to educate sites on protocol guidelines and to minimize deviations. Without the benchmark cases it is possible that 65 percent of the cases undergoing a pre-treatment review would have failed to meet the protocols requirements.Support: U24-CA-180803.« less

  20. ASVCP guidelines: quality assurance for point-of-care testing in veterinary medicine.

    PubMed

    Flatland, Bente; Freeman, Kathleen P; Vap, Linda M; Harr, Kendal E

    2013-12-01

    Point-of-care testing (POCT) refers to any laboratory testing performed outside the conventional reference laboratory and implies close proximity to patients. Instrumental POCT systems consist of small, handheld or benchtop analyzers. These have potential utility in many veterinary settings, including private clinics, academic veterinary medical centers, the community (eg, remote area veterinary medical teams), and for research applications in academia, government, and industry. Concern about the quality of veterinary in-clinic testing has been expressed in published veterinary literature; however, little guidance focusing on POCT is available. Recognizing this void, the ASVCP formed a subcommittee in 2009 charged with developing quality assurance (QA) guidelines for veterinary POCT. Guidelines were developed through literature review and a consensus process. Major recommendations include (1) taking a formalized approach to POCT within the facility, (2) use of written policies, standard operating procedures, forms, and logs, (3) operator training, including periodic assessment of skills, (4) assessment of instrument analytical performance and use of both statistical quality control and external quality assessment programs, (5) use of properly established or validated reference intervals, (6) and ensuring accurate patient results reporting. Where possible, given instrument analytical performance, use of a validated 13s control rule for interpretation of control data is recommended. These guidelines are aimed at veterinarians and veterinary technicians seeking to improve management of POCT in their clinical or research setting, and address QA of small chemistry and hematology instruments. These guidelines are not intended to be all-inclusive; rather, they provide a minimum standard for maintenance of POCT instruments in the veterinary setting. © 2013 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

  1. 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.

  2. 78 FR 14457 - Guidelines Establishing Test Procedures for the Analysis of Pollutants Under the Clean Water Act...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... Establishing Test Procedures for the Analysis of Pollutants Under the Clean Water Act; Analysis and Sampling... for use as an alternative oil and grease method. Some comments were specific to the sampling...-side comparison using the specific procedures (e.g. sampling frequency, number of samples, QA/QC, and...

  3. 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.

  4. 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

  5. Authoring and verification of clinical guidelines: a model driven approach.

    PubMed

    Pérez, Beatriz; Porres, Ivan

    2010-08-01

    The goal of this research is to provide a framework to enable authoring and verification of clinical guidelines. The framework is part of a larger research project aimed at improving the representation, quality and application of clinical guidelines in daily clinical practice. The verification process of a guideline is based on (1) model checking techniques to verify guidelines against semantic errors and inconsistencies in their definition, (2) combined with Model Driven Development (MDD) techniques, which enable us to automatically process manually created guideline specifications and temporal-logic statements to be checked and verified regarding these specifications, making the verification process faster and cost-effective. Particularly, we use UML statecharts to represent the dynamics of guidelines and, based on this manually defined guideline specifications, we use a MDD-based tool chain to automatically process them to generate the input model of a model checker. The model checker takes the resulted model together with the specific guideline requirements, and verifies whether the guideline fulfils such properties. The overall framework has been implemented as an Eclipse plug-in named GBDSSGenerator which, particularly, starting from the UML statechart representing a guideline, allows the verification of the guideline against specific requirements. Additionally, we have established a pattern-based approach for defining commonly occurring types of requirements in guidelines. We have successfully validated our overall approach by verifying properties in different clinical guidelines resulting in the detection of some inconsistencies in their definition. The proposed framework allows (1) the authoring and (2) the verification of clinical guidelines against specific requirements defined based on a set of property specification patterns, enabling non-experts to easily write formal specifications and thus easing the verification process. Copyright 2010 Elsevier Inc. All rights reserved.

  6. WE-E-BRD-01: HDR Brachytherapy I: Overview of Clinical Application and QA

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

    Libby, B; Showalter, T

    2014-06-15

    With the increased usage of high dose rate (HDR) brachytherapy and the introduction of dedicated image guided brachytherapy suites, it is necessary to review the processes and procedures associated with safely delivering these treatments in the expedited time scales that dedicated treatment suites afford. The speakers will present the clinical aspects of switching from LDR to HDR treatments, including guidelines for patient selection, and the clinical outcomes comparing LDR to HDR. The speakers will also discuss the HDR treatment process itself, because the shortened clinical timeline involved with a streamlined scan/plan/treat workflow can introduce other issues. Safety and QA aspectsmore » involved with the streamlined process, including increased personnel required for parallel tasks, and possible interfering tasks causing delays in patient treatments will also be discussed. Learning Objectives: To understand the clinical aspects of HDR Brachytherapy, including common clinical indications, patient selection, and the evolving evidence in support of this therapeutic modality To review the current prominent clinical trials for HDR brachytherapy To interpret the established guidelines for HDR brachytherapy quality assurance for implementation into practical clinical settings. To introduce the basic requirements for image guided brachytherapy.« less

  7. 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.

  8. The DEP domain-containing protein TOE-2 promotes apoptosis in the Q lineage of C. elegans through two distinct mechanisms

    PubMed Central

    Gurling, Mark; Talavera, Karla; Garriga, Gian

    2014-01-01

    Neuroblast divisions in the nematode Caenorhabditis elegans often give rise to a larger neuron and a smaller cell that dies. We have previously identified genes that, when mutated, result in neuroblast divisions that generate daughter cells that are more equivalent in size. This effect correlates with the survival of daughter cells that would normally die. We now describe a role for the DEP domain-containing protein TOE-2 in promoting the apoptotic fate in the Q lineage. TOE-2 localized at the plasma membrane and accumulated in the cleavage furrow of the Q.a and Q.p neuroblasts, suggesting that TOE-2 might position the cleavage furrow asymmetrically to generate daughter cells of different sizes. This appears to be the case for Q.a divisions where loss of TOE-2 led to a more symmetric division and to survival of the smaller Q.a daughter. Localization of TOE-2 to the membrane is required for this asymmetry, but, surprisingly, the DEP domain is dispensable. By contrast, loss of TOE-2 led to loss of the apoptotic fate in the smaller Q.p daughter but did not affect the size asymmetry of the Q.p daughters. This function of TOE-2 required the DEP domain but not localization to the membrane. We propose that TOE-2 ensures an apoptotic fate for the small Q.a daughter by promoting asymmetry in the daughter cell sizes of the Q.a neuroblast division but by a mechanism that is independent of cell size in the Q.p division. PMID:24961802

  9. SU-F-P-54: Guidelines to Check Image Registration QA of a Clinical Deformation Registration Software: A Single Institution Preliminary Study

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

    Gill, G; Souri, S; Rea, A

    Purpose: The objective of this study is to verify and analyze the accuracy of a clinical deformable image registration (DIR) software. Methods: To test clinical DIR software qualitatively and quantitatively, we focused on lung radiotherapy and analyzed a single (Lung) patient CT scan. Artificial anatomical changes were applied to account for daily variations during the course of treatment including the planning target volume (PTV) and organs at risk (OAR). The primary CT (pCT) and the structure set (pST) was deformed with commercial tool (ImSimQA-Oncology Systems Limited) and after artificial deformation (dCT and dST) sent to another commercial tool (VelocityAI-Varian Medicalmore » Systems). In Velocity, the deformed CT and structures (dCT and dST) were inversely deformed back to original primary CT (dbpCT and dbpST). We compared the dbpST and pST structure sets using similarity metrics. Furthermore, a binary deformation field vector (BDF) was created and sent to ImSimQA software for comparison with known “ground truth” deformation vector fields (DVF). Results: An image similarity comparison was made by using “ground truth” DVF and “deformed output” BDF with an output of normalized “cross correlation (CC)” and “mutual information (MI)” in ImSimQA software. Results for the lung case were MI=0.66 and CC=0.99. The artificial structure deformation in both pST and dbpST was analyzed using DICE coefficient, mean distance to conformity (MDC) and deformation field error volume histogram (DFEVH) by comparing them before and after inverse deformation. We have noticed inadequate structure match for CTV, ITV and PTV due to close proximity of heart and overall affected by lung expansion. Conclusion: We have seen similarity between pCT and dbpCT but not so well between pST and dbpST, because of inadequate structure deformation in clinical DIR system. This system based quality assurance test will prepare us for adopting the guidelines of upcoming AAPM task group 132 protocol.« less

  10. Anatomic modeling using 3D printing: quality assurance and optimization.

    PubMed

    Leng, Shuai; McGee, Kiaran; Morris, Jonathan; Alexander, Amy; Kuhlmann, Joel; Vrieze, Thomas; McCollough, Cynthia H; Matsumoto, Jane

    2017-01-01

    The purpose of this study is to provide a framework for the development of a quality assurance (QA) program for use in medical 3D printing applications. An interdisciplinary QA team was built with expertise from all aspects of 3D printing. A systematic QA approach was established to assess the accuracy and precision of each step during the 3D printing process, including: image data acquisition, segmentation and processing, and 3D printing and cleaning. Validation of printed models was performed by qualitative inspection and quantitative measurement. The latter was achieved by scanning the printed model with a high resolution CT scanner to obtain images of the printed model, which were registered to the original patient images and the distance between them was calculated on a point-by-point basis. A phantom-based QA process, with two QA phantoms, was also developed. The phantoms went through the same 3D printing process as that of the patient models to generate printed QA models. Physical measurement, fit tests, and image based measurements were performed to compare the printed 3D model to the original QA phantom, with its known size and shape, providing an end-to-end assessment of errors involved in the complete 3D printing process. Measured differences between the printed model and the original QA phantom ranged from -0.32 mm to 0.13 mm for the line pair pattern. For a radial-ulna patient model, the mean distance between the original data set and the scanned printed model was -0.12 mm (ranging from -0.57 to 0.34 mm), with a standard deviation of 0.17 mm. A comprehensive QA process from image acquisition to completed model has been developed. Such a program is essential to ensure the required accuracy of 3D printed models for medical applications.

  11. 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

  12. 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.

  13. 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

  14. Towards organizing health knowledge on community-based health services.

    PubMed

    Akbari, Mohammad; Hu, Xia; Nie, Liqiang; Chua, Tat-Seng

    2016-12-01

    Online community-based health services accumulate a huge amount of unstructured health question answering (QA) records at a continuously increasing pace. The ability to organize these health QA records has been found to be effective for data access. The existing approaches for organizing information are often not applicable to health domain due to its domain nature as characterized by complex relation among entities, large vocabulary gap, and heterogeneity of users. To tackle these challenges, we propose a top-down organization scheme, which can automatically assign the unstructured health-related records into a hierarchy with prior domain knowledge. Besides automatic hierarchy prototype generation, it also enables each data instance to be associated with multiple leaf nodes and profiles each node with terminologies. Based on this scheme, we design a hierarchy-based health information retrieval system. Experiments on a real-world dataset demonstrate the effectiveness of our scheme in organizing health QA into a topic hierarchy and retrieving health QA records from the topic hierarchy.

  15. 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

  16. SynTrack: DNA Assembly Workflow Management (SynTrack) v2.0.1

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

    MENG, XIANWEI; SIMIRENKO, LISA

    2016-12-01

    SynTrack is a dynamic, workflow-driven data management system that tracks the DNA build process: Management of the hierarchical relationships of the DNA fragments; Monitoring of process tasks for the assembly of multiple DNA fragments into final constructs; Creations of vendor order forms with selectable building blocks. Organizing plate layouts barcodes for vendor/pcr/fusion/chewback/bioassay/glycerol/master plate maps (default/condensed); Creating or updating Pre-Assembly/Assembly process workflows with selected building blocks; Generating Echo pooling instructions based on plate maps; Tracking of building block orders, received and final assembled for delivering; Bulk updating of colony or PCR amplification information, fusion PCR and chewback results; Updating with QA/QCmore » outcome with .csv & .xlsx template files; Re-work assembly workflow enabled before and after sequencing validation; and Tracking of plate/well data changes and status updates and reporting of master plate status with QC outcomes.« less

  17. Experimental Comparison of High Duty Cycle and Pulsed Active Sonars in a Littoral Environment

    DTIC Science & Technology

    2014-09-30

    A series of metrics (eg. number of detections, matched-filter gain, false alarm rates, track purity, track latency, etc.) will be used to quantify...for QA. These data were used to generate spectrograms, ambient noise and reverberation decay plots, and clutter images, all of which helped...Perhaps the most useful of these for QA were the clutter images which provided a rapid visual assessment to estimate SNR, identify at what range the

  18. Stakeholder-Driven Quality Improvement: A Compelling Force for Clinical Practice Guidelines.

    PubMed

    Rosenfeld, Richard M; Wyer, Peter C

    2018-01-01

    Clinical practice guideline development should be driven by rigorous methodology, but what is less clear is where quality improvement enters the process: should it be a priority-guiding force, or should it enter only after recommendations are formulated? We argue for a stakeholder-driven approach to guideline development, with an overriding goal of quality improvement based on stakeholder perceptions of needs, uncertainties, and knowledge gaps. In contrast, the widely used topic-driven approach, which often makes recommendations based only on randomized controlled trials, is driven by epidemiologic purity and evidence rigor, with quality improvement a downstream consideration. The advantages of a stakeholder-driven versus a topic-driven approach are highlighted by comparisons of guidelines for otitis media with effusion, thyroid nodules, sepsis, and acute bacterial rhinosinusitis. These comparisons show that stakeholder-driven guidelines are more likely to address the quality improvement needs and pressing concerns of clinicians and patients, including understudied populations and patients with multiple chronic conditions. Conversely, a topic-driven approach often addresses "typical" patients, based on research that may not reflect the needs of high-risk groups excluded from studies because of ethical issues or a desire for purity of research design.

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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

  4. 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

  5. SU-G-BRB-01: A Novel 3D Printed Patient-Specific Phantom for Spine SBRT Quality Assurance: Comparison of 3D Printing Techniques

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

    Lee, S; Kim, M; Lee, M

    Purpose: The novel 3 dimensional (3D)-printed spine quality assurance (QA) phantoms generated by two different 3D-printing technologies, digital light processing (DLP) and Polyjet, were developed and evaluated for spine stereotactic body radiation treatment (SBRT). Methods: The developed 3D-printed spine QA phantom consisted of an acrylic body and a 3D-printed spine phantom. DLP and Polyjet 3D printers using the high-density acrylic polymer were employed to produce spine-shaped phantoms based on CT images. To verify dosimetric effects, the novel phantom was made it enable to insert films between each slabs of acrylic body phantom. Also, for measuring internal dose of spine, 3D-printedmore » spine phantom was designed as divided laterally exactly in half. Image fusion was performed to evaluate the reproducibility of our phantom, and the Hounsfield unit (HU) was measured based on each CT image. Intensity-modulated radiotherapy plans to deliver a fraction of a 16 Gy dose to a planning target volume (PTV) based on the two 3D-printing techniques were compared for target coverage and normal organ-sparing. Results: Image fusion demonstrated good reproducibility of the fabricated spine QA phantom. The HU values of the DLP- and Polyjet-printed spine vertebrae differed by 54.3 on average. The PTV Dmax dose for the DLP-generated phantom was about 1.488 Gy higher than for the Polyjet-generated phantom. The organs at risk received a lower dose when the DLP technique was used than when the Polyjet technique was used. Conclusion: This study confirmed that a novel 3D-printed phantom mimicking a high-density organ can be created based on CT images, and that a developed 3D-printed spine phantom could be utilized in patient-specific QA for SBRT. Despite using the same main material, DLP and Polyjet yielded different HU values. Therefore, the printing technique and materials must be carefully chosen in order to accurately produce a patient-specific QA phantom.« less

  6. Quality Assessment of Collection 6 MODIS Atmospheric Science Products

    NASA Astrophysics Data System (ADS)

    Manoharan, V. S.; Ridgway, B.; Platnick, S. E.; Devadiga, S.; Mauoka, E.

    2015-12-01

    Since the launch of the NASA Terra and Aqua satellites in December 1999 and May 2002, respectively, atmosphere and land data acquired by the MODIS (Moderate Resolution Imaging Spectroradiometer) sensor on-board these satellites have been reprocessed five times at the MODAPS (MODIS Adaptive Processing System) located at NASA GSFC. The global land and atmosphere products use science algorithms developed by the NASA MODIS science team investigators. MODAPS completed Collection 6 reprocessing of MODIS Atmosphere science data products in April 2015 and is currently generating the Collection 6 products using the latest version of the science algorithms. This reprocessing has generated one of the longest time series of consistent data records for understanding cloud, aerosol, and other constituents in the earth's atmosphere. It is important to carefully evaluate and assess the quality of this data and remove any artifacts to maintain a useful climate data record. Quality Assessment (QA) is an integral part of the processing chain at MODAPS. This presentation will describe the QA approaches and tools adopted by the MODIS Land/Atmosphere Operational Product Evaluation (LDOPE) team to assess the quality of MODIS operational Atmospheric products produced at MODAPS. Some of the tools include global high resolution images, time series analysis and statistical QA metrics. The new high resolution global browse images with pan and zoom have provided the ability to perform QA of products in real time through synoptic QA on the web. This global browse generation has been useful in identifying production error, data loss, and data quality issues from calibration error, geolocation error and algorithm performance. A time series analysis for various science datasets in the Level-3 monthly product was recently developed for assessing any long term drifts in the data arising from instrument errors or other artifacts. This presentation will describe and discuss some test cases from the recently processed C6 products. We will also describe the various tools and approaches developed to verify and assess the algorithm changes implemented by the science team to address known issues in the products and improve the quality of the products.

  7. A Varian DynaLog file-based procedure for patient dose-volume histogram-based IMRT QA.

    PubMed

    Calvo-Ortega, Juan F; Teke, Tony; Moragues, Sandra; Pozo, Miquel; Casals-Farran, Joan

    2014-03-06

    In the present study, we describe a method based on the analysis of the dynamic MLC log files (DynaLog) generated by the controller of a Varian linear accelerator in order to perform patient-specific IMRT QA. The DynaLog files of a Varian Millennium MLC, recorded during an IMRT treatment, can be processed using a MATLAB-based code in order to generate the actual fluence for each beam and so recalculate the actual patient dose distribution using the Eclipse treatment planning system. The accuracy of the DynaLog-based dose reconstruction procedure was assessed by introducing ten intended errors to perturb the fluence of the beams of a reference plan such that ten subsequent erroneous plans were generated. In-phantom measurements with an ionization chamber (ion chamber) and planar dose measurements using an EPID system were performed to investigate the correlation between the measured dose changes and the expected ones detected by the reconstructed plans for the ten intended erroneous cases. Moreover, the method was applied to 20 cases of clinical plans for different locations (prostate, lung, breast, and head and neck). A dose-volume histogram (DVH) metric was used to evaluate the impact of the delivery errors in terms of dose to the patient. The ionometric measurements revealed a significant positive correlation (R² = 0.9993) between the variations of the dose induced in the erroneous plans with respect to the reference plan and the corresponding changes indicated by the DynaLog-based reconstructed plans. The EPID measurements showed that the accuracy of the DynaLog-based method to reconstruct the beam fluence was comparable with the dosimetric resolution of the portal dosimetry used in this work (3%/3 mm). The DynaLog-based reconstruction method described in this study is a suitable tool to perform a patient-specific IMRT QA. This method allows us to perform patient-specific IMRT QA by evaluating the result based on the DVH metric of the planning CT image (patient DVH-based IMRT QA).

  8. Tryptophan, kynurenine, and kynurenine metabolites: Relationship to lifetime aggression and inflammatory markers in human subjects

    PubMed Central

    Coccaro, Emil F.; Lee, Royce; Fanning, Jennifer R.; Fuchs, Dietmar; Goiny, Michel; Erhardt, Sophie; Christensen, Kyle; Brundin, Lena; Coussons-Read, Mary

    2017-01-01

    Inflammatory proteins are thought to be causally involved in the generation of aggression, possibly due to direct effects of cytokines in the central nervous system and/or by generation of inflammatory metabolites along the tryptophan-kynurenine (TRP/KYN) pathway, including KYN and its active metabolites kynurenic acid (KA), quinolinic acid (QA), and picolinic acid (PA). We examined plasma levels of TRP, KYN, KA, QA, and PA in 172 medication-free, medically healthy, human subjects to determine if plasma levels of these substances are altered as a function of trait aggression, and if they correlate with current plasma levels of inflammatory markers. Plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6), and soluble interleukin-1 receptor-II (sIL-1RII) protein were also available in these subjects. We found normal levels of TRP but reduced plasma levels of KYN (by 48%), QA (by 6%), and a QA/KA (by 5%) ratio in subjects with Intermittent Explosive Disorder (IED) compared to healthy controls and psychiatric controls. Moreover, the metabolites were not associated with any of the inflammatory markers studied. These data do not support the hypothesis that elevated levels of KYN metabolites would be present in plasma of subjects with IED, and associated with plasma inflammation. However, our data do point to a dysregulation of the KYN pathway metabolites in these subjects. Further work will be necessary to replicate these findings and to understand their role in inflammation and aggression in these subjects. PMID:27318828

  9. Tuning cofactor redox potentials: the 2-methoxy dihedral angle generates a redox potential difference of >160 mV between the primary (Q(A)) and secondary (Q(B)) quinones of the bacterial photosynthetic reaction center.

    PubMed

    Taguchi, Alexander T; Mattis, Aidas J; O'Malley, Patrick J; Dikanov, Sergei A; Wraight, Colin A

    2013-10-15

    Only quinones with a 2-methoxy group can act simultaneously as the primary (QA) and secondary (QB) electron acceptors in photosynthetic reaction centers from Rhodobacter sphaeroides. (13)C hyperfine sublevel correlation measurements of the 2-methoxy in the semiquinone states, SQA and SQB, were compared with quantum mechanics calculations of the (13)C couplings as a function of the dihedral angle. X-ray structures support dihedral angle assignments corresponding to a redox potential gap (ΔEm) between QA and QB of ~180 mV. This is consistent with the failure of a ubiquinone analogue lacking the 2-methoxy to function as QB in mutant reaction centers with a ΔEm of ≈160-195 mV.

  10. From Field Notes to Data Portal - A Scalable Data QA/QC Framework for Tower Networks: Progress and Preliminary Results

    NASA Astrophysics Data System (ADS)

    Sturtevant, C.; Hackley, S.; Lee, R.; Holling, G.; Bonarrigo, S.

    2017-12-01

    Quality assurance and control (QA/QC) is one of the most important yet challenging aspects of producing research-quality data. Data quality issues are multi-faceted, including sensor malfunctions, unmet theoretical assumptions, and measurement interference from humans or the natural environment. Tower networks such as Ameriflux, ICOS, and NEON continue to grow in size and sophistication, yet tools for robust, efficient, scalable QA/QC have lagged. Quality control remains a largely manual process heavily relying on visual inspection of data. In addition, notes of measurement interference are often recorded on paper without an explicit pathway to data flagging. As such, an increase in network size requires a near-proportional increase in personnel devoted to QA/QC, quickly stressing the human resources available. We present a scalable QA/QC framework in development for NEON that combines the efficiency and standardization of automated checks with the power and flexibility of human review. This framework includes fast-response monitoring of sensor health, a mobile application for electronically recording maintenance activities, traditional point-based automated quality flagging, and continuous monitoring of quality outcomes and longer-term holistic evaluations. This framework maintains the traceability of quality information along the entirety of the data generation pipeline, and explicitly links field reports of measurement interference to quality flagging. Preliminary results show that data quality can be effectively monitored and managed for a multitude of sites with a small group of QA/QC staff. Several components of this framework are open-source, including a R-Shiny application for efficiently monitoring, synthesizing, and investigating data quality issues.

  11. A cognitive evaluation of four online search engines for answering definitional questions posed by physicians.

    PubMed

    Yu, Hong; Kaufman, David

    2007-01-01

    The Internet is having a profound impact on physicians' medical decision making. One recent survey of 277 physicians showed that 72% of physicians regularly used the Internet to research medical information and 51% admitted that information from web sites influenced their clinical decisions. This paper describes the first cognitive evaluation of four state-of-the-art Internet search engines: Google (i.e., Google and Scholar.Google), MedQA, Onelook, and PubMed for answering definitional questions (i.e., questions with the format of "What is X?") posed by physicians. Onelook is a portal for online definitions, and MedQA is a question answering system that automatically generates short texts to answer specific biomedical questions. Our evaluation criteria include quality of answer, ease of use, time spent, and number of actions taken. Our results show that MedQA outperforms Onelook and PubMed in most of the criteria, and that MedQA surpasses Google in time spent and number of actions, two important efficiency criteria. Our results show that Google is the best system for quality of answer and ease of use. We conclude that Google is an effective search engine for medical definitions, and that MedQA exceeds the other search engines in that it provides users direct answers to their questions; while the users of the other search engines have to visit several sites before finding all of the pertinent information.

  12. Development of a harmonised multi sensor retrieval scheme for HCHO within the Quality Assurance For Essential Climate Variables (QA4ECV) project

    NASA Astrophysics Data System (ADS)

    De Smedt, Isabelle; Richter, Andreas; Beirle, Steffen; Danckaert, Thomas; Van Roozendael, Michel; Yu, Huan; Bösch, Tim; Hilboll, Andreas; Peters, Enno; Doerner, Steffen; Wagner, Thomas; Wang, Yang; Lorente, Alba; Eskes, Henk; Van Geffen, Jos; Boersma, Folkert

    2016-04-01

    One of the main goals of the QA4ECV project is to define community best-practices for the generation of multi-decadal ECV data records from satellite instruments. QA4ECV will develop retrieval algorithms for the Land ECVs surface albedo, leaf area index (LAI), and fraction of active photosynthetic radiation (fAPAR), as well as for the Atmosphere ECV ozone and aerosol precursors nitrogen dioxide (NO2), formaldehyde (HCHO), and carbon monoxide (CO). Here we assess best practices and provide recommendations for the retrieval of HCHO. Best practices are established based on (1) a detailed intercomparison exercise between the QA4ECV partner's for each specific algorithm processing steps, (2) the feasibility of implementation, and (3) the requirement to generate consistent multi-sensor multi-decadal data records. We propose a fitting window covering the 328.5-346 nm spectral interval for the morning sensors (GOME, SCIAMACHY and GOME-2) and an extension to 328.5-359 nm for OMI and GOME-2, allowed by improved quality of the recorded spectra. A high level of consistency between group algorithms is found when the retrieval settings are carefully aligned. However, the retrieval of slant columns is highly sensitive to any change in the selected settings. The use of a mean background radiance as DOAS reference spectrum allows for a stabilization of the retrievals. A background correction based on the reference sector method is recommended for implementation in the QA4ECV HCHO algorithm as it further reduces retrieval uncertainties. HCHO AMFs using different radiative transfer codes show a good overall consistency when harmonized settings are used. As for NO2, it is proposed to use a priori HCHO profiles from the TM5 model. These are provided on a 1°x1° latitude-longitude grid.

  13. SU-E-J-87: Building Deformation Error Histogram and Quality Assurance of Deformable Image Registration.

    PubMed

    Park, S B; Kim, H; Yao, M; Ellis, R; Machtay, M; Sohn, J W

    2012-06-01

    To quantify the systematic error of a Deformable Image Registration (DIR) system and establish Quality Assurance (QA) procedure. To address the shortfall of landmark approach which it is only available at the significant visible feature points, we adapted a Deformation Vector Map (DVM) comparison approach. We used two CT image sets (R and T image sets) taken for the same patient at different time and generated a DVM, which includes the DIR systematic error. The DVM was calculated using fine-tuned B-Spline DIR and L-BFGS optimizer. By utilizing this DVM we generated R' image set to eliminate the systematic error in DVM,. Thus, we have truth data set, R' and T image sets, and the truth DVM. To test a DIR system, we use R' and T image sets to a DIR system. We compare the test DVM to the truth DVM. If there is no systematic error, they should be identical. We built Deformation Error Histogram (DEH) for quantitative analysis. The test registration was performed with an in-house B-Spline DIR system using a stochastic gradient descent optimizer. Our example data set was generated with a head and neck patient case. We also tested CT to CBCT deformable registration. We found skin regions which interface with the air has relatively larger errors. Also mobile joints such as shoulders had larger errors. Average error for ROIs were as follows; CTV: 0.4mm, Brain stem: 1.4mm, Shoulders: 1.6mm, and Normal tissues: 0.7mm. We succeeded to build DEH approach to quantify the DVM uncertainty. Our data sets are available for testing other systems in our web page. Utilizing DEH, users can decide how much systematic error they would accept. DEH and our data can be a tool for an AAPM task group to compose a DIR system QA guideline. This project is partially supported by the Agency for Healthcare Research and Quality (AHRQ) grant 1R18HS017424-01A2. © 2012 American Association of Physicists in Medicine.

  14. 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

  15. 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

  16. Clinical validation of an in-house EPID dosimetry system for IMRT QA at the Prince of Wales Hospital

    NASA Astrophysics Data System (ADS)

    Tyler, M.; Vial, P.; Metcalfe, P.; Downes, S.

    2013-06-01

    In this study a simple method using standard flood-field corrected Electronic Portal Imaging Device (EPID) images for routine Intensity Modulated Radiation Therapy (IMRT) Quality Assurance (QA) was investigated. The EPID QA system was designed and tested on a Siemens Oncor Impression linear accelerator with an OptiVue 1000ST EPID panel (Siemens Medical Solutions USA, Inc, USA) and an Elekta Axesse linear accelerator with an iViewGT EPID (Elekta AB, Sweden) for 6 and 10 MV IMRT fields with Step-and-Shoot and dynamic-MLC delivery. Two different planning systems were used for patient IMRT field generation for comparison with the measured EPID fluences. All measured IMRT plans had >95% agreement to the planning fluences (using 3 cGy / 3 mm Gamma Criteria) and were comparable to the pass-rates calculated using a 2-D diode array dosimeter.

  17. Poster — Thur Eve — 17: In-phantom and Fluence-based Measurements for Quality Assurance of Volumetric-driven Adaptation of Arc Therapy

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

    Schaly, B; Hoover, D; Mitchell, S

    2014-08-15

    During volumetric modulated arc therapy (VMAT) of head and neck cancer, some patients lose weight which may result in anatomical deviations from the initial plan. If these deviations are substantial a new treatment plan can be designed for the remainder of treatment (i.e., adaptive planning). Since the adaptive treatment process is resource intensive, one possible approach to streamlining the quality assurance (QA) process is to use the electronic portal imaging device (EPID) to measure the integrated fluence for the adapted plans instead of the currently-used ArcCHECK device (Sun Nuclear). Although ArcCHECK is recognized as the clinical standard for patient-specific VMATmore » plan QA, it has limited length (20 cm) for most head and neck field apertures and has coarser detector spacing than the EPID (10 mm vs. 0.39 mm). In this work we compared measurement of the integrated fluence using the EPID with corresponding measurements from the ArcCHECK device. In the past year nine patients required an adapted plan. Each of the plans (the original and adapted) is composed of two arcs. Routine clinical QA was performed using the ArcCHECK device, and the same plans were delivered to the EPID (individual arcs) in integrated mode. The dose difference between the initial plan and adapted plan was compared for ArcCHECK and EPID. In most cases, it was found that the EPID is more sensitive in detecting plan differences. Therefore, we conclude that EPID provides a viable alternative for QA of the adapted head and neck plans and should be further explored.« less

  18. Prospective clinical validation of independent DVH prediction for plan QA in automatic treatment planning for prostate cancer patients.

    PubMed

    Wang, Yibing; Heijmen, Ben J M; Petit, Steven F

    2017-12-01

    To prospectively investigate the use of an independent DVH prediction tool to detect outliers in the quality of fully automatically generated treatment plans for prostate cancer patients. A plan QA tool was developed to predict rectum, anus and bladder DVHs, based on overlap volume histograms and principal component analysis (PCA). The tool was trained with 22 automatically generated, clinical plans, and independently validated with 21 plans. Its use was prospectively investigated for 50 new plans by replanning in case of detected outliers. For rectum D mean , V 65Gy , V 75Gy , anus D mean , and bladder D mean , the difference between predicted and achieved was within 0.4 Gy or 0.3% (SD within 1.8 Gy or 1.3%). Thirteen detected outliers were re-planned, leading to moderate but statistically significant improvements (mean, max): rectum D mean (1.3 Gy, 3.4 Gy), V 65Gy (2.7%, 4.2%), anus D mean (1.6 Gy, 6.9 Gy), and bladder D mean (1.5 Gy, 5.1 Gy). The rectum V 75Gy of the new plans slightly increased (0.2%, p = 0.087). A high accuracy DVH prediction tool was developed and used for independent QA of automatically generated plans. In 28% of plans, minor dosimetric deviations were observed that could be improved by plan adjustments. Larger gains are expected for manually generated plans. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 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

  20. SU-E-J-26: Analysis of Image Quality in CBCT QA Using a Treatment Planning System

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

    Xu, M

    2014-06-01

    Purpose: The objective of this study is to propose an alternative QA technique that analyzes imaging quality(IQ) in CBCT-QA processing. Methods: A catphan phantom was used to take CT imaging data set that were imported into a treatment planning system - Eclipse. The image quality was analyzed in terms of in-slice geometry resolution, Hounsfield numbers(HU) accuracy, mean-slice thickness, edge-to-center uniformity, low contrast resolution, and high contrast spatial resolution in Eclipse workstation. The CBCT-QA was also analyzed by OBI-workstation and a commercial software. Comparison was made to evaluation feasibility in a TPS environment. Results: The analysis of IQ was conducted inmore » Eclipse v10.0 TPS. In-slice geometric resolution was measured between 2-rods in section CTP404 and repeated for all 4 rods with the difference between expected and measured values less than +/−0.1 cm. For HU, the difference between expected and measured values in HU was found much less than +/−40. Mean slice thickness measured by a distance on the wire proportional to scanner increment multiplying by a factor of 0.42. After repeating measurements to 4 wires, the average difference between expected and measured values was less +/−0.124 mm in slice thickness. HU uniformity was measured in section CTP486 with the tolerance less than +/−40 HU. Low contrast resolution in section CTP515 and high contrast resolution in section CTP528 were found to be 7 disks in diameter of 4 mm and 6 lp/cm, respectively. Eclipse TPS results indicated a good agreement to those obtained in OBI workstation and ImagePro software for major parameters. Conclusion: An analysis of IQ was proposed as an alternative CBCT QA processing. Based upon measured data assessment, proposed method was accurate and consistent to IQ evaluation and TG142 guideline. The approach was to utilize TPS resource, which can be valuable to re-planning, verification, and delivery in adaptive therapy.« less

  1. Quality assurance grading guidelines for research and development at DOE facilities

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

    Powell, T.B.; Morris, R.N.

    1993-01-01

    The quality assurance (QA) requirements for the US Department of Energy (DOE) are established in DOE Order 5700.6C. This order is applicable for all DOE departmental elements, management, and maintenance and operating contractors and requires that documented Quality Assurance Programs (QAPs) are prepared at all levels; it has one attachment. The DOE Office of Energy Research (DOE-ER) has issued a standard to ensure implementation of the full intent of this order in the ER community.

  2. 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.

  3. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

    PubMed Central

    Gay, Hiram A.; Barthold, H. Joseph; O’Meara, Elizabeth; Bosch, Walter R.; El Naqa, Issam; Al-Lozi, Rawan; Rosenthal, Seth A.; Lawton, Colleen; Lee, W. Robert; Sandler, Howard; Zietman, Anthony; Myerson, Robert; Dawson, Laura A.; Willett, Christopher; Kachnic, Lisa A.; Jhingran, Anuja; Portelance, Lorraine; Ryu, Janice; Small, William; Gaffney, David; Viswanathan, Akila N.; Michalski, Jeff M.

    2012-01-01

    Purpose To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The following were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa_R, Adnexa_L, Prostate, SeminalVesc, PenileBulb, Femur_R, and Femur_L. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research. PMID:22483697

  4. Development and initial validation of a cessation fatigue scale.

    PubMed

    Mathew, Amanda R; Heckman, Bryan W; Meier, Ellen; Carpenter, Matthew J

    2017-07-01

    Smoking cessation fatigue, or tiredness of attempting to quit smoking, has been posited as a latent construct encompassing loss of motivation, loss of hope in cessation success, decreased self-efficacy, and exhaustion of self-control resources. Despite the potential clinical impact of characterizing cessation fatigue, there is currently no validated measure to assess it. Using a rational scale development approach, we developed a cessation fatigue measure and examined its reliability and construct validity in relation to a) smokers' experience of a recently failed quit attempt (QA) and b) readiness to engage in a subsequent QA. Data were drawn from an online cross-sectional survey of 484 smokers who relapsed from a QA within the past 30days. Exploratory factor analysis identified three factors within the 17-item Cessation Fatigue Scale (CFS), which we labeled: emotional exhaustion, pessimism, and devaluation. High internal consistency was observed for each factor and across the full scale. As expected, CFS overall was positively associated with withdrawal severity and difficulty quitting. CFS was negatively associated with previously validated measures of intention to quit, self-efficacy, and abstinence-related motivational engagement, even after adjusting for nicotine dependence. Findings provide initial validation for a new tool to assess cessation fatigue and contribute needed information on a theory-driven component of cessation-related motivation and relapse risk. Copyright © 2017. Published by Elsevier B.V.

  5. Japanese Guideline for Allergic Rhinitis 2014.

    PubMed

    Okubo, Kimihiro; Kurono, Yuichi; Fujieda, Shigeharu; Ogino, Satoshi; Uchio, Eiichi; Odajima, Hiroshi; Takenaka, Hiroshi

    2014-09-01

    Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 7th edition was published in 2013, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2013. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

  6. Usefulness of a new online patient-specific quality assurance system for respiratory-gated radiotherapy.

    PubMed

    Kurosawa, Tomoyuki; Tachibana, Hidenobu; Moriya, Shunsuke; Miyakawa, Shin; Nishio, Teiji; Sato, Masanori

    2017-11-01

    The accuracy of gated irradiation may decrease when treatment is performed with short "beam-on" times. Also, the dose is subject to variation between treatment sessions if the respiratory rate is irregular. We therefore evaluated the impact of the differences between gated and non-gated treatment on doses using a new online quality assurance (QA) system for respiratory-gated radiotherapy. We generated dose estimation models to associate dose and pulse information using a 0.6 cc Farmer chamber and our QA system. During gated irradiation with each of seven regular and irregular respiratory patterns, with the Farmer chamber readings as references, we evaluated our QA system's accuracy. We then used the QA system to assess the impact of respiratory patterns on dose distribution for three lung and three liver radiotherapy plans. Gated and non-gated plans were generated and compared. There was agreement within 1.7% between the ionization chamber and our system for several regular and irregular motion patterns. For dose distributions with measured errors, there were larger differences between gated and non-gated treatment for high-dose regions within the planned treatment volume (PTV). Compared with a non-gated plan, PTV D 95% for a gated plan decreased by -1.5% to -2.6%. Doses to organs at risk were similar with both plans. Our simple system estimated the radiation dose to the patient using only pulse information from the linac, even during irregular respiration. The quality of gated irradiation for each patient can be verified fraction by fraction. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. 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

  8. 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...

  9. 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...

  10. SU-F-T-344: Commissioning Constant Dose Rate VMAT in the Raystation Treatment Planning System for a Varian Clinac IX

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

    Pursley, J; Gueorguiev, G; Prichard, H

    Purpose: To demonstrate the commissioning of constant dose rate volumetric modulated arc therapy (VMAT) in the Raystation treatment planning system for a Varian Clinac iX with Exact couch. Methods: Constant dose rate (CDR) VMAT is an option in the Raystation treatment planning system, enabling VMAT delivery on Varian linacs without a RapidArc upgrade. Raystation 4.7 was used to commission CDR-VMAT for a Varian Clinac iX. Raystation arc model parameters were selected to match machine deliverability characteristics. A Varian Exact couch model was added to Raystation 4.7 and commissioned for use in VMAT optimization. CDR-VMAT commissioning checks were performed on themore » linac, including patient-specific QA measurements for 10 test patients using both the ArcCHECK from Sun Nuclear Corporation and COMPASS from IBA Dosimetry. Multi-criteria optimization (MCO) in Raystation was used for CDR-VMAT planning. Results: Raystation 4.7 generated clinically acceptable and deliverable CDR-VMAT plans for the Varian Clinac. VMAT plans were optimized including a model of the Exact couch with both rails in the out positions. CDR-VMAT plans generated with MCO in Raystation were dosimetrically comparable to Raystation MCO-generated IMRT plans. Patient-specific QA measurements with the ArcCHECK on the couch showed good agreement with the treatment planning system prediction. Patient-specific, structure-specific, multi-statistical parameter 3D QA measurements with gantry-mounted COMPASS also showed good agreement. Conclusion: Constant dose rate VMAT was successfully modeled in Raystation 4.7 for a Varian Clinac iX, and Raystation’s multicriteria optimization generated constant dose rate VMAT plans which were deliverable and dosimetrically comparable to IMRT plans.« less

  11. MO-FG-CAMPUS-TeP1-05: Rapid and Efficient 3D Dosimetry for End-To-End Patient-Specific QA of Rotational SBRT Deliveries Using a High-Resolution EPID

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

    Yang, Y M; Han, B; Xing, L

    2016-06-15

    Purpose: EPID-based patient-specific quality assurance provides verification of the planning setup and delivery process that phantomless QA and log-file based virtual dosimetry methods cannot achieve. We present a method for EPID-based QA utilizing spatially-variant EPID response kernels that allows for direct calculation of the entrance fluence and 3D phantom dose. Methods: An EPID dosimetry system was utilized for 3D dose reconstruction in a cylindrical phantom for the purposes of end-to-end QA. Monte Carlo (MC) methods were used to generate pixel-specific point-spread functions (PSFs) characterizing the spatially non-uniform EPID portal response in the presence of phantom scatter. The spatially-variant PSFs weremore » decomposed into spatially-invariant basis PSFs with the symmetric central-axis kernel as the primary basis kernel and off-axis representing orthogonal perturbations in pixel-space. This compact and accurate characterization enables the use of a modified Richardson-Lucy deconvolution algorithm to directly reconstruct entrance fluence from EPID images without iterative scatter subtraction. High-resolution phantom dose kernels were cogenerated in MC with the PSFs enabling direct recalculation of the resulting phantom dose by rapid forward convolution once the entrance fluence was calculated. A Delta4 QA phantom was used to validate the dose reconstructed in this approach. Results: The spatially-invariant representation of the EPID response accurately reproduced the entrance fluence with >99.5% fidelity with a simultaneous reduction of >60% in computational overhead. 3D dose for 10{sub 6} voxels was reconstructed for the entire phantom geometry. A 3D global gamma analysis demonstrated a >95% pass rate at 3%/3mm. Conclusion: Our approach demonstrates the capabilities of an EPID-based end-to-end QA methodology that is more efficient than traditional EPID dosimetry methods. Displacing the point of measurement external to the QA phantom reduces the necessary complexity of the phantom itself while offering a method that is highly scalable and inherently generalizable to rotational and trajectory based deliveries. This research was partially supported by Varian.« less

  12. Enriching consumer health vocabulary through mining a social Q&A site: A similarity-based approach.

    PubMed

    He, Zhe; Chen, Zhiwei; Oh, Sanghee; Hou, Jinghui; Bian, Jiang

    2017-05-01

    The widely known vocabulary gap between health consumers and healthcare professionals hinders information seeking and health dialogue of consumers on end-user health applications. The Open Access and Collaborative Consumer Health Vocabulary (OAC CHV), which contains health-related terms used by lay consumers, has been created to bridge such a gap. Specifically, the OAC CHV facilitates consumers' health information retrieval by enabling consumer-facing health applications to translate between professional language and consumer friendly language. To keep up with the constantly evolving medical knowledge and language use, new terms need to be identified and added to the OAC CHV. User-generated content on social media, including social question and answer (social Q&A) sites, afford us an enormous opportunity in mining consumer health terms. Existing methods of identifying new consumer terms from text typically use ad-hoc lexical syntactic patterns and human review. Our study extends an existing method by extracting n-grams from a social Q&A textual corpus and representing them with a rich set of contextual and syntactic features. Using K-means clustering, our method, simiTerm, was able to identify terms that are both contextually and syntactically similar to the existing OAC CHV terms. We tested our method on social Q&A corpora on two disease domains: diabetes and cancer. Our method outperformed three baseline ranking methods. A post-hoc qualitative evaluation by human experts further validated that our method can effectively identify meaningful new consumer terms on social Q&A. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 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

  14. When and why do people post questions about health and illness on Web 2.0-based Q&A sites in Japan.

    PubMed

    Nakayama, Kazuhiro; Nishio, Arisa; Yokoyama, Yukari; Setoyama, Yoko; Togari, Taisuke; Yonekura, Yuki

    2009-01-01

    Web2.0-based Q&A sites such as Yahoo! Answers and OKWave are the fastest-growing sites in Japan. Such sites exploit user-generated content and information-sharing methods and have established point systems and user ratings to reward participation. We analyzed the questions and answers concerning health and illness posted on these sites. We found that the people who posted questions desired to obtain information related to their health problems from various sources, and to seek validation of this information not only by experts but also by people who have undergone similar experiences.

  15. Agar-Silica-Gel Heating Phantom May Be Suitable for Long-Term Quality Assurance of MRgHIFU

    NASA Astrophysics Data System (ADS)

    Partanen, Ari

    2009-04-01

    In MRgHIFU, the purpose of frequent quality assurance is to detect changes in system performance to prevent adverse effects during treatments. Due to high ultrasound intensities in MRgHIFU, it is essential to assure that the procedure is safe and efficacious and that image-based guidance of the treatment is reliable. We aimed to develop a guideline for MRgHIFU QA by acquiring MR temperature maps during ultrasonic heating of an agar-silica-gel phantom over a four month-period using three separate MRgHIFU uterine leiomyoma treatment systems. From this data, the stability of the maximum temperature elevation, the targeting accuracy, and the dimensions of the heated volume were analyzed. Additionally, we studied the sensitivity of these parameters to reveal hypothetical decrease in HIFU performance. After calibration, the mean targeting offsets of the heated volume were observed to be less than 2 mm in the three orthogonal directions. The measured maximum temperature elevation and the length and the width of the heated volume remained consistent throughout the four-month period. Furthermore, it was found that the parameters under investigation were sensitive to reveal the decreased HIFU performance. We conclude that an agar-silica -based phantom is suitable for targeting accuracy and heating properties QA of MRgHIFU system even in long-term use. Moreover, this simple QA method may be used to reveal small changes in HIFU performance assuring consistent functionality and safety of the MRgHIFU system.

  16. Quinacridone-based molecular donors for solution processed bulk-heterojunction organic solar cells.

    PubMed

    Chen, John Jun-An; Chen, Teresa L; Kim, BongSoo; Poulsen, Daniel A; Mynar, Justin L; Fréchet, Jean M J; Ma, Biwu

    2010-09-01

    New soluble quinacridone-based molecules have been developed as electron donor materials for solution-processed organic solar cells. By functionalizing the pristine pigment core of quinacridone with solubilizing alkyl chains and light absorbing/charge transporting thiophene units, i.e., bithiophene (BT) and thienylbenzo[c][1,2,5]thiadiazolethienyl (BTD), we prepared a series of multifunctional quinacridone-based molecules. These molecular donors show intense absorption in the visible spectral region, and the absorption range and intensity are well-tuned by the interaction between the quinacridone core and the incorporated thiophene units. The thin film absorption edge extends with the expansion of molecular conjugation, i.e., 552 nm for N,N'-di(2-ethylhexyl)quinacridone (QA), 592 nm for 2,9-Bis(5'-hexyl-2,2'-bithiophene)-N,N'-di(2-ethylhexyl)quinacridone (QA-BT), and 637 nm for 4-(5-hexylthiophen-2-yl)-7-(thiophen-2-yl)benzo[c][1,2,5]thiadiazole (QA-BTD). The change of molecular structure also influences the electrochemical properties. Observed from cyclic voltammetry measurements, the oxidation and reduction potentials (vs ferrocene) are 0.7 and -1.83 V for QA, 0.54 and -1.76 V for QA-BT, and 0.45 and -1.68 V for QA-BTD. Uniform thin films can be generated from both single component molecular solutions and blend solutions of these molecules with [6,6]-phenyl C70-butyric acid methyl ester (PC70BM). The blend films exhibit space-charge limited current (SCLC) hole mobilities on the order of 1×10(-4) cm(2) V(-1) S(-1). Bulk heterojunction (BHJ) solar cells using these soluble molecules as donors and PC70BM as the acceptor were fabricated. Power conversion efficiencies (PCEs) of up to 2.22% under AM 1.5 G simulated 1 sun solar illumination have been achieved and external quantum efficiencies (EQEs) reach as high as ∼45%.

  17. 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

  18. 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.

  19. 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...

  20. 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.

  1. 40 CFR 98.194 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... byproduct or waste generation rate. (c) You must determine the chemical composition (percent total CaO and percent total MgO) of each type of lime product that is produced and each type of calcined byproduct or...

  2. 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.

  3. TH-A-BRC-00: New Task Groups for External Beam QA: An Overview

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

    NONE

    2016-06-15

    AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

  4. TH-A-BRC-03: AAPM TG218: Measurement Methods and Tolerance Levels for Patient-Specific IMRT Verification QA

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

    Miften, M.

    2016-06-15

    AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

  5. TH-A-BRC-01: AAPM TG-135U1 QA for Robotic Radiosurgery

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

    Dieterich, S.

    AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

  6. 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).

  7. ICPP environmental monitoring report CY-1993: Environmental characterization

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

    Not Available

    1994-05-01

    Summarized in this report are the data collected through Environmental Monitoring programs conducted at the Idaho Chemical Processing Plant (ICPP) by the Environmental Safety & Health (ES&H) Department. This report is published in response to DOE Order 5400.1. This report covers the period from December 21, 1992 through December 20, 1993. 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 all nonradiological wastemore » resulting from the ICPP operations including all airborne, liquid, and solid waste. The ES&H Department updated the Quality Assurance (QA) Project Plan for Environmental Monitoring activities during the 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, WINCO methods were used.« less

  8. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas

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

    Gay, Hiram A., E-mail: hgay@radonc.wustl.edu; Barthold, H. Joseph; Beth Israel Deaconess Medical Center, Boston, MA

    2012-07-01

    Purpose: To define a male and female pelvic normal tissue contouring atlas for Radiation Therapy Oncology Group (RTOG) trials. Methods and Materials: One male pelvis computed tomography (CT) data set and one female pelvis CT data set were shared via the Image-Guided Therapy QA Center. A total of 16 radiation oncologists participated. The following organs at risk were contoured in both CT sets: anus, anorectum, rectum (gastrointestinal and genitourinary definitions), bowel NOS (not otherwise specified), small bowel, large bowel, and proximal femurs. The following were contoured in the male set only: bladder, prostate, seminal vesicles, and penile bulb. The followingmore » were contoured in the female set only: uterus, cervix, and ovaries. A computer program used the binomial distribution to generate 95% group consensus contours. These contours and definitions were then reviewed by the group and modified. Results: The panel achieved consensus definitions for pelvic normal tissue contouring in RTOG trials with these standardized names: Rectum, AnoRectum, SmallBowel, Colon, BowelBag, Bladder, UteroCervix, Adnexa{sub R}, Adnexa{sub L}, Prostate, SeminalVesc, PenileBulb, Femur{sub R}, and Femur{sub L}. Two additional normal structures whose purpose is to serve as targets in anal and rectal cancer were defined: AnoRectumSig and Mesorectum. Detailed target volume contouring guidelines and images are discussed. Conclusions: Consensus guidelines for pelvic normal tissue contouring were reached and are available as a CT image atlas on the RTOG Web site. This will allow uniformity in defining normal tissues for clinical trials delivering pelvic radiation and will facilitate future normal tissue complication research.« less

  9. 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.

  10. On the use of harmonized HCHO and NO2 MAXDOAS measurements for the validation of GOME-2 and OMI satellite sensors

    NASA Astrophysics Data System (ADS)

    Pinardi, Gaia; Hendrick, François; Gielen, Clio; Van Roozendael, Michel; De Smedt, Isabelle; Lambert, Jean-Christopher; Granville, José; Compernolle, Steven; Richter, Andreas; Peters, Enno; Piters, Ankie; Wagner, Thomas; Wang, Yang; Drosoglou, Theano; Bais, Alkis; Wang, Shanshan; Saiz-Lopez, Alfonso

    2017-04-01

    During the last decade, the MAXDOAS technique has been increasingly recognized as a source of Fiducial Reference Measurements (FRM) suitable for the validation of satellite nadir observations of species relevant for climate and air quality like NO2 and HCHO. As part of the EU FP7 QA4ECV (Quality Assurance for Essential Climate Variables; see http://www.qa4ecv.eu/) project, efforts have been recently made to harmonize a network of a dozen of MAXDOAS spectrometers in view of their use to assess the quality of satellite climate data records generated within the same project. Harmonization tasks have addressed both retrieval steps involved in MAXDOAS retrievals, i.e. the DOAS spectral fit providing the differential slant column densities (DSCDs) and the conversion of the retrieved DSCDs into vertical profiles and/or vertical column densities (VCDs). In this work, we illustrate the successive harmonization steps and present the resulting QA4ECV MAXDOAS database v2. The approach adopted for the conversion of slant to vertical columns is based on a simplified look-up-table approach. The strength and limitation of this approach are discussed using reference data retrieved using an optimal estimation scheme. The QA4ECV MAXDOAS database is then used to validate satellite data sets of NO2 and HCHO columns derived from the Aura/OMI and MetOp/GOME-2 sensors. The methodology of comparison, which is also a subject of the QA4ECV project, is reviewed with respect to co-location criteria, impact of vertical and horizontal smoothing and representativeness of validation sites. We conclude by assessing the current strengths and limitations of the existing MAXDOAS datasets for NO2 and HCHO satellite validation.

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

    Cheng, Jing-Jy; Flood, Paul E.; LePoire, David

    In this report, the results generated by RESRAD-RDD version 2.01 are compared with those produced by RESRAD-RDD version 1.7 for different scenarios with different sets of input parameters. RESRAD-RDD version 1.7 is spreadsheet-driven, performing calculations with Microsoft Excel spreadsheets. RESRAD-RDD version 2.01 revamped version 1.7 by using command-driven programs designed with Visual Basic.NET to direct calculations with data saved in Microsoft Access database, and re-facing the graphical user interface (GUI) to provide more flexibility and choices in guideline derivation. Because version 1.7 and version 2.01 perform the same calculations, the comparison of their results serves as verification of both versions.more » The verification covered calculation results for 11 radionuclides included in both versions: Am-241, Cf-252, Cm-244, Co-60, Cs-137, Ir-192, Po-210, Pu-238, Pu-239, Ra-226, and Sr-90. At first, all nuclidespecific data used in both versions were compared to ensure that they are identical. Then generic operational guidelines and measurement-based radiation doses or stay times associated with a specific operational guideline group were calculated with both versions using different sets of input parameters, and the results obtained with the same set of input parameters were compared. A total of 12 sets of input parameters were used for the verification, and the comparison was performed for each operational guideline group, from A to G, sequentially. The verification shows that RESRAD-RDD version 1.7 and RESRAD-RDD version 2.01 generate almost identical results; the slight differences could be attributed to differences in numerical precision with Microsoft Excel and Visual Basic.NET. RESRAD-RDD version 2.01 allows the selection of different units for use in reporting calculation results. The results of SI units were obtained and compared with the base results (in traditional units) used for comparison with version 1.7. The comparison shows that RESRAD-RDD version 2.01 correctly reports calculation results in the unit specified in the GUI.« less

  12. 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...

  13. Long-term observations of tropospheric ozone: GAW Measurement Guidelines

    NASA Astrophysics Data System (ADS)

    Tarasova, Oksana; Galbally, Ian E.; Schultz, Martin G.

    2013-04-01

    The Global Atmosphere Watch (GAW) Programme of the World Meteorological Organization (WMO) coordinates long-term observations of the chemical composition and physical properties of the atmosphere which are relevant for understanding of atmospheric chemistry and climate change. Atmospheric observations of reactive gases (tropospheric ozone, carbon monoxide, volatile organic compounds and nitrogen oxides) coordinated by the GAW Programme complement local and regional scale air quality monitoring efforts. As part of the GAW quality assurance (QA) system detailed measurement guidelines for atmospheric trace species are developed by international expert teams at irregular intervals. The most recent report focuses on continuous in-situ measurements of ozone in the troposphere, performed in particular at continental or island sites with altitudes ranging from sea level to mountain tops. Data Quality Objectives (DQOs) are defined for different applications of the data (e.g. trend analysis and verification of global model forecasts). These DQOs include a thorough discussion of the tolerable level of measurement uncertainty and data completeness. The guidelines present the best practices and practical arrangements adopted by the GAW Programme in order to enable the GAW station network to approach or achieve the defined tropospheric ozone DQOs. The document includes information on the selection of station and measurement locations, required skills and training of staff, recommendations on the measurement technique and the necessary equipment to perform highest quality measurements, rules for conducting the measurements, preparing the data and archiving them, and more. Much emphasis is given to discussions about how to ensure the quality of the data through tracing calibrations back to primary standards, proper calibration and data analysis, etc. In the GAW Programme the QA system is implemented through Central Facilities (Central Calibration Laboratories, World and Regional Calibration Centers and World Data Centers), Scientific Advisory Groups and GAW Training and Education Center. These bodies support primary standards, provide calibration and data archiving facilities, coordinate comparison campaigns, perform stations audit, provide documentation and training of personnel.

  14. A teaching intervention in a contouring dummy run improved target volume delineation in locally advanced non-small cell lung cancer: Reducing the interobserver variability in multicentre clinical studies.

    PubMed

    Schimek-Jasch, Tanja; Troost, Esther G C; Rücker, Gerta; Prokic, Vesna; Avlar, Melanie; Duncker-Rohr, Viola; Mix, Michael; Doll, Christian; Grosu, Anca-Ligia; Nestle, Ursula

    2015-06-01

    Interobserver variability in the definition of target volumes (TVs) is a well-known confounding factor in (multicentre) clinical studies employing radiotherapy. Therefore, detailed contouring guidelines are provided in the prospective randomised multicentre PET-Plan (NCT00697333) clinical trial protocol. This trial compares strictly FDG-PET-based TV delineation with conventional TV delineation in patients with locally advanced non-small cell lung cancer (NSCLC). Despite detailed contouring guidelines, their interpretation by different radiation oncologists can vary considerably, leading to undesirable discrepancies in TV delineation. Considering this, as part of the PET-Plan study quality assurance (QA), a contouring dummy run (DR) consisting of two phases was performed to analyse the interobserver variability before and after teaching. In the first phase of the DR (DR1), radiation oncologists from 14 study centres were asked to delineate TVs as defined by the study protocol (gross TV, GTV; and two clinical TVs, CTV-A and CTV-B) in a test patient. A teaching session was held at a study group meeting, including a discussion of the results focussing on discordances in comparison to the per-protocol solution. Subsequently, the second phase of the DR (DR2) was performed in order to evaluate the impact of teaching. Teaching after DR1 resulted in a reduction of absolute TVs in DR2, as well as in better concordance of TVs. The Overall Kappa(κ) indices increased from 0.63 to 0.71 (GTV), 0.60 to 0.65 (CTV-A) and from 0.59 to 0.63 (CTV-B), demonstrating improvements in overall interobserver agreement. Contouring DRs and study group meetings as part of QA in multicentre clinical trials help to identify misinterpretations of per-protocol TV delineation. Teaching the correct interpretation of protocol contouring guidelines leads to a reduction in interobserver variability and to more consistent contouring, which should consequently improve the validity of the overall study results.

  15. AAPM Medical Physics Practice Guideline 5.a.: Commissioning and QA of Treatment Planning Dose Calculations — Megavoltage Photon and Electron Beams

    PubMed Central

    Das, Indra J.; Feygelman, Vladimir; Fraass, Benedick A.; Kry, Stephen F.; Marshall, Ingrid R.; Mihailidis, Dimitris N.; Ouhib, Zoubir; Ritter, Timothy; Snyder, Michael G.; Fairobent, Lynne

    2015-01-01

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. PMID:26699330

  16. AAPM Medical Physics Practice Guideline 5.a.: Commissioning and QA of Treatment Planning Dose Calculations - Megavoltage Photon and Electron Beams.

    PubMed

    Smilowitz, Jennifer B; Das, Indra J; Feygelman, Vladimir; Fraass, Benedick A; Kry, Stephen F; Marshall, Ingrid R; Mihailidis, Dimitris N; Ouhib, Zoubir; Ritter, Timothy; Snyder, Michael G; Fairobent, Lynne

    2015-09-08

    The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines:• Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.• Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

  17. Operational Support for Instrument Stability through ODI-PPA Metadata Visualization and Analysis

    NASA Astrophysics Data System (ADS)

    Young, M. D.; Hayashi, S.; Gopu, A.; Kotulla, R.; Harbeck, D.; Liu, W.

    2015-09-01

    Over long time scales, quality assurance metrics taken from calibration and calibrated data products can aid observatory operations in quantifying the performance and stability of the instrument, and identify potential areas of concern or guide troubleshooting and engineering efforts. Such methods traditionally require manual SQL entries, assuming the requisite metadata has even been ingested into a database. With the ODI-PPA system, QA metadata has been harvested and indexed for all data products produced over the life of the instrument. In this paper we will describe how, utilizing the industry standard Highcharts Javascript charting package with a customized AngularJS-driven user interface, we have made the process of visualizing the long-term behavior of these QA metadata simple and easily replicated. Operators can easily craft a custom query using the powerful and flexible ODI-PPA search interface and visualize the associated metadata in a variety of ways. These customized visualizations can be bookmarked, shared, or embedded externally, and will be dynamically updated as new data products enter the system, enabling operators to monitor the long-term health of their instrument with ease.

  18. Land ECVs from QA4ECV using an optimal estimation framework

    NASA Astrophysics Data System (ADS)

    Muller, Jan-Peter; Kharbouche, Said; Lewis, Philip; Danne, Olaf; Blessing, Simon; Giering, Ralf; Gobron, Nadine; Lanconelli, Christian; Govaerts, Yves; Schulz, Joerg; Doutriaux-Boucher, Marie; Lattanzio, Alessio; Aoun, Youva

    2017-04-01

    In the ESA-DUE GlobAlbedo project (http://www.GlobAlbedo.org), a 15 year record of land surface albedo was generated from the European VEGETATION & MERIS sensors using optimal estimation. This was based on 3 broadbands (0.4-0.7, 0.7-3, 0.4-3µm) and fused data at level-2 after converting from spectral narrowband to these 3 broadbands with surface BRFs. A 10 year long record of land surface albedo climatology was generated from Collection 5 of the MODIS BRDF product for these same broadbands. This was employed as an a priori estimate for an optimal estimation based retrieval of land surface albedo when there were insufficient samples from the European sensors. This so-called MODIS prior was derived at 1km from the 500m MOD43A1,2 BRDF inputs every 8 days using the QA bits and the method described in the GlobAlbedo ATBD which is available from the website (http://www.globalbedo.org/docs/GlobAlbedo_Albedo_ATBD_V4.12.pdf). In the ESA-STSE WACMOS-ET project, FastOpt generated fapar & LAI based on this GlobAlbedo BRDF with associated per pixel uncertainty using the TIP framework. In the successor EU-FP7-QA4ECV* project, we have developed a 33 year record (1981-2014) of Earth surface spectral and broadband albedo (i.e. including the ocean and sea-ice) using optimal estimation for the land and where available, relevant sensors for "instantaneous" retrievals over the poles (Kharbouche & Muller, this conference). This requires the longest possible land surface spectral and broadband BRDF record that can only be supplied by a 16 year of MODIS Collection 6 BRDFs at 500m but produced on a daily basis. The CEMS Big Data computer at RAL was used to generate 7 spectral bands and 3 broadband BRDF with and without snow and snow_only. We will discuss the progress made since the start of the QA4ECV project on the production of a new fused land surface BRDF/albedo spectral and broadband CDR product based on four European sensors: MERIS, (A)ATSR(2), VEGETATION, PROBA-V and two US sensors: MISR & MODIS. For the European sensors, an uniform atmospheric correction scheme has been employed to generate spectral BRF products and these have all been mapped into MODIS spectral bands whilst the US sensors have employed their own level-2 BRF retrieval schemes with associated uncertainty information. Progress is also demonstrated on the use of TIP for fapar/LAI retrieval from the broadband BRDFs as well as fapar from AVHRR based on retrievals from MERIS and OLCI. In parallel, work has taken place at two of our partners on the production of a new geostationary broadband BRF and associated albedo and their fusion with AVHRR-LTDR for a 33 year record. QA4ECV has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 607405

  19. 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)

  20. SU-F-T-479: Estimation of the Accuracy in Respiratory-Gated Radiotherapy

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

    Kurosawa, T; Miyakawa, S; Sato, M

    Purpose: Irregular respiratory patterns affects dose outputs in respiratorygated radiotherapy and there is no commercially available quality assurance (QA) system for it. We designed and developed a patient specific QA system for respiratory-gated radiotherapy to estimate irradiated output. Methods: Our in-house QA system for gating was composed of a personal computer with the USB-FSIO electronic circuit connecting to the linear accelerator (ONCOR-K, Toshiba Medical Systems). The linac implements a respiratory gating system (AZ-733V, Anzai Medical). During the beam was on, 4.2 V square-wave pulses were continually sent to the system. Our system can receive and count the pulses. At first,more » our system and an oscilloscope were compared to check the performance of our system. Next, basic estimation models were generated when ionization-chamber measurements were performed in gating using regular sinusoidal wave patterns (2.0, 2.5, 4.0, 8.0, 15 sec/cycle). During gated irradiation with the regular patterns, the number of the pulses per one gating window was measured using our system. Correlation between the number of the pulses per one gating and dose per the gating window were assessed to generate the estimation model. Finally, two irregular respiratory patterns were created and the accuracy of the estimation was evaluated. Results: Compared to the oscilloscope, our system worked similarly. The basic models were generated with the accuracy within 0.1%. The results of the gated irradiations with two irregular respiratory patterns show good agreement within 0.4% estimation accuracy. Conclusion: Our developed system shows good estimation for even irregular respiration patterns. The system would be a useful tool to verify the output for respiratory-gated radiotherapy.« less

  1. 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

  2. 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

  3. 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…

  4. EFFECTIVE ACIDITY CONSTANT BEHAVIOR NEAR ZERO CHARGE CONDITIONS

    EPA Science Inventory

    Surface site (>SOH group) acidity reactions require expressions of the form: Ka = [>SOHn-1(z-1)]aH+EXP(-DG/RT)/[>SOHnz] (where all variables have their usual meaning). One can rearrange this expression to generate an effective acidity constant historically defined as: Qa = Ka...

  5. NCI Expands Repository of Cancer Research Models

    Cancer.gov

    NCI is expanding its Patient-Derived Models Repository (PDMR), which generates and distributes models like patient-derived xenografts and organoids. In this Cancer Currents Q&A with Drs. Yvonne Evrard and James Doroshow, learn how the expansion can help cancer researchers make more rapid progress.

  6. 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

  7. 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.

  8. Characteristics of a KA-band third-harmonic peniotron driven by a high-quality linear axis-encircling electron beam

    NASA Astrophysics Data System (ADS)

    Zhao, Xiaoyun; Tuo, Xianguo; Ge, Qing; Peng, Ying

    2017-12-01

    We employ a high-quality linear axis-encircling electron beam generated by a Cuccia coupler to drive a Ka-band third-harmonic peniotron and develop a self-consistent nonlinear calculation code to numerically analyze the characteristics of the designed peniotron. It is demonstrated that through a Cuccia coupler, a 6 kV, 0.5 A pencil beam and an input microwave power of 16 kW at 10 GHz can generate a 37 kV, 0.5 A linear axis-encircling beam, and it is characterized by a very low velocity spread. Moreover, the electron beam guiding center deviation can be adjusted easily. Driven by such a beam, a 30 GHz, Ka-band third-harmonic peniotron is predicted to achieve a conversion efficiency of 51.0% and a microwave output power of 9.44 kW; the results are in good agreement with the Magic3D simulation. Using this code, we studied the factors influencing the peniotron performance, and it can provide some guidelines for the design of a Ka-band third-harmonic peniotron driven by a linear electron beam and can promote the application of high-harmonic peniotrons in practice.

  9. Quality of life in bipolar disorder: towards a dynamic understanding.

    PubMed

    Morton, E; Murray, G; Michalak, E E; Lam, R W; Beaulieu, S; Sharma, V; Cervantes, P; Parikh, S V; Yatham, L N

    2018-05-01

    Although quality of life (QoL) is receiving increasing attention in bipolar disorder (BD) research and practice, little is known about its naturalistic trajectory. The dual aims of this study were to prospectively investigate: (a) the trajectory of QoL under guideline-driven treatment and (b) the dynamic relationship between mood symptoms and QoL. In total, 362 patients with BD receiving guideline-driven treatment were prospectively followed at 3-month intervals for up to 5 years. Mental (Mental Component Score - MCS) and physical (Physical Component Score - PCS) QoL were measured using the self-report SF-36. Clinician-rated symptom data were recorded for mania and depression. Multilevel modelling was used to analyse MCS and PCS over time, QoL trajectories predicted by time-lagged symptoms, and symptom trajectories predicted by time-lagged QoL. MCS exhibited a positive trajectory, while PCS worsened over time. Investigation of temporal relationships between QoL and symptoms suggested bidirectional effects: earlier depressive symptoms were negatively associated with mental QoL, and earlier manic symptoms were negatively associated with physical QoL. Importantly, earlier MCS and PCS were both negatively associated with downstream symptoms of mania and depression. The present investigation illustrates real-world outcomes for QoL under guideline-driven BD treatment: improvements in mental QoL and decrements in physical QoL were observed. The data permitted investigation of dynamic interactions between QoL and symptoms, generating novel evidence for bidirectional effects and encouraging further research into this important interplay. Investigation of relevant time-varying covariates (e.g. medications) was beyond scope. Future research should investigate possible determinants of QoL and the interplay between symptoms and wellbeing/satisfaction-centric measures of QoL.

  10. Photovoltaic system criteria documents. Volume 2: Quality assurance criteria for photovoltaic applications

    NASA Technical Reports Server (NTRS)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    Quality assurance criteria are described for manufacturers and installers of solar photovoltaic tests and applications. Quality oriented activities are outlined to be pursued by the contractor/subcontractor to assure the physical and operational quality of equipment produced is included. In the broad sense, guidelines are provided for establishing a QA organization if none exists. Mainly, criteria is provided to be considered in any PV quality assurance plan selected as appropriate by the responsible Field Center. A framework is established for a systematic approach to ensure that photovoltaic tests and applications are constructed in a timely and cost effective manner.

  11. SP-100 flight qualification testing assessment

    NASA Technical Reports Server (NTRS)

    Jeanmougin, Nanette M.; Moore, Roger M.; Wait, David L.; Jacox, Michael G.

    1988-01-01

    The SP-100 is a compact space power system driven by a nuclear reactor that provides 100 kWe to the user at 200 VDC. The thermal energy generated by the nuclear reactor is converted into electrical energy by passive thermoelectric devices. Various options for tailoring the MIL-STD-1540B guidelines to the SP-100 nuclear power system are discussed. This study aids in selecting the appropriate qualification test program based on the cost, schedule, and test effectiveness of the various options.

  12. The protective immune response produced in dogs after primary vaccination with the LiESP/QA-21 vaccine (CaniLeish®) remains effective against an experimental challenge one year later

    PubMed Central

    2014-01-01

    Control of canine leishmaniasis is an important objective for the benefit of dogs living in or visiting endemic areas and for public health because of the zoonotic nature of this disease. Resistance or susceptibility to developing canine leishmaniasis after exposure to Leishmania infantum is primarily determined by the ability of the immune system to develop an appropriate Th1-dominated specific response to the parasite. For this reason there is a need for effective canine vaccines that can decrease the number of dogs developing progressive infections. In this study, we followed the impact of the LiESP/QA-21 canine vaccine (composed of excreted-secreted proteins of L. infantum and the QA-21 saponin adjuvant), recently launched commercially in Europe, on selected humoral and cellular immune parameters following an infectious intravenous challenge with L. infantum promastigotes administered one year after the primary vaccine course. We also followed parasitological parameters to determine the parasitological status of the challenged dogs. In contrast to controls, vaccinated dogs retained significantly stronger cell-mediated immune responses against the parasite despite a virulent challenge and had significantly lower mean parasite burdens at the end of the study, associated with a lower probability of developing active infections. These results confirm that the immune responses generated by vaccination with LiESP/QA-21 are still effective against an intravenous challenge one year after the primary vaccine course. PMID:24964736

  13. 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.

  14. 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.

  15. 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

  16. Q&A: The sci-fi optimist

    NASA Astrophysics Data System (ADS)

    Merali, Zeeya

    2014-09-01

    Best-selling science-fiction writer Neal Stephenson's works cover everything from cryptography to Sumerian mythology. Ahead of next year's novel Seveneves, he talks about his influences, the stagnation in material technologies, and Hieroglyph, the forthcoming science-fiction anthology that he kick-started to stimulate the next generation of engineers.

  17. 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.

  18. 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.

  19. THE IMPORTANCE OF A SUCCESSFUL QUALITY ASSURANCE (QA) PROGRAM FROM A RESEARCH MANAGER'S PERSPECTIVE

    EPA Science Inventory

    The paper discusses the Air Pollution Prevention and Control Division's Quality Assurance (QA) program and the approaches used to meet QA requirements in the Division. The presentation is a technical manager's perspective of the Division's requirements for and approach to QA in i...

  20. SRT and SBRT: Current practices for QA dosimetry and 3D

    NASA Astrophysics Data System (ADS)

    Benedict, S. H.; Cai, J.; Libby, B.; Lovelock, M.; Schlesinger, D.; Sheng, K.; Yang, W.

    2010-11-01

    The major feature that separates stereotactic radiation therapy (cranial SRT) and stereotactic body radiation therapy (SBRT) from conventional radiation treatment is the delivery of large doses in a few fractions which results in a high biological effective dose (BED). In order to minimize the normal tissue toxicity, quality assurance of the conformation of high doses to the target and rapid fall off doses away from the target is critical. The practice of SRT and SBRT therefore requires a high-level of confidence in the accuracy of the entire treatment delivery process. In SRT and SBRT confidence in this accuracy is accomplished by the integration of modern imaging, simulation, treatment planning and delivery technologies into all phases of the treatment process; from treatment simulation and planning and continuing throughout beam delivery. In this report some of the findings of Task group 101 of the AAPM will be presented which outlines the best-practice guidelines for SBRT. The task group report includes a review of the literature to identify reported clinical findings and expected outcomes for this treatment modality. Information in this task group is provided for establishing an SBRT program, including protocols, equipment, resources, and QA procedures.

  1. ICPP environmental monitoring report, CY 1989

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

    Not Available

    1991-01-01

    Summarized in this report are the data collected through Environmental Monitoring programs conducted at the Idaho Chemical Processing Plant (ICPP) by the Environmental Assurance (EA) Section of the Environmental Compliance and SIS Operations (EC/SIS) Department. Published in response to DOE Order 5484.1, Chap. 3, this report covers the period from December 20, 1988 through December 19, 1989. 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 5,400.05, and themore » State of Idaho Maximum Permissible Concentrations (MPCs). The Environmental Protection Agency (EPA) regulates all nonradiological waste resulting from the ICPP operations including all airborne, liquid, and solid waste. The EA Section completed a Quality Assurance (QA) Plan for Environmental Monitoring activities during the third quarter of 1986. QA activities have resulted in the ICPP's implementation of the Environmental Protection Agency rules and guidelines pertaining to the Collection, analyses, and reporting of environmentally related samples. Where no approved methods for analyses existed for radionuclides, currently used methods were submitted for the EPA approval. 17 figs., 11 tabs.« less

  2. 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

  3. Quality assurance for the clinical implementation of kilovoltage intrafraction monitoring for prostate cancer VMAT

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

    Ng, J. A.; Booth, J. T.; O’Brien, R. T.

    2014-11-01

    Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time 3D tumor monitoring system for cancer radiotherapy. KIM uses the commonly available gantry-mounted x-ray imager as input, making this method potentially more widely available than dedicated real-time 3D tumor monitoring systems. KIM is being piloted in a clinical trial for prostate cancer patients treated with VMAT (NCT01742403). The purpose of this work was to develop clinical process and quality assurance (QA) practices for the clinical implementation of KIM. Methods: Informed by and adapting existing guideline documents from other real-time monitoring systems, KIM-specific QA practices were developed. The following five KIM-specific QA testsmore » were included: (1) static localization accuracy, (2) dynamic localization accuracy, (3) treatment interruption accuracy, (4) latency measurement, and (5) clinical conditions accuracy. Tests (1)–(4) were performed using KIM to measure static and representative patient-derived prostate motion trajectories using a 3D programmable motion stage supporting an anthropomorphic phantom with implanted gold markers to represent the clinical treatment scenario. The threshold for system tolerable latency is <1 s. The tolerances for all other tests are that both the mean and standard deviation of the difference between the programmed trajectory and the measured data are <1 mm. The (5) clinical conditions accuracy test compared the KIM measured positions with those measured by kV/megavoltage (MV) triangulation from five treatment fractions acquired in a previous pilot study. Results: For the (1) static localization, (2) dynamic localization, and (3) treatment interruption accuracy tests, the mean and standard deviation of the difference are <1.0 mm. (4) The measured latency is 350 ms. (5) For the tests with previously acquired patient data, the mean and standard deviation of the difference between KIM and kV/MV triangulation are <1.0 mm. Conclusions: Clinical process and QA practices for the safe clinical implementation of KIM, a novel real-time monitoring system using commonly available equipment, have been developed and implemented for prostate cancer VMAT.« less

  4. 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

  5. SU-F-T-298: The Impact of Modeling the Treatment Couch On Patient Specific VMAT QA

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

    Gelover, E; Dalhart, A; Hyer, D

    2016-06-15

    Purpose: The aim of this work is to quantify the impact of modeling the treatment couch on the passing rate of ion chamber measurements during VMAT quality assurance. Methods: For the initial characterization, attenuation and surface dose measurements were performed following the guidelines of TG-176 for the Civco Universal couch top using an Elekta VersaHD accelerator at an energy of 6 MV. A simulation CT was performed to aid in the creation of contours for representing the shape and size of the couch top in the treatment planning system (TPS). A uniform value of density for the couch wall wasmore » determined by comparing the ratios of ion chamber measurements made in a 30×30×11 cm3 water phantom with the TPS dose values of a plan with the same geometry. At our institution, patient specific quality assurance is performed using a Sun Nuclear ArcCheck with a multi-plug for chamber measurements, a 0.125cc PTW TN31010 chamber, and a Sun Nuclear 1010 electrometer. Ten VMAT plans were transferred into the phantom geometry created in the TPS with two settings: with and without the couch. The chamber measurements were compared to both treatment plans. Results: A maximum attenuation of 3.6% was observed when the gantry angle was set to 120 and 240 degrees, passing obliquely through the couch. A uniform density of 0.6 g/cm3 for the couch wall was determined in the TPS by comparison with measured data. The VMAT ion chamber measurement/plan ratios systematically improved by 1.79% ±0.53% for all patients when the couch was included in the calculation. Conclusion: The attenuation and surface dose changes produced by the Civco couch can generate observable dose difference in VMAT plans. Including a couch model in the phantom plan used for patient specific VMAT QA can improve the ionization chamber agreement by up to ∼2%.« less

  6. 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.

  7. 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.

  8. 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.

  9. Impact of the introduction of weekly radiotherapy quality assurance meetings at one UK cancer centre

    PubMed Central

    Brammer, C V; Allerton, R; Churn, M; Joseph, M; Koh, P; Sayers, I; King, M

    2014-01-01

    Objective: The complexity of radiotherapy planning is increasing rapidly. Delivery and planning is subject to detailed quality assurance (QA) checks. The weakest link is often the oncologists' delineation of the clinical target volume (CTV). Weekly departmental meetings for radiotherapy QA (RTQA) were introduced into the Royal Wolverhampton Hospital, Wolverhampton, UK, in October 2011. This article describes the impact of this on patient care. Methods: CTVs for megavoltage photon radiotherapy courses for all radical, adjuvant and palliative treatments longer than five fractions (with the exception of two field tangential breast treatments not enrolled into clinical trials) were reviewed in the RTQA meeting. Audits were carried out in January 2012 (baseline) and September 2013, each over a 4-week period. Adherence to departmental contouring protocols was assessed and the number of major and minor alterations following peer review were determined. Results: There was no statistically significant difference for major alterations between the two study groups; 8 alterations in 80 patients (10%) for the baseline audit vs 3 alterations from 72 patients (4.2%) in the second audit (p = 0.17). A trend towards a reduction in alterations following peer review was observed. There has, however, been a change in practice resulting in a reduction in variation in CTV definition within our centre and greater adherence to protocols. There is increasing confidence in the quality and constancy of care delivered. Conclusion: Introduction of a weekly QA meeting for target volume definition has facilitated consensus and adoption of departmental clinical guidelines within the unit. Advances in knowledge: The weakest areas in radiotherapy are patient selection and definition of the CTV. Engagement in high-quality RTQA is paramount. This article describes the impact of this in one UK cancer centre. PMID:25251520

  10. Impact of the introduction of weekly radiotherapy quality assurance meetings at one UK cancer centre.

    PubMed

    Brammer, C V; Pettit, L; Allerton, R; Churn, M; Joseph, M; Koh, P; Sayers, I; King, M

    2014-11-01

    The complexity of radiotherapy planning is increasing rapidly. Delivery and planning is subject to detailed quality assurance (QA) checks. The weakest link is often the oncologists' delineation of the clinical target volume (CTV). Weekly departmental meetings for radiotherapy QA (RTQA) were introduced into the Royal Wolverhampton Hospital, Wolverhampton, UK, in October 2011. This article describes the impact of this on patient care. CTVs for megavoltage photon radiotherapy courses for all radical, adjuvant and palliative treatments longer than five fractions (with the exception of two field tangential breast treatments not enrolled into clinical trials) were reviewed in the RTQA meeting. Audits were carried out in January 2012 (baseline) and September 2013, each over a 4-week period. Adherence to departmental contouring protocols was assessed and the number of major and minor alterations following peer review were determined. There was no statistically significant difference for major alterations between the two study groups; 8 alterations in 80 patients (10%) for the baseline audit vs 3 alterations from 72 patients (4.2%) in the second audit (p = 0.17). A trend towards a reduction in alterations following peer review was observed. There has, however, been a change in practice resulting in a reduction in variation in CTV definition within our centre and greater adherence to protocols. There is increasing confidence in the quality and constancy of care delivered. Introduction of a weekly QA meeting for target volume definition has facilitated consensus and adoption of departmental clinical guidelines within the unit. The weakest areas in radiotherapy are patient selection and definition of the CTV. Engagement in high-quality RTQA is paramount. This article describes the impact of this in one UK cancer centre.

  11. TH-A-BRC-02: AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance

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

    Goetsch, S.

    AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

  12. 4D dose simulation in volumetric arc therapy: Accuracy and affecting parameters

    PubMed Central

    Werner, René

    2017-01-01

    Radiotherapy of lung and liver lesions has changed from normofractioned 3D-CRT to stereotactic treatment in a single or few fractions, often employing volumetric arc therapy (VMAT)-based techniques. Potential unintended interference of respiratory target motion and dynamically changing beam parameters during VMAT dose delivery motivates establishing 4D quality assurance (4D QA) procedures to assess appropriateness of generated VMAT treatment plans when taking into account patient-specific motion characteristics. Current approaches are motion phantom-based 4D QA and image-based 4D VMAT dose simulation. Whereas phantom-based 4D QA is usually restricted to a small number of measurements, the computational approaches allow simulating many motion scenarios. However, 4D VMAT dose simulation depends on various input parameters, influencing estimated doses along with mitigating simulation reliability. Thus, aiming at routine use of simulation-based 4D VMAT QA, the impact of such parameters as well as the overall accuracy of the 4D VMAT dose simulation has to be studied in detail–which is the topic of the present work. In detail, we introduce the principles of 4D VMAT dose simulation, identify influencing parameters and assess their impact on 4D dose simulation accuracy by comparison of simulated motion-affected dose distributions to corresponding dosimetric motion phantom measurements. Exploiting an ITV-based treatment planning approach, VMAT treatment plans were generated for a motion phantom and different motion scenarios (sinusoidal motion of different period/direction; regular/irregular motion). 4D VMAT dose simulation results and dose measurements were compared by local 3% / 3 mm γ-evaluation, with the measured dose distributions serving as ground truth. Overall γ-passing rates of simulations and dynamic measurements ranged from 97% to 100% (mean across all motion scenarios: 98% ± 1%); corresponding values for comparison of different day repeat measurements were between 98% and 100%. Parameters of major influence on 4D VMAT dose simulation accuracy were the degree of temporal discretization of the dose delivery process (the higher, the better) and correct alignment of the assumed breathing phases at the beginning of the dose measurements and simulations. Given the high γ-passing rates between simulated motion-affected doses and dynamic measurements, we consider the simulations to provide a reliable basis for assessment of VMAT motion effects that–in the sense of 4D QA of VMAT treatment plans–allows to verify target coverage in hypofractioned VMAT-based radiotherapy of moving targets. Remaining differences between measurements and simulations motivate, however, further detailed studies. PMID:28231337

  13. 4D dose simulation in volumetric arc therapy: Accuracy and affecting parameters.

    PubMed

    Sothmann, Thilo; Gauer, Tobias; Werner, René

    2017-01-01

    Radiotherapy of lung and liver lesions has changed from normofractioned 3D-CRT to stereotactic treatment in a single or few fractions, often employing volumetric arc therapy (VMAT)-based techniques. Potential unintended interference of respiratory target motion and dynamically changing beam parameters during VMAT dose delivery motivates establishing 4D quality assurance (4D QA) procedures to assess appropriateness of generated VMAT treatment plans when taking into account patient-specific motion characteristics. Current approaches are motion phantom-based 4D QA and image-based 4D VMAT dose simulation. Whereas phantom-based 4D QA is usually restricted to a small number of measurements, the computational approaches allow simulating many motion scenarios. However, 4D VMAT dose simulation depends on various input parameters, influencing estimated doses along with mitigating simulation reliability. Thus, aiming at routine use of simulation-based 4D VMAT QA, the impact of such parameters as well as the overall accuracy of the 4D VMAT dose simulation has to be studied in detail-which is the topic of the present work. In detail, we introduce the principles of 4D VMAT dose simulation, identify influencing parameters and assess their impact on 4D dose simulation accuracy by comparison of simulated motion-affected dose distributions to corresponding dosimetric motion phantom measurements. Exploiting an ITV-based treatment planning approach, VMAT treatment plans were generated for a motion phantom and different motion scenarios (sinusoidal motion of different period/direction; regular/irregular motion). 4D VMAT dose simulation results and dose measurements were compared by local 3% / 3 mm γ-evaluation, with the measured dose distributions serving as ground truth. Overall γ-passing rates of simulations and dynamic measurements ranged from 97% to 100% (mean across all motion scenarios: 98% ± 1%); corresponding values for comparison of different day repeat measurements were between 98% and 100%. Parameters of major influence on 4D VMAT dose simulation accuracy were the degree of temporal discretization of the dose delivery process (the higher, the better) and correct alignment of the assumed breathing phases at the beginning of the dose measurements and simulations. Given the high γ-passing rates between simulated motion-affected doses and dynamic measurements, we consider the simulations to provide a reliable basis for assessment of VMAT motion effects that-in the sense of 4D QA of VMAT treatment plans-allows to verify target coverage in hypofractioned VMAT-based radiotherapy of moving targets. Remaining differences between measurements and simulations motivate, however, further detailed studies.

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. Tropospheric NO2 retrieved from OMI, GOME(-2), and SCIAMACHY within the Quality Assurance For Essential Climate Variables (QA4ECV) project: retrieval improvement, harmonization, and quality assurance

    NASA Astrophysics Data System (ADS)

    Folkert Boersma, K.

    2017-04-01

    One of the prime targets of the EU-project Quality Assurance for Essential Climate Variables (QA4ECV, www.qa4ecv.eu) is the generation and subsequent quality assurance of harmonized, long-term data records of ECVs or precursors thereof. Here we report on a new harmonized and improved retrieval algorithm for NO2 columns and its application to spectra measured by the GOME, SCIAMACHY, OMI, and GOME-2(A) sensors over the period 1996-2016. Our community 'best practices' algorithm is based on the classical 3-step DOAS method. It benefits from a thorough comparison and iteration of spectral fitting and air mass factor calculation approaches between IUP Bremen, BIRA, Max Planck Institute for Chemistry, KNMI, WUR, and a number of external partners. For step 1 of the retrieval, we show that improved spectral calibration and the inclusion of liquid water and intensity-offset correction terms in the fitting procedure, lead to 10-30% smaller NO2 slant columns, in better agreement with independent measurements. Moreover, the QA4ECV NO2 slant columns show 15-35% lower uncertainties relative to earlier versions of the spectral fitting algorithm. For step 2, the stratospheric correction, the algorithm relies on the assimilation of NO2 slant columns over remote regions in the Tracer Model 5 (TM5-MP) chemistry transport model. The representation of stratospheric NOy in the model is improved by nudging towards ODIN HNO3:O3 ratios, leading to more realistic NO2 concentrations in the free-running mode, which is relevant at high latitudes near the terminator. The coupling to TM5-Mass Parallel also allows the calculation of air mass factors (AMFs, step 3) from a priori NO2 vertical profiles simulated at a spatial resolution of 1°×1°, so that hotspot gradients are better resolved in the a priori profile shapes. Other AMF improvements include the use of improved cloud information, and a correction for photon scattering in a spherical atmosphere. Preliminary comparisons indicate that the new QA4ECV tropospheric NO2 columns are ±10% lower than operational products, and provide more spatial detail on the horizontal distribution of NO2 in the troposphere. Our comparisons provide more insight in the origin and nature of the retrieval uncertainties. The final QAECV NO2 product therefore contains overall uncertainty estimates for every measurement, but also information on the contribution of uncertainties of each retrieval sub-step to the overall uncertainty budget. We conclude with a presentation of the data format and a verification of the QA4ECV NO2 columns using the traceable quality assurance methodologies developed in the QA4ECV-project, and via validation against independent measurements (using the online QA4ECV Atmospheric Validation Server tool).

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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

  6. SU-F-T-300: Impact of Electron Density Modeling of ArcCHECK Cylindricaldiode Array On 3DVH Patient Specific QA Software Tool Analysis

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

    Patwe, P; Mhatre, V; Dandekar, P

    Purpose: 3DVH software is a patient specific quality assurance tool which estimates the 3D dose to the patient specific geometry with the help of Planned Dose Perturbation algorithm. The purpose of this study is to evaluate the impact of HU value of ArcCHECK phantom entered in Eclipse TPS on 3D dose & DVH QA analysis. Methods: Manufacturer of ArcCHECK phantom provides CT data set of phantom & recommends considering it as a homogeneous phantom with electron density (1.19 gm/cc or 282 HU) close to PMMA. We performed this study on Eclipse TPS (V13, VMS) & trueBEAM STx VMS Linac &more » ArcCHECK phantom (SNC). Plans were generated for 6MV photon beam, 20cm×20cm field size at isocentre & SPD (Source to phantom distance) of 86.7 cm to deliver 100cGy at isocentre. 3DVH software requires patients DICOM data generated by TPS & plan delivered on ArcCHECK phantom. Plans were generated in TPS by assigning different HU values to phantom. We analyzed gamma index & the dose profile for all plans along vertical down direction of beam’s central axis for Entry, Exit & Isocentre dose. Results: The global gamma passing rate (2% & 2mm) for manufacturer recommended HU value 282 was 96.3%. Detector entry, Isocentre & detector exit Doses were 1.9048 (1.9270), 1.00(1.0199) & 0.5078(0.527) Gy for TPS (Measured) respectively.The global gamma passing rate for electron density 1.1302 gm/cc was 98.6%. Detector entry, Isocentre & detector exit Doses were 1.8714 (1.8873), 1.00(0.9988) & 0.5211(0.516) Gy for TPS (Measured) respectively. Conclusion: Electron density value assigned by manufacturer does not hold true for every user. Proper modeling of electron density of ArcCHECK in TPS is essential to avoid systematic error in dose calculation of patient specific QA.« less

  7. A web-based data-querying tool based on ontology-driven methodology and flowchart-based model.

    PubMed

    Ping, Xiao-Ou; Chung, Yufang; Tseng, Yi-Ju; Liang, Ja-Der; Yang, Pei-Ming; Huang, Guan-Tarn; Lai, Feipei

    2013-10-08

    Because of the increased adoption rate of electronic medical record (EMR) systems, more health care records have been increasingly accumulating in clinical data repositories. Therefore, querying the data stored in these repositories is crucial for retrieving the knowledge from such large volumes of clinical data. The aim of this study is to develop a Web-based approach for enriching the capabilities of the data-querying system along the three following considerations: (1) the interface design used for query formulation, (2) the representation of query results, and (3) the models used for formulating query criteria. The Guideline Interchange Format version 3.5 (GLIF3.5), an ontology-driven clinical guideline representation language, was used for formulating the query tasks based on the GLIF3.5 flowchart in the Protégé environment. The flowchart-based data-querying model (FBDQM) query execution engine was developed and implemented for executing queries and presenting the results through a visual and graphical interface. To examine a broad variety of patient data, the clinical data generator was implemented to automatically generate the clinical data in the repository, and the generated data, thereby, were employed to evaluate the system. The accuracy and time performance of the system for three medical query tasks relevant to liver cancer were evaluated based on the clinical data generator in the experiments with varying numbers of patients. In this study, a prototype system was developed to test the feasibility of applying a methodology for building a query execution engine using FBDQMs by formulating query tasks using the existing GLIF. The FBDQM-based query execution engine was used to successfully retrieve the clinical data based on the query tasks formatted using the GLIF3.5 in the experiments with varying numbers of patients. The accuracy of the three queries (ie, "degree of liver damage," "degree of liver damage when applying a mutually exclusive setting," and "treatments for liver cancer") was 100% for all four experiments (10 patients, 100 patients, 1000 patients, and 10,000 patients). Among the three measured query phases, (1) structured query language operations, (2) criteria verification, and (3) other, the first two had the longest execution time. The ontology-driven FBDQM-based approach enriched the capabilities of the data-querying system. The adoption of the GLIF3.5 increased the potential for interoperability, shareability, and reusability of the query tasks.

  8. 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

  9. 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.

  10. 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.

  11. Technical Note: A Feasibility Study of Using the Flat Panel Detector on Linac for the kV X-ray Generator Test.

    PubMed

    Cai, Bin; Dolly, Steven; Kamal, Gregory; Yaddanapudi, Sridhar; Sun, Baozhou; Goddu, S Murty; Mutic, Sasa; Li, Hua

    2018-04-28

    To investigate the feasibility of using kV flat panel detector on linac for consistency evaluations of kV X-ray generator performance. An in-house designed aluminum (Al) array phantom with six 9×9 cm 2 square regions having various thickness was proposed and used in this study. Through XML script-driven image acquisition, kV images with various acquisition settings were obtained using the kV flat panel detector. Utilizing pre-established baseline curves, the consistency of X-ray tube output characteristics including tube voltage accuracy, exposure accuracy and exposure linearity were assessed through image quality assessment metrics including ROI mean intensity, ROI standard deviation (SD) and noise power spectrums (NPS). The robustness of this method was tested on two linacs for a three-month period. With the proposed method, tube voltage accuracy can be verified through conscience check with a 2% tolerance and 2 kVp intervals for forty different kVp settings. The exposure accuracy can be tested with a 4% consistency tolerance for three mAs settings over forty kVp settings. The exposure linearity tested with three mAs settings achieved a coefficient of variation (CV) of 0.1. We proposed a novel approach that uses the kV flat panel detector available on linac for X-ray generator test. This approach eliminates the inefficiencies and variability associated with using third party QA detectors while enabling an automated process. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Characterization of 3D printing techniques: Toward patient specific quality assurance spine-shaped phantom for stereotactic body radiation therapy.

    PubMed

    Kim, Min-Joo; Lee, Seu-Ran; Lee, Min-Young; Sohn, Jason W; Yun, Hyong Geon; Choi, Joon Yong; Jeon, Sang Won; Suh, Tae Suk

    2017-01-01

    Development and comparison of spine-shaped phantoms generated by two different 3D-printing technologies, digital light processing (DLP) and Polyjet has been purposed to utilize in patient-specific quality assurance (QA) of stereotactic body radiation treatment. The developed 3D-printed spine QA phantom consisted of an acrylic body phantom and a 3D-printed spine shaped object. DLP and Polyjet 3D printers using a high-density acrylic polymer were employed to produce spine-shaped phantoms based on CT images. Image fusion was performed to evaluate the reproducibility of our phantom, and the Hounsfield units (HUs) were measured based on each CT image. Two different intensity-modulated radiotherapy plans based on both CT phantom image sets from the two printed spine-shaped phantoms with acrylic body phantoms were designed to deliver 16 Gy dose to the planning target volume (PTV) and were compared for target coverage and normal organ-sparing. Image fusion demonstrated good reproducibility of the developed phantom. The HU values of the DLP- and Polyjet-printed spine vertebrae differed by 54.3 on average. The PTV Dmax dose for the DLP-generated phantom was about 1.488 Gy higher than that for the Polyjet-generated phantom. The organs at risk received a lower dose for the 3D printed spine-shaped phantom image using the DLP technique than for the phantom image using the Polyjet technique. Despite using the same material for printing the spine-shaped phantom, these phantoms generated by different 3D printing techniques, DLP and Polyjet, showed different HU values and these differently appearing HU values according to the printing technique could be an extra consideration for developing the 3D printed spine-shaped phantom depending on the patient's age and the density of the spinal bone. Therefore, the 3D printing technique and materials should be carefully chosen by taking into account the condition of the patient in order to accurately produce 3D printed patient-specific QA phantom.

  13. Characterization of 3D printing techniques: Toward patient specific quality assurance spine-shaped phantom for stereotactic body radiation therapy

    PubMed Central

    Lee, Min-Young; Sohn, Jason W.; Yun, Hyong Geon; Choi, Joon Yong; Jeon, Sang Won

    2017-01-01

    Development and comparison of spine-shaped phantoms generated by two different 3D-printing technologies, digital light processing (DLP) and Polyjet has been purposed to utilize in patient-specific quality assurance (QA) of stereotactic body radiation treatment. The developed 3D-printed spine QA phantom consisted of an acrylic body phantom and a 3D-printed spine shaped object. DLP and Polyjet 3D printers using a high-density acrylic polymer were employed to produce spine-shaped phantoms based on CT images. Image fusion was performed to evaluate the reproducibility of our phantom, and the Hounsfield units (HUs) were measured based on each CT image. Two different intensity-modulated radiotherapy plans based on both CT phantom image sets from the two printed spine-shaped phantoms with acrylic body phantoms were designed to deliver 16 Gy dose to the planning target volume (PTV) and were compared for target coverage and normal organ-sparing. Image fusion demonstrated good reproducibility of the developed phantom. The HU values of the DLP- and Polyjet-printed spine vertebrae differed by 54.3 on average. The PTV Dmax dose for the DLP-generated phantom was about 1.488 Gy higher than that for the Polyjet-generated phantom. The organs at risk received a lower dose for the 3D printed spine-shaped phantom image using the DLP technique than for the phantom image using the Polyjet technique. Despite using the same material for printing the spine-shaped phantom, these phantoms generated by different 3D printing techniques, DLP and Polyjet, showed different HU values and these differently appearing HU values according to the printing technique could be an extra consideration for developing the 3D printed spine-shaped phantom depending on the patient’s age and the density of the spinal bone. Therefore, the 3D printing technique and materials should be carefully chosen by taking into account the condition of the patient in order to accurately produce 3D printed patient-specific QA phantom. PMID:28472175

  14. SU-F-I-15: Evaluation of a New MR-Compatible Respiratory Motion Device at 3T

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

    Soliman, A; Sunnybrook Health Sciences Centre, Toronto, ON; Chugh, B

    Purpose: Recent advances in MRI-guided radiotherapy has inspired the development of MRI-compatible motion devices that simulate patient periodic motion in the scanner, particularly respiratory motion. Most commercial devices rely on non MR-safe ferromagnetic stepper motors which are not practical for regular QA testing. This work evaluates the motion performance of a new fully MRI compatible respiratory motion device at 3T. Methods: The QUASAR™ MRI-compatible respiratory motion phantom has been recently developed by Modus QA Inc., London, ON, Canada. The prototype is constructed from diamagnetic materials with linear motion generated using MRI-compatible piezoelectric motors that can be safely inserted in themore » scanner bore. The tumor was represented by a fillable sphere and is attached to the linear motion generator. The spherical tumor-representative and its surroundings were filled with different concentrations of MnCl2 to produce realistic relaxation times. The motion was generated along the longitudinal (H/F) axis of the bore using sinusoidal reference waveform (amplitude = 15 mm, frequency 0.25 Hz). Imaging was then performed on 3T Philips Achieva using a 32-channel cardiac coil. Fast 2D spoiled gradient-echo was used with a spatial resolution of 1.8 × 1.8 mm{sup 2} and slice thickness of 4 mm. The motion waveform was then measured on the resultant image series by tracking the centroid of the sphere through the time series. This image-derived measured motion was compared to the software-generated reference waveform. Results: No visible distortions from the device were observed on the images. Excellent agreement between the measured and the reference waveforms were obtained. Negligible motion was observed in the lateral (R/L) direction. Conclusion: Our investigation demonstrates that this piezo-electric motor design is effective at simulating periodic motion and is a potential candidate for MRI-radiotherapy respiratory motion simulation. Future work should focus on evaluating non-sinusoidal waveforms, fast 3D pulse sequences, and perform dosimetric QA.« less

  15. 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)…

  16. Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States

    PubMed Central

    Manangan, Lilia Ponce; Tryon, Cheryl; Magee, Elvin; Miramontes, Roque

    2012-01-01

    Introduction. The Centers for Disease Control and Prevention (CDC)'s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009. Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit. Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions' QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012. Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality. PMID:22685648

  17. 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

  18. [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.

  19. AGU Climate Scientists Offer Question-and-Answer Service for Media

    NASA Astrophysics Data System (ADS)

    Jackson, Stacy

    2010-03-01

    In fall 2009, AGU launched a member-driven pilot project to improve the accuracy of climate science coverage in the media and to improve public understanding of climate science. The project's goal was to increase the accessibility of climate science experts to journalists across the full spectrum of media outlets. As a supplement to the traditional one-to-one journalist-expert relationship model, the project tested the novel approach of providing a question-and-answer (Q&A) service with a pool of expert scientists and a Web-based interface with journalists. Questions were explicitly limited to climate science to maintain a nonadvocacy, nonpartisan perspective.

  20. Teacher-Generated Final Exams in High School Science: Content, Rigor, and Assessment Literacy

    NASA Astrophysics Data System (ADS)

    Lach, Michael

    This study investigates a large collection of teacher-generated end-of-semester final exams from Chicago Public School high school science classrooms in order to explore the depth and breadth of content that students learn in science classrooms. Teachers focus on a specific set of scientific content that is driven by district guidelines and popular textbooks but not particularly aligned to standards. To most teachers, rigor means coverage instead of intellectual press. The assessments, while unsophisticated, seem to be delivering what is expected of them---a way to mimic the most basic format of the ACT exam quickly. There was little variation among high poverty and low poverty schools, matching national data and indicating issues that are more due to a particular culture of science teaching and learning than driven by particular contexts. The study identifies implications for the observed homogeneity of final exam rigor and content, identifies gaps between how the routine of final exams are design and implemented in schools, and discusses similar methodological efforts that could enhance the ability of schools and districts to access useful information about the technical core of instruction.

  1. Agile data management for curation of genomes to watershed datasets

    NASA Astrophysics Data System (ADS)

    Varadharajan, C.; Agarwal, D.; Faybishenko, B.; Versteeg, R.

    2015-12-01

    A software platform is being developed for data management and assimilation [DMA] as part of the U.S. Department of Energy's Genomes to Watershed Sustainable Systems Science Focus Area 2.0. The DMA components and capabilities are driven by the project science priorities and the development is based on agile development techniques. The goal of the DMA software platform is to enable users to integrate and synthesize diverse and disparate field, laboratory, and simulation datasets, including geological, geochemical, geophysical, microbiological, hydrological, and meteorological data across a range of spatial and temporal scales. The DMA objectives are (a) developing an integrated interface to the datasets, (b) storing field monitoring data, laboratory analytical results of water and sediments samples collected into a database, (c) providing automated QA/QC analysis of data and (d) working with data providers to modify high-priority field and laboratory data collection and reporting procedures as needed. The first three objectives are driven by user needs, while the last objective is driven by data management needs. The project needs and priorities are reassessed regularly with the users. After each user session we identify development priorities to match the identified user priorities. For instance, data QA/QC and collection activities have focused on the data and products needed for on-going scientific analyses (e.g. water level and geochemistry). We have also developed, tested and released a broker and portal that integrates diverse datasets from two different databases used for curation of project data. The development of the user interface was based on a user-centered design process involving several user interviews and constant interaction with data providers. The initial version focuses on the most requested feature - i.e. finding the data needed for analyses through an intuitive interface. Once the data is found, the user can immediately plot and download data through the portal. The resulting product has an interface that is more intuitive and presents the highest priority datasets that are needed by the users. Our agile approach has enabled us to build a system that is keeping pace with the science needs while utilizing limited resources.

  2. Peer Review Improves the Quality of MCQ Examinations

    ERIC Educational Resources Information Center

    Malau-Aduli, Bunmi S.; Zimitat, Craig

    2012-01-01

    The aim of this study was to assess the effect of the introduction of peer review processes on the quality of multiple-choice examinations in the first three years of an Australian medical course. The impact of the peer review process and overall quality assurance (QA) processes were evaluated by comparing the examination data generated in earlier…

  3. Capabilities Report 2012, West Desert Test Center

    DTIC Science & Technology

    2012-03-12

    132 FT- IR Spectrometer...electronic system files, paper logs, production batch records, QA/QC data, and PCR data generated during a test. Data analysts also track and QC raw data...Advantage +SL bench-top freeze dryers achieve shelf temperatures as low as -57°C and condenser temperatures to -67°C. The bulk milling facility produces

  4. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR ELECTRONIC DATA QA CHECK (HAND ENTRY AND SCANNED) (UA-D-26.0)

    EPA Science Inventory

    The purpose of this SOP is to define the procedure for conducting a data accuracy check on a randomly selected 10% sample of all electronic data. This procedure applies to the cleaned, working databases generated during the Arizona NHEXAS project and the "Border" study. Keyword...

  5. A Consumer's Guide to Benchmark Dose Models: Results of U.S. EPA Testing of 14 Dichotomous, 8 Continuous, and 6 Developmental Models (Presentation)

    EPA Science Inventory

    Benchmark dose risk assessment software (BMDS) was designed by EPA to generate dose-response curves and facilitate the analysis, interpretation and synthesis of toxicological data. Partial results of QA/QC testing of the EPA benchmark dose software (BMDS) are presented. BMDS pr...

  6. Perturbing laser field dependent high harmonic phase modulations

    NASA Astrophysics Data System (ADS)

    Li, Zhengyan; Kong, Fanqi; Brown, Graham; Hammond, TJ; Ko, Dong-Hyuk; Zhang, Chunmei; Corkum, P. B.

    2018-06-01

    A perturbing laser pulse modulates and controls the phase of the high harmonic radiation driven by an intense fundamental pulse. Thus, a structured wave front can impress a specific spatial phase onto the generated high harmonic wave front. This modulation procedure leads to all-optical spatial light modulators for VUV or XUV radiation created by high harmonic generation. Here, through theoretical analysis and experiment, we study the correlation between the high harmonic phase modulations and the perturbing laser field amplitude and phase, providing guidelines for practical high harmonic spatial light modulators. In addition, we show that the petahertz optical oscilloscope for measuring electric fields of a perturbing beam is most robust using low order harmonics, far from the cut-off.

  7. 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.

  8. 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.

  9. Impact of a clinical guideline for prescribing antibiotics to inpatients reporting penicillin or cephalosporin allergy.

    PubMed

    Blumenthal, Kimberly G; Shenoy, Erica S; Varughese, Christy A; Hurwitz, Shelley; Hooper, David C; Banerji, Aleena

    2015-10-01

    Self-reported penicillin allergy infrequently reflects an inability to tolerate penicillins. Inpatients reporting penicillin allergy receive alternative antibiotics that might be broader spectrum, more toxic, or less effective. To develop and assess a clinical guideline for the general inpatient provider that directs taking a history and prescribing antibiotics for patients with penicillin or cephalosporin allergy. A guideline was implemented to assist providers with assessing allergy history and prescribing antibiotics for patients with reported penicillin or cephalosporin allergy. The guideline used a standard 2-step graded challenge or test dose. A quasi-experimental study was performed to assess safety, feasibility, and impact on antibiotic use by comparing treatment 21 months before guideline implementation with 12 months after guideline implementation. Significantly more test doses to β-lactam antibiotics were performed monthly after vs before guideline implementation (median 14.5, interquartile range 13-16.25, vs 2, interquartile range 1-3.25, P < .001). Seven adverse drug reactions occurred during guideline-driven test doses, with no significant difference in rate (3.9% vs 6.1%, P = .44) or severity (P > .5) between periods. Guideline-driven test doses decreased alternative antimicrobial therapy after the test dose, including vancomycin (68.3% vs 37.2%, P < .001), aztreonam (11.5% vs 0.5%, P < .001), aminoglycosides (6.0% vs 1.1%, P = .004), and fluoro quinolones (15.3% vs 3.3%, P < .001). The implementation of an inpatient antibiotic prescribing guideline for patients with penicillin or cephalosporin allergy was associated with an almost 7-fold increase in the number of test doses to β-lactams without increased adverse drug reactions. Patients assessed with guideline-driven test doses were observed to have significantly decreased alternative antibiotic exposure. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. The use and QA of biologically related models for treatment planning: short report of the TG-166 of the therapy physics committee of the AAPM.

    PubMed

    Allen Li, X; Alber, Markus; Deasy, Joseph O; Jackson, Andrew; Ken Jee, Kyung-Wook; Marks, Lawrence B; Martel, Mary K; Mayo, Charles; Moiseenko, Vitali; Nahum, Alan E; Niemierko, Andrzej; Semenenko, Vladimir A; Yorke, Ellen D

    2012-03-01

    Treatment planning tools that use biologically related models for plan optimization and/or evaluation are being introduced for clinical use. A variety of dose-response models and quantities along with a series of organ-specific model parameters are included in these tools. However, due to various limitations, such as the limitations of models and available model parameters, the incomplete understanding of dose responses, and the inadequate clinical data, the use of biologically based treatment planning system (BBTPS) represents a paradigm shift and can be potentially dangerous. There will be a steep learning curve for most planners. The purpose of this task group is to address some of these relevant issues before the use of BBTPS becomes widely spread. In this report, the authors (1) discuss strategies, limitations, conditions, and cautions for using biologically based models and parameters in clinical treatment planning; (2) demonstrate the practical use of the three most commonly used commercially available BBTPS and potential dosimetric differences between biologically model based and dose-volume based treatment plan optimization and evaluation; (3) identify the desirable features and future directions in developing BBTPS; and (4) provide general guidelines and methodology for the acceptance testing, commissioning, and routine quality assurance (QA) of BBTPS.

  11. 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.

  12. WE-A-210-00: Educational: Diagnostic Ultrasound QA

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

    NONE

    This presentation will focus on the present role of ultrasound medical physics in clinical practices. The first part of the presentation will provide an overview of ultrasound QC methodologies and testing procedures. A brief review of ultrasound phantoms utilized in these testing procedures will be presented. The second part of the presentation will summarize ultrasound imaging technical standards and professional guidelines by American College of Radiology (ACR), American Institute of Ultrasound in Medicine (AIUM), American Association of Physicists in Medicine (AAPM) and International Electrotechnical Commission (IEC). The current accreditation requirements by ACR and AIUM for ultrasound practices will be describedmore » and the practical aspects of implementing QC programs to be compliant with these requirements will be discussed. Learning Objectives: Achieve familiarity with common ultrasound QC test methods and ultrasound phantoms. Understand the coverage of the existing testing standards and professional guidelines on diagnostic ultrasound imaging. Learn what a medical physicist needs to know about ultrasound program accreditation and be able to implement ultrasound QC programs accordingly.« less

  13. Clinical practice guideline development manual: a quality-driven approach for translating evidence into action.

    PubMed

    Rosenfeld, Richard M; Shiffman, Richard N

    2009-06-01

    Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing health-care variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective-or potentially harmful-interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. This manual describes the principles and practices used successfully by the American Academy of Otolaryngology-Head and Neck Surgery to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for action-ready recommendations with multidisciplinary applicability. The development process, which allows moving from conception to completion in 12 months, emphasizes a logical sequence of key action statements supported by amplifying text, evidence profiles, and recommendation grades that link action to evidence. As clinical practice guidelines become more prominent as a key metric of quality health care, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are-and are not-and how they are best utilized to improve care. The information in this manual should help clinicians and organizations achieve these goals.

  14. 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.

  15. 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.

  16. The Impact of Quality Assurance Assessment on Diffusion Tensor Imaging Outcomes in a Large-Scale Population-Based Cohort

    PubMed Central

    Roalf, David R.; Quarmley, Megan; Elliott, Mark A.; Satterthwaite, Theodore D.; Vandekar, Simon N.; Ruparel, Kosha; Gennatas, Efstathios D.; Calkins, Monica E.; Moore, Tyler M.; Hopson, Ryan; Prabhakaran, Karthik; Jackson, Chad T.; Verma, Ragini; Hakonarson, Hakon; Gur, Ruben C.; Gur, Raquel E.

    2015-01-01

    Background Diffusion tensor imaging (DTI) is applied in investigation of brain biomarkers for neurodevelopmental and neurodegenerative disorders. However, the quality of DTI measurements, like other neuroimaging techniques, is susceptible to several confounding factors (e.g. motion, eddy currents), which have only recently come under scrutiny. These confounds are especially relevant in adolescent samples where data quality may be compromised in ways that confound interpretation of maturation parameters. The current study aims to leverage DTI data from the Philadelphia Neurodevelopmental Cohort (PNC), a sample of 1,601 youths ages of 8–21 who underwent neuroimaging, to: 1) establish quality assurance (QA) metrics for the automatic identification of poor DTI image quality; 2) examine the performance of these QA measures in an external validation sample; 3) document the influence of data quality on developmental patterns of typical DTI metrics. Methods All diffusion-weighted images were acquired on the same scanner. Visual QA was performed on all subjects completing DTI; images were manually categorized as Poor, Good, or Excellent. Four image quality metrics were automatically computed and used to predict manual QA status: Mean voxel intensity outlier count (MEANVOX), Maximum voxel intensity outlier count (MAXVOX), mean relative motion (MOTION) and temporal signal-to-noise ratio (TSNR). Classification accuracy for each metric was calculated as the area under the receiver-operating characteristic curve (AUC). A threshold was generated for each measure that best differentiated visual QA status and applied in a validation sample. The effects of data quality on sensitivity to expected age effects in this developmental sample were then investigated using the traditional MRI diffusion metrics: fractional anisotropy (FA) and mean diffusivity (MD). Finally, our method of QA is compared to DTIPrep. Results TSNR (AUC=0.94) best differentiated Poor data from Good and Excellent data. MAXVOX (AUC=0.88) best differentiated Good from Excellent DTI data. At the optimal threshold, 88% of Poor data and 91% Good/Excellent data were correctly identified. Use of these thresholds on a validation dataset (n=374) indicated high accuracy. In the validation sample 83% of Poor data and 94% of Excellent data was identified using thresholds derived from the training sample. Both FA and MD were affected by the inclusion of poor data in an analysis of age, sex and race in a matched comparison sample. In addition, we show that the inclusion of poor data results in significant attenuation of the correlation between diffusion metrics (FA and MD) and age during a critical neurodevelopmental period. We find higher correspondence between our QA method and DTIPrep for Poor data, but we find our method to be more robust for apparently high-quality images. Conclusion Automated QA of DTI can facilitate large-scale, high-throughput quality assurance by reliably identifying both scanner and subject induced imaging artifacts. The results present a practical example of the confounding effects of artifacts on DTI analysis in a large population-based sample, and suggest that estimates of data quality should not only be reported but also accounted for in data analysis, especially in studies of development. PMID:26520775

  17. 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

  18. 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

  19. 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.

  20. [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.

  1. 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

  2. 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...

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. SU-F-I-02: Comparative Analysis and Constancy Check of Image Quality Parameters for Three Linear Accelerators Per TG 142 Protocol

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

    Altundal, Y; Pokhrel, D; Jiang, H

    Purpose: To compare image quality parameters and assessing the image stability of three different linear accelerators (linac) for 2D and 3D imaging modalities: planar kV, MV images and cone-beam CT (CBCT). Methods: QCkV1, QC-3 and Cathpan-600 phantoms were utilized to acquire kV, MV and CBCT images respectively on monthly basis per TG142 QA protocol for over 2 years on 21Ex, NovalisTx and TrueBeam linacs. DICOM images were analyzed with the help of QA analysis software: PIPsPro from Standard Imaging. For planar kV and MV images, planar spatial resolution, contrast to noise ratio (CNR) and noise; for CBCT, HU values weremore » collected and analyzed. Results: Two years of monthly QA measurements were analyzed for the planar and CBCT images. Values were normalized to the mean and the standard deviations (STD) are presented. For the kV planar radiographic images the STD of spatial resolution for f30, f40, f50, CNR and noise for 21Ex are 0.006, 0.011, 0.013, 0.046, 0.026; Novalis-Tx are 0.009, 0.016, 0.016, 0.067, 0.053 ; TrueBeam are 0.007, 0.005, 0.009, 0.017, 0.016 respectively. For the MV planar radiographic images, the STD of spatial resolution for f30, f40, f50, CNR and noise for 21Ex are 0.009, 0.010, 0.008, 0.023, 0.023; for Novalix-Tx are 0.012, 0.010, 0.008, 0.029, 0.023 and for TrueBeam are 0.010, 0.010, 0.007, 0.022, 0.022 respectively. For the CBCT images, HU constancies of Air, Polystyrene, Teflon, PMP, LDPE and Delrin for 21Ex are 0.014, 0.070, 0.031, 0.053, 0.076, 0.087; for Novalis Tx are 0.019, 0.047, 0.035, 0.059, 0.077, 0.087 and for TrueBeam are 0.011, 0.044, 0.025, 0.044, 0.056, 0.020 respectively. Conclusion: These Imaging QA results demonstrated that the TrueBeam, performed better in terms of image quality stability for both kV planer and CBCT images as well as EPID MV images, however other two linacs were also satisfied TG142 guidelines.« less

  9. 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.

  10. A comprehensive and efficient daily quality assurance for PBS proton therapy

    NASA Astrophysics Data System (ADS)

    Actis, O.; Meer, D.; König, S.; Weber, D. C.; Mayor, A.

    2017-03-01

    There are several general recommendations for quality assurance (QA) measures, which have to be performed at proton therapy centres. However, almost each centre uses a different therapy system. In particular, there is no standard procedure for centres employing pencil beam scanning and each centre applies a specific QA program. Gantry 2 is an operating therapy system which was developed at PSI and relies on the most advanced technological innovations. We developed a comprehensive daily QA program in order to verify the main beam characteristics to assure the functionality of the therapy delivery system and the patient safety system. The daily QA program entails new hardware and software solutions for a highly efficient clinical operation. In this paper, we describe a dosimetric phantom used for verifying the most critical beam parameters and the software architecture developed for a fully automated QA procedure. The connection between our QA software and the database allows us to store the data collected on a daily basis and use it for trend analysis over longer periods of time. All the data presented here have been collected during a time span of over two years, since the beginning of the Gantry 2 clinical operation in 2013. Our procedure operates in a stable way and delivers the expected beam quality. The daily QA program takes only 20 min. At the same time, the comprehensive approach allows us to avoid most of the weekly and monthly QA checks and increases the clinical beam availability.

  11. 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.

  12. Effective Integration of Technology and Instruction. Q&A with Michael Jay. REL Mid-Atlantic Educator Effectiveness Webinar Series

    ERIC Educational Resources Information Center

    Regional Educational Laboratory Mid-Atlantic, 2015

    2015-01-01

    In this webinar, long-time educator and developer of education technology Michael Jay discussed the importance of using technology to support learning and gave examples of how teachers can integrate technology into their instruction based on the Common Core State Standards and the Next Generation Science Standards. The PowerPoint presentation and…

  13. In vivo investigation of twin-screw extruded lipid implants for vaccine delivery.

    PubMed

    Even, Marie-Paule; Young, Katie; Winter, Gerhard; Hook, Sarah; Engert, Julia

    2014-07-01

    Sustained release systems have become the focus of attention in vaccine delivery as they may reduce or prevent the need for repeated dosing. In this work, lipid implants were prepared by twin-screw extrusion and investigated as vaccine delivery systems in vivo. The lipid implants consisted of cholesterol, soybean lecithin, and Dynasan 114. Ovalbumin (OVA) was employed as a model antigen and Quil-A (QA) as an adjuvant. In addition, OVA and QA loaded liposomes were prepared by the lipid-film hydration method, freeze-dried and then added to the lipid matrix prior to extrusion. Implants were administered subcutaneously and the kinetics of antigen release as well as the overall immune response stimulated were analysed by measuring CD4(+) and CD8(+) T cell proliferation, OVA-specific IgG production as well as cytokine (IFN-γ and IL4) secretion. Vaccine release from the implants was completed by 14 days. Inclusion of adjuvant into the implants was required for the generation of cellular and humoral immune responses. Inclusion of liposomes into the implant did not enhance the resulting immune responses generated. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. 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.

  15. 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...

  16. 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.

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. Realistic simulations of the coupling between the protomotive force and the mechanical rotation of the F0-ATPase

    PubMed Central

    Mukherjee, Shayantani; Warshel, Arieh

    2012-01-01

    The molecular origin of the action of the F0 proton gradient-driven rotor presents a major puzzle despite significant structural advances. Although important conceptual models have provided guidelines of how such systems should work, it has been challenging to generate a structure-based molecular model using physical principles that will consistently lead to the unidirectional proton-driven rotational motion during ATP synthesis. This work uses a coarse-grained (CG) model to simulate the energetics of the F0-ATPase system in the combined space defined by the rotational coordinate and the proton transport (PTR) from the periplasmic side (P) to the cytoplasmic side (N). The model establishes the molecular origin of the rotation, showing that this effect is due to asymmetry in the energetics of the proton path rather than only the asymmetry of the interaction of the Asp on the c-ring helices and Arg on the subunit-a. The simulation provides a clear conceptual background for further exploration of the electrostatic basis of proton-driven mechanochemical systems. PMID:22927379

  3. Comprehensive Genomic Profiling Facilitates Implementation of the National Comprehensive Cancer Network Guidelines for Lung Cancer Biomarker Testing and Identifies Patients Who May Benefit From Enrollment in Mechanism-Driven Clinical Trials.

    PubMed

    Suh, James H; Johnson, Adrienne; Albacker, Lee; Wang, Kai; Chmielecki, Juliann; Frampton, Garrett; Gay, Laurie; Elvin, Julia A; Vergilio, Jo-Anne; Ali, Siraj; Miller, Vincent A; Stephens, Philip J; Ross, Jeffrey S

    2016-06-01

    The National Comprehensive Cancer Network (NCCN) guidelines for patients with metastatic non-small cell lung cancer (NSCLC) recommend testing for EGFR, BRAF, ERBB2, and MET mutations; ALK, ROS1, and RET rearrangements; and MET amplification. We investigated the feasibility and utility of comprehensive genomic profiling (CGP), a hybrid capture-based next-generation sequencing (NGS) test, in clinical practice. CGP was performed to a mean coverage depth of 576× on 6,832 consecutive cases of NSCLC (2012-2015). Genomic alterations (GAs) (point mutations, small indels, copy number changes, and rearrangements) involving EGFR, ALK, BRAF, ERBB2, MET, ROS1, RET, and KRAS were recorded. We also evaluated lung adenocarcinoma (AD) cases without GAs, involving these eight genes. The median age of the patients was 64 years (range: 13-88 years) and 53% were female. Among the patients studied, 4,876 (71%) harbored at least one GA involving EGFR (20%), ALK (4.1%), BRAF (5.7%), ERBB2 (6.0%), MET (5.6%), ROS1 (1.5%), RET (2.4%), or KRAS (32%). In the remaining cohort of lung AD without these known drivers, 273 cancer-related genes were altered in at least 0.1% of cases, including STK11 (21%), NF1 (13%), MYC (9.8%), RICTOR (6.4%), PIK3CA (5.4%), CDK4 (4.3%), CCND1 (4.0%), BRCA2 (2.5%), NRAS (2.3%), BRCA1 (1.7%), MAP2K1 (1.2%), HRAS (0.7%), NTRK1 (0.7%), and NTRK3 (0.2%). CGP is practical and facilitates implementation of the NCCN guidelines for NSCLC by enabling simultaneous detection of GAs involving all seven driver oncogenes and KRAS. Furthermore, without additional tissue use or cost, CGP identifies patients with "pan-negative" lung AD who may benefit from enrollment in mechanism-driven clinical trials. National Comprehensive Cancer Network guidelines for patients with metastatic non-small cell lung cancer (NSCLC) recommend testing for several genomic alterations (GAs). The feasibility and utility of comprehensive genomic profiling were studied in NSCLC and in lung adenocarcinoma (AD) without GAs. Of patients with NSCLC, 71% harbored at least one GA to a gene listed in the guidelines or KRAS; 273 cancer-related genes were altered in at least 0.1% of the AD cases. Although logistical and administrative hurdles limit the widespread use of next-generation sequencing, the data confirm the feasibility and potential utility of comprehensive genomic profiling in clinical practice. ©AlphaMed Press.

  4. Treatment algorithms and protocolized care.

    PubMed

    Morris, Alan H

    2003-06-01

    Excess information in complex ICU environments exceeds human decision-making limits and likely contributes to unnecessary variation in clinical care, increasing the likelihood of clinical errors. I reviewed recent critical care clinical trials searching for information about the impact of protocol use on clinically pertinent outcomes. Several recently published clinical trials illustrate the importance of distinguishing efficacy and effectiveness trials. One of these trials illustrates the danger of conducting effectiveness trials before the efficacy of an intervention is established. The trials also illustrate the importance of distinguishing guidelines and inadequately explicit protocols from adequately explicit protocols. Only adequately explicit protocols contain enough detail to lead different clinicians to the same decision when faced with the same clinical scenario. Differences between guidelines and protocols are important. Guidelines lack detail and provide general guidance that requires clinicians to fill in many gaps. Computerized or paper-based protocols are detailed and, when used for complex clinical ICU problems, can generate patient-specific, evidence-based therapy instructions that can be carried out by different clinicians with almost no interclinician variability. Individualization of patient therapy can be preserved by these protocols when they are driven by individual patient data. Explicit decision-support tools (eg, guidelines and protocols) have favorable effects on clinician and patient outcomes and can reduce the variation in clinical practice. Guidelines and protocols that aid ICU decision makers should be more widely distributed.

  5. Production and quality assurance automation in the Goddard Space Flight Center Flight Dynamics Facility

    NASA Technical Reports Server (NTRS)

    Chapman, K. B.; Cox, C. M.; Thomas, C. W.; Cuevas, O. O.; Beckman, R. M.

    1994-01-01

    The Flight Dynamics Facility (FDF) at the NASA Goddard Space Flight Center (GSFC) generates numerous products for NASA-supported spacecraft, including the Tracking and Data Relay Satellites (TDRS's), the Hubble Space Telescope (HST), the Extreme Ultraviolet Explorer (EUVE), and the space shuttle. These products include orbit determination data, acquisition data, event scheduling data, and attitude data. In most cases, product generation involves repetitive execution of many programs. The increasing number of missions supported by the FDF has necessitated the use of automated systems to schedule, execute, and quality assure these products. This automation allows the delivery of accurate products in a timely and cost-efficient manner. To be effective, these systems must automate as many repetitive operations as possible and must be flexible enough to meet changing support requirements. The FDF Orbit Determination Task (ODT) has implemented several systems that automate product generation and quality assurance (QA). These systems include the Orbit Production Automation System (OPAS), the New Enhanced Operations Log (NEOLOG), and the Quality Assurance Automation Software (QA Tool). Implementation of these systems has resulted in a significant reduction in required manpower, elimination of shift work and most weekend support, and improved support quality, while incurring minimal development cost. This paper will present an overview of the concepts used and experiences gained from the implementation of these automation systems.

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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

  3. 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

  4. 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

  5. Monte Carlo based, patient-specific RapidArc QA using Linac log files.

    PubMed

    Teke, Tony; Bergman, Alanah M; Kwa, William; Gill, Bradford; Duzenli, Cheryl; Popescu, I Antoniu

    2010-01-01

    A Monte Carlo (MC) based QA process to validate the dynamic beam delivery accuracy for Varian RapidArc (Varian Medical Systems, Palo Alto, CA) using Linac delivery log files (DynaLog) is presented. Using DynaLog file analysis and MC simulations, the goal of this article is to (a) confirm that adequate sampling is used in the RapidArc optimization algorithm (177 static gantry angles) and (b) to assess the physical machine performance [gantry angle and monitor unit (MU) delivery accuracy]. Ten clinically acceptable RapidArc treatment plans were generated for various tumor sites and delivered to a water-equivalent cylindrical phantom on the treatment unit. Three Monte Carlo simulations were performed to calculate dose to the CT phantom image set: (a) One using a series of static gantry angles defined by 177 control points with treatment planning system (TPS) MLC control files (planning files), (b) one using continuous gantry rotation with TPS generated MLC control files, and (c) one using continuous gantry rotation with actual Linac delivery log files. Monte Carlo simulated dose distributions are compared to both ionization chamber point measurements and with RapidArc TPS calculated doses. The 3D dose distributions were compared using a 3D gamma-factor analysis, employing a 3%/3 mm distance-to-agreement criterion. The dose difference between MC simulations, TPS, and ionization chamber point measurements was less than 2.1%. For all plans, the MC calculated 3D dose distributions agreed well with the TPS calculated doses (gamma-factor values were less than 1 for more than 95% of the points considered). Machine performance QA was supplemented with an extensive DynaLog file analysis. A DynaLog file analysis showed that leaf position errors were less than 1 mm for 94% of the time and there were no leaf errors greater than 2.5 mm. The mean standard deviation in MU and gantry angle were 0.052 MU and 0.355 degrees, respectively, for the ten cases analyzed. The accuracy and flexibility of the Monte Carlo based RapidArc QA system were demonstrated. Good machine performance and accurate dose distribution delivery of RapidArc plans were observed. The sampling used in the TPS optimization algorithm was found to be adequate.

  6. Engineering policy guidelines for design of driven piles.

    DOT National Transportation Integrated Search

    2011-08-01

    These guidelines were developed as part of a comprehensive research program undertaken by the Missouri Department of : Transportation (MoDOT) to reduce costs associated with design and construction of bridge foundations while maintaining appropriate ...

  7. Clinical practice guideline development manual: A quality-driven approach for translating evidence into action

    PubMed Central

    Rosenfeld, Richard M.; Shiffman, Richard N.

    2010-01-01

    Background Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing healthcare variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective – or potentially harmful – interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. Purpose This manual describes the principles and practices used successfully by the American Academy of Otolaryngology – Head and Neck Surgery to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for action-ready recommendations with multi-disciplinary applicability. The development process, which allows moving from conception to completion in twelve months, emphasizes a logical sequence of key action statements supported by amplifying text, evidence profiles, and recommendation grades that link action to evidence. Conclusions As clinical practice guidelines become more prominent as a key metric of quality healthcare, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are – and are not – and how they are best utilized to improve care. The information in this manual should help clinicians and organizations achieve these goals. PMID:19464525

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP)

    PubMed Central

    Jermoumi, M.; Korideck, H.; Bhagwat, M.; Zygmanski, P.; Makrigiogos, G.M.; Berbeco, R.I.; Cormack, R.C.; Ngwa, W.

    2016-01-01

    Purpose To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). Methods and materials A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm3) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. Results Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. Conclusions The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests. PMID:25964129

  14. Comprehensive quality assurance phantom for the small animal radiation research platform (SARRP).

    PubMed

    Jermoumi, M; Korideck, H; Bhagwat, M; Zygmanski, P; Makrigiogos, G M; Berbeco, R I; Cormack, R C; Ngwa, W

    2015-07-01

    To develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the Small Animal Radiation Research Platform (SARRP). A QA phantom was developed for carrying out daily, monthly and annual QA tasks including: imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of 15 (60 × 60 × 5 mm(3)) kV-energy tissue equivalent solid water slabs. The phantom can incorporate optically stimulated luminescence dosimeters (OSLD), Mosfet or film. One slab, with inserts and another slab with hole patterns are particularly designed for image QA. Output constancy measurement results showed daily variations within 3%. Using the Mosfet in phantom as target, results showed that the difference between TPS calculations and measurements was within 5%. Annual QA results for the Percentage depth dose (PDD) curves, lateral beam profiles, beam flatness and beam profile symmetry were found consistent with results obtained at commissioning. PDD curves obtained using film and OSLDs showed good agreement. Image QA was performed monthly, with image-quality parameters assessed in terms of CBCT image geometric accuracy, CT number accuracy, image spatial resolution, noise and image uniformity. The results show that the developed QA phantom can be employed as a tool for comprehensive performance evaluation of the SARRP. The study provides a useful reference for development of a comprehensive quality assurance program for the SARRP and other similar small animal irradiators, with proposed tolerances and frequency of required tests. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. 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.

  16. 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

  17. Eddy covariance carbonyl sulfide flux measurements with a quantum cascade laser absorption spectrometer

    NASA Astrophysics Data System (ADS)

    Gerdel, Katharina; Spielmann, Felix M.; Hammerle, Albin; Wohlfahrt, Georg

    2016-04-01

    Carbonyl sulfide (COS) is the most abundant sulfur containing trace gas present in the troposphere at concentrations of around 500 ppt. Recent interest in COS by the ecosystem-physiological community has been sparked by the fact that COS co-diffuses into plant leaves pretty much the same way as carbon dioxide (CO2) does, but in contrast to CO2, COS is not known to be emitted by plants. Thus uptake of COS by vegetation has the potential to be used as a tracer for canopy gross photosynthesis, which cannot be measured directly, however represents a key term in the global carbon cycle. Since a few years, quantum cascade laser absorption spectrometers (QCLAS) are commercially available with the precision, sensitivity and time response suitable for eddy covariance (EC) flux measurements. While there exist a handful of published reports on EC flux measurements in the recent literature, no rigorous investigation of the applicability of QCLAS for EC COS flux measurements has been carried out so far, nor have been EC processing and QA/QC steps developed for carbon dioxide and water vapor flux measurements within FLUXNET been assessed for COS. The aim of this study is to close this knowledge gap, to discuss critical steps in the post-processing chain of COS EC flux measurements and to devise best-practice guidelines for COS EC flux data processing. To this end we collected EC COS (and CO2, H2O and CO) flux measurements above a temperate mountain grassland in Austria over the vegetation period 2015 with a commercially available QCLAS. We discuss various aspects of EC data post-processing, in particular issues with the time-lag estimation between sonic anemometer and QCLAS signals and QCLAS time series detrending, as well as QA/QC, in particular flux detection limits, random flux uncertainty, the interaction of various processing steps with common EC QA/QC filters (e.g. detrending and stationarity tests), u*-filtering, etc.

  18. Magnetic field effects on electron transfer reactions involving sextet-spin ( S = 5/2) intermediates generated on photoexcitation of a Cr(III)-porphyrin complex

    NASA Astrophysics Data System (ADS)

    Mori, Yukie; Hoshino, Mikio; Hayashi, Hisaharu

    The excited trip-sextet ( 6 T 1 ) state of chloro-(3-methylimidazol)-( meso -tetraphenylporphyrinato) chromium(III) (Cr III P) is quenched by 1,1 '-dibenzyl-4,4 '-bipyridinium (BV 2+ ) in acetonitrile through electron transfer to give 5 (Cr III P .+ ) and 2 BV .+ . The intermediate is a geminate ion pair in the sextet (Sx) state 6 [ 5 (Cr III P .+ ) 2 BV .+ ], which decays through either the escape from a solvent cage to give the free ions or the spin conversion to the quartet (Qa) state followed by back electron transfer. The free ion yield ( ΦFI ) increased with increasing magnetic field from 0 to 4 T and then slightly decreased from 4 T to 10 T. These magnetic field effects are explained as follows. Under low fields where the Zeeman splitting of the spin sublevels is lower than or comparable with the electron spin dipole-dipole interaction within 5 (Cr III P .+ ), this interaction effectively induces the Sx ⇔Qa conversion of [ 5 (Cr III P .+ ) 2 BV + ] to result in low ΦFI values. Under high fields where the Zeeman splitting is larger than the dipole-dipole interaction, the Sx Qa conversion is decreased with increasing field to cause higher ΦFI values. The slight decrease in ΦFI above 4 T may be due to the Δg mechanism.

  19. 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...

  20. 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…

  1. 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…

  2. 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…

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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.

  8. Development and implementation of a comprehensive quality assurance program at a community endoscopy facility.

    PubMed

    Hilsden, Robert Jay; Rostom, Alaa; Dubé, Catherine; Pontifex, Darlene; McGregor, S Elizabeth; Bridges, Ronald J

    2011-10-01

    Quality assurance (QA) is a process that includes the systematic evaluation of a service, institution of improvements and ongoing evaluation to ensure that effective changes were made. QA is a fundamental component of any organized colorectal cancer screening program. However, it should play an equally important role in opportunistic screening. Establishing the processes and procedures for a comprehensive QA program can be a daunting proposition for an endoscopy unit. The present article describes the steps taken to establish a QA program at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Alberta) - a colorectal cancer screening centre and nonhospital endoscopy unit that is dedicated to providing colorectal cancer screening-related colonoscopies. Lessons drawn from the authors' experience may help others develop their own initiatives. The Global Rating Scale, a quality assessment and improvement tool developed for the gastrointestinal endoscopy services of the United Kingdom's National Health Service, was used as the framework to develop the QA program. QA activities include monitoring the patient experience through surveys, creating endoscopist report cards on colonoscopy performance, tracking and evaluating adverse events and monitoring wait times.

  9. 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.

  10. [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.

  11. 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

  12. 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?

  13. 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

  14. 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.

  15. 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

  16. A Web-Based Data-Querying Tool Based on Ontology-Driven Methodology and Flowchart-Based Model

    PubMed Central

    Ping, Xiao-Ou; Chung, Yufang; Liang, Ja-Der; Yang, Pei-Ming; Huang, Guan-Tarn; Lai, Feipei

    2013-01-01

    Background Because of the increased adoption rate of electronic medical record (EMR) systems, more health care records have been increasingly accumulating in clinical data repositories. Therefore, querying the data stored in these repositories is crucial for retrieving the knowledge from such large volumes of clinical data. Objective The aim of this study is to develop a Web-based approach for enriching the capabilities of the data-querying system along the three following considerations: (1) the interface design used for query formulation, (2) the representation of query results, and (3) the models used for formulating query criteria. Methods The Guideline Interchange Format version 3.5 (GLIF3.5), an ontology-driven clinical guideline representation language, was used for formulating the query tasks based on the GLIF3.5 flowchart in the Protégé environment. The flowchart-based data-querying model (FBDQM) query execution engine was developed and implemented for executing queries and presenting the results through a visual and graphical interface. To examine a broad variety of patient data, the clinical data generator was implemented to automatically generate the clinical data in the repository, and the generated data, thereby, were employed to evaluate the system. The accuracy and time performance of the system for three medical query tasks relevant to liver cancer were evaluated based on the clinical data generator in the experiments with varying numbers of patients. Results In this study, a prototype system was developed to test the feasibility of applying a methodology for building a query execution engine using FBDQMs by formulating query tasks using the existing GLIF. The FBDQM-based query execution engine was used to successfully retrieve the clinical data based on the query tasks formatted using the GLIF3.5 in the experiments with varying numbers of patients. The accuracy of the three queries (ie, “degree of liver damage,” “degree of liver damage when applying a mutually exclusive setting,” and “treatments for liver cancer”) was 100% for all four experiments (10 patients, 100 patients, 1000 patients, and 10,000 patients). Among the three measured query phases, (1) structured query language operations, (2) criteria verification, and (3) other, the first two had the longest execution time. Conclusions The ontology-driven FBDQM-based approach enriched the capabilities of the data-querying system. The adoption of the GLIF3.5 increased the potential for interoperability, shareability, and reusability of the query tasks. PMID:25600078

  17. Skin cancer screening: recommendations for data-driven screening guidelines and a review of the US Preventive Services Task Force controversy

    PubMed Central

    Johnson, Mariah M; Leachman, Sancy A; Aspinwall, Lisa G; Cranmer, Lee D; Curiel-Lewandrowski, Clara; Sondak, Vernon K; Stemwedel, Clara E; Swetter, Susan M; Vetto, John; Bowles, Tawnya; Dellavalle, Robert P; Geskin, Larisa J; Grossman, Douglas; Grossmann, Kenneth F; Hawkes, Jason E; Jeter, Joanne M; Kim, Caroline C; Kirkwood, John M; Mangold, Aaron R; Meyskens, Frank; Ming, Michael E; Nelson, Kelly C; Piepkorn, Michael; Pollack, Brian P; Robinson, June K; Sober, Arthur J; Trotter, Shannon; Venna, Suraj S; Agarwala, Sanjiv; Alani, Rhoda; Averbook, Bruce; Bar, Anna; Becevic, Mirna; Box, Neil; E Carson, William; Cassidy, Pamela B; Chen, Suephy C; Chu, Emily Y; Ellis, Darrel L; Ferris, Laura K; Fisher, David E; Kendra, Kari; Lawson, David H; Leming, Philip D; Margolin, Kim A; Markovic, Svetomir; Martini, Mary C; Miller, Debbie; Sahni, Debjani; Sharfman, William H; Stein, Jennifer; Stratigos, Alexander J; Tarhini, Ahmad; Taylor, Matthew H; Wisco, Oliver J; Wong, Michael K

    2017-01-01

    Melanoma is usually apparent on the skin and readily detected by trained medical providers using a routine total body skin examination, yet this malignancy is responsible for the majority of skin cancer-related deaths. Currently, there is no national consensus on skin cancer screening in the USA, but dermatologists and primary care providers are routinely confronted with making the decision about when to recommend total body skin examinations and at what interval. The objectives of this paper are: to propose rational, risk-based, data-driven guidelines commensurate with the US Preventive Services Task Force screening guidelines for other disorders; to compare our proposed guidelines to recommendations made by other national and international organizations; and to review the US Preventive Services Task Force's 2016 Draft Recommendation Statement on skin cancer screening. PMID:28758010

  18. SU-G-201-15: Nomogram as an Efficient Dosimetric Verification Tool in HDR Prostate Brachytherapy

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

    Liang, J; Todor, D

    Purpose: Nomogram as a simple QA tool for HDR prostate brachytherapy treatment planning has been developed and validated clinically. Reproducibility including patient-to-patient and physician-to-physician variability was assessed. Methods: The study was performed on HDR prostate implants from physician A (n=34) and B (n=15) using different implant techniques and planning methodologies. A nomogram was implemented as an independent QA of computer-based treatment planning before plan execution. Normalized implant strength (total air kerma strength Sk*t in cGy cm{sup 2} divided by prescribed dose in cGy) was plotted as a function of PTV volume and total V100. A quadratic equation was used tomore » fit the data with R{sup 2} denoting the model predictive power. Results: All plans showed good target coverage while OARs met the dose constraint guidelines. Vastly different implant and planning styles were reflected on conformity index (entire dose matrix V100/PTV volume, physician A implants: 1.27±0.14, physician B: 1.47±0.17) and PTV V150/PTV volume ratio (physician A: 0.34±0.09, physician B: 0.24±0.07). The quadratic model provided a better fit for the curved relationship between normalized implant strength and total V100 (or PTV volume) than a simple linear function. Unlike the normalized implant strength versus PTV volume nomogram which differed between physicians, a unique quadratic model based nomogram (Sk*t)/D=−0.0008V2+0.0542V+1.1185 (R{sup 2}=0.9977) described the dependence of normalized implant strength on total V100 over all the patients from both physicians despite two different implant and planning philosophies. Normalized implant strength - total V100 model also generated less deviant points distorting the smoothed ones with a significantly higher correlation. Conclusion: A simple and universal, excel-based nomogram was created as an independent calculation tool for HDR prostate brachytherapy. Unlike similar attempts, our nomogram is insensitive to implant style and does not rely on reproducing dose calculations using TG-43 formalism, thus making it a truly independent check.« less

  19. 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

  20. An architecture for a continuous, user-driven, and data-driven application of clinical guidelines and its evaluation.

    PubMed

    Shalom, Erez; Shahar, Yuval; Lunenfeld, Eitan

    2016-02-01

    Design, implement, and evaluate a new architecture for realistic continuous guideline (GL)-based decision support, based on a series of requirements that we have identified, such as support for continuous care, for multiple task types, and for data-driven and user-driven modes. We designed and implemented a new continuous GL-based support architecture, PICARD, which accesses a temporal reasoning engine, and provides several different types of application interfaces. We present the new architecture in detail in the current paper. To evaluate the architecture, we first performed a technical evaluation of the PICARD architecture, using 19 simulated scenarios in the preeclampsia/toxemia domain. We then performed a functional evaluation with the help of two domain experts, by generating patient records that simulate 60 decision points from six clinical guideline-based scenarios, lasting from two days to four weeks. Finally, 36 clinicians made manual decisions in half of the scenarios, and had access to the automated GL-based support in the other half. The measures used in all three experiments were correctness and completeness of the decisions relative to the GL. Mean correctness and completeness in the technical evaluation were 1±0.0 and 0.96±0.03 respectively. The functional evaluation produced only several minor comments from the two experts, mostly regarding the output's style; otherwise the system's recommendations were validated. In the clinically oriented evaluation, the 36 clinicians applied manually approximately 41% of the GL's recommended actions. Completeness increased to approximately 93% when using PICARD. Manual correctness was approximately 94.5%, and remained similar when using PICARD; but while 68% of the manual decisions included correct but redundant actions, only 3% of the actions included in decisions made when using PICARD were redundant. The PICARD architecture is technically feasible and is functionally valid, and addresses the realistic continuous GL-based application requirements that we have defined; in particular, the requirement for care over significant time frames. The use of the PICARD architecture in the domain we examined resulted in enhanced completeness and in reduction of redundancies, and is potentially beneficial for general GL-based management of chronic patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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.

  3. Analysis of Intelligent Transportation Systems Using Model-Driven Simulations.

    PubMed

    Fernández-Isabel, Alberto; Fuentes-Fernández, Rubén

    2015-06-15

    Intelligent Transportation Systems (ITSs) integrate information, sensor, control, and communication technologies to provide transport related services. Their users range from everyday commuters to policy makers and urban planners. Given the complexity of these systems and their environment, their study in real settings is frequently unfeasible. Simulations help to address this problem, but present their own issues: there can be unintended mistakes in the transition from models to code; their platforms frequently bias modeling; and it is difficult to compare works that use different models and tools. In order to overcome these problems, this paper proposes a framework for a model-driven development of these simulations. It is based on a specific modeling language that supports the integrated specification of the multiple facets of an ITS: people, their vehicles, and the external environment; and a network of sensors and actuators conveniently arranged and distributed that operates over them. The framework works with a model editor to generate specifications compliant with that language, and a code generator to produce code from them using platform specifications. There are also guidelines to help researchers in the application of this infrastructure. A case study on advanced management of traffic lights with cameras illustrates its use.

  4. Analysis of Intelligent Transportation Systems Using Model-Driven Simulations

    PubMed Central

    Fernández-Isabel, Alberto; Fuentes-Fernández, Rubén

    2015-01-01

    Intelligent Transportation Systems (ITSs) integrate information, sensor, control, and communication technologies to provide transport related services. Their users range from everyday commuters to policy makers and urban planners. Given the complexity of these systems and their environment, their study in real settings is frequently unfeasible. Simulations help to address this problem, but present their own issues: there can be unintended mistakes in the transition from models to code; their platforms frequently bias modeling; and it is difficult to compare works that use different models and tools. In order to overcome these problems, this paper proposes a framework for a model-driven development of these simulations. It is based on a specific modeling language that supports the integrated specification of the multiple facets of an ITS: people, their vehicles, and the external environment; and a network of sensors and actuators conveniently arranged and distributed that operates over them. The framework works with a model editor to generate specifications compliant with that language, and a code generator to produce code from them using platform specifications. There are also guidelines to help researchers in the application of this infrastructure. A case study on advanced management of traffic lights with cameras illustrates its use. PMID:26083232

  5. Tentative Guidelines for the Development of an Ability-Based Emotional Intelligence Intervention Program for Gifted Students

    ERIC Educational Resources Information Center

    Zeidner, Moshe

    2017-01-01

    This paper presents a number of general principles and guidelines for the development of an emotional intelligence training program designed to foster emotional abilities in gifted students. The presented guidelines underscore the need for EI theory-driven program planning geared to the needs of gifted students; integrating activities into routine…

  6. 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...

  7. 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...

  8. 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.

  9. 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 ...

  10. 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.

  11. 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

  12. 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

  13. 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

  14. A Phase II Study of Intensity Modulated Radiation Therapy to the Pelvis for Postoperative Patients With Endometrial Carcinoma: Radiation Therapy Oncology Group Trial 0418

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

    Jhingran, Anuja, E-mail: ajhingra@mdanderson.org; Winter, Kathryn; Portelance, Lorraine

    2012-09-01

    Purpose: To determine the feasibility of pelvic intensity modulated radiation therapy (IMRT) for patients with endometrial cancer in a multi-institutional setting and to determine whether this treatment is associated with fewer short-term bowel adverse events than standard radiation therapy. Methods: Patients with adenocarcinoma of the endometrium treated with pelvic radiation therapy alone were eligible. Guidelines for target definition and delineation, dose prescription, and dose-volume constraints for the targets and critical normal structures were detailed in the study protocol and a web-based atlas. Results: Fifty-eight patients were accrued by 25 institutions; 43 were eligible for analysis. Forty-two patients (98%) had anmore » acceptable IMRT plan; 1 had an unacceptable variation from the prescribed dose to the nodal planning target volume. The proportions of cases in which doses to critical normal structures exceeded protocol criteria were as follows: bladder, 67%; rectum, 76%; bowel, 17%; and femoral heads, 33%. Twelve patients (28%) developed grade {>=}2 short-term bowel adverse events. Conclusions: Pelvic IMRT for endometrial cancer is feasible across multiple institutions with use of a detailed protocol and centralized quality assurance (QA). For future trials, contouring of vaginal and nodal tissue will need continued monitoring with good QA and better definitions will be needed for organs at risk.« less

  15. 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

  16. 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.

  17. 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.

  18. Clinical operations generation next… The age of technology and outsourcing

    PubMed Central

    Temkar, Priya

    2015-01-01

    Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations. PMID:26623386

  19. Design criteria and candidate electrical power systems for a reusable Space Shuttle booster.

    NASA Technical Reports Server (NTRS)

    Merrifield, D. V.

    1972-01-01

    This paper presents the results of a preliminary study to establish electrical power requirements, investigate candidate power sources, and select a representative power generation concept for the NASA Space Shuttle booster stage. Design guidelines and system performance requirements are established. Candidate power sources and combinations thereof are defined and weight estimates made. The selected power source concept utilizes secondary silver-zinc batteries, engine-driven alternators with constant speed drive, and an airbreathing gas turbine. The need for cost optimization, within safety, reliability, and performance constraints, is emphasized as being the most important criteria in design of the final system.

  20. Clinical operations generation next… The age of technology and outsourcing.

    PubMed

    Temkar, Priya

    2015-01-01

    Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations.

  1. Beyond lip service: Towards human rights-driven guidelines for South African speech-language pathologists.

    PubMed

    Pascoe, Michelle; Klop, Daleen; Mdlalo, Thandeka; Ndhambi, Mikateko

    2018-02-01

    Developed with a strong awareness of past injustices, South Africa's progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one's language of choice, but is often perceived as a "Cinderella" right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country.

  2. Quantification of coronary microvascular resistance using angiographic images for volumetric blood flow measurement: in vivo validation

    PubMed Central

    Zhang, Zhang; Takarada, Shigeho

    2011-01-01

    Structural coronary microcirculation abnormalities are important prognostic determinants in clinical settings. However, an assessment of microvascular resistance (MR) requires a velocity wire. A first-pass distribution analysis technique to measure volumetric blood flow has been previously validated. The aim of this study was the in vivo validation of the MR measurement technique using first-pass distribution analysis. Twelve anesthetized swine were instrumented with a transit-time ultrasound flow probe on the proximal segment of the left anterior descending coronary artery (LAD). Microspheres were injected into the LAD to create a model of microvascular dysfunction. Adenosine (400 μg·kg−1·min−1) was used to produce maximum hyperemia. A region of interest in the LAD arterial bed was drawn to generate time-density curves using angiographic images. Volumetric blood flow measurements (Qa) were made using a time-density curve and the assumption that blood was momentarily replaced with contrast agent during the injection. Blood flow from the flow probe (Qp), coronary pressure (Pa), and right atrium pressure (Pv) were continuously recorded. Flow probe-based normalized MR (NMRp) and angiography-based normalized MR (NMRa) were calculated using Qp and Qa, respectively. In 258 measurements, Qa showed a strong correlation with the gold standard Qp (Qa = 0.90 Qp + 6.6 ml/min, r2 = 0.91, P < 0.0001). NMRa correlated linearly with NMRp (NMRa = 0.90 NMRp + 0.02 mmHg·ml−1·min−1, r2 = 0.91, P < 0.0001). Additionally, the Bland-Altman analysis showed a close agreement between NMRa and NMRp. In conclusion, a technique based on angiographic image data for quantifying NMR was validated using a swine model. This study provides a method to measure NMR without using a velocity wire, which can potentially be used to evaluate microvascular conditions during coronary arteriography. PMID:21398596

  3. SU-E-T-254: Development of a HDR-BT QA Tool for Verification of Source Position with Oncentra Applicator Modeling

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

    Kumazaki, Y; Miyaura, K; Hirai, R

    2015-06-15

    Purpose: To develop a High Dose Rate Brachytherapy (HDR-BT) quality assurance (QA) tool for verification of source position with Oncentra applicator modeling, and to report the results of radiation source positions with this tool. Methods: We developed a HDR-BT QA phantom and automated analysis software for verification of source position with Oncentra applicator modeling for the Fletcher applicator used in the MicroSelectron HDR system. This tool is intended for end-to-end tests that mimic the clinical 3D image-guided brachytherapy (3D-IGBT) workflow. The phantom is a 30x30x3 cm cuboid phantom with radiopaque markers, which are inserted into the phantom to evaluate applicatormore » tips and reference source positions; positions are laterally shifted 10 mm from the applicator axis. The markers are lead-based and scatter radiation to expose the films. Gafchromic RTQA2 films are placed on the applicators. The phantom includes spaces to embed the applicators. The source position is determined as the distance between the exposed source position and center position of two pairs of the first radiopaque markers. We generated a 3D-IGBT plan with applicator modeling. The first source position was 6 mm from the applicator tips, and the second source position was 10 mm from the first source position. Results: All source positions were consistent with the exposed positions within 1 mm for all Fletcher applicators using in-house software. Moreover, the distance between source positions was in good agreement with the reference distance. Applicator offset, determined as the distance from the applicator tips at the first source position in the treatment planning system, was accurate. Conclusion: Source position accuracy of applicator modeling used in 3D-IGBT was acceptable. This phantom and software will be useful as a HDR-BT QA tool for verification of source position with Oncentra applicator modeling.« less

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. Long term high resolution rainfall runoff observations for improved water balance uncertainty and database QA-QC in the Walnut Gulch Experimental Watershed.

    NASA Astrophysics Data System (ADS)

    Bitew, M. M.; Goodrich, D. C.; Demaria, E.; Heilman, P.; Kautz, M. A.

    2017-12-01

    Walnut Gulch is a semi-arid environment experimental watershed and Long Term Agro-ecosystem Research (LTAR) site managed by USDA-ARS Southwest Watershed Research Center for which high-resolution long-term hydro-climatic data are available across its 150 km2 drainage area. In this study, we present the analysis of 50 years of continuous hourly rainfall data to evaluate runoff control and generation processes for improving the QA-QC plans of Walnut Gulch to create high-quality data set that is critical for reducing water balance uncertainties. Multiple linear regression models were developed to relate rainfall properties, runoff characteristics and watershed properties. The rainfall properties were summarized to event based total depth, maximum intensity, duration, the location of the storm center with respect to the outlet, and storm size normalized to watershed area. We evaluated the interaction between the runoff and rainfall and runoff as antecedent moisture condition (AMC), antecedent runoff condition (ARC) and, runoff depth and duration for each rainfall events. We summarized each of the watershed properties such as contributing area, slope, shape, channel length, stream density, channel flow area, and percent of the area of retention stock ponds for each of the nested catchments in Walnut Gulch. The evaluation of the model using basic and categorical statistics showed good predictive skill throughout the watersheds. The model produced correlation coefficients ranging from 0.4-0.94, Nash efficiency coefficients up to 0.77, and Kling-Gupta coefficients ranging from 0.4 to 0.98. The model predicted 92% of all runoff generations and 98% of no-runoff across all sub-watersheds in Walnut Gulch. The regression model also indicated good potential to complement the QA-QC procedures in place for Walnut Gulch dataset publications developed over the years since the 1960s through identification of inconsistencies in rainfall and runoff relations.

  10. Clinical Practice Guideline Development Manual, Third Edition: a quality-driven approach for translating evidence into action.

    PubMed

    Rosenfeld, Richard M; Shiffman, Richard N; Robertson, Peter

    2013-01-01

    Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing health care variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective-or potentially harmful-interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. The third edition of this manual describes the principles and practices used successfully by the American Academy of Otolaryngology--Head and Neck Surgery Foundation to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for actionable recommendations with multidisciplinary applicability. The development process emphasizes a logical sequence of key action statements supported by amplifying text, action statement profiles, and recommendation grades linking action to evidence. New material in this edition includes standards for trustworthy guidelines, updated classification of evidence levels, increased patient and public involvement, assessing confidence in the evidence, documenting differences of opinion, expanded discussion of conflict of interest, and use of computerized decision support for crafting actionable recommendations. As clinical practice guidelines become more prominent as a key metric of quality health care, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are--and are not--and how they are best used to improve care. The information in this manual should help clinicians and organizations achieve these goals.

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. Thymic DCs derived IL-27 regulates the final maturation of CD4+ SP thymocytes

    PubMed Central

    Tang, Hui; Zhang, Jie; Sun, Xiuyuan; Qian, Xiaoping; Zhang, Yu; Jin, Rong

    2016-01-01

    IL-27, as a pleiotropic cytokine, promotes the differentiation of naïve T cells to Th1, while suppressing Th2 and Th17 differentiation in the periphery. However, the role of IL-27 in the thymocyte development remains unknown. Here we showed that IL-27 was highly expressed in thymic plasmacytoid dendritic cells (pDCs) while its receptor expression was mainly detected in CD4+ single-positive (SP) thymocytes. Deletion of the p28 subunit in DCs resulted in a reduction of the most mature Qa-2+ subsets of CD4+ SP T cells. This defect was rescued by intrathymic administration of exogenous IL-27. In vitro differentiation assay further demonstrated that IL-27 alone was able to drive the maturation of the newly generated 6C10+CD69+CD4+ SP cells into Qa-2+ cells. Collectively, this study has revealed an important role of thymic DCs-derived IL-27 in the regulation of the phenotypic maturation of CD4+ SP thymocytes. PMID:27469302

  16. Automated generation of patient-tailored electronic care pathways by translating computer-interpretable guidelines into hierarchical task networks.

    PubMed

    González-Ferrer, Arturo; ten Teije, Annette; Fdez-Olivares, Juan; Milian, Krystyna

    2013-02-01

    This paper describes a methodology which enables computer-aided support for the planning, visualization and execution of personalized patient treatments in a specific healthcare process, taking into account complex temporal constraints and the allocation of institutional resources. To this end, a translation from a time-annotated computer-interpretable guideline (CIG) model of a clinical protocol into a temporal hierarchical task network (HTN) planning domain is presented. The proposed method uses a knowledge-driven reasoning process to translate knowledge previously described in a CIG into a corresponding HTN Planning and Scheduling domain, taking advantage of HTNs known ability to (i) dynamically cope with temporal and resource constraints, and (ii) automatically generate customized plans. The proposed method, focusing on the representation of temporal knowledge and based on the identification of workflow and temporal patterns in a CIG, makes it possible to automatically generate time-annotated and resource-based care pathways tailored to the needs of any possible patient profile. The proposed translation is illustrated through a case study based on a 70 pages long clinical protocol to manage Hodgkin's disease, developed by the Spanish Society of Pediatric Oncology. We show that an HTN planning domain can be generated from the corresponding specification of the protocol in the Asbru language, providing a running example of this translation. Furthermore, the correctness of the translation is checked and also the management of ten different types of temporal patterns represented in the protocol. By interpreting the automatically generated domain with a state-of-art HTN planner, a time-annotated care pathway is automatically obtained, customized for the patient's and institutional needs. The generated care pathway can then be used by clinicians to plan and manage the patients long-term care. The described methodology makes it possible to automatically generate patient-tailored care pathways, leveraging an incremental knowledge-driven engineering process that starts from the expert knowledge of medical professionals. The presented approach makes the most of the strengths inherent in both CIG languages and HTN planning and scheduling techniques: for the former, knowledge acquisition and representation of the original clinical protocol, and for the latter, knowledge reasoning capabilities and an ability to deal with complex temporal and resource constraints. Moreover, the proposed approach provides immediate access to technologies such as business process management (BPM) tools, which are increasingly being used to support healthcare processes. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. 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.; hide

    2009-01-01

    At the request of the Exploration Systems Mission Directorate (ESMD) and the Constellation Program (CxP) Safety, Reliability; and Quality Assurance (SR&QA) Requirements Director, the NASA Engineering and Safety Center (NESC) participated in the Cx SR&QA Requirements forum. The Requirements Forum was held June 24-26; 2008, at GRC's Plum Brook Facility. The forums purpose was to gather all stakeholders into a focused meeting to help complete the process of refining the CxP to refine its Level II SR&QA requirements or defining project-specific requirements tailoring. Element prime contractors had raised specific questions about the wording and intent of many requirements in areas they felt were driving costs without adding commensurate value. NESC was asked to provide an independent and thorough review of requirements that contractors believed were driving Program costs, by active participation in the forum. This document contains information from the forum.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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

    Jermoumi, M; Ngwa, W; Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

    Purpose: Use of Small Animal Radiation Research Platform (SARRP) systems for conducting state-of-the-art image guided radiotherapy (IGRT) research on small animals has become more common over the past years. The purpose of this work is to develop and test the suitability and performance of a comprehensive quality assurance (QA) phantom for the SARRP. Methods: A QA phantom was developed for carrying out daily, monthly and annual QA tasks including imaging, dosimetry and treatment planning system (TPS) performance evaluation of the SARRP. The QA phantom consists of nine (60×60×5 mm3) KV-energy tissue equivalent solid water slabs that can be employed formore » annual dosimetry QA with film. Three of the top slabs are replaceable with ones incorporating Mosfets or OSLDs arranged in a quincunx pattern, or a slab drilled to accommodate an ion chamber insert. These top slabs are designed to facilitate routine daily and monthly QA tasks such as output constancy, isocenter congruency test, treatment planning system (TPS) QA, etc. One slab is designed with inserts for image QA. A prototype of the phantom was applied to test the performance of the imaging, planning and treatment delivery systems. Results: Output constancy test results showed daily variations within 3%. For isocenter congruency test, the phantom could be used to detect 0.3 mm deviations of the CBCT isocenter from the radiation isocenter. Using the Mosfet in phantom as target, the difference between TPS calculations and measurements was within 5%. Image-quality parameters could also be assessed in terms of geometric accuracy, CT number accuracy, linearity, noise and image uniformity, etc. Conclusion: The developed phantom can be employed as a simple tool for comprehensive performance evaluation of the SARRP. The study provides a reference for development of a comprehensive quality assurance program for the SARRP, with proposed tolerances and frequency of required tests.« less

  6. SU-E-T-88: Comprehensive Automated Daily QA for Hypo- Fractionated Treatments

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

    McGuinness, C; Morin, O

    2014-06-01

    Purpose: The trend towards more SBRT treatments with fewer high dose fractions places increased importance on daily QA. Patient plan specific QA with 3%/3mm gamma analysis and daily output constancy checks may not be enough to guarantee the level of accuracy required for SBRT treatments. But increasing the already extensive amount of QA procedures that are required is a daunting proposition. We performed a feasibility study for more comprehensive automated daily QA that could improve the diagnostic capabilities of QA without increasing workload. Methods: We performed the study on a Siemens Artiste linear accelerator using the integrated flat panel EPID.more » We included square fields, a picket fence, overlap and representative IMRT fields to measure output, flatness, symmetry, beam center, and percent difference from the standard. We also imposed a set of machine errors: MLC leaf position, machine output, and beam steering to compare with the standard. Results: Daily output was consistent within +/− 1%. Change in steering current by 1.4% and 2.4% resulted in a 3.2% and 6.3% change in flatness. 1 and 2mm MLC leaf offset errors were visibly obvious in difference plots, but passed a 3%/3mm gamma analysis. A simple test of transmission in a picket fence can catch a leaf offset error of a single leaf by 1mm. The entire morning QA sequence is performed in less than 30 minutes and images are automatically analyzed. Conclusion: Automated QA procedures could be used to provide more comprehensive information about the machine with less time and human involvement. We have also shown that other simple tests are better able to catch MLC leaf position errors than a 3%/3mm gamma analysis commonly used for IMRT and modulated arc treatments. Finally, this information could be used to watch trends of the machine and predict problems before they lead to costly machine downtime.« less

  7. 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

  8. 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

  9. Strategic Planning for Deepening the All-Around Structural Reform of Education: Issues of Structural Reform in the "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)"

    ERIC Educational Resources Information Center

    Songhua, Tan; Wang, Catherine Yan

    2012-01-01

    The "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)" (hereafter abbreviated as the "Guideline") posits that the development of education must be driven by reform and innovation. It devotes six chapters to mapping out the targets, tasks, and major policy measures for reforming the…

  10. 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

  11. 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

  12. 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

  13. Magnetically-actuated artificial cilia for microfluidic propulsion.

    PubMed

    Khaderi, S N; Craus, C B; Hussong, J; Schorr, N; Belardi, J; Westerweel, J; Prucker, O; Rühe, J; den Toonder, J M J; Onck, P R

    2011-06-21

    In this paper we quantitatively analyse the performance of magnetically-driven artificial cilia for lab-on-a-chip applications. The artificial cilia are fabricated using thin polymer films with embedded magnetic nano-particles and their deformation is studied under different external magnetic fields and flows. A coupled magneto-mechanical solid-fluid model that accurately captures the interaction between the magnetic field, cilia and fluid is used to simulate the cilia motion. The elastic and magnetic properties of the cilia are obtained by fitting the results of the computational model to the experimental data. The performance of the artificial cilia with a non-uniform cross-section is characterised using the numerical model for two channel configurations that are of practical importance: an open-loop and a closed-loop channel. We predict that the flow and pressure head generated by the artificial cilia can be as high as 18 microlitres per minute and 3 mm of water, respectively. We also study the effect of metachronal waves on the flow generated and show that the fluid propelled increases drastically compared to synchronously beating cilia, and is unidirectional. This increase is significant even when the phase difference between adjacent cilia is small. The obtained results provide guidelines for the optimal design of magnetically-driven artificial cilia for microfluidic propulsion.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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).

  20. 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...

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. Technical Note: Evaluation of plastic scintillator detector for small field stereotactic patient-specific quality assurance.

    PubMed

    Qin, Yujiao; Gardner, Stephen J; Kim, Joshua; Huang, Yimei; Wen, Ning; Doemer, Anthony; Chetty, Indrin J

    2017-10-01

    To evaluate the performance of a commercial plastic scintillator detector (PSD) for small-field stereotactic patient-specific quality assurance (QA) measurements using flattening-filter-free beam. A total of 10 spherical targets [volume range: (0.03 cc-2 cc)] were planned with two techniques: (a) dynamic conformal arc (DCA-10 plans) and (b) volumetric modulated arc therapy (VMAT-10 plans). All plans were generated using Varian Eclipse treatment planning system, and AcurosXB v.13 algorithm in 1.0 mm grid size. Additionally, 14 previously treated cranial and spine SRS plans were evaluated [6 DCA, 8 VMAT, volume range: (0.04 cc-119.02 cc)]. Plan modulation was quantified via two metrics: MU per prescription dose (MU/Rx) and Average Leaf Pair Opening (ALPO). QA was performed on the Varian Edge linear accelerator equipped with HDMLC. Three detectors were used: (a) PinPoint ion chamber (PTW; active volume 0.015 cc), (b) Exradin W1 PSD (Standard Imaging; active volume 0.002 cc), and (c) Gafchromic EBT3 film (Ashland). PinPoint chamber and PSD were positioned perpendicular to beam axis in a Lucy phantom (Standard Imaging); films were placed horizontally capturing the coronal plane. PSD, film, and PinPoint chamber measured average differences of 1.00 ± 1.54%, 1.30 ± 1.69%, and -0.66 ± 2.36%, respectively, compared to AcurosXB dose calculation. As the target volume decreased, PinPoint chamber measured lower doses (maximum -5.07% at 0.07 cc target), while PSD and film measured higher doses (2.87% and 2.54% at 0.03 cc target) than AcurosXB. Film agreed with the benchmark detector PSD by an average difference of 0.31 ± 1.20%, but suffered from larger uncertainty; PinPoint chamber underestimated dose by more than 4% for targets smaller than 0.2 cc. Taking PSD as the measurement standard, DCA plans achieved good QA results across all volumes studied, with an average of -0.07 ± 0.89%; for VMAT plans, PSD measured consistently higher dose (1.95 ± 1.36%) than AcurosXB. Correlation study revealed that plan modulation quantified by both MU/Rx and ALPO correlated significantly with QA results. Among all three detectors, PSD demonstrated superior performances in plans with small fields and heavy modulation. High consistency and low uncertainty made PSD a suitable detector for clinical routine SRS QA. PinPoint chamber should be avoided for targets smaller than 0.2 cc; film dosimetry can be utilized with careful evaluation of its uncertainty bracket. Compared to PSD measurements, AcurosXB calculation demonstrated high accuracy for nonmodulated small fields. The positive correlation between plan modulation and QA discrepancy calls for our attention for clinical SRS plans with high modulation. © 2017 American Association of Physicists in Medicine.

  8. Transformation of the California mental health system: stakeholder-driven planning as a transformational activity.

    PubMed

    Cashin, Cheryl; Scheffler, Richard; Felton, Mistique; Adams, Neal; Miller, Leonard

    2008-10-01

    This study describes strategies developed by California counties to transform their mental health systems under the 2004 Mental Health Services Act (MHSA). This voter initiative places a 1% tax on annual incomes over $1 million; tax monies are earmarked to transform county-operated mental health services into systems that are oriented more toward recovery. MHSA implementation itself can be considered "transformational" by balancing greater standardization of mental health service delivery in the state with a locally driven planning process. A qualitative content analysis of the three-year plans submitted by 12 counties to receive funds under MHSA was conducted to identify common themes, as well as innovative approaches. These 12 (out of 58) counties were chosen to represent both small and large counties, as well as geographic diversity, and they represent 62.3% of the state population. This analysis showed that the state guidelines and local planning process generated consistency across counties in establishing full-service partnerships with a "whatever it takes" approach to providing goal-directed services and supports to consumers and their families. There was, however, little convergence around the specific strategies to achieve this vision, reflecting both the local planning process and a relative lack of clear policy and guidance on evidence-based practices. There are many obstacles to the successful implementation of these ambitious plans. However, the state-guided, but stakeholder-driven, transformation in California appears to generate innovative approaches to recovery-oriented services, involve consumers and family members in service planning and delivery, and build community partnerships that create new opportunities for consumers to meet their recovery goals.

  9. SU-F-T-585: A Novel Phantom for Dosimetric Validation of SBRT for Spinal Lesions

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

    Papanikolaou, KN; Ha, C; Kirby, N

    2016-06-15

    Purpose: SBRT is proving to be a very efficacious treatment modality for an increasing number of indications, including spine lesions. We have developed a novel phantom to serve as an end-to-end QA tool for either patient specific QA or commissioning QA of SBRT for spine lesions. Methods: In this feasibility study, we have selected a patient with a single metastatic lesion in the L5 vertebral body. The patient’s CT simulation scan was used to develop a VMAT treatment plan delivering 18Gy to at least 90% of the target volume, following the guidelines of RTOG 0631. The treatment plan was developedmore » with the Pinnacle planning system using the adaptive convolution superposition calculation mode. The approved plan was re-calculated using the Monaco planning system. We performed a pseudo-in-vivo study whereby we manufactured two copies of a phantom to the exact shape and anatomy of the patient. The phantom was made from the CT images of the patient using a 3D printer with sub-millimeter accuracy. One phantom was filled with a gel dosimeter and the other was made with two ion chamber inserts to allow us to obtain point dose measurements in the target’s center and the spinal cord. Results: The prescribed dose of 18Gy was planned for the target while keeping the maximum spinal cord dose to less than 14Gy in 0.03cc of the cord. The VMAT plan was delivered to both the gel dosimeter filed phantom and the phantom with the ion chambers. The 3D gel dosimetry revealed a very good agreement between the monte carlo and measured point and volumetric dose. Conclusion: A patient like phantom was developed and validated for use as an end-to-end tool of dose verification for SBRT of spine lesions. We found that gel dosimetry is ideally suited to assess positional and dosimetric accuracy in 3D. RTsafe provided the phantoms and the gel dosimeter used for this study.« less

  10. Implementation of the validation testing in MPPG 5.a "Commissioning and QA of treatment planning dose calculations-megavoltage photon and electron beams".

    PubMed

    Jacqmin, Dustin J; Bredfeldt, Jeremy S; Frigo, Sean P; Smilowitz, Jennifer B

    2017-01-01

    The AAPM Medical Physics Practice Guideline (MPPG) 5.a provides concise guidance on the commissioning and QA of beam modeling and dose calculation in radiotherapy treatment planning systems. This work discusses the implementation of the validation testing recommended in MPPG 5.a at two institutions. The two institutions worked collaboratively to create a common set of treatment fields and analysis tools to deliver and analyze the validation tests. This included the development of a novel, open-source software tool to compare scanning water tank measurements to 3D DICOM-RT Dose distributions. Dose calculation algorithms in both Pinnacle and Eclipse were tested with MPPG 5.a to validate the modeling of Varian TrueBeam linear accelerators. The validation process resulted in more than 200 water tank scans and more than 50 point measurements per institution, each of which was compared to a dose calculation from the institution's treatment planning system (TPS). Overall, the validation testing recommended in MPPG 5.a took approximately 79 person-hours for a machine with four photon and five electron energies for a single TPS. Of the 79 person-hours, 26 person-hours required time on the machine, and the remainder involved preparation and analysis. The basic photon, electron, and heterogeneity correction tests were evaluated with the tolerances in MPPG 5.a, and the tolerances were met for all tests. The MPPG 5.a evaluation criteria were used to assess the small field and IMRT/VMAT validation tests. Both institutions found the use of MPPG 5.a to be a valuable resource during the commissioning process. The validation testing in MPPG 5.a showed the strengths and limitations of the TPS models. In addition, the data collected during the validation testing is useful for routine QA of the TPS, validation of software upgrades, and commissioning of new algorithms. © 2016 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  11. Space station pressurized laboratory safety guidelines

    NASA Technical Reports Server (NTRS)

    Mcgonigal, Les

    1990-01-01

    Before technical safety guidelines and requirements are established, a common understanding of their origin and importance must be shared between Space Station Program Management, the User Community, and the Safety organizations involved. Safety guidelines and requirements are driven by the nature of the experiments, and the degree of crew interaction. Hazard identification; development of technical safety requirements; operating procedures and constraints; provision of training and education; conduct of reviews and evaluations; and emergency preplanning are briefly discussed.

  12. The Serpent in Our Garden: Al-Qa’Ida and The Long War

    DTIC Science & Technology

    2008-03-25

    researched and written on terrorism since the late 1970s, holds the following observations in the new age of terrorism: - Terrorism has become...time of his fathers death in a helicopter crash at the age of eleven, it was estimated Osama inherited between eighty and three hundred million...Napoleonic warfare – conscription and firepower) through the 2nd-generation (U.S. Civil War/World War I – age of firepower and nation-state aligned

  13. A metadata reporting framework for standardization and synthesis of ecohydrological field observations

    NASA Astrophysics Data System (ADS)

    Christianson, D. S.; Varadharajan, C.; Detto, M.; Faybishenko, B.; Gimenez, B.; Jardine, K.; Negron Juarez, R. I.; Pastorello, G.; Powell, T.; Warren, J.; Wolfe, B.; McDowell, N. G.; Kueppers, L. M.; Chambers, J.; Agarwal, D.

    2016-12-01

    The U.S. Department of Energy's (DOE) Next Generation Ecosystem Experiment (NGEE) Tropics project aims to develop a process-rich tropical forest ecosystem model that is parameterized and benchmarked by field observations. Thus, data synthesis, quality assurance and quality control (QA/QC), and data product generation of a diverse and complex set of ecohydrological observations, including sapflux, leaf surface temperature, soil water content, and leaf gas exchange from sites across the Tropics, are required to support model simulations. We have developed a metadata reporting framework, implemented in conjunction with the NGEE Tropics Data Archive tool, to enable cross-site and cross-method comparison, data interpretability, and QA/QC. We employed a modified User-Centered Design approach, which involved short development cycles based on user-identified needs, and iterative testing with data providers and users. The metadata reporting framework currently has been implemented for sensor-based observations and leverages several existing metadata protocols. The framework consists of templates that define a multi-scale measurement position hierarchy, descriptions of measurement settings, and details about data collection and data file organization. The framework also enables data providers to define data-access permission settings, provenance, and referencing to enable appropriate data usage, citation, and attribution. In addition to describing the metadata reporting framework, we discuss tradeoffs and impressions from both data providers and users during the development process, focusing on the scalability, usability, and efficiency of the framework.

  14. 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.

  15. 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...

  16. 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...

  17. 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...

  18. 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.

  19. 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.

  20. 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

  1. Random Matrix Approach to Quantum Adiabatic Evolution Algorithms

    NASA Technical Reports Server (NTRS)

    Boulatov, Alexei; Smelyanskiy, Vadier N.

    2004-01-01

    We analyze the power of quantum adiabatic evolution algorithms (Q-QA) for solving random NP-hard optimization problems within a theoretical framework based on the random matrix theory (RMT). We present two types of the driven RMT models. In the first model, the driving Hamiltonian is represented by Brownian motion in the matrix space. We use the Brownian motion model to obtain a description of multiple avoided crossing phenomena. We show that the failure mechanism of the QAA is due to the interaction of the ground state with the "cloud" formed by all the excited states, confirming that in the driven RMT models. the Landau-Zener mechanism of dissipation is not important. We show that the QAEA has a finite probability of success in a certain range of parameters. implying the polynomial complexity of the algorithm. The second model corresponds to the standard QAEA with the problem Hamiltonian taken from the Gaussian Unitary RMT ensemble (GUE). We show that the level dynamics in this model can be mapped onto the dynamics in the Brownian motion model. However, the driven RMT model always leads to the exponential complexity of the algorithm due to the presence of the long-range intertemporal correlations of the eigenvalues. Our results indicate that the weakness of effective transitions is the leading effect that can make the Markovian type QAEA successful.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. Off-label use of medicines: The need for good practice guidelines.

    PubMed

    Dooms, Marc; Killick, James

    2017-01-01

    'Off-label use' is the term used for the prescription and dispensing of a medicinal product for any indication, patient group, route of administration, dosage or treatment regimen other than that listed in the Summary of Product Characteristics. In this article the authors present a brief overview of current practices of off-label use in Europe and the applicable European law and jurisprudence. They then go on to present a set of guidelines for best practice in off-label use which underlines the need for guidance on prescription to be firmly rooted in the need to ensure patient safety above all other concerns. The article was written from desk research and expert engagement, including a presentation and Q&A in the European Parliament. This article intends to demonstrate that off-label use entails increased risks for patients, especially when it is not underpinned by rigorous clinical studies or the reporting routes for use are not well defined. Europe is seeing a growing trend the promotion of off-label prescription of medicinal products for reasons other than pure medical need, including motives such as cost-containment. This poses a numer of questions for the ethical and legal framework for medicine prescription and dispensing in Europe.

  9. 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.

  10. SU-F-T-399: Migration of Treatment Planning Systems Without Beam Data Measurement

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

    Tolakanahalli, R; Tewatia, D

    2016-06-15

    Purpose: Data acquisition for commissioning is steered by Treatment Planning System (TPS) requirements which can be cumbersome and time consuming involving significant clinic downtime. The purpose of this abstract is to answer if we could circumvent this by extracting data from existing TPS and speed up the process. Methods: Commissioning beam data was obtained from a clinically commissioned TPS (Pinnacle™) using Matlab™ generated Pinnacle™ executable scripts to commission a secondary 3D dose verification TPS (Eclipse™). Profiles and output factors for commissioning as required by Eclipse™ were computed on a 50 cm{sup 3} water phantom at a dose grid resolution ofmore » 2mm3. Verification doses were computed and compared to clinical TPS dose profiles as per TG-106 guidelines. Standard patient plans from Pinnacle™ including IMRT and VMAT plans were re-computed keeping the same monitor units (in order to perform true comparison) using Eclipse™. Computed dose was exported back to Pinnacle for comparison to original plans. This methodology enables us to alleviate all ambiguities that arise in such studies. Results: Profile analysis using in-house software for 6x, showed that for all field sizes including small MLC generated fields, 100% of infield and penumbra data points of Eclipse™ match Pinnacle™ generated and measured profiles with 2%/2 mm gamma criteria. Excellent agreement was observed in the penumbra regions, with all data points passing DTA criteria for complex C-shaped and S-shaped profiles. Patient plan dose volume histograms (DVHs) and isodose lines agreed well to within a 1.5% for target coverage. Conclusion: Secondary 3D dose checking is of utmost importance with advanced techniques such as IMRT and VMAT. Migration of TPS is possible without compromising accuracy or enduring the cumbersome measurement of commissioning data. Economizing time for commissioning such a verification system or for migration of TPS can add great QA value and minimize downtime.« less

  11. Enrichment Clusters: A Practical Plan for Real-World, Student-Driven Learning.

    ERIC Educational Resources Information Center

    Renzulli, Joseph S.; Gentry, Marcia; Reis, Sally M.

    This guidebook provides a rationale and guidelines for implementing a student-driven learning approach using enrichment clusters. Enrichment clusters allow students who share a common interest to meet each week to produce a product, performance, or targeted service based on that common interest. Chapter 1 discusses different models of learning.…

  12. 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.

  13. 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.

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. Evaluation of procedures for quality assurance specifications

    DOT National Transportation Integrated Search

    2004-10-01

    The objective of this project was to develop a comprehensive quality assurance (QA) manual, supported by scientific evidence and statistical theory, which provides step-by-step procedures and instructions for developing effective and efficient QA spe...

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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...

  12. Antibacterial effect of composite resins containing quaternary ammonium polyethyleneimine nanoparticles

    NASA Astrophysics Data System (ADS)

    Yudovin-Farber, Ira; Beyth, Nurit; Weiss, Ervin I.; Domb, Abraham J.

    2010-02-01

    Quaternary ammonium polyethyleneimine (QA-PEI)-based nanoparticles were synthesized by crosslinking with dibromopentane followed by N-alkylation with various alkyl halides and further N-methylation with methyl iodide. Insoluble pyridinium-type particles were prepared by suspension polymerization of 4-vinyl pyridine followed by N-alkylation with alkyl halides. Polyamine-based nanoparticles embedded in restorative composite resin at 1% w/w were tested for antibacterial activity against Streptococcus mutans using direct contact test. Activity analysis revealed that the alkyl chain length of the QA-PEI nanoparticles plays a significant role in antibacterial activity of the reagent. The most potent compound was octyl-alkylated QA-PEI embedded in restorative composite resin at 1% w/w that totally inhibited S. mutans growth in 3-month-aged samples. This data indicates that restorative composite resin with antibacterial properties can be produced by the incorporation of QA-PEI nanoparticles.

  13. [Interaction between clinical and research towards venture business].

    PubMed

    Sumida, Iori

    2014-01-01

    The author as a medical physicist has supported multiple institutions where the advanced radiation therapies as well as the conventional radiation therapy have been performed. Since the advanced radiation treatment techniques have spread rapidly, the quality assurance (QA) has been more important and complex that results in the increase of QA items. In order to maintain the quality of radiation therapy as accurate as possible, the efficient and objective approach for performing QA should be important. Author has developed some QA software which has solved those approaches based on the experiment. In this paper the background in multiple institutions as a view point of radiation treatment situation is presented and what author contributes to those institutions by a medical physics support is shown, finally it is considered that how the developed software has spread in Japan and used for many institutions via venture business.

  14. Predictive time-series modeling using artificial neural networks for Linac beam symmetry: an empirical study.

    PubMed

    Li, Qiongge; Chan, Maria F

    2017-01-01

    Over half of cancer patients receive radiotherapy (RT) as partial or full cancer treatment. Daily quality assurance (QA) of RT in cancer treatment closely monitors the performance of the medical linear accelerator (Linac) and is critical for continuous improvement of patient safety and quality of care. Cumulative longitudinal QA measurements are valuable for understanding the behavior of the Linac and allow physicists to identify trends in the output and take preventive actions. In this study, artificial neural networks (ANNs) and autoregressive moving average (ARMA) time-series prediction modeling techniques were both applied to 5-year daily Linac QA data. Verification tests and other evaluations were then performed for all models. Preliminary results showed that ANN time-series predictive modeling has more advantages over ARMA techniques for accurate and effective applicability in the dosimetry and QA field. © 2016 New York Academy of Sciences.

  15. Peace Data Standard: A Practical and Theoretical Framework for Using Technology to Examine Intergroup Interactions

    PubMed Central

    Guadagno, Rosanna E.; Nelson, Mark; Lock Lee, Laurence

    2018-01-01

    The current paper presents a theoretical framework for standardizing Peace Data as a means of understanding the conditions under which people’s technology use results in positive engagement and peace. Thus, the main point of our paper is that Big Data can be conceptualized in terms of its value to peace. We define peace as a set of positive, prosocial behaviors that maximize mutually beneficial positive outcomes resulting from interactions with others. To accomplish this goal, we present hypothetical and real-world, data driven examples that illustrate our thinking in this domain and present guidelines for how to identify, collect, utilize, and evaluate Peace Data generated during mediated interactions and further suggest that Peace Data has four primary components: group identity information, behavior data, longitudinal data, and metadata. This paper concludes with a call for participation in a Peace Data association and suggested for guidelines for how scholars and practitioners can identify Peace Data in their own domains. Ethical considerations and suggestions for future research are also discussed. PMID:29892239

  16. Construction, Analysis, and Data-Driven Augmentation of Supersaturated Designs

    DTIC Science & Technology

    2013-09-01

    guidelines and considerations. 27 Table 7. Supersaturated Design Example with 8 Runs and 14 Factors Design Factors Run x1 x2 x3 x4 x5 x6 x7 x8 x9 x10 x11...much larger than the guidelines proposed by Marley 55 and Woods (2010). They recommend the factor-to-run ratio should be less than 2. Because our ratio...established approach in experimental design: Box (1992) provided general guidelines to consider, and traditional augmentation strategies like fold-over

  17. Hubble Space Telescope: SRM/QA observations and lessons learned

    NASA Technical Reports Server (NTRS)

    Rodney, George A.

    1990-01-01

    The Hubble Space Telescope (HST) Optical Systems Board of Investigation was established on July 2, 1990 to review, analyze, and evaluate the facts and circumstances regarding the manufacture, development, and testing of the HST Optical Telescope Assembly (OTA). Specifically, the board was tasked to ascertain what caused the spherical aberration and how it escaped notice until on-orbit operation. The error that caused the on-orbit spherical aberration in the primary mirror was traced to the assembly process of the Reflective Null Corrector, one of the three Null Correctors developed as special test equipment (STE) to measure and test the primary mirror. Therefore, the safety, reliability, maintainability, and quality assurance (SRM&QA) investigation covers the events and the overall product assurance environment during the manufacturing phase of the primary mirror and Null Correctors (from 1978 through 1981). The SRM&QA issues that were identified during the HST investigation are summarized. The crucial product assurance requirements (including nonconformance processing) for the HST are examined. The history of Quality Assurance (QA) practices at Perkin-Elmer (P-E) for the period under investigation are reviewed. The importance of the information management function is discussed relative to data retention/control issues. Metrology and other critical technical issues also are discussed. The SRM&QA lessons learned from the investigation are presented along with specific recommendations. Appendix A provides the MSFC SRM&QA report. Appendix B provides supplemental reference materials. Appendix C presents the findings of the independent optical consultants, Optical Research Associates (ORA). Appendix D provides further details of the fault-tree analysis portion of the investigation process.

  18. On the use of biomathematical models in patient-specific IMRT dose QA

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

    Zhen Heming; Nelms, Benjamin E.; Tome, Wolfgang A.

    2013-07-15

    Purpose: To investigate the use of biomathematical models such as tumor control probability (TCP) and normal tissue complication probability (NTCP) as new quality assurance (QA) metrics.Methods: Five different types of error (MLC transmission, MLC penumbra, MLC tongue and groove, machine output, and MLC position) were intentionally induced to 40 clinical intensity modulated radiation therapy (IMRT) patient plans (20 H and N cases and 20 prostate cases) to simulate both treatment planning system errors and machine delivery errors in the IMRT QA process. The changes in TCP and NTCP for eight different anatomic structures (H and N: CTV, GTV, both parotids,more » spinal cord, larynx; prostate: CTV, rectal wall) were calculated as the new QA metrics to quantify the clinical impact on patients. The correlation between the change in TCP/NTCP and the change in selected DVH values was also evaluated. The relation between TCP/NTCP change and the characteristics of the TCP/NTCP curves is discussed.Results:{Delta}TCP and {Delta}NTCP were summarized for each type of induced error and each structure. The changes/degradations in TCP and NTCP caused by the errors vary widely depending on dose patterns unique to each plan, and are good indicators of each plan's 'robustness' to that type of error.Conclusions: In this in silico QA study the authors have demonstrated the possibility of using biomathematical models not only as patient-specific QA metrics but also as objective indicators that quantify, pretreatment, a plan's robustness with respect to possible error types.« less

  19. SU-F-T-163: Improve Proton Therapy Efficiency: Report of a Workshop

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

    Zheng, Y; Flanz, J; Mah, D

    Purpose: The technology of proton therapy, especially the pencil beam scanning technique, is evolving very quickly. However, the efficiency of proton therapy seems to lag behind conventional photon therapy. The purpose of the abstract is to report on the findings of a workshop on improvement of QA, planning and treatment efficiency in proton therapy. Methods: A panel of physicists, clinicians, and vendor representatives from over 18 institutions in the United States and internationally were convened in Knoxville, Tennessee in November, 2015. The panel discussed several topics on how to improve proton therapy efficiency, including 1) lean principle and failure modemore » and effects analysis, 2) commissioning and machine QA, 3) treatment planning, optimization and evaluation, 4) patient positioning and IGRT, 5) vendor liaison and machine availability, and 6) staffing, education and training. Results: The relative time needed for machine QA, treatment planning & check in proton therapy was found to range from 1 to 2.5 times of that in photon therapy. Current status in proton QA, planning and treatment was assessed. Key areas for efficiency improvement, such as elimination of unnecessary QA items or steps and development of efficient software or hardware tools, were identified. A white paper to summarize our findings is being written. Conclusion: It is critical to improve efficiency by developing reliable proton beam lines, efficient software tools on treatment planning, optimization and evaluation, and dedicated proton QA device. Conscious efforts and collaborations from both industry leaders and proton therapy centers are needed to achieve this goal and further advance the technology of proton therapy.« less

  20. Training Scalable Restricted Boltzmann Machines Using a Quantum Annealer

    NASA Astrophysics Data System (ADS)

    Kumar, V.; Bass, G.; Dulny, J., III

    2016-12-01

    Machine learning and the optimization involved therein is of critical importance for commercial and military applications. Due to the computational complexity of many-variable optimization, the conventional approach is to employ meta-heuristic techniques to find suboptimal solutions. Quantum Annealing (QA) hardware offers a completely novel approach with the potential to obtain significantly better solutions with large speed-ups compared to traditional computing. In this presentation, we describe our development of new machine learning algorithms tailored for QA hardware. We are training restricted Boltzmann machines (RBMs) using QA hardware on large, high-dimensional commercial datasets. Traditional optimization heuristics such as contrastive divergence and other closely related techniques are slow to converge, especially on large datasets. Recent studies have indicated that QA hardware when used as a sampler provides better training performance compared to conventional approaches. Most of these studies have been limited to moderately-sized datasets due to the hardware restrictions imposed by exisitng QA devices, which make it difficult to solve real-world problems at scale. In this work we develop novel strategies to circumvent this issue. We discuss scale-up techniques such as enhanced embedding and partitioned RBMs which allow large commercial datasets to be learned using QA hardware. We present our initial results obtained by training an RBM as an autoencoder on an image dataset. The results obtained so far indicate that the convergence rates can be improved significantly by increasing RBM network connectivity. These ideas can be readily applied to generalized Boltzmann machines and we are currently investigating this in an ongoing project.

  1. Managing the Quality of Environmental Data in EPA Region 9

    EPA Pesticide Factsheets

    EPA Pacific Southwest, Region 9's Quality Assurance (QA) section's primary mission is to effectively oversee and carry out the Quality System and Quality Management Plan, and project-level quality assurance and quality control (QA/QC) activities.

  2. 40 CFR 98.434 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Contained in Pre-Charged Equipment or Closed-Cell Foams § 98.434 Monitoring and QA/QC requirements. (a) For... equipment or closed-cell foam in the correct quantities (metric tons) and units (kg per piece of equipment...

  3. 40 CFR 98.434 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Contained in Pre-Charged Equipment or Closed-Cell Foams § 98.434 Monitoring and QA/QC requirements. (a) For... equipment or closed-cell foam in the correct quantities (metric tons) and units (kg per piece of equipment...

  4. 40 CFR 98.434 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Contained in Pre-Charged Equipment or Closed-Cell Foams § 98.434 Monitoring and QA/QC requirements. (a) For... equipment or closed-cell foam in the correct quantities and units. [74 FR 56374, Oct. 30, 2009, as amended...

  5. 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.

  6. Exploring a model-driven architecture (MDA) approach to health care information systems development.

    PubMed

    Raghupathi, Wullianallur; Umar, Amjad

    2008-05-01

    To explore the potential of the model-driven architecture (MDA) in health care information systems development. An MDA is conceptualized and developed for a health clinic system to track patient information. A prototype of the MDA is implemented using an advanced MDA tool. The UML provides the underlying modeling support in the form of the class diagram. The PIM to PSM transformation rules are applied to generate the prototype application from the model. The result of the research is a complete MDA methodology to developing health care information systems. Additional insights gained include development of transformation rules and documentation of the challenges in the application of MDA to health care. Design guidelines for future MDA applications are described. The model has the potential for generalizability. The overall approach supports limited interoperability and portability. The research demonstrates the applicability of the MDA approach to health care information systems development. When properly implemented, it has the potential to overcome the challenges of platform (vendor) dependency, lack of open standards, interoperability, portability, scalability, and the high cost of implementation.

  7. MO-A-BRB-01: TG191: Clinical Use of Luminescent Dosimeters

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

    Kry, S.

    This presentation will highlight the upcoming TG-191 report: Clinical Use of Luminescent Dosimeters. Luminescent dosimetry based on TLD and OSLD is a practical, accurate, and precise technique for point dosimetry in medical physics applications. The charges of Task Group 191 were to detail the methodologies for practical and optimal luminescent dosimetry in a clinical setting. This includes (1) To review the variety of TLD/OSL materials available, including features and limitations of each. (2) To outline the optimal steps to achieve accurate and precise dosimetry with luminescent detectors and to evaluate the uncertainty induced when less rigorous procedures are used. (3)more » To develop consensus guidelines on the optimal use of luminescent dosimeters for clinical practice. (4) To develop guidelines for special medically relevant uses of TLDs/OSLs (e.g., mixed field i.e. photon/neutron dosimetry, particle beam dosimetry, skin dosimetry). While this report provides general guidelines for arbitrary TLD and OSLD processes, the report, and therefore this presentation, provide specific guidance for TLD-100 (LiF:Ti,Mg) and nanoDot (Al2O3:C) dosimeters because of their prevalence in clinical practice. Learning Objectives: Understand the available dosimetry systems, and basic theory of their operation Understand the range of dose determination methodologies and the uncertainties associated with them Become familiar with special considerations for TLD/OSLD relevant for special clinical situations Learn recommended commissioning and QA procedures for these dosimetry systems.« less

  8. MO-A-BRB-00: TG191: Clinical Use of Luminescent Dosimeters

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

    NONE

    This presentation will highlight the upcoming TG-191 report: Clinical Use of Luminescent Dosimeters. Luminescent dosimetry based on TLD and OSLD is a practical, accurate, and precise technique for point dosimetry in medical physics applications. The charges of Task Group 191 were to detail the methodologies for practical and optimal luminescent dosimetry in a clinical setting. This includes (1) To review the variety of TLD/OSL materials available, including features and limitations of each. (2) To outline the optimal steps to achieve accurate and precise dosimetry with luminescent detectors and to evaluate the uncertainty induced when less rigorous procedures are used. (3)more » To develop consensus guidelines on the optimal use of luminescent dosimeters for clinical practice. (4) To develop guidelines for special medically relevant uses of TLDs/OSLs (e.g., mixed field i.e. photon/neutron dosimetry, particle beam dosimetry, skin dosimetry). While this report provides general guidelines for arbitrary TLD and OSLD processes, the report, and therefore this presentation, provide specific guidance for TLD-100 (LiF:Ti,Mg) and nanoDot (Al2O3:C) dosimeters because of their prevalence in clinical practice. Learning Objectives: Understand the available dosimetry systems, and basic theory of their operation Understand the range of dose determination methodologies and the uncertainties associated with them Become familiar with special considerations for TLD/OSLD relevant for special clinical situations Learn recommended commissioning and QA procedures for these dosimetry systems.« less

  9. An ultrasound transient elastography system with coded excitation.

    PubMed

    Diao, Xianfen; Zhu, Jing; He, Xiaonian; Chen, Xin; Zhang, Xinyu; Chen, Siping; Liu, Weixiang

    2017-06-28

    Ultrasound transient elastography technology has found its place in elastography because it is safe and easy to operate. However, it's application in deep tissue is limited. The aim of this study is to design an ultrasound transient elastography system with coded excitation to obtain greater detection depth. The ultrasound transient elastography system requires tissue vibration to be strictly synchronous with ultrasound detection. Therefore, an ultrasound transient elastography system with coded excitation was designed. A central component of this transient elastography system was an arbitrary waveform generator with multi-channel signals output function. This arbitrary waveform generator was used to produce the tissue vibration signal, the ultrasound detection signal and the synchronous triggering signal of the radio frequency data acquisition system. The arbitrary waveform generator can produce different forms of vibration waveform to induce different shear wave propagation in the tissue. Moreover, it can achieve either traditional pulse-echo detection or a phase-modulated or a frequency-modulated coded excitation. A 7-chip Barker code and traditional pulse-echo detection were programmed on the designed ultrasound transient elastography system to detect the shear wave in the phantom excited by the mechanical vibrator. Then an elasticity QA phantom and sixteen in vitro rat livers were used for performance evaluation of the two detection pulses. The elasticity QA phantom's results show that our system is effective, and the rat liver results show the detection depth can be increased more than 1 cm. In addition, the SNR (signal-to-noise ratio) is increased by 15 dB using the 7-chip Barker coded excitation. Applying 7-chip Barker coded excitation technique to the ultrasound transient elastography can increase the detection depth and SNR. Using coded excitation technology to assess the human liver, especially in obese patients, may be a good choice.

  10. Identification and characterization of conservative organic tracers for use as hydrologic tracers for the Yucca Mountain site characterization study. Final report

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

    Stetzenbach, K.; Farnham, I.

    1996-06-01

    Extensive tracer testing is expected to take place at the C-well complex in the Nevada Test Site as part of the Yucca Mountain Site Characterization Project. The C-well complex consists of one pumping well, C3, and two injection wells, C1 and C2 into which tracer will be introduced. The goal of this research was to provide USGS with numerous tracers to completed these tests. Several classes of fluorinated organic acids have been evaluated. These include numerous isomers of fluorinated benzoic acids, cinnamic acids, and salicylic acids. Also several derivatives of 2-hydroxy nicotinic acid (pyridone) have been tested. The stability ofmore » these compounds was determined using batch and column tests. Ames testing (mutagenicity/carcinogenicity) was conducted on the fluorinated benzoic acids and a literature review of toxicity of the fluorobenzoates and three perfluoro aliphatic acids was prepared. Solubilities were measured and method development work was performed to optimize the detection of these compounds. A Quality Assurance (QA) Program was developed under existing DOE and USGS guidelines. The program includes QA procedures and technical standard operating procedures. A tracer test, using sodium iodide, was performed at the C-well complex. HRC chemists performed analyses on site, to provide real time data for the USGS hydrologists and in the laboratories at UNLV. Over 2,500 analyses were performed. This report provides the results of the laboratory experiments and literature reviews used to evaluate the potential tracers and reports on the results of the iodide C-well tracer test.« less

  11. CONFOCAL MICROSCOPY SYSTEM PERFORMANCE: QA TESTS, QUANTITATION AND SPECTROSCOPY

    EPA Science Inventory

    Confocal Microscopy System Performance: QA tests, Quantitation and Spectroscopy.

    Robert M. Zucker 1 and Jeremy M. Lerner 2,
    1Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research Development, U.S. Environmen...

  12. EVALUATION OF CONFOCAL MICROSCOPY SYSTEM PERFORMANCE: PRETTY PICTURES OR CONFOCAL QA

    EPA Science Inventory

    Evaluation of confocal microscopy system performance: Pretty pictures or confocal QA?

    Robert M. Zucker

    Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, N...

  13. INTRODUCING CHANGES TO QUALITY SYSTEMS IN LARGE, ESTABLISHED ORGANIZATIONS

    EPA Science Inventory

    To achieve the agency's mission of having defensible and reliable scientific data with which to make informed decisions, the EPA Quality Assurance (QA) community must continue its successful efforts in increasing support for QA activities through personal communication and carefu...

  14. Develop a Methodology to Evaluate the Effectiveness of QC/QA Specifications (Phase II)

    DOT National Transportation Integrated Search

    1998-08-01

    The Texas Department of Transportation (TxDOT) has been implementing statistically based quality control/quality assurance (QC/QA) specifications for hot mix asphalt concrete pavements since the early 1990s. These specifications have been continuousl...

  15. Quality assurance in radiotherapy.

    PubMed

    Kouloulias, V E

    2003-03-01

    In 1999, the European Organisation for Research and Treatment of Cancer (EORTC), being a European pioneer in the field of cancer research as well as in quality assurance (QA), launched an Emmanuel van der Schueren fellowship for QA in radiotherapy. In this paper, the work that has been done during the first E. van der Schueren fellowship is reported, focusing on four phase III EORTC clinical trials: 22921 for rectal cancer, 22961 and 22991 for prostate cancer and 22922 for breast cancer. A historical review of the QA programme of the EORTC Radiotherapy group during the past 20 years is included.

  16. 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.

  17. 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.

  18. Current external beam radiation therapy quality assurance guidance: does it meet the challenges of emerging image-guided technologies?

    PubMed

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

    2008-01-01

    The traditional prescriptive quality assurance (QA) programs that attempt to ensure the safety and reliability of traditional external beam radiation therapy are limited in their applicability to such advanced radiation therapy techniques as three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, inverse treatment planning, stereotactic radiosurgery/radiotherapy, and image-guided radiation therapy. The conventional QA paradigm, illustrated by the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 40 (TG-40) report, consists of developing a consensus menu of tests and device performance specifications from a generic process model that is assumed to apply to all clinical applications of the device. The complexity, variation in practice patterns, and level of automation of high-technology radiotherapy renders this "one-size-fits-all" prescriptive QA paradigm ineffective or cost prohibitive if the high-probability error pathways of all possible clinical applications of the device are to be covered. The current approaches to developing comprehensive prescriptive QA protocols can be prohibitively time consuming and cost ineffective and may sometimes fail to adequately safeguard patients. It therefore is important to evaluate more formal error mitigation and process analysis methods of industrial engineering to more optimally focus available QA resources on process components that have a significant likelihood of compromising patient safety or treatment outcomes.

  19. A Strategy to Establish a Quality Assurance/Quality Control Plan for the Application of Biosensors for the Detection of E. coli in Water.

    PubMed

    Hesari, Nikou; Kıratlı Yılmazçoban, Nursel; Elzein, Mohamad; Alum, Absar; Abbaszadegan, Morteza

    2017-01-03

    Rapid bacterial detection using biosensors is a novel approach for microbiological testing applications. Validation of such methods is an obstacle in the adoption of new bio-sensing technologies for water testing. Therefore, establishing a quality assurance and quality control (QA/QC) plan is essential to demonstrate accuracy and reliability of the biosensor method for the detection of E. coli in drinking water samples. In this study, different reagents and assay conditions including temperatures, holding time, E. coli strains and concentrations, dissolving agents, salinity and pH effects, quality of substrates of various suppliers of 4-methylumbelliferyl glucuronide (MUG), and environmental water samples were included in the QA/QC plan and used in the assay optimization and documentation. Furthermore, the procedural QA/QC for the monitoring of drinking water samples was established to validate the performance of the biosensor platform for the detection of E. coli using a culture-based standard technique. Implementing the developed QA/QC plan, the same level of precision and accuracy was achieved using both the standard and the biosensor methods. The established procedural QA/QC for the biosensor will provide a reliable tool for a near real-time monitoring of E. coli in drinking water samples to both industry and regulatory authorities.

  20. Allosteric potentiation of quisqualate receptors by a nootropic drug aniracetam.

    PubMed

    Ito, I; Tanabe, S; Kohda, A; Sugiyama, H

    1990-05-01

    1. Allosteric potentiation of the ionotropic quisqualate (iQA) receptor by a nootropic drug aniracetam (1-p-anisoyl-2-pyrrolidinone) was investigated using Xenopus oocytes injected with rat brain mRNA and rat hippocampal slices. 2. Aniracetam potentiates the iQA responses induced in Xenopus oocytes by rat brain mRNA in a reversible manner. This effect was observed above the concentrations of 0.1 mM. Kainate. N-methyl-D-aspartate and gamma-aminobutyric acid responses induced in the same oocytes were not affected. 3. The specific potentiation of iQA responses was accompanied by an increase in the conductance change of iQA and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) responses, but the affinity of receptors for agonist and the ion-selectivity of the channels (reversal potentials) were not changed. 4. Aniracetam reversibly potentiated the iQA responses recorded intracellularly from the pyramidal cells in the CA1 region of rat hippocampal slices. The excitatory postsynaptic potentials (EPSPs) in Schaffer collateral-commissural-CA1 synapses were also potentiated by aniracetam. 5. Population EPSPs recorded in the mossy fibre-CA3 synapses as well as Schaffer-commissural synapses were also potentiated by aniracetam. The amplitudes of the potentiation were not changed by the formation of long-term potentiation.

  1. Allosteric potentiation of quisqualate receptors by a nootropic drug aniracetam.

    PubMed Central

    Ito, I; Tanabe, S; Kohda, A; Sugiyama, H

    1990-01-01

    1. Allosteric potentiation of the ionotropic quisqualate (iQA) receptor by a nootropic drug aniracetam (1-p-anisoyl-2-pyrrolidinone) was investigated using Xenopus oocytes injected with rat brain mRNA and rat hippocampal slices. 2. Aniracetam potentiates the iQA responses induced in Xenopus oocytes by rat brain mRNA in a reversible manner. This effect was observed above the concentrations of 0.1 mM. Kainate. N-methyl-D-aspartate and gamma-aminobutyric acid responses induced in the same oocytes were not affected. 3. The specific potentiation of iQA responses was accompanied by an increase in the conductance change of iQA and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) responses, but the affinity of receptors for agonist and the ion-selectivity of the channels (reversal potentials) were not changed. 4. Aniracetam reversibly potentiated the iQA responses recorded intracellularly from the pyramidal cells in the CA1 region of rat hippocampal slices. The excitatory postsynaptic potentials (EPSPs) in Schaffer collateral-commissural-CA1 synapses were also potentiated by aniracetam. 5. Population EPSPs recorded in the mossy fibre-CA3 synapses as well as Schaffer-commissural synapses were also potentiated by aniracetam. The amplitudes of the potentiation were not changed by the formation of long-term potentiation. PMID:1975272

  2. Determination of perchlorate from tea leaves using quaternary ammonium modified magnetic carboxyl-carbon nanotubes followed by liquid chromatography-tandem quadrupole mass spectrometry.

    PubMed

    Zhao, Yong-Gang; Zhang, Yun; Wang, Feng-Lian; Zhou, Jian; Zhao, Qi-Ming; Zeng, Xiu-Qiong; Hu, Mei-Qin; Jin, Mi-Cong; Zhu, Yan

    2018-08-01

    The novel quaternary ammonium modified magnetic carboxyl-carbon nanotubes (QA-Mag-CCNTs) have been synthesised and characterized. QA-Mag-CCNTs were applied in magnetic dispersive solid phase extraction (Mag-dSPE) for preconcentration of perchlorate from tea leaves prior to liquid chromatography-tandem quadrupole mass spectrometry (LC-MS/MS) analysis. The Mag-dSPE procedure for preconcentration of perchlorate succeed in overcoming the flaw (containing target analyte randomly) of commercially available SPE cartridge. Under optimal conditions, the results showed higher extraction efficiency of QA-Mag-CCNTs, with recoveries between 85.2% and 107%. And the satisfactory precision with inter-day and intra-day RSD values were lower than 8.0%. Furthermore, QA-Mag-CCNTs were evaluated for reuse up to 20 times. The limit of quantification (LOQ) for perchlorate was 8.21 ng kg -1 . The developed method was successfully applied in tea leaves for food-safety risk monitoring in Zhejiang province, China. The results showed the concentrations of perchlorate in 229 out of 240 collected samples were in the range of 0.082-988 μg kg -1 . It was confirmed that QA-Mag-CCNTs were highly effective materials used for preconcentration of perchlorate. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. 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

  4. Contrasting patterns of RUNX2 repeat variations are associated with palate shape in phyllostomid bats and New World primates.

    PubMed

    Ferraz, Tiago; Rossoni, Daniela M; Althoff, Sérgio L; Pissinatti, Alcides; Paixão-Cortês, Vanessa R; Bortolini, Maria Cátira; González-José, Rolando; Marroig, Gabriel; Salzano, Francisco M; Gonçalves, Gislene L; Hünemeier, Tábita

    2018-05-18

    Establishing the genetic basis that underlies craniofacial variability in natural populations is one of the main topics of evolutionary and developmental studies. One of the genes associated with mammal craniofacial variability is RUNX2, and in the present study we investigated the association between craniofacial length and width and RUNX2 across New World bats (Phyllostomidae) and primates (Catarrhini and Platyrrhini). Our results showed contrasting patterns of association between the glutamate/alanine ratios (Q/A ratio) and palate shape in these highly diverse groups. In phyllostomid bats, we found an association between shorter/broader faces and increase of the Q/A ratio. In New World monkeys (NWM) there was a positive correlation of increasing Q/A ratios to more elongated faces. Our findings reinforced the role of the Q/A ratio as a flexible genetic mechanism that would rapidly change the time of skull ossification throughout development. However, we propose a scenario in which the influence of this genetic adjustment system is indirect. The Q/A ratio would not lead to a specific phenotype, but throughout the history of a lineage, would act along with evolutionary constraints, as well as other genes, as a facilitator for adaptive morphological changes.

  5. A Strategy to Establish a Quality Assurance/Quality Control Plan for the Application of Biosensors for the Detection of E. coli in Water

    PubMed Central

    Hesari, Nikou; Kıratlı Yılmazçoban, Nursel; Elzein, Mohamad; Alum, Absar; Abbaszadegan, Morteza

    2017-01-01

    Rapid bacterial detection using biosensors is a novel approach for microbiological testing applications. Validation of such methods is an obstacle in the adoption of new bio-sensing technologies for water testing. Therefore, establishing a quality assurance and quality control (QA/QC) plan is essential to demonstrate accuracy and reliability of the biosensor method for the detection of E. coli in drinking water samples. In this study, different reagents and assay conditions including temperatures, holding time, E. coli strains and concentrations, dissolving agents, salinity and pH effects, quality of substrates of various suppliers of 4-methylumbelliferyl glucuronide (MUG), and environmental water samples were included in the QA/QC plan and used in the assay optimization and documentation. Furthermore, the procedural QA/QC for the monitoring of drinking water samples was established to validate the performance of the biosensor platform for the detection of E. coli using a culture-based standard technique. Implementing the developed QA/QC plan, the same level of precision and accuracy was achieved using both the standard and the biosensor methods. The established procedural QA/QC for the biosensor will provide a reliable tool for a near real-time monitoring of E. coli in drinking water samples to both industry and regulatory authorities. PMID:28054956

  6. Multi-institutional MicroCT image comparison of image-guided small animal irradiators

    NASA Astrophysics Data System (ADS)

    Johnstone, Chris D.; Lindsay, Patricia; E Graves, Edward; Wong, Eugene; Perez, Jessica R.; Poirier, Yannick; Ben-Bouchta, Youssef; Kanesalingam, Thilakshan; Chen, Haijian; E Rubinstein, Ashley; Sheng, Ke; Bazalova-Carter, Magdalena

    2017-07-01

    To recommend imaging protocols and establish tolerance levels for microCT image quality assurance (QA) performed on conformal image-guided small animal irradiators. A fully automated QA software SAPA (small animal phantom analyzer) for image analysis of the commercial Shelley micro-CT MCTP 610 phantom was developed, in which quantitative analyses of CT number linearity, signal-to-noise ratio (SNR), uniformity and noise, geometric accuracy, spatial resolution by means of modulation transfer function (MTF), and CT contrast were performed. Phantom microCT scans from eleven institutions acquired with four image-guided small animal irradiator units (including the commercial PXi X-RAD SmART and Xstrahl SARRP systems) with varying parameters used for routine small animal imaging were analyzed. Multi-institutional data sets were compared using SAPA, based on which tolerance levels for each QA test were established and imaging protocols for QA were recommended. By analyzing microCT data from 11 institutions, we established image QA tolerance levels for all image quality tests. CT number linearity set to R 2  >  0.990 was acceptable in microCT data acquired at all but three institutions. Acceptable SNR  >  36 and noise levels  <55 HU were obtained at five of the eleven institutions, where failing scans were acquired with current-exposure time of less than 120 mAs. Acceptable spatial resolution (>1.5 lp mm-1 for MTF  =  0.2) was obtained at all but four institutions due to their large image voxel size used (>0.275 mm). Ten of the eleven institutions passed the set QA tolerance for geometric accuracy (<1.5%) and nine of the eleven institutions passed the QA tolerance for contrast (>2000 HU for 30 mgI ml-1). We recommend performing imaging QA with 70 kVp, 1.5 mA, 120 s imaging time, 0.20 mm voxel size, and a frame rate of 5 fps for the PXi X-RAD SmART. For the Xstrahl SARRP, we recommend using 60 kVp, 1.0 mA, 240 s imaging time, 0.20 mm voxel size, and 6 fps. These imaging protocols should result in high quality images that pass the set tolerance levels on all systems. Average SAPA computation time for complete QA analysis for a 0.20 mm voxel, 400 slice Shelley phantom microCT data set was less than 20 s. We present image quality assurance recommendations for image-guided small animal radiotherapy systems that can aid researchers in maintaining high image quality, allowing for spatially precise conformal dose delivery to small animals.

  7. Study of impacts of different evaluation criteria on gamma pass rates in VMAT QA using MatriXX and EPID

    NASA Astrophysics Data System (ADS)

    Noufal, Manthala Padannayil; Abdullah, Kallikuzhiyil Kochunny; Niyas, Puzhakkal; Subha, Pallimanhayil Abdul Raheem

    2017-12-01

    Aim: This study evaluates the impacts of using different evaluation criteria on gamma pass rates in two commercially available QA methods employed for the verification of VMAT plans using different hypothetical planning target volumes (PTVs) and anatomical regions. Introduction: Volumetric modulated arc therapy (VMAT) is a widely accepted technique to deliver highly conformal treatment in a very efficient manner. As their level of complexity is high in comparison to intensity-modulated radiotherapy (IMRT), the implementation of stringent quality assurance (QA) before treatment delivery is of paramount importance. Material and Methods: Two sets of VMAT plans were generated using Eclipse planning systems, one with five different complex hypothetical three-dimensional PTVs and one including three anatomical regions. The verification of these plans was performed using a MatriXX ionization chamber array embedded inside a MultiCube phantom and a Varian EPID dosimetric system attached to a Clinac iX. The plans were evaluated based on the 3%/3 mm, 2%/2 mm, and 1%/1 mm global gamma criteria and with three low-dose threshold values (0%, 10%, and 20%). Results: The gamma pass rates were above 95% in all VMAT plans, when the 3%/3mm gamma criterion was used and no threshold was applied. In both systems, the pass rates decreased as the criteria become stricter. Higher pass rates were observed when no threshold was applied and they tended to decrease for 10% and 20% thresholds. Conclusion: The results confirm the suitability of the equipments used and the validity of the plans. The study also confirmed that the threshold settings greatly affect the gamma pass rates, especially for lower gamma criteria.

  8. 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

  9. Design of the data quality control system for the ALICE O2

    NASA Astrophysics Data System (ADS)

    von Haller, Barthélémy; Lesiak, Patryk; Otwinowski, Jacek; ALICE Collaboration

    2017-10-01

    ALICE (A Large Ion Collider Experiment) is the heavy-ion detector designed to study the physics of strongly interacting matter and the quark-gluon plasma at the CERN Large Hadron Collider (LHC). A major upgrade of the experiment is planned for 2019-20. In order to cope with a 100 times higher data rate and with the continuous readout of the Time Projection Chamber (TPC), it is necessary to upgrade the Online and Offline computing to a new common system called O2. The online Data Quality Monitoring (DQM) and the offline Quality Assurance (QA) are critical aspects of the data acquisition and reconstruction software chains. The former intends to provide shifters with precise and complete information in order to quickly identify and overcome problems while the latter aims at providing good quality data for physics analyses. DQM and QA typically involve the gathering of data, its distributed analysis by user-defined algorithms, the merging of the resulting objects and their visualization. This paper discusses the architecture and the design of the data Quality Control system that regroups the DQM and QA. In addition it presents the main design requirements and early results of a working prototype. A special focus is put on the merging of monitoring objects generated by the QC tasks. The merging is a crucial and challenging step of the O2 system, not only for QC but also for the calibration. Various scenarios and implementations have been made and large-scale tests carried out. This document presents the final results of this extensive work on merging. We conclude with the plan of work for the coming years that will bring the QC to production by 2019.

  10. Guidelines in preparing computer-generated plots for NASA technical reports with the LaRC graphics output system

    NASA Technical Reports Server (NTRS)

    Taylor, N. L.

    1983-01-01

    To response to a need for improved computer-generated plots that are acceptable to the Langley publication process, the LaRC Graphics Output System has been modified to encompass the publication requirements, and a guideline has been established. This guideline deals only with the publication requirements of computer-generated plots. This report explains the capability that authors of NASA technical reports can use to obtain publication--quality computer-generated plots or the Langley publication process. The rules applied in developing this guideline and examples illustrating the rules are included.

  11. Pharmacy-Driven Dexmedetomidine Stewardship and Appropriate Use Guidelines in a Community Hospital Setting.

    PubMed

    Schickli, M Alexandra; Eberwein, Kip A; Short, Marintha R; Ratliff, Patrick D

    2017-01-01

    Dexmedetomidine is a widely utilized agent in the intensive care unit (ICU) because it does not suppress respiratory drive and may be associated with less delirium than midazolam or propofol. Cost of dexmedetomidine therapy and debate as to the proper duration of use has brought its use to the forefront of discussion. To validate the efficacy and cost savings associated with pharmacy-driven dexmedetomidine appropriate use guidelines and stewardship in mechanically ventilated patients. This was a retrospective cohort study of adult patients who received dexmedetomidine for ICU sedation while on mechanical ventilation at a 433-bed not-for-profit community hospital. Included patients were divided into pre-enactment (PRE) and postenactment (POST) of dexmedetomidine guideline groups. A total of 100 patients (50 PRE and 50 POST) were included in the analysis. A significant difference in duration of mechanical ventilation (11.1 vs 6.2 days, P = 0.006) and incidence of reintubation (36% vs 18% of patients, P = 0.043) was seen in the POST group. Aggregate use of dexmedetomidine 200-µg vials (37.1 vs 18.4 vials, P = 0.010) and infusion days (5.4 vs 2.5 days, P = 0.006) were significantly lower in the POST group. Dexmedetomidine acquisition cost savings were calculated at $374 456.15 in the POST group. There was no difference between the PRE and POST groups with regard to ICU length of stay, expected mortality, and observed mortality. Pharmacy-driven dexmedetomidine appropriate use guidelines decreased the use of dexmedetomidine and increased cost savings at a community hospital without adversely affecting clinical outcomes.

  12. EPA GEOSPATIAL QUALITY COUNCIL

    EPA Science Inventory

    The EPA Geospatial Quality Council (previously known as the EPA GIS-QA Team - EPA/600/R-00/009 was created to fill the gap between the EPA Quality Assurance (QA) and Geospatial communities. All EPA Offices and Regions were invited to participate. Currently, the EPA Geospatial Q...

  13. Development of concrete QC/QA specifications for highway construction in Kentucky.

    DOT National Transportation Integrated Search

    2001-08-01

    There is a growing trend toward quality-based specifications in highway construction. A large number of quality control/quality assurance (QC/QA) specifications shift the responsibility of day-to-day testing from the state DOH to the contractor. This...

  14. 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...

  15. Portland cement concrete pavement review of QC/QA data 2000 through 2009.

    DOT National Transportation Integrated Search

    2011-04-01

    This report analyzes the Quality Control/Quality Assurance (QC/QA) data for Portland cement concrete pavement : (PCCP) awarded in the years 2000 through 2009. Analysis of the overall performance of the projects is accomplished by : reviewing the Calc...

  16. QUALITY ASSURANCE IN RESEARCH LABORATORIES: RULES AND REASON

    EPA Science Inventory

    The progression of QA policies and their interpretations, at all EPA levels, has at times been troublesome to some scientists and QA professionals in EPA's Office of Research and Development, suggesting a need for more open discussions among all stakeholders than routinely occurs...

  17. Functional diversification of Arabidopsis SEC1-related SM proteins in cytokinetic and secretory membrane fusion.

    PubMed

    Karnahl, Matthias; Park, Misoon; Krause, Cornelia; Hiller, Ulrike; Mayer, Ulrike; Stierhof, York-Dieter; Jürgens, Gerd

    2018-06-12

    Sec1/Munc18 (SM) proteins contribute to membrane fusion by interacting with Qa-SNAREs or nascent trans -SNARE complexes. Gymnosperms and the basal angiosperm Amborella have only a single SEC1 gene related to the KEULE gene in Arabidopsis However, the genomes of most angiosperms including Arabidopsis encode three SEC1-related SM proteins of which only KEULE has been functionally characterized as interacting with the cytokinesis-specific Qa-SNARE KNOLLE during cell-plate formation. Here we analyze the closest paralog of KEULE named SEC1B. In contrast to the cytokinesis defects of keule mutants, sec1b mutants are homozygous viable. However, the keule sec1b double mutant was nearly gametophytically lethal, displaying collapsed pollen grains, which suggests substantial overlap between SEC1B and KEULE functions in secretion-dependent growth. SEC1B had a strong preference for interaction with the evolutionarily ancient Qa-SNARE SYP132 involved in secretion and cytokinesis, whereas KEULE interacted with both KNOLLE and SYP132. This differential interaction with Qa-SNAREs is likely conferred by domains 1 and 2a of the two SM proteins. Comparative analysis of all four possible combinations of the relevant SEC1 Qa-SNARE double mutants revealed that in cytokinesis, the interaction of SEC1B with KNOLLE plays no role, whereas the interaction of KEULE with KNOLLE is prevalent and functionally as important as the interactions of both SEC1B and KEU with SYP132 together. Our results suggest that functional diversification of the two SEC1-related SM proteins during angiosperm evolution resulted in enhanced interaction of SEC1B with Qa-SNARE SYP132, and thus a predominant role of SEC1B in secretion.

  18. Working alliance and empathy as mediators of brief telephone counseling for cigarette smokers who are not ready to quit

    PubMed Central

    Klemperer, Elias M.; Hughes, John R.; Callas, Peter W.; Solomon, Laura J.

    2016-01-01

    Working alliance and empathy are believed to be important components of counseling, though few studies have empirically tested this. We recently conducted a randomized controlled trial in which brief motivational and reduction counseling failed to increase the number of participants who made a quit attempt (QA) in comparison to usual care (i.e., brief advice to quit). Our negative findings could have been due to non-specific factors. This secondary analysis used a subset of participants (n=347) to test a) whether, in comparison to usual care, brief telephone-based motivational or reduction counseling predicted greater working alliance or empathy, b) whether changes in these non-specific factors predicted an increased probability of a QA at a 6-month follow-up, and c) whether counseling affected the probability of a QA via working alliance or empathy (i.e., mediation). Findings were similar for both active counseling conditions (motivational and reduction) vs usual care. In comparison to usual care, active counseling predicted greater working alliance (p<.001) and empathy (p<.05). Greater working alliance predicted a greater probability of a QA (p<.001) but, surprisingly, greater empathy predicted a decreased probability of a QA (p<.05) at the 6-month follow-up. Both working alliance (p<.001) and empathy (p<.05) mediated the active counseling's effects on the probability of a QA. One explanation for our motivational and reduction interventions' failure to influence QAs in comparison to usual care is that working alliance and empathy had opposing effects on quitting. Our analyses illustrate how testing non-specific factors as mediators can help explain why a treatment failed. PMID:28165273

  19. Working alliance and empathy as mediators of brief telephone counseling for cigarette smokers who are not ready to quit.

    PubMed

    Klemperer, Elias M; Hughes, John R; Callas, Peter W; Solomon, Laura J

    2017-02-01

    Working alliance and empathy are believed to be important components of counseling, although few studies have empirically tested this. We recently conducted a randomized controlled trial in which brief motivational and reduction counseling failed to increase the number of participants who made a quit attempt (QA) in comparison to usual care (i.e., brief advice to quit). Our negative findings could have been due to nonspecific factors. This secondary analysis used a subset of participants (n = 347) to test (a) whether, in comparison to usual care, brief telephone-based motivational or reduction counseling predicted greater working alliance or empathy; (b) whether changes in these nonspecific factors predicted an increased probability of a QA at a 6-month follow-up; and (c) whether counseling affected the probability of a QA via working alliance or empathy (i.e., mediation). Findings were similar for both active counseling conditions (motivational and reduction) versus usual care. In comparison to usual care, active counseling predicted greater working alliance (p < .001) and empathy (p < .05). Greater working alliance predicted a greater probability of a QA (p < .001) but, surprisingly, greater empathy predicted a decreased probability of a QA (p < .05) at the 6-month follow-up. Working alliance (p < .001) and empathy (p < .05) mediated the active counseling's effects on the probability of a QA. One explanation for our motivational and reduction interventions' failure to influence QAs in comparison to usual care is that working alliance and empathy had opposing effects on quitting. Our analyses illustrate how testing nonspecific factors as mediators can help explain why a treatment failed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Examination of the properties of IMRT and VMAT beams and evaluation against pre-treatment quality assurance results

    NASA Astrophysics Data System (ADS)

    Crowe, S. B.; Kairn, T.; Middlebrook, N.; Sutherland, B.; Hill, B.; Kenny, J.; Langton, C. M.; Trapp, J. V.

    2015-03-01

    This study aimed to provide a detailed evaluation and comparison of a range of modulated beam evaluation metrics, in terms of their correlation with QA testing results and their variation between treatment sites, for a large number of treatments. Ten metrics including the modulation index (MI), fluence map complexity, modulation complexity score (MCS), mean aperture displacement (MAD) and small aperture score (SAS) were evaluated for 546 beams from 122 intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) treatment plans targeting the anus, rectum, endometrium, brain, head and neck and prostate. The calculated sets of metrics were evaluated in terms of their relationships to each other and their correlation with the results of electronic portal imaging based quality assurance (QA) evaluations of the treatment beams. Evaluation of the MI, MAD and SAS suggested that beams used in treatments of the anus, rectum, head and neck were more complex than the prostate and brain treatment beams. Seven of the ten beam complexity metrics were found to be strongly correlated with the results from QA testing of the IMRT beams (p < 0.00008). For example, values of SAS (with multileaf collimator apertures narrower than 10 mm defined as ‘small’) less than 0.2 also identified QA passing IMRT beams with 100% specificity. However, few of the metrics are correlated with the results from QA testing of the VMAT beams, whether they were evaluated as whole 360° arcs or as 60° sub-arcs. Select evaluation of beam complexity metrics (at least MI, MCS and SAS) is therefore recommended, as an intermediate step in the IMRT QA chain. Such evaluation may also be useful as a means of periodically reviewing VMAT planning or optimiser performance.

  1. The role of monitoring interpretive rates, concordance between cytotechnologist and pathologist interpretations before sign-out, and turnaround time in gynecologic cytology quality assurance: findings from the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference working group 1.

    PubMed

    Clary, Karen M; Davey, Diane D; Naryshkin, Sonya; Austin, R Marshall; Thomas, Nicole; Chmara, Beth Anne; Sugrue, Chiara; Tworek, Joseph

    2013-02-01

    The College of American Pathologists (CAP) conducted a national survey of gynecologic cytology quality assurance (QA) practices. Experts in gynecologic cytology were asked to join 5 working groups that studied the survey data on different aspects of QA. Evaluating the survey data and follow-up questions online, together with a review of pertinent literature, the working groups developed a series of preliminary statements on good laboratory practices in cytology QA. These were presented at a consensus conference and electronic voting occurred. To evaluate a set of QA monitors in gynecologic cytology. Working group 1 evaluated (1) monitoring interpretive rate categories for Papanicolaou tests (Pap tests), (2) concordance of cytotechnologist and pathologist interpretations before sign-out, and (3) turnaround time for Pap tests. The statements are based on a survey of gynecologic cytology QA practice patterns and of opinions from working group members and consensus conference attendees. The outcomes of this process demonstrate the current state of practice patterns in gynecologic cytology QA. Monitoring interpretive rates for all Bethesda System categories is potentially useful, and it is most useful to monitor interpretive rates for cytotechnologists individually and in comparison to the entire laboratory. Laboratories need to determine what level of discrepancy between cytotechnologist and pathologist interpretations of Pap tests is important to track. Laboratories should consider formalizing procedures and policies to adjudicate such discrepant interpretations. Turnaround time should be monitored in gynecologic cytology, but individual laboratories should determine how to measure and use turnaround time internally.

  2. SU-F-P-07: Applying Failure Modes and Effects Analysis to Treatment Planning System QA

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

    Mathew, D; Alaei, P

    2016-06-15

    Purpose: A small-scale implementation of Failure Modes and Effects Analysis (FMEA) for treatment planning system QA by utilizing methodology of AAPM TG-100 report. Methods: FMEA requires numerical values for severity (S), occurrence (O) and detectability (D) of each mode of failure. The product of these three values gives a risk priority number (RPN). We have implemented FMEA for the treatment planning system (TPS) QA for two clinics which use Pinnacle and Eclipse TPS. Quantitative monthly QA data dating back to 4 years for Pinnacle and 1 year for Eclipse have been used to determine values for severity (deviations from predeterminedmore » doses at points or volumes), and occurrence of such deviations. The TPS QA protocol includes a phantom containing solid water and lung- and bone-equivalent heterogeneities. Photon and electron plans have been evaluated in both systems. The dose values at multiple distinct points of interest (POI) within the solid water, lung, and bone-equivalent slabs, as well as mean doses to several volumes of interest (VOI), have been re-calculated monthly using the available algorithms. Results: The computed doses vary slightly month-over-month. There have been more significant deviations following software upgrades, especially if the upgrade involved re-modeling of the beams. TG-100 guidance and the data presented here suggest an occurrence (O) of 2 depending on the frequency of re-commissioning the beams, severity (S) of 3, and detectability (D) of 2, giving an RPN of 12. Conclusion: Computerized treatment planning systems could pose a risk due to dosimetric errors and suboptimal treatment plans. The FMEA analysis presented here suggests that TPS QA should immediately follow software upgrades, but does not need to be performed every month.« less

  3. Involving mental health service users in quality assurance

    PubMed Central

    Weinstein, Jenny

    2006-01-01

    Abstract Objective  This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. Background  QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. Design  This retrospective small‐scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection‐type event and one that took place in 2000 as a collaborative process with a user‐led QA agenda. Setting and participants  The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention  The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user‐led QA process for service development. Results  The first traditional top–down inspection‐type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user‐led agenda focused on different priorities, evolving a new approach to seeking users’ views and achieving a higher response rate. Conclusions  Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization. PMID:16677189

  4. A Comprehensive Quality Assurance Program for Personnel and Procedures in Radiation Oncology: Value of Voluntary Error Reporting and Checklists

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

    Kalapurakal, John A., E-mail: j-kalapurakal@northwestern.edu; Zafirovski, Aleksandar; Smith, Jeffery

    Purpose: This report describes the value of a voluntary error reporting system and the impact of a series of quality assurance (QA) measures including checklists and timeouts on reported error rates in patients receiving radiation therapy. Methods and Materials: A voluntary error reporting system was instituted with the goal of recording errors, analyzing their clinical impact, and guiding the implementation of targeted QA measures. In response to errors committed in relation to treatment of the wrong patient, wrong treatment site, and wrong dose, a novel initiative involving the use of checklists and timeouts for all staff was implemented. The impactmore » of these and other QA initiatives was analyzed. Results: From 2001 to 2011, a total of 256 errors in 139 patients after 284,810 external radiation treatments (0.09% per treatment) were recorded in our voluntary error database. The incidence of errors related to patient/tumor site, treatment planning/data transfer, and patient setup/treatment delivery was 9%, 40.2%, and 50.8%, respectively. The compliance rate for the checklists and timeouts initiative was 97% (P<.001). These and other QA measures resulted in a significant reduction in many categories of errors. The introduction of checklists and timeouts has been successful in eliminating errors related to wrong patient, wrong site, and wrong dose. Conclusions: A comprehensive QA program that regularly monitors staff compliance together with a robust voluntary error reporting system can reduce or eliminate errors that could result in serious patient injury. We recommend the adoption of these relatively simple QA initiatives including the use of checklists and timeouts for all staff to improve the safety of patients undergoing radiation therapy in the modern era.« less

  5. Facing the facts: The Runx2 gene is associated with variation in facial morphology in primates.

    PubMed

    Ritzman, Terrence B; Banovich, Nicholas; Buss, Kaitlin P; Guida, Jennifer; Rubel, Meagan A; Pinney, Jennifer; Khang, Bao; Ravosa, Matthew J; Stone, Anne C

    2017-10-01

    The phylogenetic and adaptive factors that cause variation in primate facial form-including differences among the major primate clades and variation related to feeding and/or social behavior-are relatively well understood. However, comparatively little is known about the genetic mechanisms that underlie diversity in facial form in primates. Because it is essential for osteoblastic differentiation and skeletal development, the runt-related transcription factor 2 (Runx2) is one gene that may play a role in these genetic mechanisms. Specifically, polymorphisms in the QA ratio (determined by the ratio of the number of polyglutamines to polyalanines in one functional domain of Runx2) have been shown to be correlated with variation in facial length and orientation in other mammal groups. However, to date, the relationship between variation in this gene and variation in facial form in primates has not been explicitly tested. To test the hypothesis that the QA ratio is correlated with facial form in primates, the current study quantified the QA ratio, facial length, and facial angle in a sample of 33 primate species and tested for correlation using phylogenetic generalized least squares. The results indicate that the QA ratio of the Runx2 gene is positively correlated with variation in relative facial length in anthropoid primates. However, no correlation was found in strepsirrhines, and there was no correlation between facial angle and the QA ratio in any groups. These results suggest that, in primates, the QA ratio of the Runx2 gene may play a role in modulating facial size, but not facial orientation. This study therefore provides important clues about the genetic and developmental mechanisms that may underlie variation in facial form in primates. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. [Introduction of a quality management system compliant with DIN EN 9001:2000 in a university department of nuclear medicine].

    PubMed

    Jansen-Schmidt, V; Paschen, U; Kröger, S; Bohuslavizki, K H; Clausen, M

    2001-12-01

    In 1995, the management of the University Clinic Hamburg-Eppendorf proposed to establish a total quality assurance (QA) system. A revised QA-system has been introduced stepwise in the department of nuclear medicine since 1997, and certification was achieved in accordance with DIN EN ISO 9001:2000 on February 14, 2001. The QA-handbook is divided into two parts. The first part contains operational (diagnostic and therapeutic) procedures in so-called standard operating procedures (SOP). They describe the indication of procedures as well as the competences and time necessary in a standardized manner. Up to now, more than 70 SOPs have been written as a collaborative approach between technicians and physicians during daily clinical routine after analysing and discussing the procedures. Thus, the results were more clearly defined processes and more satisfied employees. The second part consists of general rules and directions concerning the security of work and equipment as well as radiation protection tasks, hygiene etc. as it is required by the law. This part was written predominantly by the management of the department of nuclear-medicine and the QA-coordinator. Detailed information for the patients, documentation of the work-flows as well as the medical report was adopted to the QM-system. Although in the introduction phase of a QA-system a vast amount of time is necessary, some months later a surplus for the clinical workday will become available. The well defined relations of competences and procedures will result in a gain of time, a reduction of costs and a help to ensure the legal demands. Last but not least, the QA-system simply helps to build up confidence and acceptance both by the patients and the referring physicians.

  7. Enhanced susceptibility to acute pneumococcal otitis media in mice deficient in complement C1qa, factor B, and factor B/C2.

    PubMed

    Tong, Hua Hua; Li, Yong Xing; Stahl, Gregory L; Thurman, Joshua M

    2010-03-01

    To define the roles of specific complement activation pathways in host defense against Streptococcus pneumoniae in acute otitis media (AOM), we investigated the susceptibility to AOM in mice deficient in complement factor B and C2 (Bf/C2(-/)(-)), C1qa (C1qa(-/)(-)), and factor B (Bf(-)(/)(-)). Bacterial titers of both S. pneumoniae serotype 6A and 14 in the middle ear lavage fluid samples from Bf/C2(-/)(-), Bf(-)(/)(-), and C1qa(-/)(-) mice were significantly higher than in samples from wild-type mice 24 h after transtympanical infection (P < 0.05) and remained persistently higher in samples from Bf/C2(-/)(-) mice than in samples from wild-type mice. Bacteremia occurred in Bf/C2(-/)(-), Bf(-)(/)(-), and C1qa(-/)(-) mice infected with both strains, but not in wild-type mice. Recruitment of inflammatory cells was paralleled by enhanced production of inflammatory mediators in the middle ear lavage samples from Bf/C2(-/)(-) mice. C3b deposition on both strains was greatest for sera obtained from wild-type mice, followed by C1qa(-)(/)(-) and Bf(-)(/)(-) mice, and least for Bf/C2(-)(/)(-) mice. Opsonophagocytosis and whole-blood killing capacity of both strains were significantly decreased in the presence of sera or whole blood from complement-deficient mice compared to wild-type mice. These findings indicate that both the classical and alternative complement pathways are critical for middle ear immune defense against S. pneumoniae. The reduced capacity of complement-mediated opsonization and phagocytosis in the complement-deficient mice appears to be responsible for the impaired clearance of S. pneumoniae from the middle ear and dissemination to the bloodstream during AOM.

  8. Radiation oncology and medical physicists quality assurance in British Columbia Cancer Agency Provincial Prostate Brachytherapy Program.

    PubMed

    Keyes, Mira; Morris, William James; Spadinger, Ingrid; Araujo, Cynthia; Cheung, Arthur; Chng, Nick; Crook, Juanita; Halperin, Ross; Lapointe, Vince; Miller, Stacy; Pai, Howard; Pickles, Tom

    2013-01-01

    To describe in detail British Columbia (BC) Cancer Agency (BCCA) Provincial Prostate Brachytherapy (PB) Quality Assurance (QA) Program. The BCCA PB Program was established in 1997. It operates as one system, unified and supported by electronic and information systems, making it a single PB treatment provider for province of BC and Yukon. To date, >4000 patients have received PB (450 implants in 2011), making it the largest program in Canada. The Program maintains a large provincial prospective electronic database with records on all patients, including disease characteristics, risk stratification, pathology, preplan and postimplant dosimetric data, follow-up of prostate-specific antigen, and toxicity outcomes. QA was an integral part of the program since its inception. A formal QA Program was established in 2002, with key components that include: unified eligibility criteria and planning system, comprehensive database, physics and oncologist training and mentorship programs, peer review process, individual performance outcomes and feedback process, structured continuing education and routine assessment of the program's dosimetry, toxicity and prostate-specific antigen outcomes, administration and program leadership that promotes a strong culture of patient safety. The emphasis on creating a robust, broad-based network of skilled providers has been achieved by the program's requirements for training, education, and the QA process. The formal QA process is considered a key factor for the success of cancer control outcomes achieved at BCCA. Although this QA model may not be wholly transferable to all PB programs, some of its key components may be applicable to other programs to ensure quality in PB and patient safety. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  9. Towards Ontology-Driven Information Systems: Guidelines to the Creation of New Methodologies to Build Ontologies

    ERIC Educational Resources Information Center

    Soares, Andrey

    2009-01-01

    This research targeted the area of Ontology-Driven Information Systems, where ontology plays a central role both at development time and at run time of Information Systems (IS). In particular, the research focused on the process of building domain ontologies for IS modeling. The motivation behind the research was the fact that researchers have…

  10. 40 CFR 98.364 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... by Gas Chromatography (incorporated by reference see § 98.7). All gas composition monitors shall be...-90 (Reapproved 2006) Standard Practice for Analysis of Reformed Gas by Gas Chromatography... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Manure Management § 98.364 Monitoring and QA/QC requirements...

  11. 40 CFR 98.364 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... by Gas Chromatography (incorporated by reference see § 98.7). All gas composition monitors shall be...-90 (Reapproved 2006) Standard Practice for Analysis of Reformed Gas by Gas Chromatography... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Manure Management § 98.364 Monitoring and QA/QC requirements...

  12. QC/QA differences between hot mix asphalt (HMA) and warm mix asphalt (WMA).

    DOT National Transportation Integrated Search

    2013-01-01

    WMA represents a group of technologies which allow a reduction in temperatures at which asphalt mixtures are produced and placed on the road. ODOT Materials Division has conducted preliminary inquiries into QC/QA testing for WMA. Some respondents ind...

  13. 40 CFR 98.164 - Monitoring and QA/QC requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING Hydrogen Production § 98.164 Monitoring and QA/QC requirements. The GHG emissions data for hydrogen production process units must be quality-assured as specified in... Instrumental Determination of Carbon, Hydrogen, and Nitrogen in Petroleum Products and Lubricants (incorporated...

  14. Hot mix asphalt voids acceptance review of QC/QA data 2000 through 2010.

    DOT National Transportation Integrated Search

    2011-10-01

    This report analyzes the quality control/quality assurance (QC/QA) data for hot mix asphalt (HMA) using : voids acceptance as the testing criteria awarded in the years 2000 through 2010. Analysis of the overall : performance of the projects is accomp...

  15. 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...

  16. Maintaining High Quality Data and Consistency Across a Diverse Flux Network: The Ameriflux QA/QC Technical Team

    NASA Astrophysics Data System (ADS)

    Chan, S.; Billesbach, D. P.; Hanson, C. V.; Biraud, S.

    2014-12-01

    The AmeriFlux quality assurance and quality control (QA/QC) technical team conducts short term (<2 weeks) intercomparisons using a portable eddy covariance system (PECS) to maintain high quality data observations and data consistency across the AmeriFlux network (http://ameriflux.lbl.gov/). Site intercomparisons identify discrepancies between the in situ and portable measurements and calculated fluxes. Findings are jointly discussed by the site staff and the QA/QC team to improve in the situ observations. Despite the relatively short duration of an individual site intercomparison, the accumulated record of all site visits (numbering over 100 since 2002) is a unique dataset. The ability to deploy redundant sensors provides a rare opportunity to identify, quantify, and understand uncertainties in eddy covariance and ancillary measurements. We present a few specific case studies from QA/QC site visits to highlight and share new and relevant findings related to eddy covariance instrumentation and operation.

  17. 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

  18. 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.

  19. Technical note: A 3D-printed phantom for routine accuracy check of Gamma Knife Icon HDMM system.

    PubMed

    Wu, Chuan; Radevic, Marlyn B; Glass, Jennifer S; Skubic, Stan E

    2018-05-23

    To report a novel 3D-printed device ("SH phantom") that is designed for routine accuracy check of the Gamma Knife Icon High Definition Motion Management (HDMM) system. SH phantom was designed using tinkerCAD software and printed on a commercial 3D printer. We evaluated the SH phantom on our Gamma Knife Icon unit regarding its usability and accuracy for routine HDMM QA. Single-axis and multiple-axis measurements validated the SH phantom design and implementation. An HDMM QA accuracy of 0.22 mm or better along single axis was found using SH phantom. The SH phantom proved to be a quick and simple tool to use to perform the HDMM system QA. The SH phantom was tested successfully and adopted by us as part of monthly QA for the Gamma Knife Icon. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  20. A model-driven privacy compliance decision support for medical data sharing in Europe.

    PubMed

    Boussi Rahmouni, H; Solomonides, T; Casassa Mont, M; Shiu, S; Rahmouni, M

    2011-01-01

    Clinical practitioners and medical researchers often have to share health data with other colleagues across Europe. Privacy compliance in this context is very important but challenging. Automated privacy guidelines are a practical way of increasing users' awareness of privacy obligations and help eliminating unintentional breaches of privacy. In this paper we present an ontology-plus-rules based approach to privacy decision support for the sharing of patient data across European platforms. We use ontologies to model the required domain and context information about data sharing and privacy requirements. In addition, we use a set of Semantic Web Rule Language rules to reason about legal privacy requirements that are applicable to a specific context of data disclosure. We make the complete set invocable through the use of a semantic web application acting as an interactive privacy guideline system can then invoke the full model in order to provide decision support. When asked, the system will generate privacy reports applicable to a specific case of data disclosure described by the user. Also reports showing guidelines per Member State may be obtained. The advantage of this approach lies in the expressiveness and extensibility of the modelling and inference languages adopted and the ability they confer to reason with complex requirements interpreted from high level regulations. However, the system cannot at this stage fully simulate the role of an ethics committee or review board.

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