Aspects Of Quality Assurance Research Articles

Clinical aspects of spatially fractionated radiation therapy treatments

PurposeTo provide clinical guidance for centers wishing to implement photon spatially fractionated radiation therapy (SFRT) treatments using either a brass grid or volumetric modulated arc therapy (VMAT) lattice approach. MethodsWe describe in detail processes which have been developed over the course of a 3-year period during which our institution treated over 240 SFRT cases. The importance of patient selection, along with aspects of simulation, treatment planning, quality assurance, and treatment delivery are discussed. Illustrative examples involving clinical cases are shown, and we discuss safety implications relevant to the heterogeneous dose distributions. ResultsSFRT can be an effective modality for tumors which are otherwise challenging to manage with conventional radiation therapy techniques or for patients who have limited treatment options. However, SFRT has several aspects which differ drastically from conventional radiation therapy treatments. Therefore, the successful implementation of an SFRT treatment program requires the multidisciplinary expertise and collaboration of physicians, physicists, dosimetrists, and radiation therapists. ConclusionsWe have described methods for patient selection, simulation, treatment planning, quality assurance and delivery of clinical SFRT treatments which were built upon our experience treating a large patient population with both a brass grid and VMAT lattice approach. Preclinical research and patient trials aimed at understanding the mechanism of action are needed to elucidate which patients may benefit most from SFRT, and ultimately expand its use.

Best Practice Guideline - DEGUM Recommendations on Breast Ultrasound.

Alongside mammography, breast ultrasound is an important and well-established method in assessment of breast lesions. With the "Best Practice Guideline", the DEGUM Breast Ultrasound (in German, "Mammasonografie") working group, intends to describe the additional and optional application modalities for the diagnostic confirmation of breast findings and to express DEGUM recommendations in this Part II, in addition to the current dignity criteria and assessment categories published in Part I, in order to facilitate the differential diagnosis of ambiguous lesions.The present "Best Practice Guideline" has set itself the goal of meeting the requirements for quality assurance and ensuring quality-controlled performance of breast ultrasound. The most important aspects of quality assurance are explained in this Part II of the Best Practice Guideline.

Influence of powder size on defect generation in laser powder bed fusion of AlSi10Mg alloy

The particle size distribution (PSD) often changes as powders are cycled for recycled and different powder batches are used, challenging a critical aspect of quality assurance in the Laser Powder Bed Fusion (LPBF) process. It is therefore important to understand how powder PSD affects the processability of powder in the context of LPBF. In this work, a batch of AlSi10Mg powder was sieved into four sets of powder with controlled PSD (D50 ranging from 16 μm to 76 μm). Single-track and cuboid samples were made from powders with variations in laser power whiling fixing other laser processing parameters constantly. It is shown that coarser powders are much more sensitive to changes in laser power in terms of melt pool characteristics, defect population and size, showing significant improvements in relative density upon increasing laser power. The simulations reveal with the combination of low laser power and coarse powders, pores mainly originate from insufficient melting of powders at the sides of melt pools due to insufficient and inhomogeneous absorption of laser energy. It is possible to achieve nearly fully-dense parts when processing coarse powders given that the incident laser beam energy is sufficient.

No time for improvement? The chronopolitics of quality assurance

Time is an omnipresent key dimension in everyone’s life, yet academic time has only recently found scholarly attention. The temporal aspects of quality assurance, in particular, are basically unchartered territory. Taking a chronopolitical perspective, this article aims to close the gap, by critically examining how temporalities are firmly embedded in many quality assurance schemes and routines. Using various examples from internal and external quality assurance, the author demonstrates and discusses how such mechanisms are not only binding time but regulating and governing it, imposing temporal norms regarding tempo, rhythm, time-spans, time-scales and time ownership on higher education institutions and the people working and learning there. Concludingly, the article advocates a more reflective approach towards the notion of time in quality assurance, as latent temporalities appear to be far more consequential for the effectiveness of quality assurance than methodological micro-differences.

Managerial and engineering solutions made to ensure the quality of construction and installation work at various stages of the life cycle of a construction facility

Introduction. Current regulations indicate the need to ensure the quality of work performed at various stages of construction projects. Pursuant to the Urban Planning Code, quality control functions are assigned to a technical coordinator, as well as organizations that perform the work themselves. A number of approved sets of rules describe basic principles to be complied with by the companies performing this work. Research literature also focuses on and describes in detail the main problems that arise during the implementation of capital construction projects, as well as methods and techniques used to prevent and eliminate any deviations thus identified. At the same time, very few research works address fundamentals of work performance procedures and quality assurance technologies applied in the course of engineering surveying, development of design documentation and project budgets, performance of construction and installation work, operation, demolition and disposal of construction waste. These works are fragmented and disparate elements of a consolidated quality assurance system, and they need more research.
 
 Materials and methods. The author analyzed current regulations that ensure principal aspects of quality assurance at various stages of the life cycle of a construction facility. Principles of the systems approach to construction procedures and technologies, needed to ensure the pre-set parameters, are proposed. Specific conditions of construction control at the stage of engineering surveys and implementation of construction and installation works (including reconstruction, restoration, major repairs) of various classes of reliability and durability are considered.
 
 Results. Current regulations, documentation and scientific research projects, used to perform construction control, inspection of buildings and structures, as well as various types of monitoring, do not allow for the uniformity of companies responsible for quality assurance.
 
 Conclusions. The proposed systems approach to the arrangement of quality assurance work at various stages of the life cycle of a construction facility will in the shortest possible time allow for the development of uniform principles underlying the operation of entities that guarantee quality, prevent and timely identify various deviations.

Human-in-control and quality assurance aspects for a benchmarking framework for DeepFake detection models

Human-in-control is a principle that has long been established in forensics as a strict requirement and is nowadays also receiving more and more attention in many other fields of application where artificial intelligence (AI) is used. This renewed interest is due to the fact that many regulations (among others the the EU Artificial Intelligence Act (AIA)) emphasize it as a necessity for any critical AI application scenario. In this paper, human-in-control and quality assurance aspects for a benchmarking framework to be used in media forensics are discussed and their usage is illustrated in the context of the media forensics sub-discipline of DeepFake detection.

Assessment of the Quality of Obstetric Services From the Perspective of Maternity Patients and Service Providers in a Tertiary Care Obstetric Unit in Lithuania.

Although largely focused on the patient, the provision of healthcare services is a 2-way process and its success hinges on the interactions between patients and physicians. Given the growing role of subjective, patient-dependent assessment of the quality of care received, which is increasingly influenced by the individual aspects of the interaction between patients and care providers, in addition to the explicitly measurable, objective assessment of the quality of care received based on clinical indicators, quality assessment of services should especially consider and explore the attitudes, needs and dynamics of all the parties involved in the healthcare process. This study was designed to assess the attitudes of maternity patients and healthcare providers towards the quality of obstetric care. A quantitative questionnaire survey was conducted in a tertiary level healthcare facility providing obstetric services in Lithuania. Research findings suggested that maternity patients rate both the technical and functional quality of obstetric services higher than the staff providing it. Midwives and obstetricians-gynaecologists view quality assurance as a complex process, rather than focus solely on quantitative indicators. Since midwives were rated slightly higher than physicians in terms of services they provide, it may be appropriate to ensure and encourage a wider use of midwife-only deliveries in low-risk births. A comprehensive assessment of the quality assurance aspects as viewed by the patients and the staff should be included in the regular quality assessments of healthcare facilities as one of the most informative assessment tools on the service quality.

Randomized Trials Fit for the 21st Century: A Joint Opinion From the European Society of Cardiology, American Heart Association, American College of Cardiology, and the World Heart Federation.

Randomized Trials Fit for the 21st Century: A Joint Opinion From the European Society of Cardiology, American Heart Association, American College of Cardiology, and the World Heart Federation.

Condition Assessment of HVDC Cables during their Lifecycle

Recent market developments towards power generation in remote renewable power plants such as concentrated solar power plants in deserts or large off-shore wind parks, raise an interest for long distance power transmission via extruded HVDC cables. HVDC cables require quality assurance during the complete product lifecycle, mainly: a) R&D activities for design verification and - validation b) routine tests in the factory for confirmation of proper manufacturing c) acceptance test after erection and commissioning to exclude defects caused during transport and installation d) ageing monitoring and quick fault detection and location detection during service life. Considering increasing voltage levels, increasing cable lengths and ground or even offshore installation, the dielectric testing of extruded HVDC cables in the factory and on site remains challenging. The long-term validation of insulation coordination requires high voltages for quality assurance tests which represent typical expectable stresses during service. Typical examples are wave shape, partial discharge behavior and dielectric field stress in the insulation medium. Hence, different technical solutions are available to generate these required high voltages for testing of HVDC cables. This paper discusses essential technical and commercial aspects of HVDC cable quality assurance and presents suitable methods for HVDC cable testing.

Evaluation of the Readiness of Small and Medium Enterprises on the Indonesian National Standard

Indonesia’s economic condition, which is experiencing a weakening due to the pandemic, has created a competitive climate among businesses. Jago Jaya Shuttlecock is one of the SMEs in the city of Surakarta that has been producing shuttlecocks since 1971. Jago Jaya Shuttlecock wants its products to be SNI certified for the expansion of the marketing network and to increase the class of the products it produces. Therefore, this research was conducted to assess the readiness of SMEs to obtain SNI certificates. This was done by examining quality control using a control chart and the process capability in accordance with the quality requirements in SNI 0036-2014. This research also examined the readiness of SMEs in the SNI certification process from the aspects of administration, technical quality assurance, and economic capability. The problem was analyzed using the Failure Modes and Effect Analysis (FMEA) and obtained suggestions for improvements according to the priority of action if the specification is out of control and the Cpk indicator <1.5. In the preparation of SMEs in the SNI certification process, it was found that the readiness in the administrative, technical aspects of quality assurance and economic aspects were 100%, 17%, and 100% respectively. Based on the results, recommendations were given to improve the quality assurance system.
 Keywords: Readiness, SMEs, SNI, Indonesian National Standard

The implication of Islamic Boarding School policy in developing the quality of Islamic religious education in East Java, Indonesia

This paper discusses the implication of Islamic boarding school education quality policy in Indonesia. The presence of state in developing quality began with the issuance of Law Number 18 of 2019 concerning Islamic Boarding Schools and Presidential Decree 82 of 2021 concerning funding for implementation of Islamic Boarding Schools which later affected its existence in Indonesia, especially Islamic boarding schools in East Java. The results have implications for 2 aspects, namely the management of macro aspects and micro aspects. Management on macro aspects, among others; first, the regulatory aspect of Islamic Boarding School quality assurance, second, the funding aspect of Islamic Boarding School, and third, the managerial aspect of Islamic Boarding School. While the management of the micro aspects, among others; (1) The philosophical values and vision and mission of Islamic Boarding School; (2) Human resource management; (3) Management of facilities and infrastructure.

Styler: learning formatting conventions to repair Checkstyle violations

Ensuring the consistent usage of formatting conventions is an important aspect of modern software quality assurance. To do so, the source code of a project should be checked against the formatting conventions (or rules) adopted by its development team, and then the detected violations should be repaired if any. While the former task can be automatically done by format checkers implemented in linters, there is no satisfactory solution for the latter. Manually fixing formatting convention violations is a waste of developer time and code formatters do not take into account the conventions adopted and configured by developers for the used linter. In this paper, we present Styler, a tool dedicated to fixing formatting rule violations raised by format checkers using a machine learning approach. For a given project, Styler first generates training data by injecting violations of the project-specific rules in violation-free source code files. Then, it learns fixes by feeding long short-term memory neural networks with the training data encoded into token sequences. Finally, it predicts fixes for real formatting violations with the trained models. Currently, Styler supports a single checker, Checkstyle, which is a highly configurable and popular format checker for Java. In an empirical evaluation, Styler repaired 41% of 26,791 Checkstyle violations mined from 104 GitHub projects. Moreover, we compared Styler with the IntelliJ plugin CheckStyle-IDEA and the machine-learning-based code formatters Naturalize and CodeBuff. We found out that Styler fixes violations of a diverse set of Checkstyle rules (24/25 rules), generates smaller repairs in comparison to the other systems, and predicts repairs in seconds once trained on a project. Through a manual analysis, we identified cases in which Styler does not succeed to generate correct repairs, which can guide further improvements in Styler. Finally, the results suggest that Styler can be useful to help developers repair Checkstyle formatting violations.

Theoretical aspects of quality assurance of education at local level

In the article, we make a foray into the key concepts: quality, quality in education, quality assurance, quality management, quality management in education. The structure, functions, processes, components and implementation procedures of the Quality Assurance System at local level are presented, reporting on the responsibility of OLSDÎ on quality assurance, as well as on the current situation in the Republic of Moldova on quality management of education at local level.

Sachkunde Interventionelle Echokardiographie

Structural heart disease interventions have undergone an enormous development and many innovative approaches have become routinely performed procedures. Consequently, procedural standardization for the purpose of quality assurance is of increasing relevance. Interventional echocardiography plays a major role for the quality of structural heart procedures. At the same time, echocardiographic guiding can be extremely demanding for the echocardiographer and the understanding of the employed devices and procedural steps is an essential prerequisite. The present position paper summarizes these aspects with the goal of a standardized approach to interventional echocardiography. Its content will serve as the basis of future seminars by the German Cardiac Society. These courses will be mandatory to obtain the competence certificate for interventional echocardiography by the German Cardiac Society. Apart from the abovementioned aspects of quality assurance, the goal of the present initiative is to promote the perception of interventional echocardiography as a newly formed competence equivalent to the performance of interventional procedures.

Quality Assurance of a Cross-Border and Sub-Specialized Teleradiology Service.

Background: The current literature discusses aspects of quality assurance (QA) and sub-specialization. However, the challenges of these topics in a teleradiology network have been less explored. In a project report, we aimed to review the development and enforcement of sub-specialized radiology at Telemedicine Clinic (TMC), one of the largest teleradiology providers in Europe, and to describe each step of its QA. Evaluation: The company-specific background was provided by the co-authors—current and former staff members of TMC. Detailed descriptions of the structures of sub-specialization and QA at TMC are provided. Exemplary quantitative evaluation of caseloads and disagreement rates of secondary reviews are illustrated. Description of Sub-specialization and Quality Assurance at TMC: Sub-specialization at TMC is divided into musculoskeletal radiology, neuroradiology, head and neck, a body, and an emergency section operating at local daytime in Europe and Australia. Quality assurance is based on a strict selection process of radiologists, specific reporting guidelines, feedback through the secondary reading of 100% of all radiology reports for new starters, and a minimum of 5% of radiology reports on a continuous basis for all other radiologists, knowledge sharing activities and ongoing training. The level of sub-specialization of each radiologist is monitored continuously on an individual basis in detail. After prospective secondary readings, the mean disagreement rate at TMC indicating at least possibly clinically relevant findings was 4% in 2021. Conclusion: With continuing and current developments in radiology in mind, the essential features of sub-specialization and innovative QA are relevant for further expansion of teleradiology services and for most radiology departments worldwide to respond to the increasing demand for value-based radiology.

Quality Assurance in HECA Colleges During the COVID-19 Pandemic: A Mixed Methods Analysis through the lens of QQI’s Core Criteria

The National Forum’s 2020 Network and Discipline Fund was launched in November 2020 andfocuses on Shared Solutions to Common Challenges. Its overarching aim is to support networksand discipline groups to work together to respond proactively to identified challenges in teachingand learning in higher education, including those that have come to light through the suddenmove to online/remote teaching and learning.The National Forum’s 2020 Network and DisciplineFund, drawing on the Higher Education Colleges’Association (HECA) members’ experience, providedthe HECA Academic Quality Enhancement Forum(HAQEF) with opportunities to strengthen its networksand discipline group, support their efforts to enhanceteaching and learning, and produce useful insights andresources into the application of quality assurance ofblended and online learning.In the pandemic period, many colleges were forcedto change from a face-to-face delivery model ofeducation and training to an online format of delivery.This disruption meant that assumptions about andplans for how the courses were to be delivered andmanaged had to be rapidly reviewed. With governmentpronouncements advising all staff to work from homewhere possible, the majority of internal roles andprocesses of colleges were also affected. The qualityassurance (QA) policies, processes and procedures thatwere developed by colleges had to be modified to reflectthis change in circumstances.This document reports on the results of a mixedmethods study of QA developments that came about asa result of the initial changes enforced by the pandemicand the move to working from home. It also looked atwhat was learned about the management of quality inthis sector during this time.Data was collected by HAQEF via a survey of QApersonnel from the member colleges of HECA andfollow up interviews. The survey consisted of 11questions, one for each Core Area of Quality, as set outin the QQI Core QA Guidelines (2016). The questionsasked for reflections on each provider’s experienceof managing this aspect of QA, what resources orinstances of good practice they could share withpractitioners and which stakeholders were involvedin this adaptation. The interviews asked about themeasures that were undertaken to adapt QA processesin the pandemic period and what challenges could bereported from this adaptation.The report is divided into 11 chapters, with eachchapter centred on a discussion of one Core Area ofQuality as set out in the QQI Core QA Guidelines. Anoverview of the core area is developed, followed by acommentary on common experiences of the groupin this area. Most sections conclude with resources,volunteered by member colleges of HECA, that wasrated as useful in how the cohort navigated themanagement of QA in this core area.

Standardization of molecular monitoring of CML: results and recommendations from the European treatment and outcome study

Standardized monitoring of BCR::ABL1 mRNA levels is essential for the management of chronic myeloid leukemia (CML) patients. From 2016 to 2021 the European Treatment and Outcome Study for CML (EUTOS) explored the use of secondary, lyophilized cell-based BCR::ABL1 reference panels traceable to the World Health Organization primary reference material to standardize and validate local laboratory tests. Panels were used to assign and validate conversion factors (CFs) to the International Scale and assess the ability of laboratories to assess deep molecular response (DMR). The study also explored aspects of internal quality control. The percentage of EUTOS reference laboratories (n = 50) with CFs validated as optimal or satisfactory increased from 67.5% to 97.6% and 36.4% to 91.7% for ABL1 and GUSB, respectively, during the study period and 98% of laboratories were able to detect MR4.5 in most samples. Laboratories with unvalidated CFs had a higher coefficient of variation for BCR::ABL1IS and some laboratories had a limit of blank greater than zero which could affect the accurate reporting of DMR. Our study indicates that secondary reference panels can be used effectively to obtain and validate CFs in a manner equivalent to sample exchange and can also be used to monitor additional aspects of quality assurance.

Food Quality Inspection and Grading Using Efficient Image Segmentation and Machine Learning-Based System

One of the most critical aspects of quality assurance is inspecting products for defects before they are sold or shipped. A good product is more vital than having more of the same item for a customer’s enjoyment. The client has a significant role in determining the quality of a product. Another way to think about quality is as the total of all the characteristics that contribute to the creation of items that the client enjoys. Recently, the application of machine vision and image processing technology to improve the surface quality of fruits and other foods has increased significantly. This is primarily because these technologies make significant advancements in areas where the human eye falls short. This means that, by utilizing computer vision and image processing techniques, time-consuming and subjective industrial quality control processes can be eliminated. This article discusses how to check and assess food using picture segmentation and machine learning. It is capable of classifying fruits and determining whether a piece of fruit is rotten. To begin, Gaussian elimination is used to remove noise from images. Then, photos are subjected to histogram equalization in order to improve their quality. Segmentation of the image is carried out using the K-means clustering technique. Then, fruit photos are classified using machine learning methods such as KNN, SVM, and C4.5. These algorithms determine if a fruit is damaged or not.

Current aspects of quality assurance of Greek teacher professional training in the conditions of European integration

The article deals with the сurrent aspects of Greek teacher training quality assurance in the context of European integration processes. The entry of a higher pedagogical school into the European educational space is a complex and multifaceted task that requires the study of the best foreign experience in ensuring the quality of teacher training in the context of deepening European integration. Inside the education system teachers have a complex mission as far as the production and reproduction of official and unofficial school knowledge is concerned. The analysis of teacher education and training institutions development, and the recentpolicy initiatives and legislation, suggest that these Departments Teacher Education Policies and Developments in Europe are under the influences of diverse social and political forces. Therefore, any attempts to introduce reforms will be affected by the pressures and possibilities carried by the initiatives and practices of the EU and other supranational entities of global governance, initiatives which are spreading rapidly across national space.

Central Venous Access for Peripheral Stem Cell Collection in Autologous Donors: Safety within an Outpatient Transplantation Program

IntroductionOne important aspect of quality assurance in transplantation relates to the maintenance of central venous access (CVA), especially in outpatient conditions in which patients have a higher degree of activity and manipulation of CVA tends to be more frequent. A comprehensive program oriented to prevent and control complications related to CVA insertion, maintenance and removal is thought to be a highly effective strategy to improve safety outcomes.MethodsA retrospective study evaluating complications related to central venous access (CVA) in patients undergoing hematopoietic stem cell transplantation (HSCT) was conducted using electronic medical records (EMR) at our center. Laboratory and radiology reports were collected in order to identify complications related to CVA. Patients from May 2015 to July 2021 were included in the study. As per local protocol, insertion of Mahurkar catheter for cell collection is conducted by an experienced surgeon under general anesthesia on day -3 and after a short-stay (6 hours) in hospital patients are discharged. On day -2, cell collection is accomplished following all cautionary measures and removal of catheter is done on day -1. Maintenance and care of CVA is guided by standardized protocols related to cleaning, manipulation, blood sample collection and removal. All patients signed a consent to participate in the study and the study protocol was approved by Clínica Ruiz IRB. To be considered as statistically significant, results had to display a two-sided p value <0.05.ResultsA total of 1088 patients recruited since May 2015 were included in the study. Main indication for auto-HSCT was multiple sclerosis with 1066 (98%), followed by chronic inflammatory demyelinating polyneuropathy with 16 (1.5%) and 5 (0.5%) patients with other autoimmune disorders. Median age of donors was 46 (40 - 54) years. Median dose of CD34 + cells x10 6/kg infused per patient was 7.0 (3.7 - 11.3) and the median of collection events per patient was 1 (1 - 2). Cell collection was accomplished via apheresis in (99.5%) of patients, of those CVA was used as collection site in 998 (92%) patients, while a change for peripheral venous access occurred in 85 (8%) patients, due to different reasons, most frequent being any type of CVA obstruction in 62 (83%) of donors. Pneumothorax occurred in 11 (1.1%) patients in whom CVA was used for collection. All cases were successful managed with pleural drainage and hospital admission longer than 24 hours was required for 3 (27%). Furthermore, catheter-related bloodstream infections were identified in 3 (0.3%) patients whom were admitted and treated with broad-spectrum antibiotics and discharged with no further events. There were no misplacement, thrombotic- nor hemorrhagic-related events in patients with CVA. A multifactorial analysis revealed that relevant factors such as, age, sex and type of disease were not correlated with any type of CVA-related complications.ConclusionsWe have shown that prevention and control of complications related to CVA at our campuses are highly effective. The proportion of patients experiencing a CVA-related complication was minimal in comparison with other experiences. DisclosuresGomez-Almaguer: Roche: Honoraria, Speakers Bureau; Takeda: Honoraria, Speakers Bureau; Bristol-Myers-Squibb: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau.