Double Checking Research Articles

Sequential human redundancy: Can social loafing diminish the safety of double checks?

It is often assumed that if two people work on a failure-detection task one after the other, they will observe more failures than when only one person undertakes the task (4-eyes principle). However, human beings have also been found to exert less effort on tasks that they share responsibility for, a phenomenon called social loafing. In the current research, we assessed the effectiveness of sequential human redundancy in light of possible social loafing. In two laboratory experiments, teams of two participants performed a quality-control task in a blinded and in a nonblinded condition, operationally defined by whether or not evaluations of the first checker were forwarded to the second one. In the blinded condition, no social loafing was found, and a near-perfect overall team performance was observed. In contrast, nonblinded redundancy led to a substantial effort reduction of the second checker. However, despite this social-loafing effect at the second position, even nonblinded redundancy led to an overall safety advantage over a single-checker condition. Our research suggests that social loafing in sequential-human-redundancy work settings can occur but does not necessarily reduce the gains in overall reliability. Blinded processes, however, seem to provoke less social loafing than nonblinded processes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of the hospital pharmacy in preventing medication errors in Brazilian hospitals

In recent years, medication errors have received considerable attention from healthcare professionals, health institutions, and health authorities worldwide. The purpose of this work was to identify preventive strategies to prevent drug-dispensing errors and harms to patients in Brazilian hospitals. An integrative review was conducted on Scientific Electronic Library Online, Google Scholar, Medical Literature Analysis and Retrieval System Online Database and Portal of Periodicals of the Coordination for the Improvement of Higher Education using the following keywords: medication errors, dispensing errors, and hospital pharmacy. 96 papers were first selected and after analysis, those that did not fulfill the inclusion criteria, that is discussion of dispensing errors in a hospital setting or evaluation or suggestions of preventive drug- dispensing actions, were excluded, and only 11 papers were included in this review. Low implementation actions to prevent dispensing medication errors were the most common. In general, hospitals have been adopting safer dispensing systems namely unit-dose drug dispensing system, medication reconciliation, potentially dangerous drugs supervision, development of guidebooks of properly drug storage and medication prepare and dispensing, double checks during dispensing and differentiation similar pronunciation and spelling drugs. All strategies were found to be in accordance with international recommendations to prevent medication and dispensing errors.

Application of Niosomes in Cosmetics: A Systematic Review

A rising volume of the literature acknowledges the significance of nanotechnology in the cosmetics industry, particularly with the invention and use of techniques based on niosomes to generate unique formulations with both medicinal and aesthetic benefits. The current study’s objectives are to undertake a comprehensive review of the previously published data on the use and applications of niosomes in cosmetics and to give a succinct summary of that data. Preferred Reporting standards for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in the design of the current review. The core concept and keywords were derived from the research question using the SPIDER tool. The main steps of this review included: design of the research question, preliminary research, search strategy, searching the database, exclusion and inclusion criteria, approval by authors, title and abstract screening, reporting of the number of data selected, full text download and reading, manual research (Google Scholar, Scopus, and WoS), data extraction and quality assessment, double data checking, and manuscript writing, revision, and submission. After thorough data analysis, it was discovered that a cosmetic product’s aesthetic impact significantly improved when it was created utilising niosomes technology. The majority of cosmeceutical niosomes’ skin and hair products demonstrated an enhanced therapeutic and cosmeceutical effect. These discoveries may contribute to the treatment of skin conditions under the umbrella of cosmeceutical niosomes.

Medication safety in the perioperative setting: A comparison of methods for detecting medication errors and adverse medication events.

The purpose of this study was to evaluate perioperative medication-related incidents (medication errors (MEs) and/or adverse medication events (AMEs)) identified by 2 different reporting methods (self-report and direct observation), and to compare the types and severity of incidents identified by each method. We compared perioperative medication-related incidents identified by direct observation in Nanji et al's 2016 study[1] to those identified by self-report via a facilitated incident reporting system at the same 1046-bed tertiary care academic medical center during the same 8-month period. Incidents, including MEs and AMEs were classified by type and severity. In 277 operations involving 3671 medication administrations, 193 MEs and/or AMEs were observed (5.3% incident rate). While none of the observed incidents were self-reported, 10 separate medication-related incidents were self-reported from different (unobserved) operations that occurred during the same time period, which involved a total of 21,576 operations and approximately 280,488 medication administrations (0.004% self-reported incident rate). The distribution of incidents (ME, AME, or both) did not differ by direct observation versus self-report methodology. The types of MEs identified by direct observation differed from those identified by self-report (P = .005). Specifically, the most frequent types of MEs identified by direct observation were labeling errors (N = 37; 24.2%), wrong dose errors (N = 35; 22.9%) and errors of omission (N = 27; 17.6%). The most frequent types of MEs identified by self-report were wrong dose (N = 5; 50%) and wrong medication (N = 4; 40%). The severity of incidents identified by direct observation and self-report differed, with self-reported incidents having a higher average severity (P < .001). The procedure types associated with medication-related incidents did not differ by direct observation versus self-report methodology. Direct observation captured many more perioperative medication-related incidents than self-report. The ME types identified and their severity differed between the 2 methods, with a higher average incident severity in the self-reported data.

Musical Time in Tōru Takemitsu’s November Steps

This article offers a formal analysis of Tōru Takemitsu’s composition November Steps and discusses the composer’s statements that the piece has eleven variations (that he calls “Steps”) and is an equivalent of a Western Theme and Variations form as well as of a Japanese traditional form called danmono. There is a discrepancy between these statements and the music’s temporal organization. Not too much has been written about November Steps, and musicologists that have done it have avoided the “perplexing task” of double checking what is true about them and what is not. Therefore, this article’s goal is to unveil the mysteries about November Steps’ form, which is thoroughly considered here as musical time. The work displays a unique conception of temporality, identified here as circular, at one level, and cyclic, at another. The article explains the notion of circularity as applied to musical time, and also discusses the relationship between this specific work and the Japanese and Western traditional concepts of time that are reflected in the music.

Nursing bedside handover in an intensive care unit with a mixed structure: Nursing professionals' perception.

The main objective is to determine if the infrastructure of critical care units influences the perception of professionals using this handover method. Nursing bedside handover is considered a safe information transfer method that can help reduce communication errors; however, it has some disadvantages expressed by health professionals and patients, related to confidentiality, stress and less rest. Qualitative descriptive study. The perception of nursing professionals who work in a critical care unit with a mixed structure (open and closed boxes) in a tertiary care hospital was evaluated through a semi-structured interview with a battery of common questions (prepared after literature review) and spontaneous questions according to the objectives of the study. Five thematic areas related to the study objectives were observed: patient safety, message content, confidentiality/privacy, intimacy/rest/noise, and patient participation. Nursing bedside handover improves safe communication between professionals, because it avoids errors or distractions by double or triple checking (if we include the patient) as well as empowering the patient and including him in his recovery. Carrying it out in closed boxes increases confidentiality and improves intimacy as there are no other patients or relatives nearby who can hear the message. However, the place or shift where the handover is performed does not interfere with the effectiveness of the communication of the message. The morning shift is the busiest, which could affect the patient's rest, a fact that could be solved if it is carried out in a closed box. Carrying out the handover in individual boxes in intensive care units would provide greater privacy to the patient and reduce the perception of external noise, contributing to the reduction of interruptions and the increase of the patient's rest. It is also a key element in patient safety through verification by double or triple check-up, the structuring of the message and the visualization of devices presented by the patient. In addition, it will allow the professional to start a process of early humanization and participation of the patient in the health process.

ANALISIS PENGENDALIAN KUALITAS TERHADAP PRODUKSI PALM KERNEL DENGAN MENGGUNAKAN METODE LEAN SIX SIGMA

Abstrak: Based on the data analysis on the quality improvement program using lean six sigma that has been carried out, the following conclusions can be drawn: From 1 month of observation of defects in PT Sultra Prima Lestari's cloth masks, it is known that the DPMO value and the sigma value still do not meet the ideal number, which is 3.4 failures per million opportunities. With an average DPMO value of 141,614 and a sigma value of 5.1, it shows that the palm kernel oil production process has not yet reached the target of improving the quality of Six Sigma, namely reaching a sigma level of 6 Sigma (6σ), so it is necessary to make continuous improvements to palm kernel oil production process at PT Sultra Prima Lestari.After analyzing using this method, there are 4 types of product defects at PT Sultra Prima Lestari. Factors that cause product defects, namely labor (human), materials, equipment, and methods.&#x0D; Efforts that can be made to overcome product defects of PT Sultra Prima Lestari based on the DMAIC concept, include: Humans: Workers can improve the quality of masks by carrying out SOPs on materials and tools, then double checking the whole process.Material: Materials or materials can be improved in quality by choosing fresh fruit that is not easy to mold, of high quality, and according to SOPs. Equipment: The durability of the equipment used can be increased by carrying out routine maintenance on a monthly schedule and equipment components that have been damaged can be replaced by purchasing new and high-quality equipment components. Methods: Palm kernel oil production methods can be improved by implementing SOPs and double checking&#x0D; &#x0D; Keywords : Define, Measure, Analyze, Inprove, Control

P-774 Risks management in a donor program: application of Failure Mode and Effect Analysis from gamete matching to gamete thawing

Abstract Study question Is failure mode and effects analysis (FMEA) a useful and effective method of risk assessment in a gamete donor program? Summary answer The analysis of the potential failures, their causes and effects significantly improved the safety strategies previously adopted in our gamete donor program. What is known already At present, in Italy, the donation of fresh gametes is possible, but almost unmanageable due to the lack of donors and the refund to donors forbidden by law. As a result, many IVF Italian Centers established agreements with foreign gametes cryo-banks in order to meet the huge demand for donation treatments. The exchange of personal sensitive data and gametes between the sending and receiving centers represents a crucial aspect in a donor cycle. Each stage of this process, from gamete request to gamete thawing, is not error-free. FMEA represents a strategy to identify and mitigate potential failures before they occur. Study design, size, duration Fifty-eight oocyte and 4 sperm donation cycles were performed at our IVF facility from September 2019 to January 2021. Gametes came from a single Spanish cryo-bank. FMEA represents a proactive risk evaluation tool useful to identify real or potential failures and to develop actions to minimize risks. FMEA was conducted, in January 2021, by a team consisting of 2 gynaecologists, 3 embryologists and 2 quality managers and repeated 8 months later. Participants/materials, setting, methods Processes were analyzed to identify and score the potential failure modes using the risk priority number (RPN) scoring system. The calculation has been obtained by multiplying 3 factors: severity, occurrence and detectability scored from 1-5. After calculating the criticality of each failure mode, an action plan was prepared and then effectiveness of new process was monitored. Finally, FMEA was repeated and the improved RPN after the corrective actions was calculated. Main results and the role of chance In our gamete donation program, we mapped four phases: gamete request, donor-recipient matching, gamete delivery and gamete thawing. All the steps presented multiple failures and 11 different potential failure modes had been identified. Failure modes as the incorrect transcription of the recipient data, the acceptance of a donor proposal not well-matched with recipients and the receipt of gametes unsuitable for the couple correlate to high-risk scores with 30 RPN. These events may have severe consequences such as an incorrect matching between donor and recipient, and the subsequent birth of a child from a mismatched donor. Although gamete request, donor-recipient matching and receiving gametes phases are mainly characterized by document checking, the introduction of witnessing by another physician or embryologist, reduced the risk by 50%. Therefore, the introduction of double checking by a second operator represents an essential control measure to avoid errors. Limitations, reasons for caution This study is influenced by the general limitations of the FMEA approach, such as different personal experiences and skills of the participants since failures may be unrecognized, underestimated or overstated. Wider implications of the findings Performing a risk assessment in a donor program represents a valid strategy to mitigate risks of incorrect matching and loss of traceability. Since errors in data record and acceptance of donor proposal may cause important down streaming consequences, the double witnessing is strongly encouraged. Trial registration number NA

KEPATUHAN PERAWAT MELAKSANAKAN PRINSIP DUA BELAS BENAR PEMBERIAN OBAT

The behavior of nurses in giving drugs to patients must be in accordance with Standard Operational Procedures (SPO) so that patients are safe from drug-administration errors. There is still a lack of knowledge of nurses about the 12 correct principles of giving drugs to patients, not double checking with other nurses when giving drugs and there are still nurses who do not wait for patients to take their drugs and leave drugs on the patient's table. This study aims to identify the compliance of nurses in implementing the 12 correct principles of drug administration. This research design uses a descriptive study. The number of samples was 40 implementing nurses who were selected using simple random sampling. The measuring instrument used is a knowledge and compliance questionnaire of nurses about the twelve correct principles of drug administration. Data were analyzed using Descriptive Statistical Proportion Percentage Analysis (ASDPP). The results showed that most of the more than 50% (65%) of the respondents had an obedient attitude. Nurses more often do double checks before giving drugs. The Head of the Division of Nursing can provide updates on the 12 correct principles of drug administration.

Clinical Decision‐Making in Endocrine Physiology: Induced Hypoglycemia in Dogs

Clinical endocrinology cases present unique challenges to veterinary students, as assessment and management encompasses various shades of grey. In order to process nuances and make clinical decisions, students must have a firm grasp of the basic tenets of endocrine physiology, such as the relationship between various hormones and negative feedback loops. We hypothesized that incorporating current diabetes monitoring technology into a hands‐on first‐year veterinary physiology laboratory would improve their understanding of glucose homeostasis. Students receive didactic instruction in foundational endocrine physiology concepts during their physiology lecture class. The laboratory applies the concept of glucose homeostasis and the role of insulin and counterregulatory hormones, as well as the impetus for clinical decision‐making in hypoglycemic patients. Before entering the laboratory, students complete a pre‐laboratory questionnaire assessing medical math, glucose homeostasis concepts, and overall predictions for decision‐making as a team (approximately six students per laboratory group). Each group is assigned a dog from the Veterinary Physiology and Pharmacology (VTPP) teaching colony. The dogs are non‐diabetic and fasted the night before the laboratory takes place. A flash glucose monitoring system (FGMS), which measures interstitial glucose concentration, is applied to each dog before the start of that day’s laboratory. The students must weigh their dog and calculate a dose of regular insulin at 0.3 U/kg; one of the abstract’s authors double checks each dose for accuracy. Students administer regular insulin intravenously and use various methods to check the blood glucose with a portable blood glucose meter (PBGM) and the interstitial glucose concentration with the FGMS every 10 minutes. Based on the glucose concentration and the dog’s clinical signs, students are empowered to make corrections using a single dose of dexamethasone, intravenous dextrose, and/or food. Once the dog is normoglycemic and they have completed at least 90 minutes’ worth of readings, the exercise is complete. Students complete a post‐laboratory survey assessing the same concepts as the pre‐laboratory survey. In the pre‐laboratory survey, students frequently commented that they expected to gain a better understanding of glucose homeostasis and the effects of insulin on dogs. They discussed delegating work and the impact of various communication styles on the overall flow of the laboratory session. In the post‐laboratory survey, students frequently commented on their newfound respect for how rapidly insulin acts within the body, as well as treating the clinical signs of hypoglycemia quickly. The students identified communication obstacles and various techniques and solutions developed in a short time period. Our endocrine physiology laboratory cements key concepts introduced in lecture, as 94% (164/174) of students reported that the laboratory improved their understanding of glucose homeostasis. When asked if their group communicated well, 97% (168/174) of students agreed. The laboratory is uniquely situated to blend conceptual physiology knowledge with critical thinking and clinical decision‐making skills.

Exploring profiles of coaches' fidelity to Double Check's Motivational Interviewing-embedded coaching: Outcomes associated with fidelity

Motivational interviewing (MI) is applied in a variety of clinical and coaching models to promote behavior change, with increasing interest in its potential to optimize school-based implementation fidelity. Yet there has been less consideration of fidelity indicators for MI-embedded coaching and their associations with outcomes. We leveraged exisiting data from 151 teachers across 18 schools, who were part of a larger 39 middle school randomized controlled trial of a teacher coaching model, to explore profiles of fidelity and the associations between fidelity and outcomes. We conducted latent profile analysis (LPA) to examine profiles of four components of fidelity (i.e., adherence, dosage, quality, and teachers' responsiveness). Next, we examined whether observed teacher practices and student behaviors varied across fidelity profiles. Because coaches and independent coders reported adherence, we also examined the reliability of retrospective coach adherence ratings. Results indicated that coaches show promise as a reliable rater of adherence. The LPA indicated that there were two (high and lower) fidelity profiles. Statistically significantly fewer instances of student non-cooperation were observed in classrooms where the teacher was engaged in high fidelity coaching, reflecting a large effect size. Moderate-sized, but non-statistically significant, effects also emerged for teacher opportunities to respond and reactive behavior management. We identify concrete areas to ensure that reliability can be achieved in other contexts. Future directions are also considered regarding fidelity measurement and how to optimize coaching.

Do Teachers’ Perceptions of High Cultural Responsiveness Predict Better Behavioral Outcomes for Students?

Teachers’ perceptions of high cultural responsiveness in the classroom may be related to positive behavioral outcomes (e.g., higher academic engagement, lower social risk), but little research has explored this possibility. This article addresses this research gap by building upon findings from a preliminary paper in which these relationships were evidenced. Specifically, we present two interrelated follow-up studies. Study 1 examined the relationship between ratings of 20 U.S. teachers on a measure of cultural responsiveness, the Double Check Self-Refection Tool, and students’ observed classroom behavior. Results from multilevel modeling indicated that higher Double Check scores significantly predicted higher academic engagement and lower disruptive behavior for 454 students observed. Study 2 investigated the relationship between ratings of 30 U.S. teachers on the Double Check Self-Refection Tool and ratings of 622 students’ risk on the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS). Results indicated higher Double Check scores were associated with lower ratings of students’ social and emotional risk. Findings also indicated identification as a Black student and a student with a disability predicted teachers’ perceptions of higher risk, consistent with previous research. As results remain preliminary, implications include recommendations for additional research and high-quality professional development to promote teachers’ cultural responsiveness.

Security of E-Banking transactions in Bangladesh: Does it need more importance from COVID-19 perspective?

Electronic banking service has grown in Bangladesh since 2001. Now, it has become most suitable and convenient fund transfer method in COVID-19 pandemic situation. The security risk issue is the most vital in the e-banking fund transfer. A survey was conducted where the risk factors were measured on five-point Likert scale by 200 bankers and customers in the pandemic period through phone and E-mail. After necessary modification and correction of collected data, descriptive statistics, Cronbach’s Alpha, Kolmogorov-Smirnov test, Shapiro-Wilk test, Mann Whitney U test and Kruskal-Wallis H test were conducted in IBM SPSS Statistics 20 and MS Excel 2010to test the hypothesis of the risk factor. Result shows the highest banking transaction risk factor is Account Information Security and lowest banking transaction risk factor is Double Check identity from the perspective of customers. The result also shows that less than 2 years experiences of e-banking are significantly more satisfied than the risk factor of 2 years to 6 years and more than 6 years e-banking experiences. IIUC Business Review Vol. 10, Dec. 2021 pp. 9-24

Profile of Storage System of LASA Drug Services in a Pharmacy, Besuki District, Situbondo Regency

The development of drug production is relatively rapid, causing several drugs that have almost the same shape, name, and packaging. This can cause medication errors in the form of errors in administering drugs to patients. Drugs that are nearly the same shape and name are known as LASA (Look Alike Sound Alike) drugs. This study aimed to determine the profile of the LASA drug storage and service system at pharmacies in Besuki District, Situbondo Regency. This research includes qualitative research through in-depth interviews and direct observation. The sample used in this study is a saturated sample. The results showed that the LASA drug storage system in pharmacies throughout Besuki District, Situbondo Regency only implemented a system of giving the distance between drugs one and other drugs, while other provisions for storing Lasa drugs were not carried out. The LASA drug service system is carried out by conducting double checks, memorizing various LASA drugs, and contacting doctors to clarify prescriptions for LASA drugs. Based on these results, it can be concluded that pharmacies in Besuki District, Situbondo Regency, do not meet the criteria in the LASA drug storage system. Meanwhile, in the LASA drug service system, pharmacies throughout Besuki District, Situbondo Regency have met the requirements for LASA drug services.

The Effect of Independent Double Check Implementation against the Six Correction Principle in Preparation and Administration of Injected Medication on Inpatients X Hospital, West Java

The study was conducted from March until June 2021. The number of nurses involved were: 39 first nurses and 33 second nurses. The research data were analysed using SPSS program version 25. The implementation of IDC on 5895 injected medication affected right time (p=0.000) and right documentation (p=0.041) in preparation of medication. IDC has a partial or simultaneous effect with the characteristics of the first nurse on the right dose and right time in preparation of drugs (p = 0.000). IDC also affects the right dose, right time and right documentation in administration of injected medication (p&lt;0.05). The characteristics of the first nurse's education had a partial effect on right documentation in preparation and administration of drugs, and right time in administration of injected medication (p&lt;0.05). Nurses' work experience also had a partial effect on right documentation in administration of injected medication (p= 0.001). IDC implementation reduces ME &lt; 5%.

Harmonization and Visualization of Data from a Transnational Multi-Sensor Personal Exposure Campaign.

Use of a multi-sensor approach can provide citizens with holistic insights into the air quality of their immediate surroundings and their personal exposure to urban stressors. Our work, as part of the ICARUS H2020 project, which included over 600 participants from seven European cities, discusses the data fusion and harmonization of a diverse set of multi-sensor data streams to provide a comprehensive and understandable report for participants. Harmonizing the data streams identified issues with the sensor devices and protocols, such as non-uniform timestamps, data gaps, difficult data retrieval from commercial devices, and coarse activity data logging. Our process of data fusion and harmonization allowed us to automate visualizations and reports, and consequently provide each participant with a detailed individualized report. Results showed that a key solution was to streamline the code and speed up the process, which necessitated certain compromises in visualizing the data. A thought-out process of data fusion and harmonization of a diverse set of multi-sensor data streams considerably improved the quality and quantity of distilled data that a research participant received. Though automation considerably accelerated the production of the reports, manual and structured double checks are strongly recommended.

Drug Resistant Tuberculosis in the Northern Region of Zambia: A Retrospective Study

BackgroundZambia like many countries in sub-Saharan Africa is affected with drug resistant tuberculosis. However, the drug resistant tuberculosis situation over the years has not been described in various regions of the country. Consequently, this study aims to determine the drug resistant tuberculosis burden in northern regions of Zambia over a four-year period based on data generated from a Regional Tuberculosis Reference Laboratory.MethodTwo hundred and thirty two (232) Tuberculosis Drug Susceptibility Testing results over a four-year period (2016-2019) were reviewed. Data was collected from tuberculosis registers and patient request forms and entered into a pre-tested standardized checklist and later entered in Excel Computer software. Double blinded checking was done by two independent data clerks to minimize duplication of cases. Cleaned data was then imported in R programme for analysis. Bivariant and descriptive statistics were performed and reported.ResultsOf 232 Drug Susceptibility Testing results, 90.9% were drug resistant TB while 9% were drug susceptible. Fifty three percent (53%) of these were multi-drug resistant Tuberculosis and 32% were confirmed as Rifampicin Mono-resistance. Only 1.7% of the Multi-drug resistant Tuberculosis patients were Pre-extensively drug-resistant Tuberculosis. Copperbelt province had the largest proportion (46.0%) of multi-drug resistant tuberculosis patients followed by Luapula (8.1%) and North-Western (4.7%) provinces. In new and previously treated patients, the proportion of Multi-drug resistant tuberculosis was 71.8% and 28.7% respectively. History of previous anti-tuberculosis treatment and treatment failure were associated with multi-drug resistance TB.Conclusion and RecommendationThis study has shown a small increase in the proportions of drug resistant tuberculosis cases over the four years under review with high rates being recorded on the Copperbelt Province. Previous treatment to first line TB treatment and treatment failure were associated with development of Multi-drug resistance. We therefore recommend strengthened routine laboratory surveillance and improved case management of multi-drug resistant tuberculosis patients in the region.

Automated hyperparameter selection for the PC algorithm

• The performance of the PC algorithm depends heavily on the choice of the Type I error rate α . • We propose to automatically tune α for a user chosen metric using a procedure called AutoPC. • AutoPC double checks the output of PC by rerunning the algorithm on restricting conditioning sets. • AutoPC provably maximizes the chosen metric and recovers the true CPDAG in the sample limit. • The algorithm also easily achieves state-of-the-art accuracy across multiple metrics with both synthetic and real data. The PC algorithm infers causal relations using conditional independence tests that require a pre-specified Type I α level. PC is however unsupervised, so we cannot tune α using traditional cross-validation. We therefore propose AutoPC, a fast procedure that optimizes α directly for a user chosen metric. We in particular force PC to double check its output by executing a second run on the recovered graph. We choose the final output as the one which maximizes stability between the two runs. AutoPC consistently outperforms the state of the art across multiple metrics.

Shannon Pratt's Valuing a Business - Preserving a Legacy

Shannon Pratt's <i>Valuing a Business</i> - Preserving a Legacy

Technical note: GAMMORA, a free, open-source, and validated GATE-based model for Monte-Carlo simulations of the Varian TrueBeam.

Monte Carlo (MC) is the reference computation method for medical physics. In radiotherapy, MC computations are necessary for some issues (such as assessing figures of merit, double checks, and dose conversions). A tool based on GATE is proposed to easily create full MC simulations of the Varian TrueBeam STx. GAMMORA is a package that contains photon phase spaces as a pre-trained generative adversarial network (GAN) and the TrueBeam's full geometry. It allows users to easily create MC simulations for simple or complex radiotherapy plans such as VMAT. To validate the model, the characteristics of generated photons are first compared to those provided by Varian (IAEA format). Simulated data are also compared to measurements in water and heterogeneous media. Simulations of 8 SBRT plans are compared to measurements (in a phantom). Two examples of applications (a second check and interplay effect assessment) are presented. The simulated photons generated by the GAN have the same characteristics (energy, position, and direction) as the IAEA data. Computed dose distributions of simple cases (in water) and complex plans delivered in a phantom are compared to measurements, and the Gamma index (3%/3mm) was always superior to 98%. The feasibility of both clinical applications is shown. This model is now shared as a free and open-source tool that generates radiotherapy MC simulations. It has been validated and used for five years. Several applications can be envisaged for research and clinical purposes.