Quality Assurance Research Articles

Cross-border higher education and quality assurance: the role of international organisations

Purpose Over the years, International Organisations have started to look at Cross Border Higher Education (CBHE) with more attention, namely, at the impact and challenges entailed by this type of educational provision due to the emergence of low-quality offers and degree mills. This paper aims to discuss the role of these organisations in the development and promotion of CBHE and its quality assurance in Europe. Design/methodology/approach This paper conducts interviews using a previously drafted guideline with top-level managers of seven relevant international organisations involved in quality assurance at European and international level, namely, INQAAHE, EUA, ENQA, ESU, EQAR, ECA and EURASHE. It analysed the data collected using a grid created through the articulation of the guidelines’ questions and the empirical data. Findings The interviews’ content analysis indicated that these international organisations are important stakeholders in the development of CBHE quality assurance in Europe, particularly through the promotion of cooperation and trust between the different actors involved in it. These organisations can assume two different roles: a Technical-Professional Role and a Community Building Role. Originality/value This work’s originality stems from the fact that at least to our knowledge there is no other empirical work so far on the role and the views of different international organisations on the challenges CBHE entails for quality at the European level.

An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives

BackgroundMany countries are improving medical education in teaching hospitals through more focus on internal quality assurance, for example by creating new stakeholders like hospital-wide education committees. Adequate oversight is thought essential to ensure the quality of medical education. How teaching hospitals distribute roles and responsibilities for quality control across educational stakeholders to organize this oversight is rarely investigated. This study aims to answer the following exploratory question: Who are the primary stakeholders involved in educational governance, and what are their roles in safeguarding educational quality in teaching hospitals?MethodsWe conducted an exploratory qualitative study of educational governance structures in all teaching hospitals in the Netherlands with at least three training programs. We carried out document analysis of recent governance codes, documents drafted by Dutch teaching hospitals to describe their methods of internal governance for the national accreditor, and analyzed the data using a thematic analysis approach through the lens of organizational theories of Mintzberg and Freidson.ResultsThe study identified key stakeholders in quality management of medical education in all teaching hospitals of the Netherlands. An overview of their roles and responsibilities is given and a stakeholder map is drafted. Teaching hospitals gave the hospital-wide education committee three different roles: an advisory role, a quality controller role and a conflict mediation role.DiscussionHospitals have set up the assignment of decision-making power in different ways, creating different variants of hospital-wide education committees and potentially causing them to be less effective at quality management. Whether these different roles affect the quality management of medical education in practice requires practice-oriented research. The study reveals remarkable ambiguity regarding the assignment and exercise of decision-making power between actors. This study contributes to the literature by identifying key actors and their roles in the quality management of postgraduate medical education, providing a foundation for follow-up research.

Organizational Climate Management in the Context of Initial Mathematics Teacher Education

Objective: This study aims to analyze the impact of organizational management on motivation, satisfaction and commitment in teacher training in the context of Chilean quality assurance policies that emphasize a positive school climate and good coexistence. Methods: Using a Likert scale with a Cronbach’s alpha of 0.957, we surveyed 62 students in a mathematics teacher education program. A multiple linear regression analysis was conducted to examine how motivation, satisfaction, and engagement were related to organizational management and climate. Findings: The results show that motivation and satisfaction are significant predictors, explaining 61.5% of the variance in organizational management, while commitment also influences climate, but to a lesser extent. These results underscore the importance of motivation and satisfaction for effective organizational management and suggest that these factors may be more important than commitment in shaping a positive organizational climate. Novelty/Improvement:This study contributes to the literature by highlighting the need for management models that are tailored to specific educational contexts and calls for future research to examine additional variables that influence organizational climate in higher education to improve our understanding of the factors that influence educational environments. Doi: 10.28991/ESJ-2024-SIED1-018 Full Text: PDF

MAGNESIUM –PICRATE COMPLEXES AS COUPLING AGENTS TO ENHANCE UV-VISIBLE SPECTROPHOTOMETRIC DRUG ANALYSIS

This research investigates the production of magnesium-picrate complexes and their use as coupling agents to improve UV-Visible spectrophotometric detection and quantification of vital medicinal medicines. The analyzed pharmaceuticals comprise Diclofenac Sodium, Ciprofloxacin HCl, Levoceitrizine 2HCl, Levofloxacin Hemihydrate, Nimesulide, Piroxicam BCD, and Terbinafine HCl. The synthesized magnesium-picrate complexes, upon heating with medication solutions, exhibited substantial increases in absorbance at their specific characteristic wavelengths. The increases were documented as 70.82%, 47.95%, 64.11%, 64.05%, 39.24%, 81.16%, and 87.10%, respectively, reflecting increased molar absorptivity. The 90% yield of magnesium-picrate complexes and their capacity to improve spectrum detection highlight their promise in optimizing UV-Visible spectrophotometric techniques for pharmaceutical quality assurance.

Magnetic resonance imaging safety in Asia-Oceania: call for action.

Magnetic Resonance Imaging (MRI) safety is a critical concern in the Asia-Oceania region, as it is elsewhere in the world, due to the unique and complex MRI environment that demands attention. This call-for-action outlines ten critical steps to enhance MRI safety and promote a culture of responsibility and accountability in the Asia-Oceania region. Key focus areas include strengthening education and expertise, improving quality assurance, fostering collaboration, increasing public awareness, and establishing national safety boards. By implementing these actions, we aim to significantly reduce MRI-related incidents and create a culture of safety across diverse healthcare settings in the Asia-Oceania Region.

SOCIAL AND HEALTH IMPLICATIONS OF THE USE OF TRADITIONAL APHRODISIACS (KAYAN MATA) AMONG MARRIED WOMEN IN NORTHERN NIGERIA

People over time, have considered the possibility to arouse sexual desires with drugs and food. However, how this is largely attended to, based on the uniqueness of the different groups and cultures. Prior to the use of modern vaccines, traditional aphrodisiacs such as herbal or animal extracts were purported to boost erotic pleasure, induce sexual desire and stimulate genitalia. In recent years, the use of aphrodisiacs has become popular with the increased prevalence of sexual problems worldwide. Aphrodisiacs refer to any substance (food or drug) that stimulates sexual desire and enhance sexual desire and performance. In Northern Nigeria, traditional aphrodisiacs known as Kayan mata, are sold by the roadside and in herbal chemists, most of which are not certified fit for human consumption. Dispensers do not have any information on their manufacturing dates, expiry dates, batch number nor chemical compositions as well as the prescribed dosage. The acceptance and use of Kayan mata among women in Northern Nigeria is associated with the desire to have influence over decision-making and control partners in intimate relationship. However, many issues have been presented in different quarters with respect to the use and demand for traditional aphrodisiacs. Nevertheless, little is known about the social and health implications of the use of these substances. This, therefore requires further interrogation to broaden the horizon of the public on the increasing phenomenon. Secondary sources of data were employed for this work. Also, Social Exchange Theory provided theoretical orientation to issues related to the thrust of the paper. A large number of married women use traditional aphrodisiac which are mainly sold by traditional healers. Therefore, there is need to set up more orthodox care facilities for sexual dysfunction and community health education on female sexual dysfunction. Furthermore, there is the need for quality assurance, safety and standardization of these substances for the benefit of the consumers.

Automated 3D semantic segmentation of PCB X-ray CT images and netlist extraction

Printed Circuit Board (PCB) design reconstruction is essential for addressing part obsolescence, intellectual property recovery, compliance, quality assurance, and enhancing national capabilities. Traditional methods for PCB design extraction, both non-geometry-based and geometry-based, have limitations in accuracy, efficiency, and scalability. This paper presents an automated approach, combining image processing and machine learning, to achieve 3D semantic segmentation of PCB X-ray Computed Tomography (X-ray CT) images and subsequent netlist extraction. By employing a 3D U-Net architecture with a ResNet-18 backbone and training on synthetic data, we introduce a first-of-its-kind method for direct 3D semantic segmentation, significantly improving over previous efforts. Our approach eliminates the need for extensive labeled datasets by using inherently labeled synthetic data. Further, this method enhances ease of segmentation by significantly reducing or eliminating the preprocessing effort required for 2D image stacks. It also improves universality by expanding the scope of application beyond images with specific 2D stack criteria, segmenting the 3D image in its entirety. Additionally, this method enables the processing of images of PCBs that have undergone bending, which is common among PCBs with a thickness below a certain threshold. The implications of this approach extend beyond PCBs, finding applications in various physical and biological sciences where 3D image segmentation is crucial. This methodology includes high-resolution 3D imaging, watershed segmentation, machine learning-based semantic segmentation, and netlist extraction. Validation with both synthetic and real-world PCB datasets shows high accuracy and robustness, offering a scalable solution for PCB design reconstruction.

Roller-Compacted Concrete Pavement, An Industry Perspective

This paper presents a summary of findings and experiences in implementing Roller- Compacted Concrete Pavement (“RCC Pavement”) at industrial distribution facilities. The author’s experiences in RCC Pavement involved defining and taking complete responsibility from concept to completion, including but not limited to, material selection, mixture design, structural design, production, transportation, placement and curing. Using ten-plus years of experience and incorporating pertinent research findings, processes and tests lead to the development of Quality Assurance (“QA”) Processes and Quality Control (“QC”) tests/observations. Continuous improvement has been made on developing a QC program. The author’s experiences involved the use of RCC Pavement as a finished surface and dictated a high performance RCC Pavement (compressive and flexural strength as high as 40 MPa and 5MPa, respectively after only 7 days); therefore, all placement utilized an ABG paver and vibrating screed with dual tamping bars to obtain high density RCC Pavement while minimizing roller displacement and maximizing smoothness and riding characteristics of the final RCC Pavement surface. Size of the projects has limited these experiences to production of RCC Pavement through the use of either a wetbatch concrete plant or a dry-batch concrete plan in conjunction with a horizontal shaft mixer.

Measurement of Concrete Thickness and Detection of Defects Using Ultrasound Methods

The use of Non-destructive Evaluation (NDE) techniques has proven to be effective in determining the thickness of plate like concrete elements and locating defects such as cracks, delaminations, voids, honeycombing, and debonding. Some of the problems that have plagued the concrete paving industry are testing for quality assurance and verification of thickness of existing concrete slabs without compromising their structural integrity by traditional coring methods. There are several Non-Destructive Evaluation (NDE) techniques that have been proven to be an effective way to combat these problems. This paper outlines one of these techniques, Ultrasound-Echo (UE). UE utilizes two ultrasonic probes, one transmits a stress wave field into the concrete specimen, and the other receives the natural response of the concrete specimen in the time domain. A Fast Fourier Transform (FFT) is then applied to the received response so it can be examined in the Frequency Domain. Using the wave speed of the concrete, the peak or resonant frequency can be used to calculate the thickness of the concrete element where the concrete element is free of defects. In areas of detectable defects, there will be pronounced shift in the resonant frequency. Requirements for self calibration of the wave speed and testing procedures for the ultrasound test equipment are discussed. To verify the accuracy of UE to identify defects, a test slab with purposebuilt delaminations and air voids at known locations was constructed. A comprehensive measurement of this special test slab was performed using an UE device, and analyzed results are presented. Defective sections of the test slab are clearly identified by the UE method with recommendation given for detection of the defects.

On the correction factors for small field dosimetry in 1.5T MR-linacs

Objective. Clinical dosimetry in the presence of a 1.5 T magnetic field is challenging, let alone in case small fields are involved. The scope of this study is to determine a set of relevant correction factors for a variety of MR-compatible detectors with emphasis on small fields. Two dosimetry formalisms adopted from the literature are considered.Approach. Six small-cavity ionization chambers (from three manufacturers), four active solid-state detectors and a thermoluminescence dosimeter microcube were modeled in the EGSnrc Monte Carlo code. Phase space files for field sizes down to 1 × 1 cm2of the Unity 1.5 T/7 MV MR-linac (Elekta, UK) were used as source models. Simulations were performed to calculate thekQB,QfB,f(also known askB,Q),kQmsrB,fmsrandkQclin,QmsrB,fclin,fmsrrelevant to two different dosimetry formalisms. Two detector orientations with respect to the magnetic field were considered. Moreover, the effect of the ionization chamber's stem length (a construction parameter) on the correction factor was investigated. Simulations were also carried out to determine whether correction factors obtained in water can be applied in dosimetry procedures involving water-equivalent solid phantoms.Main results. Under thekQB,QfB,f-based formalism, the required corrections to ionization chamber responses did not exceed 1.5% even for the smallest field size considered. A much wider range ofkQB,QfB,fvalues was obtained for the active solid-state detectors included in the simulations. This is the first study to reportkQclin,QmsrB,fclin,fmsrvalues for ionization chambers. The impact of the stem on correction factors is not significant for lengths ⩾0.75 cm. Correction factors determined in water are also valid in dosimetry protocols employing solid phantoms.Significance. This work substantially expands the range of available detectors that can be used in small field dosimetry, enabling more options for commissioning, beam modeling and quality assurance procedures in 1.5 T MR-Linacs. However, more studies are needed to establish a complete and reliable dataset.

Global urban activity changes from COVID-19 physical distancing restrictions

During the COVID-19 pandemic changes in human activity became widespread through official policies and organically in response to the virus’s transmission, which in turn, impacted the environment and the economy. The pandemic has been described as a natural experiment that tested how social and economic disruptions impacted different components of the global Earth System. To move this beyond hypotheses, locally-resolved, globally-available measures of how, where, and when human activity changed are critically needed. Here we use satellite-derived nighttime lights to quantify and map daily changes in human activity that are atypical for each urban area globally for two years after the onset of the pandemic using machine learning anomaly detectors. Metrics characterizing changes in lights from pre-COVID baseline in human settlements and quality assurance measures are reported. This dataset, TRacking Anomalous COVID-19 induced changEs in NTL (TRACE-NTL), is the first to resolve COVID-19 disruptions for all metropolitan regions globally, daily. It is suitable to support a variety of post-pandemic studies that assess how changes in human activity impact environmental systems.

Revised Dowel Bar Tolerances for Ontario Concrete Pavements

Effective load transfer is a key design element for jointed plain concrete pavement and has a significant impact on long-term pavement performance. To facilitate load transfer and to allow expansion and contraction of the joints, dowel bars should be placed parallel to the vertical and horizontal planes of the pavement. In the past, it was difficult to verify the alignment of dowel bars within a concrete pavement. Recently, the Ontario Ministry of Transportation was given the opportunity to verify dowel bar alignment with an innovative non-destructive technique known as magnetic imaging tomography (MIT). The MIT scan was found to be a quick and accurate method of measuring dowel bar alignment across a transverse joint, allowing real-time, non-destructive assessment of the dowel bar alignment at joints throughout a concrete paving contract. In Ontario, MIT scan data collection and analysis during concrete paving led to process and equipment improvements. The MIT scan was rapidly adopted both as a quality control tool for the contractor and a quality assurance tool for the ministry. Based on data collected over several paving seasons, changes were made to ministry specifications and dowel bar tolerances. The revised dowel bar tolerances for Ontario pavements are presented in this paper.

Exploring the voice of patients: Mapping their experience following care in an integrated health area

Measuring patient-reported experience measures (PREMs) is essential for the continuous improvement of quality. This study aims to assess the quality perceived by patients in the key care processes of an integrated health area measuring PREM elements, with the goal of identifying opportunities for improvement. The research was conducted in the first half of 2023 within a Spanish integrated health area, analysing five key healthcare processes: Primary Care, Emergency Services, Hospitalisation, Consultations, and Surgery. To assess perceived quality, PREM elements such as accessibility, information, and professionalism were measured using the Net Promoter Score (NPS). The Lot Quality Assurance Sampling (LQAS) method was employed to identify specific areas for improvement by detecting rejected lots and optimising sample sizes. Although the perceived quality was generally high, with good or excellent NPS scores, significant variability was observed between processes. A total of 104 rejected lots (21%) were identified across the processes evaluated. The highest number of rejections occurred in and Emergency Services (67%), with notable issues in accessibility and information. The study underscores the need for targeted interventions in accessibility and information to enhance the patient experience, particularly in Primary Care and Emergency Services. The measurement of PREM elements using NPS, in conjunction with the LQAS method, proves to be an effective tool for identifying and prioritising areas for improvement, especially when applied on a regular basis.

A Method for Validating PET and SPECT Cameras for Quantitative Clinical Imaging Trials Using Novel Radionuclides.

Our aim is to report methodology that has been developed to calibrate and verify PET and SPECT quantitative image accuracy and quality assurance for use with nonstandard radionuclides, especially with longer half-lives, in clinical imaging trials. Methods: Procedures have been developed for quantitative PET and SPECT image calibration for use in clinical trials. The protocol uses a 3-step approach: check quantitative accuracy with a previously calibrated radionuclide in a simple geometry, check the novel trial radionuclide in the same geometry, and check the novel radionuclide in a more challenging, complex geometry (the National Electrical Manufacturers Association [NEMA] NU-2 International Electrotechnical Commission [IEC] image-quality phantom). The radionuclides used in the trial as an example are 124I (PET) and 131I (SPECT). In both cases, whole-body tomographic SPECT and PET imaging with accompanying low-dose CT are required. PET accuracy is based on calibrating the dose calibrator to produce quantitative images for radionuclides other than 18F, with all images reconstructed on each individual site's PET systems. For SPECT, an independent sensitivity measurement is made and then used to calibrate the SPECT images reconstructed at the core laboratory. After calibration, the final testing for both PET and SPECT uses the NEMA NU-2 IEC image-quality phantom to derive several metrics including quantitative accuracy based on an average SUV (SUVavg). Results: Using the method described, 7 sites in Australia have been qualified for 10 PET/CT scanners using 124I imaging and 8 SPECT/CT systems for 131I. One PET/CT system was found to give a result outside the specification of an SUVavg of 1.0 ± 0.05. All SPECT/CT systems gave an SUVavg accurate to within ±10% (SUVmean, 1.0 ± 0.1) of the true value for reconstructed radioactivity concentration in Bq/cm3 Conclusion: A general methodology has been developed to calibrate and validate PET and SPECT systems for quantitative imaging in clinical trials. The preparation of the test objects and the procedures is relatively simple and can generally be implemented by the staff at the site of the imaging center with the equipment supplied by the clinical trials organization.

Improved operation efficiency strengthens organizational quality in higher education

This paper examines quality assurance as an effective tool for organizational development, reviewing the theories and history of quality management. After describing the theoretical foundations used in the USA, focusing on heavy industries, it discusses European models such as TQM, ISO and EFQM systems in more detail, then moves on to critical approaches, especially with regard to the applicability and effectiveness of quality assurance in education and higher education. The second half of this paper focuses specifically on quality assurance in higher education, in particular European standards, approaching it from the perspective of internationalisation. In this context, this paper addresses the issues of brain drain, digital campus, stakeholder involvement and student-centredness. Finally, the paper concludes that quality assurance in higher education is not only an essential but a necessary process as well, which can also be the most effective tool for organizational development.

Efficient and accurate commissioning and quality assurance of radiosurgery beam via prior-embedded implicit neural representation learning.

Dosimetric commissioning and quality assurance (QA) for linear accelerators (LINACs) present a significant challenge for clinical physicists due to the high measurement workload and stringent precision standards. This challenge is exacerbated for radiosurgery LINACs because of increased measurement uncertainty and more demanding setup accuracy for small-field beams. Optimizing physicists' effort during beam measurements while ensuring the quality of the measured data is crucial for clinical efficiency and patient safety. To develop a radiosurgery LINAC beam model that embeds prior knowledge of beam data through implicit neural representation (NeRP) learning and to evaluate the model's effectiveness in guiding beam data sampling, predicting complete beam dataset from sparse samples, and verifying detector choice and setup during commissioning and QA. Beam data including lateral profile and tissue-phantom-ratio (TPR), collected from CyberKnife LINACs, were investigated. Multi-layer perceptron (MLP) neural networks were optimized to parameterize a continuous function of the beam data, implicitly defined by the mapping from measurement coordinates to measured dose values. Beam priors were embedded into network weights by first training the network to learn the NeRP of a vendor-provided reference dataset. The prior-embedded network was further fine-tuned with sparse clinical measurements and used to predict unacquired beam data. Prospective and retrospective evaluations of different beam data samples in finetuning the model were performed using the reference beam dataset and clinical testing datasets, respectively. Model prediction accuracy was evaluated over 10 clinical datasets collected from various LINACs with different manufacturing modes and collimation systems. Model sensitivity in detecting beam data acquisition errors including inaccurate detector positioning and inappropriate detector choice was evaluated using two additional datasets with intentionally introduced erroneous samples. Prospective and retrospective evaluations identified consistent beam data samples that are most effective in fine-tuning the model for complete beam data prediction. Despite of discrepancies between clinical beam and the reference beam, fine-tuning the model with sparse beam profile measured at a single depth or with beam TPR measured at a single collimator size predicted beam data that closely match ground truth water tank measurements. Across the 10 clinical beam datasets, the averaged mean absolute error (MAE) in percentage dose was lower than 0.5% and the averaged 1D Gamma passing rate (1%/0.5mm for profile and 1%/1mm for TPR) was higher than 99%. In contrast, the MAE and Gamma passing rates were above 1% and below 95% between the reference beam dataset and clinical beam datasets. Model sensitivity to beam data acquisition errors was demonstrated by significant model prediction changes when fine-tuned with erroneous versus correct beam data samples, as quantified by a Gamma passing rate as low as 18.16% between model predictions. A model for small-field radiosurgery beam was proposed that embeds prior knowledge of beam properties and predicts the entire beam data from sparse measurements. The model can serve as a valuable tool for clinical physicists to verify the accuracy of beam data acquisition and promises to improve commissioning and QA reliability and efficiency with substantially reduced number of beam measurements.

Genomics costing tool: considerations for improving cost-efficiencies through cross scenario comparison

Next-generation sequencing (NGS) is crucial for monitoring and investigating infectious disease outbreaks, providing essential data for public health decisions. The COVID-19 pandemic has significantly expanded pathogen sequencing and bioinformatics capacities worldwide, creating an opportunity to leverage these advancements for other pathogens with pandemic and epidemic potential. In response to the need for a systematic cost estimation approach for sustainable genomic surveillance, particularly in low- and middle-income countries, five institutions collaborated to develop the genomics costing tool (GCT). These institutions are the Association of Public Health Laboratories (APHL), FIND, The Global Fund to Fight AIDS, Tuberculosis and Malaria, the UK Health Security Agency (UKHSA), and the World Health Organization (WHO). To validate the GCT, it was piloted in public health laboratories across three WHO regions: African, Eastern Mediterranean, and European. The pilot exercises were intended to assess the tool’s accuracy, utility, and functionality, exploring scenarios for validating past expenditure, routine use, cost optimization, and scaling up sequencing services. Data from these pilots demonstrated significant cost reductions per sample with increased throughput, underscoring the economic benefits of the optimized use of sequencing platforms underpinned by sample throughput. The GCT enables laboratories to estimate and visualize costs, plan budgets, and improve cost-efficiencies for sequencing and bioinformatics based on factors such as equipment purchase and preventative maintenance, reagents and consumables, annual sample throughput, human resources training, quality assurance and management. This publication shares key findings from pilot exercises offering detailed insights into the cost of routine NGS implementation using either short- or long-read sequencing technologies, demonstrating the utility of GCT as an asset to support efforts for sustainable funding and strategic planning in genomic surveillance.

Developing an automatic treatment record review system for quality assurance of patient treatment delivery in radiation therapy

Background and purposeTreatment record contains most of information related to treatment plan delivery in radiation therapy. Reviewing treatment record is an important quality assurance (QA) task for safety and quality of patient treatments. This task is usually performed by senior medical physicists. However, it is time-consuming, tedious, and error-prone. To assist this process, a treatment record review system (TRRS) is developed to automatically review items related to treatment delivery record.MethodsThe treatment record is firstly extracted from oncology information system (OIS). Based on the daily patient treatment information, the original plan from the treatment planning system is identified. Then the original plan and the delivered plan are correlated. Eight review categories (parameter consistency, treatment completeness, treatment progression, image guidance, override, treatment couch, documentation, and treatment mode) are created. Tailored rules are designed for various review items to automate the review process. As a result, for each daily treatment record, a reviewed flag (pass, failure, warning, and N/A) is assigned by the TRRS. Finally, this system is evaluated by 6 months patient treatment records collected in our institute and compared to the manual process on the same data.ResultsTRRS processed a total of 76,651 treatment fractions from 4230 patients with an average of 574 treatments per day. The percentage of the detected anomalies among the total records was 0.76%. The average processing time was 3.9 s and 282 s per treatment record for the automatic and manual processes, respectively. Comparing with the manual process, the time efficiency of TRRS is improved by a factor of 72. The average numbers of anomalies detected by the automatic and manual processes are 21 and 13 per day, respectively. TRRS detects 61.5% more anomalies than those of the manual process.ConclusionTRRS is not only efficient in processing a large amount of treatment records on a daily basis but also effective in finding more anomalies than those of physics weekly check. The application of the TRRS could significantly reduce the workload of the review physicists and let them focus on more important works related to patient safety.

Fitness for Purpose of Text-to-Image Generative Artificial Intelligence Image Creation in Medical Imaging.

The recent emergence of text-to-image generative artificial intelligence (AI) diffusion models such as DALL-E, Firefly, Stable Diffusion, and Midjourney has been touted with popular hype about the transformative potential in health care. This hype-driven, rapid assimilation comes with few professional guidelines and without regulatory oversight. Despite documented limitations, text-to-image generative AI creations have permeated nuclear medicine and medical imaging. Given the representation of medical imaging professions and potential dangers in misrepresentation and errors from both a reputation and community harm perspective, critical quality assurance of text-to-image generative AI creations is required. Here, tools for evaluating the quality and fitness for purpose of generative AI images in nuclear medicine and imaging are discussed. Generative AI text-to-image creation suffers quality limitations that are generally prohibitive of mainstream use in nuclear medicine and medical imaging. Text-to-image generative AI diffusion models should be used within a framework of critical quality assurance for quality and accuracy.

AAPM Task Group Report 274: Fluence rate dosimetry for photodynamic therapy (PDT).

Photodynamic therapy (PDT) is a treatment modality clinically approved for several oncologic indications, including esophageal and endobronchial cancers, precancerous conditions including Barrett's esophagus and actinic keratosis, and benign conditions like age-related macular degeneration. While it is currently clinically underused, PDT is an area of significant research interest. Because PDT relies on the absorption of light energy by intrinsic or administered absorbers, the dosimetric quantity of interest is the absorbed energy per unit mass of tissue, proportional to the fluence rate of light in tissue. It has been demonstrated that the fluence rate at the tissue surface may differ significantly from the incident irradiance of light because of multiple scattering and absorption, both of which may vary among patients and tissue types. This report will review the current state-of-the-art fluence rate dosimetry technology. It will describe the two types of detectors currently available for fluence rate measurement, scattering-tip and fluorescence-based detectors, and review their principles of operation. The report will recommend strategies to establish calibration and quality assurance procedures for clinical fluence rate dosimetry equipment, and it will establish guidelines for clinical implementation of fluence rate dosimetry.