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Background Clinical practice guidelines (CPGs) are statements to assist practitioners and stakeholders in decisions about healthcare. Low methodological quality guidelines may prejudice decision-making and negatively affect clinical outcomes in non-communicable diseases, such as cardiovascular diseases worsted by poor lipid management. We appraised the quality of CPGs on dyslipidemia management and synthesized the most updated pharmacological recommendations. Methods A systematic review following international recommendations was performed. Searches to retrieve CPG on pharmacological treatments in adults with dyslipidaemia were conducted in PubMed, Scopus, and Trip databases. Eligible articles were assessed using AGREE II (methodological quality) and AGREE-REX (recommendation excellence) tools. Descriptive statistics were used to summarize data. The most updated guidelines (published after 2019) had their recommendations qualitatively synthesized in an exploratory analysis. Results Overall, 66 guidelines authored by professional societies (75%) and targeting clinicians as primary users were selected. The AGREE II domains Scope and Purpose (89%) and Clarity of Presentation (97%), and the AGREE-REX item Clinical Applicability (77.0%) obtained the highest values. Conversely, guidelines were methodologically poorly performed/documented (46%) and scarcely provided data on the implementability of practical recommendations (38%). Recommendations on pharmacological treatments are overall similar, with slight differences concerning the use of supplements and the availability of drugs. Conclusion High-quality dyslipidaemia CPG, especially outside North America and Europe, and strictly addressing evidence synthesis, appraisal, and recommendations are needed, especially to guide primary care decisions. CPG developers should consider stakeholders' values and preferences and adapt existing statements to individual populations and healthcare systems to ensure successful implementation interventions. [ABSTRACT FROM AUTHOR]

Context.--Machine learning applications in the pathology clinical domain are emerging rapidly. As decision support systems continue to mature, laboratories will increasingly need guidance to evaluate their performance in clinical practice. Currently there are no formal guidelines to assist pathology laboratories in verification and/or validation of such systems. These recommendations are being proposed for the evaluation of machine learning systems in the clinical practice of pathology. Objective.--To propose recommendations for performance evaluation of in vitro diagnostic tests on patient samples that incorporate machine learning as part of the preanalytical, analytical, or postanalytical phases of the laboratory workflow. Topics described include considerations for machine learning model evaluation including risk assessment, predeployment requirements, data sourcing and curation, verification and validation, change control management, human-computer interaction, practitioner training, and competency evaluation. Data Sources.--An expert panel performed a review of the literature, Clinical and Laboratory Standards Institute guidance, and laboratory and government regulatory frameworks. Conclusions.--Review of the literature and existing documents enabled the development of proposed recommendations. This white paper pertains to performance evaluation of machine learning systems intended to be implemented for clinical patient testing. Further studies with real-world clinical data are encouraged to support these proposed recommendations. Performance evaluation of machine learning models is critical to verification and/or validation of in vitro diagnostic tests using machine learning intended for clinical practice. [ABSTRACT FROM AUTHOR]

AbstractThis study aims to investigate the effect of teaching hospital management practices on the quality performance of health services by involving elements such as hospital accreditation standards, quality management, and JCI Academic Hospital-specific standards that are indirectly connected. This study chose a survey-based quantitative approach to clinical professional students in vertical teaching hospitals under the direct management of the Ministry of Health of the Republic of Indonesia. Six proposed hypotheses were tested by Partial Least Square-Structural Equation Modeling (PLS-SEM) analysis. The test results showed a positive influence between hospital teaching governance and hospital accreditation compliance, quality assurance and JCI Academic Hospital standards. Third, compliance with teaching hospital standards was also found to have a significant positive effect on the performance of teaching hospital service quality. Understanding the role of governance in encouraging the performance of teaching hospital service quality can help develop effective managerial strategies in achieving complete service quality for patients and clinical profession participants. This research resulted in contributions to existing practices and literature as governance modeling in dual quality standards charged to teaching hospitals. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the clinical and analytical accuracy of a new veterinary-calibrated portable blood glucose monitor (PBGM) compared to a reference laboratory analyzer. ANIMALS Client-owned dogs (n = 77) and cats (n = 64). METHODS Peripheral and paired capillary whole-blood glucose concentrations measured via PBGM were compared to plasma glucose concentrations measured via a Cobas c501 reference analyzer (Roche). Analytical accuracy was evaluated with the Spearman rank correlation coefficient, Bland-Altman difference plot analysis, and Deming regression. Clinical accuracy was evaluated with Parkes error grid analysis. Paired peripheral and capillary blood samples were compared with the Wilcoxon matched-pairs signed-rank test. RESULTS There was a high correlation between PBGM and reference analyzer readings in dogs and cats. Human quality assurance standards (International Organization for Standardization 15197:2013 guidelines) for analytical accuracy were met for 95% of feline peripheral blood samples and 89% of canine samples. Similar veterinary standards (American Society of Veterinary Clinical Pathology guidelines) were met for 89% of canine and 92% of feline peripheral blood glucose measurements. Error grid analysis showed that all peripheral canine and 97% of feline measurements were clinically accurate (zone A). Any altered clinical decision for the remaining feline measurements was expected to minimally impact outcome (zone B). No significant difference was found between peripheral and capillary blood glucose measurements in either species. CLINICAL RELEVANCE The PBGM produced clinically accurate results and is suitable for use in veterinary and home settings to measure blood glucose. [ABSTRACT FROM AUTHOR]

Background: Obstetric fistulas are abnormal open connection(s) between the vagina and the urinary tract or the rectum resulting from tragic injuries sustained by mothers during childbirth that lead to urine and/or faecal incontinence. Due to the rapidly growing middle class in sub-Saharan Africa (SSA) and the corresponding quest for hospital delivery and caesarean section, surgery-related (iatrogenic) obstetric fistulas are on the rise. Worryingly, there is scanty data on surgery-related fistulas. This review aims to collate empirical evidence on the magnitude of iatrogenic obstetric fistulas in SSA, generate country-specific data and explore factors that influence obstetric surgery-related fistulas. Methods: All relevant databases, PubMed, LILACS, CINAHL, SCOPUS and Google Scholar will be searched from 1st January 2000 to 31st March 2024 using search terms developed from the major concepts in the title without restrictions by language. The Cochrane Library, African Journals Online, Data Base of African Thesis and Dissertations Including Research (DATAD-R D Space) and preprint repositories will also be searched. Reference lists of relevant studies will be searched and experts in the field will be contacted for additional (unpublished) studies. The search output will be exported to Endnote where duplicate studies will be removed. The deduplicated studies will be exported to Rayyan where study screening and selection will be conducted. At least two authors will independently select studies, extract data and assess quality in the included studies using pretested tools. Disagreements between reviewers will be resolved through discussion. Data analysis will be performed with RevMan 5.4. Comparative binary outcomes will be reported as odds ratio (OR) or risk ratio (RR) and for continuous outcomes, mean difference and standard deviations (SDs) will be used. Non-comparative studies will be analysed as weighted proportions. Heterogeneity between studies will be assessed graphically and statistically, and where a significant level is detected, the random-effects model meta-analysis will be performed. All estimates will be reported with their 95% confidence intervals (CIs). Where data permit, we will conduct subgroup and sensitivity analyses to test the robustness of the estimates on key quality domains. The overall quality of the evidence will be assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Expected study outcomes: This systematic review and meta-analysis uses rigorous methods and best practices to attempt to collate all empirical evidence and estimate country-specific proportions of iatrogenic (surgery-related) fistulas among obstetric fistula patients across countries in SSA. This review will explore context-specific variables, provide insights into their impact and relate them to the type and experience of personnel performing the obstetric procedures that lead to obstetric fistulas. The findings of the full review are expected to inform the development of national and regional Training Programs for Medical Officers, support the development of a consensus "minimum acceptable standard of care" and inform quality assurance standards for clinicians involved in the provision of surgical obstetric care. [ABSTRACT FROM AUTHOR]

The author discusses the updated Osteoarthritis of the Knee Clinical Care Standard in Australia, an important tool that can support best practice care for people presenting with suspected knee osteoarthritis. Topics include aims of the Clinical Care Standards developed by the Australian Commission on Safety and Quality in Health Care, an overview of the updated Osteoarthritis of the Knee Clinical Care Standard, and features to support cultural safety, equity, and effective communication.

As part of the Pandonia Global Network (PGN), Pandora spectrometers are widely deployed around the world. These ground-based, remote-sensing instruments are federated such that they employ a common algorithm and data protocol for reporting on trace gas column densities and lower atmospheric profiles using two modes based on direct-sun and sky-scan observations. To aid users in the analysis of Pandora observations, the PGN standard quality assurance procedure assigns flags to the data indicating high, medium, and low quality. This work assesses the suitability of these data quality flags for filtering data in the scientific analysis of nitrogen dioxide (NO2) and formaldehyde (HCHO), two critical precursors controlling tropospheric ozone production. Pandora data flagged as high quality assures scientifically valid data and is often more abundant for direct-sun NO2 columns. For direct-sun HCHO and sky-scan observations of both molecules, large amounts of data flagged as low quality also appear to be valid. Upon closer inspection of the data, independent uncertainty is shown to be a better indicator of data quality than the standard quality flags. After applying an independent uncertainty filter, Pandora data flagged as medium or low quality in both modes can be demonstrated to be scientifically useful. Demonstrating the utility of this filtering method is enabled by correlating contemporaneous but independent direct-sun and sky-scan observations. When evaluated across 15 Pandora sites in North America, this new filtering method increased the availability of scientifically useful data by as much as 90 % above that tagged as high quality. A method is also developed for combining the direct-sun and sky-scan observations into a single dataset by accounting for biases between the two observing modes and differences in measurement integration times. This combined data provides a more continuous record useful for interpreting Pandora observations against other independent variables such as hourly observations of surface ozone. When Pandora HCHO columns are correlated with surface ozone measurements, data filtered by independent uncertainty exhibits similarly strong and more robust relationships than high-quality data alone. These results suggest that Pandora data users should carefully assess data across all quality flags and consider their potential for useful application to scientific analysis. The present study provides a method for maximizing use of Pandora data with expectation of more robust satellite validation and comparisons with ground-based observations in support of air quality studies. [ABSTRACT FROM AUTHOR]

The global halal market is expanding fast as halal products establish themselves as a new standard for safety and quality assurance. The constituent of a product, whether pharmaceutical or cosmetic, determines its halal classification. Ingredients that do not correspond to the halal standard are commonly known as critical ingredients. As a result, various substitutes for critical ingredients should be developed to raise global demand for the halal market. This study aims to review the current research development on the alternatives for halal critical ingredients in halal pharmaceuticals and cosmetics and to explore the testing methods used to test the alternative option for halal critical ingredients. This systematic study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and all the publications in this review meet the research eligibility requirements, which were searched and selected using electronic databases such as PubMed, Scopus, and MyCite. This study examined approximately 21 publications that proposed various substances derived from sources such as plants, animals, marines, and microbes. Three publications illustrated the possible use of the choice in insulin resistant patients, whereas seven articles discussed on the potential replacement for gelatine. Insulin and gelatine are the most frequently explored topics among the publications included in this review. Their alternative possibilities, whether derived from plants, marine sources, or microbe-based substances, are thoroughly evaluated to determine their desired effect or activity. The testing methodologies demonstrated that the alternative possibilities are far superior to the critical ingredients in terms of texture, morphology, activity, composition, and even the cost of synthesis. [ABSTRACT FROM AUTHOR]

Robust demonstration of high-quality, fit-for-purpose interprofessional education (IPE) is essential for today's health professional students, staff, curricula, and regulatory bodies. As IPE moves from discrete "events" to fully embedded spirals of learning across degree programme curricula, effective mechanisms for monitoring continuous quality improvement are paramount. An accreditation tool was therefore developed for all learning activities contributing to the IPE curriculum of a university in Aotearoa New Zealand. We worked over 15 months, introducing a user-friendly tool to collect data, managing accreditation processes, and integrating with wider systems. We identified key levers to monitor, adjust, and continuously improve quality in IPE teaching and learning at individual-activity and programmatic levels. [ABSTRACT FROM AUTHOR]

Accurate and timely reporting of adverse events (AEs) in clinical trials is crucial to ensuring data integrity and patient safety. However, AE under-reporting remains a challenge, often highlighted in Good Clinical Practice (GCP) audits and inspections. Traditional detection methods, such as on-site investigator audits via manual source data verification (SDV), have limitations. Addressing this, the open-source R package {simaerep} was developed to facilitate rapid, comprehensive, and near-real-time detection of AE under-reporting at each clinical trial site. This package leverages patient-level AE and visit data for its analyses. To validate its efficacy, three member companies from the Inter coMPany quALity Analytics (IMPALA) consortium independently assessed the package. Results showed that {simaerep} consistently and effectively identified AE under-reporting across all three companies, particularly when there were significant differences in AE rates between compliant and non-compliant sites. Furthermore, {simaerep}'s detection rates surpassed heuristic methods, and it identified 50% of all detectable sites as early as 25% into the designated study duration. The open-source package can be embedded into audits to enable fast, holistic, and repeatable quality oversight of clinical trials. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effects of the Enhancing Quality Using the Inspection Program (EQUIP) on quality control (QC) and quality assurance (QA) at an academic medical center. Methods EQUIP audit logs for technologist image quality review as well as mammography unit QA and QC formed the basis for study data. One randomly selected screening mammogram was evaluated by the lead interpreting physician (LIP) using EQUIP criteria for each technologist for each imaging site worked, initially semiannually and then monthly. One randomly selected screening mammogram interpreted by each interpreting physician (IP) for each imaging site was evaluated on a semiannual basis. Quarterly, the LIP reviewed QA and QC logs for each mammography unit with deficiencies further investigated. Results Of 214 965 eligible screening mammograms performed, 5955 (2.8%) underwent EQUIP image quality review. Five were found to be technically inadequate (0.08%, 5955/214 965). The LIP identified 20 significant interpretive differences compared with the clinical interpretation resulting in 10 biopsies and 7 previously undetected malignancies, with supplemental cancer detection rate of 1.2/1000 cases reviewed. Two hundred ninety mammography unit QA/QC reviews identified 31 potential deficiencies, 29 of which were due to human documentation error (93.4%). Conclusion EQUIP review of both IP and technologists' quality and mammography unit QA/QC logs as performed identified few deficiencies. EQUIP policies should be evaluated at each institution and modified to best utilize resources and provide opportunities for meaningful quality improvement. Although not an EQUIP focus, supplemental cancer detection was observed as might be expected with double reading. [ABSTRACT FROM AUTHOR]

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The International Council on Harmonisation E8 Guidance Revision 1 (ICH E8(R1)) calls for creating a Culture of Quality that "values and rewards critical thinking and open, proactive dialogue about what is critical to quality." Across the biopharma landscape, clinical sites, sponsors, and service providers are working to translate this far-reaching guideline into working practices. This manuscript deconstructs key elements that comprise the critical thinking and open, proactive Culture of Quality "enablers." In addition, maturity models are provided so readers can visualize what a Culture of Quality looks like in their clinical research organization. These provide examples of high performing cultures of quality and useful tools for teams or organizations to measure and evolve their respective quality cultures. [ABSTRACT FROM AUTHOR]

Many conditions managed by pediatric ophthalmologists are rare diseases, and even if pharmacological treatments are available, these have often not been evaluated in children. Off-label prescribing is a common practice in pediatric ophthalmology. In addition, there is often no commercial case for the production of a medicine that may only be used for a small number of patients worldwide. Compounded preparations prepared locally are therefore still in frequent use, although it is known that production may not meet stringent quality assurance standards. For several indications, commercial preparations, evaluated in rigorous clinical trials with children, are now available. Myopia management is joining the list of these indications, with low-concentration atropine formulations derived from recent clinical trials in Australia, USA, and Europe now entering the market. This short article gives an overview of the background and recent developments of compounded and commercial preparations for use in pediatric ophthalmology. [ABSTRACT FROM AUTHOR]

The article is devoted to the justification of the role of micro-credentials in the professional development of teachers on the example of the Open University (UK). It was emphasized that the introduction of micro-credentials is a modern trend in the European area of higher education. The absence of a generally accepted definition of micro-credentials is accentuated; both their advantages over traditional systems of professional development of teachers and the disadvantages of their implementation are emphasized. It was found that the growth in the number and role of micro- credentials s in the UK and the lack of a generally accepted understanding led the Quality Assurance Agency to outline the necessary characteristics of micro-credentials: clearly defined admission and access requirements (including recognition of prior learning); course design, including training, teaching, assessment and certification; learning outcomes and skills; course certification; standard quality assurance mechanisms. It has been determined that micro-credentials are based on content studied at a «microlevel», i.e. independent, but smaller than a degree qualification. It has been determined that micro-credentials are based on content studied at a «microlevel», in other words independent, but smaller than a degree qualification. The experience of the Open University in introducing micro-credentials for the professional development of teachers was analyzed using the example of the microcredit «Mentoring and coaching in professional training». It is noted that the Open University promotes a flexible, inclusive, adaptive, accessible education system that relies on the independence and autonomy of those who study, and micro-credentials allow students to acquire practical skills that correspond to their career aspirations and personal interests, without receiving a full educational degree. [ABSTRACT FROM AUTHOR]

Background: Due to stigma and mistreatment, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients and their families often face barriers to accessing and receiving equitable health care. Pediatric settings are not immune to this health inequity, yet there is limited literature to address it with pediatric nurses. Method: An evidence-based education program on the care of LGBTQ patients was delivered electronically to pediatric nurses. Using a pre- and posttest design, knowledge and attitudes regarding care of LGBTQ patients were collected via online questionnaires. Results: Knowledge significantly increased from pre- to posttest (p =.02). Attitudes related to LGBTQ concepts either remained consistently positive or shifted in the positive direction. Conclusion: Providing education regarding LGBTQ patients to pediatric nurses can improve related knowledge and attitudes. Expansion of evidence-based LGBTQ education to pediatric nurses is likely to contribute to lessening the health care barriers and inequities faced by these patients and their families. [J Contin Educ Nurs. 2024;55(4):181–186.] [ABSTRACT FROM AUTHOR]

Food safety is the basic characteristic of food and the most important one because food has the direct impact on our health. The COVID-19 pandemic influenced the whole food chain and consumer behavior by the restrictions, shutdowns and fear of being infected. This paper presents the results of the survey conducted among 71 enterprises operating in the food industry in Poland in 2022. The representatives were asked to assess the influence of the pandemic on food safety standards and their usefulness during the pandemic. They were also asked about the positive and negative aspects of the pandemic from the perspective of the food industry. It was shown that the pandemic strengthened the need and understanding of the hygienic standards, collaborations with suppliers and employee training. On the other hand, caused the more frequent food quality and safety inspections, shortages of the employees and supplies, and economic losses. [ABSTRACT FROM AUTHOR]

Objective: This study assesses the robustness of first‐order radiomic texture features namely interquartile range (IQR), coefficient of variation (CV) and standard deviation (SD) derived from computed tomography (CT) images by varying dose, reconstruction algorithms and slice thickness using scans of a uniform water phantom, a commercial anthropomorphic liver phantom, and a human liver in‐vivo. Materials and Methods: Scans were acquired on a 16 cm detector GE Revolution Apex Edition CT scanner with variations across three different nominal slice thicknesses: 0.625, 1.25, and 2.5 mm, three different dose levels: CTDIvol of 13.86 mGy for the standard dose, 40% reduced dose and 60% reduced dose and two different reconstruction algorithms: a deep learning image reconstruction (DLIR‐high) algorithm and a hybrid iterative reconstruction (IR) algorithm ASiR‐V50% (AV50) were explored, varying one at a time. To assess the effect of non‐linear modifications of images by AV50 and DLIR‐high, images of the water phantom were also reconstructed using filtered back projection (FBP). Quantitative measures of IQR, CV and SD were extracted from twelve pre‐selected, circular (1 cm diameter) regions of interest (ROIs) capturing different texture patterns across all scans. Results: Across all scans, imaging, and reconstruction settings, CV, IQR and SD were observed to increase with reduction in dose and slice thickness. An exception to this observation was found when using FBP reconstruction. Lower values of CV, IQR and SD were observed in DLIR‐high reconstructions compared to AV50 and FBP. The Poisson statistics were more stringently noted in FBP than DLIR‐high and AV50, due to the non‐linear nature of the latter two algorithms. Conclusion: Variation in image noise due to dose reduction algorithms, tube current, and slice thickness show a consistent trend across phantom and patient scans. Prospective evaluation across multiple centers, scanners and imaging protocols is needed for establishing quality assurance standards of radiomics. [ABSTRACT FROM AUTHOR]

Precise and accurate Fe isotope data of thirteen silicate minerals, including olivine, garnet, amphibole and biotite are reported here using the non-matrix-matched BCR-2G reference glass for isotope ratio calibration combined with a Ni doping method for instrumental mass bias correction by LA-MC-ICP-MS under wet-plasma conditions. All the in situ Fe isotope data are consistent with the recommended Fe isotopic values determined by SN-MC-ICP-MS. These results indicate that in situ Fe isotopic determinations by LA-MC-ICP-MS under wet-plasma conditions are matrix-independent for a variety of silicate minerals, and BCR-2G glass is suitable as the reference material for microbeam Fe isotopic analysis for silicate minerals. However, for other microbeam Fe isotopic analysis, e.g., SIMS, finding matrix-matched standards for data quality assurance is also required. Multiple analyses on two international olivine standards (San Carlos and ALM) and four natural silicate minerals (YY09-04 olivine, YS-13 garnet, YS-31 amphibole and Moosilauke biotite) reveal homogeneous Fe isotopic compositions with the external reproducibility better than 0.20‰ for δ56Fe values (2SD). Thus, these silicate minerals are proposed as matrix-matched in-house standards for isotope ratio calibrations and data quality control during microbeam Fe isotopic analysis. YY11-12 olivine, YS-42 garnet, YS-37 amphibole and YS-20 biotite with the external reproducibility of 0.23‰, 0.28‰, 0.23‰ and 0.25‰ for δ56Fe values (2SD), respectively, are only suitable as in-house standards for data quality monitoring during microbeam Fe isotopic analysis. [ABSTRACT FROM AUTHOR]

The Slovak Accreditation Agency for Higher Education (SAAHE) issued new standards and criteria for universities quality management systems in 2020 (SAAHES-IS 2020). Requirements and criteria determined in the SAAHES-IS 2020 are based on the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG). However, some Slovak universities implemented and maintained their quality management system (QMS) according to the ISO 9001 standard in the past. The object of the research presented in our paper is a Slovak university certified according to the ISO 9001. The subject of the research is employee's awareness about selected requirements of both standards, ISO 9001 and SAAHES-IS 2020. The main objectives of the research are: (1) to identify common requirements of both standards, (2) to explore employees awareness related to the identified common requirements and (3) to create decision assumptions how processes should be assured, either in accordance with ISO 9001 or SAAHES-IS 2020. This paper has also a methodological benefit. It allows to compare any standardized management systems that have common requirements. Employees awareness of the selected quality requirements has three elementary pillars in our research. They are the knowledge about requirement definition, how the given requirement is assured in the management practice and how employee contributes in the given requirement assurance. [ABSTRACT FROM AUTHOR]

A multistate health system updated the nurse extern policy and skills list. Because of a knowledge gap and inconsistent practices, there was a need for a standardized program. A literature review, Internet search, and focus group informed the creation of the nurse extern program. The program, which includes a toolkit and role-specific pathways, aligns training practices across the health system. [ABSTRACT FROM AUTHOR]

This study developed a management framework for quality assurance to enhance Technical-Vocational Education and Training (TVET) and technology pre-service teacher education programs in CALABARZON (Cavite, Laguna, Batangas, Rizal, and Quezon). Using the three-round Delphi consensus-building technique, the research assessed quality assurance practices and challenges in managing Bachelor of Technology and Livelihood Education (BTLEd) and Bachelor of Technical Vocational Teacher Education (BTVTEd) programs. The study also examined key factors affecting student performance in licensure examinations, career decision influences, and strategies to improve program appeal. Thirteen Delphi experts, including College Deans and program chairs, and 117 BTLEd and BTVTEd graduates participated. Thematic and statistical analyses, including the Mann-Whitney U test, compared assessment differences between graduates concerning licensure exam performance, career decisions, and program appeal strategies. The findings highlight that Teacher Education Institutions (TEIs) in the region prioritize quality assurance through curriculum reviews, faculty engagement, accreditation, facility maintenance, and continuous improvement. However, they face challenges such as resource limitations, curriculum misalignment, faculty development issues, and lack of specific quality assurance standards for TVET programs. Graduates noted factors influencing their licensure exam performance and career decisions, emphasizing the importance of review preparation, teaching strategies, and professional development. To enhance program appeal, there is a need for sustained career guidance, institutional initiatives, and program awareness efforts. The study recommends strengthening collaboration with stakeholders and implementing the proposed management framework to align with national and international standards. [ABSTRACT FROM AUTHOR]

Background: The first clinical trials to assess the feasibility of FLASH radiotherapy in humans have started (FAST‐01, FAST‐02) and more trials are foreseen. To increase comparability between trials it is important to assure treatment quality and therefore establish a standard for machine quality assurance (QA). Currently, the AAPM TG‐224 report is considered as the standard on machine QA for proton therapy, however, it was not intended to be used for ultra‐high dose rate (UHDR) proton beams, which have gained interest due to the observation of the FLASH effect. Purpose: The aim of this study is to find consensus on practical guidelines on machine QA for UHDR proton beams in transmission mode in terms of which QA is required, how they should be done, which detectors are suitable for UHDR machine QA, and what tolerance limits should be applied. Methods: A risk assessment to determine the gaps in the current standard for machine QA was performed by an international group of medical physicists. Based on that, practical guidelines on how to perform machine QA for UHDR proton beams were proposed. Results: The risk assessment clearly identified the need for additional guidance on temporal dosimetry, addressing dose rate (constancy), dose spillage, and scanning speed. In addition, several minor changes from AAPM TG‐224 were identified; define required dose rate levels, the use of clinically relevant dose levels, and the use of adapted beam settings to minimize activation of detector and phantom materials or to avoid saturation effects of specific detectors. The final report was created based on discussions and consensus. Conclusions: Consensus was reached on what QA is required for UHDR scanning proton beams in transmission mode for isochronous cyclotron‐based systems and how they should be performed. However, the group discussions also showed that there is a lack of high temporal resolution detectors and sufficient QA data to set appropriate limits for some of the proposed QA procedures. [ABSTRACT FROM AUTHOR]

The context of health care in Australia is shifting very rapidly; more chronic diseases, budgetary stress and the constant threat of the next pandemic and climate change mean that patterns of disease and care are changing, and the workforce is under pressure. Health systems have learned to respond as best they can, but there are many challenges and opportunities for the Australian health care system to plan and implement an evidence‐based and sustainable approach to health care delivery in the next decade. To support this approach, many peak bodies and authoritative agencies, such as the Australian government in their 2022 Strengthening Medicare Taskforce Report, have described laudable visions for health care, but no one has laid out a tangible blueprint for whole‐of‐system change. Here, we outline nine strategies that span principles of integrated, value‐based care, with a focus on prevention and quality, the development of a skilled workforce and health‐literate population and the use of emerging technologies such as genomics and artificial intelligence. These strategies form a potential path for the Australian health care system to meet the changing requirements of the current decade and take the aspirational visions of the future of health care into an improved, patient‐based health system that delivers care in line with best practices. [ABSTRACT FROM AUTHOR]

Free clinics may present long wait times. A retrospective chart review was conducted at a free clinic to understand contributing factors. Three wait times (total visit time, lobby wait time, and triage time) were analyzed across 349 patients. Variables included in the models were the total number of patients, providers, and volunteers; interpreter services; social work involvement; medical complexity; new vs. returning patient; scheduled vs. walk-in appointment; transportation provision; medical volunteer training level; and on-site medications and labs. Data analysis with multiple regressions was conducted. Factors that significantly affected wait times included the level of medical complexity (p<.001), medical volunteer training levels (p<.001), in-house labs (p<.001), in-house medications (p=.04), and new patients (p=.01). An intervention involving time benchmarks at the beginning of clinics reduced first-wave lobby wait times (p<.001). Future interventions addressing these factors may reduce wait times at other clinics. [ABSTRACT FROM AUTHOR]

Quality constitutes the cutting-edge of contemporary industry, much more sharpened with the emergence of Industry 4.0. Yet, the assurance of delivering high-quality products remains a challenging problem that requires cautious controls and timely actions through the entire phases of the production cycle. To that end, zero-defect manufacturing (ZDM) has given prominence to a comprehensive methodology that ensures quality control and defects eradication at every phase of the procedure, prioritizing the continuous supervision of each distinctive component to satisfy the corresponding quality assurance standards. Continuous supervision and detection of possible flaws are subjective to exploiting high-tech sensors for high-precision monitoring and assessment. Considering the above, adopting active vision technology can further enhance the promising capabilities of ZDM. The paper highlights the active vision's benefits to the ZDM strategy and introduces a practical framework for applying such technology through the different stages. Innovations and challenges that have to be taken into consideration are also discussed. [ABSTRACT FROM AUTHOR]

Third-party certification (TPC) is the standard approach to quality assurance for organic production, but its administrative burden and cost make it difficult for smallholders to access it. Internal Control Systems (ICS) and Participatory Guarantee Systems (PGS) are possible alternative approaches because they are more accessible and less costly. Regulation (EU) 2018/848 on organic production allows ICS for small farmers. However, PGS are not included, despite being promoted by the International Federation of Organic Agriculture Movements (IFOAM) and officially recognised by several countries worldwide. This study aims to evaluate the possible future inclusion of PGS at the European level. Twenty-eight experts participated in a Delphi exercise, and both optimistic and pessimistic views were agreed upon amongst them. In the pessimistic view, bureaucratic excess and standardisation requirements needed in the process of PGS institutionalisation could emerge, resulting in even more rigid practices compared to the current ones. In the optimistic view, recognising PGS as a legitimate approach to guarantee the quality of organic products could foster the inclusion of smallholders by lowering certification costs, increasing cohesion and competencies amongst rural development actors and increasing the reputation of PGS-certified local products. [ABSTRACT FROM AUTHOR]

Aim: Many developments in cervical cancer screening have happened in the past century, helping women in earlier detection of cervical cancer and its precursors. Cytology still holds the fort as being a specific test, though it suffers in sensitivity. As a part of the quality control program, the aim of the study is to determine the total number of abnormal liquid-based cervical cytology (LBC) at our center and correlate the abnormal LBC with histology and human papillomavirus (HPV) DNA test results. Method: Retrospective analysis of 4286 LBC screening cases was carried out over a period of 5 years. For cytology–histology correlation, cervical biopsy and cytology test results were analyzed. The two-tier grading system for biopsy interpretation was used. HPV DNA test results wherever available were correlated. Results: Of the 4286 LBC cases, 157 samples (3.7%) were unsatisfactory for evaluation, 3915 samples (91.3%) were negative for intra-epithelial lesion or malignancy, and 214 samples (5%) showed epithelial cell abnormality. ASC-US was reported in 60 cases (1.4%), ASC-H in 35 cases (0.8%), LSIL in 47 cases (1.1%), HSIL in 41 cases (1.0%), squamous cell carcinoma in a single case (0.02%), and atypical glandular cells in 30 cases (0.7%). The ASC/SIL ratio was 1.07:1. The CHC major discrepancy was calculated as 16.2%. The concordance of HSIL on cytology and biopsy as a measure of PPV is 94.4%. Of the epithelial cell abnormalities, 24 cases were positive for high-risk HPV (hrHPV). Molecular test results of 2737 samples showed HPV detected in 50 cases, of which 24 cases were positive for hrHPV. Conclusion: The study helped us to analyze the quality parameters of our cytopathology laboratory which are within the acceptable limits. [ABSTRACT FROM AUTHOR]

Quality assurance is integral to benchmarking and continuous improvement in the clinical care of people affected by cancer. Quality assurance systems are built upon agreed clinical and administrative standards. The Cardiovascular and Interventional Radiology Society of Europe (CIRSE) first developed a set of Standards for Interventional Oncology Services modelled on the Standards of Practice in Radiation Oncology developed in Australia and New Zealand. A subset of these Standards has been used to develop a tiered International Accreditation System in Interventional Oncology (IASIOS). This system covers the entirety of the patient care pathway from referral through to discharge and is clearly aimed at setting the benchmark for safe, quality interventional oncology (IO) services. Such a system has multiple benefits, including increasing the awareness of the availability of IO services and assurance in the quality of the care delivered to patients. [ABSTRACT FROM AUTHOR]

The onus of proof in criminal cases is beyond any reasonable doubt, and the issue on the lack of complete internal validation data can be manipulated when it comes to justifying the validity and reliability of the X‐chromosomal short tandem repeats analysis for court representation. Therefore, this research evaluated the efficiency of the optimized 60% reduced volumes for polymerase chain reaction (PCR) amplification using the Qiagen Investigator® Argus X‐12 QS Kit, as well as the capillary electrophoresis (CE) sample preparation for blood samples on Flinder's Technology Associates (FTA) cards. Good‐quality DNA profile (3000–12,000 RFU) from the purified blood sample on FTA card (1.2 mm) were obtained using the optimized PCR (10.0 μL of PCR reaction volume and 21 cycles) and CE (9.0 μL Hi‐Di™ Formamide and 0.3 μL DNA Size Standard 550 [BTO] and 27 s injection time) conditions. The analytical and stochastic thresholds were 100 and 200 RFU, respectively. Hence, the internal validation data supported the use of the optimized 60% reduced PCR amplification reaction volume of the Qiagen Investigator® Argus X‐12 QS Kit as well as the CE sample preparation for producing reliable DNA profiles that comply with the quality assurance standards for forensic DNA testing laboratories, while optimizing the analytical cost. [ABSTRACT FROM AUTHOR]

The assessment of cancer patient outcomes is important for any oncology departments. In head and neck cancer, not all patients are suitable for clinical studies. Unfortunately not all oncology centres are well resourced to undertake all available head and neck cancer trials. As a tertiary oncology unit with catchment radius of 50 miles and diverse patient demographics, it remains vital to assess outcomes of patients not included in formal studies. The aim of this study was to gather real world survival data of patients treated with definitive (chemo) radiotherapy. As standard of care, head and neck cancer patients are referred from 7 district general hospitals via 2 regional supra-multidisciplinary teams (sMDT). The data of patients demographics, and the clinical details of the head and neck cancer, are as routine collected prospectively for the institution electronic database. The date of disease recurrence on any patients is prospectively recorded at the sMDT. Non-HPV mucosal head and neck cancer patients who received definitive radiotherapy outside clinical trials between Jan 2018 and May 2022 were retrospectively reviewed. All advanced stage patients (Stages III & IVa/b) were considered concomitant chemotherapy. Radiotherapy volume quality assurance was standard prior to radiation [1]. HPV-mediated oropharynx patients, as well those treated with post-operative or adjuvant radiation, were excluded. The progression free survival (PFS) were calculated from the prospective database, and the overall survival (OS) retrospectively from the institution main death register. A total of 267 patients were identified: 122 (46%) Larynx, 68 (25%) p16- Oropharynx, 34 (13%) Hypopharynx, 33 (12%) Nasopharynx, and 10 (4%) Nasal Cavity/Paranasal sinus patients. In terms of UICC 8th edition staging, there were 33 Stage I (12%), 55 Stage II (21%), 71 Stage III (27%), and 108 Stage IVa/b (40%) cases across all tumour sites. The median age was 65 (range 58 - 72). The male to female ratio was 3.2 to 1. Ninety percent (n = 240) of the patients had performance status of 0 or 1. Majority of the patients (n = 209, 78%) had had exposure to tobacco: 122 (46%) ex-smokers and 87 (33%) current smokers. The median smoking pack years for the tobacco exposed patients was 30 (range 10 - 40). As for alcohol consumption, 130 (49%) patients consumed at least 14 units per week, with 30 (11%) being non-drinkers. All patients received 65Gy in 30 fractions (f) over 6 weeks, unless they were T1/2N0M0 glottic cancer for which they received 55Gy in 20f over 4 weeks. A total of 107 patients (40%) had at least 1 cycle of concomitant chemotherapy with their radiation. The median follow up was 3 years. Across all tumour sites, the 2 and 3 year PFS was 60% and 55% respectively, while the 2 and 3 year OS was 74% and 65% respectively. The OS probability according to the UICC staging across all disease sites is shown in Figure 1. For the Larynx subsite, there were 26 Stage I (21%), 30 Stage II (25%), 51 Stage III (42%), and 15 Stage IVa/b (12%) patients. The 2 and 3 year PFS for larynx patients were 70% and 65% respectively, with the 2 and 3 year OS being 82% and 75% respectively. For the p16- oropharynx cohort, there were 3 Stage I (4%), 12 Stage II (18%), 3 Stage III (4%), and 50 Stage IVa/b (74%) patients. In comparison to the larynx cohort, there were higher proportion of advanced stage patients in the Oropharynx cohort. As a result, the 2 and 3 year PFS for the p16-Oropharynx was 44% and 40% respectively, while the 2 and 3 year OS was 60% and 50% respectively. As for the hypopharynx group, there were no Stage I (0%) but 3 Stage II (9%), 8 Stage III (24%), and 23 Stage IVa/b (68%) cases. The 2 and 3 year PFS was 40% and 25% respectively, while the 2 and 3 year OS was 55% and 42% respectively. Separately, there were 2 Stage I (6%), 8 Stage II (24%), 8 Stage III (24%), and 15 Stage IVa (45%) Nasopharynx patients. The 2 and 3 year PFS for nasopharynx cohort was 75% and 60% respectively, with the 2 and 3 year OS being 78% and 70% respectively. [Display omitted] Despite varying tumour sites, the OS of patients overall corresponded to the UICC Stage of their disease, indicating the importance of accurate initial staging as part of prognostication. [ABSTRACT FROM AUTHOR]

Standardization of the quality of the depolarized katuk pellet production process as a feed additive is very important to maintain product quality. The production process requires dry katuk leaves (DKK) as raw materials which are then processed into depolarized katuk leaves (DKD), and continues in the pelleting process to become depolarized katuk pellets (PKD). Quality standard can be done by measuring the parameters of nutritional value and also the yield of methanol extract. Nutritional values were obtained from the results of proximate analysis, namely the percentage of dry matter, ash content, crude protein, crude fiber, crude fat, beta-N, calcium, phosphorus, and gross energy (Cal/g). Mean while, the yield of methanol extract was obtained by maceration using methanol solvent. This study aims to evaluate the nutritional value and yield of crude methanol extract of katuk leaves (DKK, DKD, PKD) which can be used as a quality assurance standard for the depolarized katuk pellet production process. In general, the nutritional value of DKD and PKD had the same value as that of DKK, except for calcium which was quite high (P<0.05) in DKD and PKD, and the percentage of crude fiber was lower (P<0.05) in PKD compared to DKK and DKD. The percentage of crude fat in pellets (PKD) was higher (P<0.05) when compared to DKK and DKD. The yield of methanol extract was very high (P<0.05) in DKK, compared to DKD and PKD. The nutritional parameters and the yield of the katuk leaf extract can be used as quality assurance standards for the depolarized katuk pellet production process. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The accreditation of engineering programmes is a subject of great interest in the last decades. However, most studies in the literature are focused on case studies or deal with the different levels of acceptance of the groups involved in the accreditation. There are two main approaches for the accreditation of engineering programmes, i.e., at national or international level. Whereas most developed countries have established national standards for the quality assurance of the university studies, international accreditation systems for engineering studies are limited to 3 alternatives. The interaction between national and international accreditation systems is poorly understood despite of their significance in the design and management of the programme. We aim to fill in this gap and provide useful guidance for universities aiming to apply for the EUR-ACE® label in their chemical engineering programmes (bachelor or master). In general, there is a high level of complementarity between the Spanish and EUR-ACE accreditation systems. However, there are still challenges. For instance, the ad hoc procedure proposed by the national accreditation agency in Spain does not fully consider chemical engineering as a traditional branch of engineering. In addition, the changes in the Spanish accreditation system might negatively impact the current ad hoc procedure for EUR-ACE accreditation for some universities. The incorporation of IChemE in the accreditation process would be an option to deal with this issue. • Practical guide for EUR-ACE accreditation of chemical engineering studies in Spain. • High level of complementarity between national and EUR-ACE accreditation systems. • Main challenge is the shift from programmes to centres accreditation. • Professionals of chemical engineering not eligible for evaluation panels in Spain. • Solution: to incorporate IChemE into Spanish EUR-ACE accreditation procedure. [ABSTRACT FROM AUTHOR]

In the increasingly competitive landscape of the manufacturing industry, leveraging advancements in information technology has become pivotal for gaining a competitive edge. Specifically, the furniture manufacturing industry has adopted decision support systems (DSS) to meet diverse information needs. However, user concerns regarding these systems, including information reporting speed, order reception, and the accuracy of raw material usage calculations, persist. The development of any system necessitates the application of quality assurance standards that align with user requirements. In light of these concerns, the measurement of software quality emerges as an essential strategy to assuage user doubts about the DSS. Employing the ISO 9126 standard as an assessment parameter provides a reliable framework for evaluating the quality of the DSS. Although the ISO 9126 model possesses several characteristics, this study focuses exclusively on two: functionality and reliability. The anticipated outcome of this research is a refined understanding of user satisfaction pertaining to the implementation of the DSS. Consequently, this study's findings may contribute to the DSS's credibility, specifically concerning the speed of reporting, order reception, and the precision of raw material usage calculation. This, in turn, can influence the decision-making process in production, thereby enhancing the overall effectiveness of the manufacturing industry. [ABSTRACT FROM AUTHOR]

The study aims to prepare a proposed vision for developing open education in Yemeni universities in light of Arab and foreign experiences. To achieve this goal, this study uses the descriptive method and based on this method, the two researchers describe the open university education system in terms of its concept, goals, foundations, principles and advantages. They further review a number of Arab and foreign experiences that dealt with the field of open education including British open universities, open education in Tanzania, open education in Egypt, Saudi Arabia, and the Republic of Yemen, represented by University of Sciences and Technology and Seiyun University. The reality of open education in Yemeni universities is also examined to benefit from the above in preparing the proposed vision for the development of open education in Yemeni universities, which dealt with the administrative and technical units of open education. The study also benefits from the model of the proposed educational portfolio planning, the e-learning system, procedures for implementing educational meetings, the proposed organizational structure model for colleges of education, and the approved quality assurance standards. The study recommends adopting the five-stage Addie Model when colleges plan students’ educational portfolios. It furthermore recommends formulating a clear philosophy for open education by the Ministry of Higher Education in the Republic of Yemen that serves as guidelines for academic work in universities. [ABSTRACT FROM AUTHOR]

The current research aims to identify the extent to which quality assurance standards are applied at Lahj University from the point of view of deans and heads of departments in its colleges. The research community consisted of deans and heads of departments in the faculties of Lahj University, and the data was collected through a questionnaire consisting of five pivots: strategic planning, academic programs, human resources, facilities, and professional support for the faculty member. The questionnaire was distributed to the research sample of (30) deans and department heads. The researcher reached a set of results, the most important of which are: 1- The results of the research showed that the general arithmetic average of the responses of the members of the research sample on the extent of the application of quality assurance standards at Lahj University is 2.86, a value located at the (satisfactory level) according to the rating system specified in this research. 2- The results confirmed that there were no statistically significant differences in the responses of deans and heads of departments on the extent of application of quality assurance standards at Lahj University at the level of significance (0.05) attributed to the variables of college, job and years of experience. Through the results reached, the researcher recommends a number of recommendations, the most important of which are: 1- Spreading the culture of quality among the employees of Lahj University through holding seminars and workshops on quality standards in higher education. 2- Providing the necessary financial support for the application of quality assurance standards at Lahj University. [ABSTRACT FROM AUTHOR]

Copyright of Global Journal of Economics & Business is the property of Refaad for Studies, Research & Development and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Quality assurance measurement of IMRT/VMAT treatment plans is resource intensive, and other more efficient methods to achieve the same confidence are desirable. Purpose: We aimed to analyze treatment plans in the context of the treatment planning systems that created them, in order to predict which ones will fail a standard quality assurance measurement. To do so, we sought to create a tool external to the treatment planning system that could analyze a set of MLC positions and provide information that could be used to calculate various evaluation metrics. Methods: The tool was created in Python to read in DICOM plan files and determine the beam fluence fraction incident on each of seven different zones, each classified based on the RayStation MLC model. The fractions, termed grid point fractions, were validated by analyzing simple test plans. The average grid point fractions, over all control points for 46 plans were then computed. These values were then compared with gamma analysis pass percentages and median dose differences to determine if any significant correlations existed. Results: Significant correlation was found between the grid point fraction metrics and median dose differences, but not with gamma analysis pass percentages. Correlations were positive or negative, suggesting differing model parameter value sensitivities, as well as potential insight into the treatment planning system dose model. Conclusions: By decomposing MLC control points into different transmission zones, it is possible to create a metric that predicts whether the analyzed plan will pass a quality assurance measurement from a dose calculation accuracy standpoint. The tool and metrics developed in this work have potential applications in comparing clinical beam models or identifying their weak points. Implementing the tool within a treatment planning system would also provide more potential plan optimization parameters. [ABSTRACT FROM AUTHOR]

Exploration of novel drugs from natural resources may not always result in the effective management of complex metabolic conditions like diabetes using the "one disease, one therapy, and one target" paradigm. As a result, the field of synergistic pharmacology, which includes polyherbal medicines, has become the preferred method for discovering new pharmaceuticals. This study aims to standardize a polyherbal antidiabetic formulation by combining Costus pictus, Gymnema slyvestre, and Momordica charantia via synergism to enhance the bioavailability of the active compounds, reduce the toxicity and promote therapeutic effects of the selected herbs for antidiabetic activity. The formulation was standardized by evaluating its physical characteristics, powder characteristics, physicochemical properties, phytochemical properties, chromatographic analysis, fluorescence analysis, and safety parameters concerning toxins, microbes, and residues. The loss on drying was 8%, which was within the prescribed limits, indicating that the product has a long storage life. Inorganic metallic salts, such as silica and phosphates, are negligible in the powder, as indicated by its ash value (7.51%), acid-insoluble ash (1.07%), water-soluble ash (2.97%), and sulphated ash (7.76%). The extractive value of water was the highest (12.66%), compared to alcohol (3.54%) and ether (3.34%). The polyherbal formulation was acidic with pH of 6.5 and 6.0 in 1% and 10% solution, respectively, which minimizes the possibility of microbial contamination. The phytochemical analysis confirmed the presence of alkaloids, triterpenoids, flavonoids, phenols, saponins, glycosides, tannins, and diterpenes. Based on the safety evaluation results, the formulation is safe to consume and free of heavy metal contamination, microbial load, pesticide residue, and aflatoxin. The established metrics are sufficient for assessing polyherbal formulation and can be used as reference standards for quality control and assurance. The lack of standardization studies has hampered the translation of new drug candidates into commercially viable therapies, so standardized alternatives are imperative for determining safety, efficacy, and reliability. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: For enhanced environmental management of the Ciliwung River, toxic pollutions such as cadmium dan lead data are required. Cadmium and lead have widespread industrial applications. However, cadmium and lead are poisonous and classified as cancer-causing non-essential elements. Moreover, cadmium and lead accumulation in Ciliwung River-caught eels has not yet been examined. Consequently, it is essential to acquire the gathered data from this study. The primary objective of this study was to explore the accumulation of cadmium and lead in sediments and eel organs along the Ciliwung River and to estimate the weekly cadmium and lead intake from eel consumed by the people. METHODS: Sediment and eel samples were collected at six sampling locations ranging from the upstream, midstream, and downstream regions. Method of 3051a of the United States Environmental Protection Agency was applied to analyze the metal yield from the sediment samples and targeted eel organs (gills, digestive tract, and flesh). In addition, quality control and quality assurance standards were employed, and Certified Reference Materials were used to ensure the quality of data and instruments. FINDINGS: The average concentrations of cadmium (0.7825±0.3768 milligram per kilogram) and lead (36.9333±14.9040 milligram per kilogram) were greater than their natural levels. The average cadmium concentration in riverine sediment was below the interim sediment quality guidelines. However, the lead concentration exceeded the guidelines. The cadmium and lead accumulation patterns in the sediment and eels were found to be lowest in the upstream and found increased in the downstream are. In this case, the gills acquired the most concentration of cadmium (1.4571±0.3433 microgram per gram) and lead (43.2489±18.6775 microgram per gram). The fact that eel gills accumulated the highest cadmium and lead indicates the presence of heavy metals in their environment. The accumulation of cadmium and lead in the eel surpassed the permitted levels. According to the Provisional Tolerable Weekly Intake estimation, this research showed 0.0328 milligram/week for the cadmium and 1.2826 milligram/week for the lead. CONCLUSION: The prevalence of cadmium and lead in riverine sediments and eels in the Ciliwung River is believed to be predominantly the result of inefficient wastewater management. However, cadmium and lead pollution must be handled with extreme caution because it interferes with the physiological processes of the biota, hence decreasing the population of eels and posing a health risk if consumed. In general, Asian swamp eels from the Ciliwung River are still edible. As a result, it is hoped that enhanced management will reduce the number of pollutants entering the riverine ecosystem. [ABSTRACT FROM AUTHOR]

As cone‐beam computed tomography (CBCT) has become the localization method for a majority of cases, the indications for diode‐based confirmation of accurate patient set‐up and treatment are now limited and must be balanced between proper resource allocation and optimizing efficiency without compromising safety. We undertook a de‐implementation quality improvement project to discontinue routine diode use in non‐intensity modulated radiotherapy (IMRT) cases in favor of tailored selection of scenarios where diodes may be useful. After analysis of safety reports from the last 5 years, literature review, and stakeholder discussions, our safety and quality (SAQ) committee introduced a recommendation to limit diode use to specific scenarios in which in vivo verification may add value to standard quality assurance (QA) processes. To assess changes in patterns of use, we reviewed diode use by clinical indication 4 months prior and after the implementation of the revised policy, which includes use of diodes for: 3D conformal photon fields set up without CBCT; total body irradiation (TBI); electron beams; cardiac devices within 10 cm of the treatment field; and unique scenarios on a case‐by‐case basis. We identified 4459 prescriptions and 1038 unique instances of diode use across five clinical sites from 5/2021 to 1/2022. After implementation of the revised policy, we observed an overall decrease in diode use from 32% to 13.2%, with a precipitous drop in 3D cases utilizing CBCT (from 23.2% to 4%), while maintaining diode utilization in the 5 selected scenarios including 100% of TBI and electron cases. By identifying specific indications for diode use and creating a user‐friendly platform for case selection, we have successfully de‐implemented routine diode use in favor of a selective process that identifies cases where the diode is important for patient safety. In doing so, we have streamlined patient care and decreased cost without compromising patient safety. [ABSTRACT FROM AUTHOR]

Successful application of external photon beam therapy in oncology requires that the dose delivered by a medical linear accelerator and distributed within the patient's body is accurately calculated. Monte Carlo simulation is currently the most accurate method for this purpose but is computationally too extensive for routine clinical application. A very elaborate and time-consuming part of such Monte Carlo simulation is generation of the full set (phase space) of ionizing radiation components (mainly photons) to be subsequently used in simulating dose delivery to the patient. We propose a method of generating phase spaces in medical linear accelerators through learning, by artificial intelligence models, the joint multidimensional probability density distribution of the photon properties (their location in space, energy, and momentum). The models are conditioned with respect to the parameters of the primary electron beam (unique to each medical accelerator), which, through Bremsstrahlung, generates the therapeutical beam of ionizing radiation. Two variants of conditional generative adversarial networks are chosen, trained, and compared. We also present the second-best type of deep learning architecture that we studied: a variational autoencoder. Differences between dose distributions obtained in a water phantom, in a test phantom, and in real patients using generative-adversarial-network-based and Monte-Carlo-based phase spaces are very close to each other, as indicated by the values of standard quality assurance tools of radiotherapy. Particle generation with generative adversarial networks is three orders of magnitude faster than with Monte Carlo. The proposed GAN model, together with our earlier machine-learning-based method of tuning the primary electron beam of an MC simulator, delivers a complete solution to the problem of tuning a Monte Carlo simulator against a physical medical accelerator. [ABSTRACT FROM AUTHOR]

The American lobster (Homarus americanus) is the most valuable seafood on Canada's Atlantic coast, generating over CAD 800 million in export revenue alone for New Brunswick. However, labor shortages plague the lobster industry, and lobsters must be processed quickly to maintain food safety and quality assurance standards. This paper proposes a lobster estimation orientation approach using a convolutional neural network model, with the aim of guiding the FANUC LR Mate 200 iD robotic arm for lobster manipulation. To validate this technique, four state-of-the-art object detection algorithms were evaluated on an American lobster images dataset: YOLOv7, YOLOv7-tiny, YOLOV4, and YOLOv3. In comparison to other versions, YOLOv7 demonstrated a superior performance with an F1-score of 95.2%, a mean average precision (mAP) of 95.3%, a recall rate of 95.1%, and 111 frames per second (fps). Object detection models were deployed on the NVIDIA Jetson Xavier NX, with YOLOv7-tiny achieving the highest fps rate of 25.6 on this platform. Due to its outstanding performance, YOLOv7 was selected for developing lobster orientation estimation. This approach has the potential to improve efficiency in lobster processing and address the challenges faced by the industry, including labor shortages and compliance with food safety and quality standards. [ABSTRACT FROM AUTHOR]

Background: Comprehensive cleft care is a multidisciplinary team endeavor. While untreated craniofacial conditions have multiple undue repercussions, cleft care in outreach settings can be fraught with significant perioperative morbidity risks. Aim: Propose updated quality assurance standards addressing logistic and operational considerations essential for the delivery of safe and effective cleft lip and /or palate (CL/P) care in low and middle-income countries (LMICs) settings. Methods: Based on American Cleft Palate-Craniofacial Association (ACPA) quality standards, published literature, published protocols by Global Smile Foundation (GSF), and the senior author's three-decade experience, updated standards for outreach cleft care were synthesized. Results: Ten axes for safe, effective, and sustainable cleft lip and palate care delivery in underserved settings were generated: 1) site assessment, 2) establishment of community partnerships, 3) team composition and credentialing, 4) team training and mission preparation, 5) implementation of quality assurance guidelines, operative safety checklists, and emergency response protocols, 6) immediate and long-term postoperative care, 7) medical record keeping, 8) outcomes evaluation, 9) education, and 10) capacity building and sustainability. Subsequent analysis further characterized essential components of each of those ten axes to delineate experience derived and evidence-based recommendations. Discussion: Quality assurance guidelines are essential for the safe delivery of comprehensive cleft care to patients with CL/P in any setting. Properly designed surgical outreach programs relying on honest community partnerships can be effectively used as vehicles for local capacity building and the establishment of sustainable cleft care ecosystems. [ABSTRACT FROM AUTHOR]

Copyright of Journal of the College Of Basic Education is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)