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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 217 records · Page 12
All sourcesNASA NTRSDOE OSTI
DOE OSTI2024

Collateral benefits: River flow normalization for endangered fish enabled riparian rejuvenation

Abstract Like most rivers worldwide, the transboundary North American Kootenay/i River has experienced multiple impacts including watershed developments, river channelization, and floodplain clearing, draining, and diking. Construction of Libby Dam was authorized by the 1964 Columbia River Treaty (CRT) between the United States and Canada, and in 1975 began regulating downstream flows for flood risk management and hydropower generation. Following cumulative impacts, the endemic Kootenai River White Sturgeon population collapsed and was designated as endangered in 1994 (U.S. Endangered Species Act). Subsequent Biological Opinions from the U.S. Fish and Wildlife Service prescribed Libby Dam operations to provide springtime flow pulses for sturgeon spawning. These provided the unanticipated benefit of substantial seedling recruitment of native and introduced riparian cottonwoods and willows. The regulated flow regime was further adaptively managed to provide a more normative (natural) regime, to balance ecological functions with flood risk management and hydropower generation. The broadened ecological considerations would be consistent with the proposed priorities for the modernization of the international CRT. The observed responses revealed that (1) diverse aquatic and riparian organisms are dependent on common river flow characteristics; (2) a normalized flow regime provided substantial ecological benefits; and (3) due to multiple influences, hybrid ecosystems develop along regulated rivers, with a blending of natural and altered processes and communities. For other regulated rivers, we recommend that (1) high springtime flows be allowed, as feasible; (2) followed by the gradual post‐peak recession; and (3) the maintenance of sufficient flows through the warm and dry interval of mid to late summer.

Rood, Stewart B.↗
DOE OSTI2025

Workforce planning: a review of methodologies

Workforce planning deals with determining the number of employees and associated skills necessary to meet the future operational needs of an organization. A workforce system consists of six elements: recruitment, attrition, promotion, training, retention, and scheduling. Historically, several workforce modeling and analysis methodologies have been developed to capture these elements. This paper reviews the results of workforce and manpower models published within peer-reviewed literature between 1959 and 2021 to provide an in-depth analysis of current models. The focus of this review is on analytical, simulation, and empirical models found in literature that were collected based on a citation requirement and keyword search criteria. Results demonstrate the trends in workforce modeling research and discuss the common uses of each model type and the advantages/disadvantages related to each model. Based on the common attributes of workforce systems, the discussion focuses on the most frequently used model type for each element and the best use for each model. Lastly, recommendations are made for the development of workforce models that allow the most comprehensive view of the workforce systems of the future.

42 ENGINEERING↗
DOE OSTI2022

Growth and survival rates of dispersing free embryos and settled larvae of pallid sturgeon ( Scaphirhynchus albus ) in the Missouri River, Montana and North Dakota

We released nearly 1.0 million 1-day post-hatch (dph) and 5-dph pallid sturgeon (Scaphirhynchus albus) free embryos in the Missouri River on 1 July 2019 and sequentially captured survivors at multiple sites through a 240-km river reach to quantify daily growth and survival rates during the early life stages. Genetic analysis was used to assign captured fish to released family lots and known ages. Growth rate was similar (0.74–0.75 mm day –1 ) between the 1- and 5-dph age groups during the 3–4-day dispersal period when water temperature averaged 16.8 °C. Daily survival rate was 0.64 during 1–4 dph for the original 1-dph age group and 0.80 during 5–7 dph for the original 5-dph age group. Total survival during free embryo dispersal (hatch to 9 dph) was estimated as 0.0437. The transition from dispersing as free embryos to settling as benthic larvae was verified for fish originally released as 5 dph. Growth of settled larvae was quantified with a Gompertz model through 75 dph (9 September; 112 mm) when water temperature was 18.8–21.0 °C in the rearing areas. Settled larvae had an estimated daily survival rate of 0.96, and estimated total survival during 9–75 dph was 0.0714. This study provides the first empirical survival estimates for pallid sturgeon early life stages in natural settings and is one of few studies reporting similar information for other sturgeon species. Applications of this work extend to pallid sturgeon restoration programs where population models are being developed to predict recruitment potential and population responses to river management alternatives.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2022

Psb27, a photosystem II assembly protein, enables quenching of excess light energy during its participation in the PSII lifecycle

Photosystem II (PSII), the enzyme responsible for oxidizing water into molecular oxygen, undergoes a complex lifecycle during which multiple assembly proteins transiently bind to and depart from PSII assembly intermediate complexes. Psb27 is one such protein. It associates with the CP43 chlorophyll-binding subunit of PSII to form a Psb27-PSII sub-complex that constitutes 7–10% of the total PSII pool. Psb27 remains bound to PSII assembly intermediates and dissociates prior to the formation of fully functional PSII. In this study, we compared a series of Psb27 mutant strains in the cyanobacterium Synechocystis sp. PCC 6803 with varied expression levels of Psb27: wild type (WT); psb27 genetic deletion (Del27), genetically complemented psb27 (Com27); and over-expressed Psb27 (OE27). The Del27 strain demonstrated decreased non-photochemical fluorescence quenching, while the OE27 strain showed increased non-photochemical quenching and tolerance to fluctuating light conditions. Multiple flashes and fluorescence decay analysis indicated that OE27 has the least affected maximum PSII quantum yield of the mutants. OE27 also displayed a minimal impact on the half-life of the fast component of QA – reoxidation over multiple flashes, indicating robust PSII function. Further, we propose that the close association between Psb27 and CP43, and the absence of a fully functional manganese cluster in the Psb27-PSII complex create a PSII sub-population that dissipates excitation energy prior to its recruitment into the functional PSII pool. Efficient energy dissipation prevents damage to this pre-PSII pool and allows for efficient PSII repair and maturation. Participation of Psb27 in the PSII life cycle ensures high-quality PSII assembly.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2020

Socio-Structural and Neighborhood Predictors of Incident Criminal Justice Involvement in a Population-Based Cohort of Young Black MSM and Transgender Women

Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over 18 months of follow-up. We report, controlling for respondent age, gender and sexual identity, spirituality (aOR 0.56, 95% CI 0.33-0.96), and presence of a mother figure (aOR 0.41, 95% CI 0.19-0.89) were protective against CJI. Economic hardship (financial or residential instability vs. neither aOR 2.23, 95% CI 1.10-4.51), two or more past episodes of CJI vs. none (aOR 2.66, 95% CI 1.40-5.66), and substance use (marijuana use vs. none aOR 2.79, 95% CI 1.23-6.34; other drug use vs. none aOR 4.49, 95% CI 1.66-12.16) were associated with CJI during follow-up. Research to identify and leverage resilience factors that can buffer the effects of socioeconomic marginalization may increase the effectiveness of interventions to address the socio-structural factors that increase the risk for CJI among Black MSM and transgender women. Given the intersection of incarceration, HIV and other STIs, and socio-structural stressors, criminal justice settings are important venues for interventions to reduce health inequities in these populations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Prospective associations among relationship abuse, sexual harassment and bullying in a community sample of sexual minority and exclusively heterosexual youth

ABSTRACT Introduction Sexual minority youth (SMY) are at significantly greater risk for experiencing adolescent relationship abuse (ARA) than exclusively heterosexual youth, yet little is known about the factors that elevate their risks for such abuse. Peer victimization (i.e., bullying, sexual harassment) has been associated with ARA among heterosexual youth. SMY experience higher rates of peer victimization than heterosexual youth, suggesting that it may be a risk factor for ARA among these youth. Using longitudinal data from a community sample of adolescents recruited from the northeastern US, we examined whether sexual identity was associated prospectively with ARA, and whether that relationship would be indirect, and mediated via bullying and sexual harassment at a 12‐month follow‐up. We expected to find higher rates of peer victimization and ARA among SMY than heterosexual youth, and we expected that sexual harassment and bullying would predict subsequent relationship abuse. Methods Adolescents ( N = 800; 58% female; 81% European‐American; 19% SMY) between 13 and 15 years ( M = 14.45, SD = 0.85) completed a web survey at baseline, 6‐months and 12‐months. Results Consistent with prior studies, SMY reported higher rates of bullying, sexual harassment, and relationship abuse than heterosexual youth. SMY who reported sexual harassment at baseline were more likely to report relationship abuse over time. Contrary to our expectations, however, bully victimization did not predict subsequent relationship abuse. Conclusions Sexual harassment can be particularly harmful for SMY because it targets gender and sexual identity at a formative developmental period and puts youth at risk for relationship abuse.

Hequembourg, Amy L.↗
DOE OSTI2023

Extrapair offspring of the blue-footed booby show no sign of higher fitness in the first 10 years of life

According to the good genes and genetic compatibility hypotheses, females of socially monogamous species obtain genetic benefits for their offspring by performing extrapair copulations with males of higher quality than their social mates or males with whom they are more genetically compatible. If extrapair offspring do receive genetic benefits in the form of advantageous alleles or more compatible allele combinations, they should outperform their within-pair half-siblings' survival and/or reproductive output. Here, in this study, we followed 52 extrapair and 737 within-pair blue-footed booby, Sula nebouxii, offspring during their first 10 years of life (excluding the embryonic period and the first 10 days after hatching) to assess whether they differed in fledging probability, fledgling body condition, recruitment probability, age at first reproduction, number of breeding events or accumulated breeding success. Extrapair and within-pair offspring did not differ in any of these proxies of fitness. Furthermore, we found that extrapair offspring were equally likely to occur in any hatching position. However, differences in fledgling production over the lifetime could not be ruled out, and because only within-pair production of eggs and fledglings was tallied, the possibility remains that extrapair offspring could produce more extrapair offspring later in life than do within-pair offspring. Furthermore, the possibility of context-dependent genetic benefits occurring only under stressful conditions cannot be discounted because our sample of offspring was obtained in a single exceptionally favourable reproductive season.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2022

High-level co-production of 3-hydroxypropionic acid and 1,3-propanediol from glycerol: Metabolic engineering and process optimization

3-Hydroxypropionic acid (3-HP) and 1,3-propanediol (1,3-PDO) are value-added chemicals with versatile applications in the chemical, pharmaceutical, and food industries. Nevertheless, sustainable production of 3-HP and 1,3-PDO is often limited by the lack of efficient strains and suitable fermentation configurations. We report attempts have been made to improve the co-production of both metabolites through metabolic engineering of Escherichia coli and process optimization. First, the 3-HP and 1,3-PDO co-biosynthetic pathways were recruited and optimized in E. coli, followed by coupling the pathways to the transhydrogenase-mediated cofactor regeneration systems that increased cofactor availability and product synthesis. Next, pathway rebalancing and block of by-product formation significantly improved 3-HP and 1,3-PDO net titer. Subsequently, glycerol flux toward 3-HP and 1,3-PDO synthesis was maximized by removing metabolic repression and fine-tuning the glycerol oxidation pathway. Lastly, the combined fermentation process optimization and two-stage pH-controlled fed-batch fermentation co-produced 140.50 g/L 3-HP and 1,3-PDO, with 0.85 mol/mol net yield.

1,3-propanediol↗
DOE OSTI2025

Ion-selective conformational stabilization of a disordered repeats-in-toxin protein domain

Ion-binding intrinsically disordered proteins (IDPs) recruit and bind to specific metal ions to perform critical biological functions. In proteins where ion binding and structural transitions are coupled, interactions with off-target toxic metals can dramatically disrupt protein structure and function, exemplified by lead and mercury poisoning. Understanding the complex mechanisms underlying how IDPs exclude or allow binding to different ionic species is crucial for addressing the origins of metal toxicity in biological systems. Here, we elucidate mechanisms of ion selectivity in an IDP that adopts a structure upon Ca 2+ binding. We probed ion-induced conformational changes of a repeats-in-toxin (RTX) protein domain in the presence of different ion ligands—Mg 2+ , Ca 2+ , Sr 2+ , and Ba 2+ —with chemical similarities but drastically different ionic radii. RTX adopts ion-selective conformations measured by x-ray crystallography, small-angle x-ray scattering, and circular dichroism. High-resolution x-ray structures reveal that Sr 2+ induces a nearly identical RTX structure as natively binding Ca 2+ , enabled by the intrinsic flexibility and disorder of the protein. Small-angle x-ray scattering and circular dichroism indicate that smaller Mg 2+ does not induce a significant conformational change in RTX, whereas larger Ba 2+ induces a partially folded structure. These results highlight the importance of geometric constraints imposed by protein structure in determining metal ion selectivity, yielding insights into how off-target ion binding may result in protein misfolding and malfunction.

Gudinas, Alana P. [Stanford Univ., CA (United Stat↗
DOE OSTI2020

Structural Insights into the SPRED1-Neurofibromin-KRAS Complex and Disruption of SPRED1-Neurofibromin Interaction by Oncogenic EGFR

Sprouty-related, EVH1 domain-containing (SPRED) proteins negatively regulate RAS/mitogen-activated protein kinase (MAPK) signaling following growth factor stimulation. This inhibition of RAS is thought to occur primarily through SPRED1 binding and recruitment of neurofibromin, a RasGAP, to the plasma membrane. Here, we report the structure of neurofibromin (GTPase-activating protein [GAP]-related domain) complexed with SPRED1 (EVH1 domain) and KRAS. The structure provides insight into how the membrane targeting of neurofibromin by SPRED1 allows simultaneous interaction with activated KRAS. SPRED1 and NF1 loss-of-function mutations occur across multiple cancer types and developmental diseases. Analysis of the neurofibromin-SPRED1 interface provides a rationale for mutations observed in Legius syndrome and suggests why SPRED1 can bind to neurofibromin but no other RasGAPs. We show that oncogenic EGFR(L858R) signaling leads to the phosphorylation of SPRED1 on serine 105, disrupting the SPRED1-neurofibromin complex. The structural, biochemical, and biological results provide new mechanistic insights about how SPRED1 interacts with neurofibromin and regulates active KRAS levels in normal and pathologic conditions.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2021

Antibody:CD47 ratio regulates macrophage phagocytosis through competitive receptor phosphorylation

Cancer immunotherapies often modulate macrophage effector function by introducing either targeting antibodies that activate Fcγ receptors (FcγRs) or blocking antibodies that disrupt inhibitory SIRPα-CD47 engagement. However, how these competing signals are integrated is poorly understood, raising questions about how to effectively titrate immune responses. Here, we find that macrophage phagocytic decisions are regulated by the ratio of activating ligand to inhibitory ligand over a broad range of absolute molecular densities. Using both endogenous and chimeric receptors, we show that activating:inhibitory ligand ratios of at least 10:1 are required to promote phagocytosis of model antibody-opsonized CD47-inhibited targets and that lowering that ratio reduces FcγR phosphorylation because of inhibitory phosphatases recruited to CD47-bound SIRPα. We demonstrate that ratiometric signaling is critical for phagocytosis of tumor cells and can be modified by blocking SIRPα, indicating that balancing targeting and blocking antibodies may be important for controlling macrophage phagocytosis in cancer immunotherapy.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2023

Discovery and characterization of a selective IKZF2 glue degrader for cancer immunotherapy

Malignant tumors can evade destruction by the immune system by attracting immune-suppressive regulatory T cells (Treg) cells. The IKZF2 (Helios) transcription factor plays a crucial role in maintaining function and stability of Treg cells, and IKZF2 deficiency reduces tumor growth in mice. Here we report the discovery of NVP-DKY709, a selective molecular glue degrader of IKZF2 that spares IKZF1/3. We describe the recruitment-guided medicinal chemistry campaign leading to NVP-DKY709 that redirected the degradation selectivity of cereblon (CRBN) binders from IKZF1 toward IKZF2. Selectivity of NVP-DKY709 for IKZF2 was rationalized by analyzing the DDB1:CRBN:NVP-DKY709:IKZF2(ZF2 or ZF2-3) ternary complex X-ray structures. Exposure to NVP-DKY709 reduced the suppressive activity of human Treg cells and rescued cytokine production in exhausted T-effector cells. In vivo, treatment with NVP-DKY709 delayed tumor growth in mice with a humanized immune system and enhanced immunization responses in cynomolgus monkeys. NVP-DKY709 is being investigated in the clinic as an immune-enhancing agent for cancer immunotherapy.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2021

Efficient and reversible electron bifurcation with either normal or inverted potentials at the bifurcating cofactor

A longstanding mystery surrounding electron bifurcation is the significance of inverted (or “crossed”) reduction potentials of the two-electron bifurcating cofactor. Using a many-electron open-system kinetic model, we show that reversible and efficient electron bifurcation is possible without inverted reduction potentials at the bifurcating site if the absolute value of the difference between first and second reduction potentials of the bifurcating species is sufficiently large (on the scale of the redox-potential span of the high- and low-potential branches). Surprisingly, the case with strong, normally ordered potentials at the bifurcating cofactor can produce electron bifurcation that is just as effective as the case with strongly inverted potentials. Lastly, this finding amplifies the puzzle surrounding the recruitment of inverted potentials in the few well-characterized bifurcating systems of nature and suggests that electron bifurcating cofactors without strongly inverted potentials may yet be discovered.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2020

Computer-aided classification of suspicious pigmented lesions using wide-field images

Early identification of melanoma is conducted through whole-body visual examinations to detect suspicious pigmented lesions, a situation that fluctuates in accuracy depending on the experience and time of the examiner. Computer-aided diagnosis tools for skin lesions are typically trained using pre-selected single-lesion images, taken under controlled conditions, which limits their use in wide-field scenes. Here, we propose a computer-aided classifier system with such input conditions to aid in the rapid identification of suspicious pigmented lesions at the primary care level. 133 patients with a multitude of skin lesions were recruited for this study. All lesions were examined by a board-certified dermatologist and classified into “suspicious” and “non-suspicious”. A new clinical database was acquired and created by taking Wide-Field images of all major body parts with a consumer-grade camera under natural illumination condition and with a consistent source of image variability. 3–8 images were acquired per patient on different sites of the body, and a total of 1759 pigmented lesions were extracted. A machine learning classifier was optimized and build into a computer aided classification system to binary classify each lesion using a suspiciousness score. In a testing set, our computer-aided classification system achieved a sensitivity of 100% for suspicious pigmented lesions that were later confirmed by dermoscopy examination (“SPL_A”) and 83.2% for suspicious pigmented lesions that were not confirmed after examination (“SPL_B”). Sensitivity for non-suspicious lesions was 72.1%, and accuracy was 75.9%. With these results we defined a suspiciousness score that is aligned with common macro-screening (naked eye) practices. This work demonstrates that wide-field photography combined with computer-aided classification systems can distinguish suspicious from non-suspicious pigmented lesions, and might be effective to assess the severity of a suspicious pigmented lesions. We believe this approach could be useful to support skin screenings at a population-level.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

Micromovements and discomfort associated with flight mission with helmet operation tasks with different levels of cognitive workload

When performing stationary tasks under elevated cognitive workload, individuals must perform continual muscle contractions to maintain stability of the body, resulting in fatigue of the postural muscles. When the muscles perform these contractions in a prolonged manner, the body potentially responds through small changes in body movements—micromovements that may lead to discomfort. The study purpose was to evaluate impact of cognitive load on micromovements. The micromovements were measured during three different cognitive workloads; low, medium, and high. The NASA-TLX score was used to evaluate the perceived mental workload and discomfort was assessed by visual analog scale. In total, 60 subjects (30 males and 30 females) were recruited and performed cognitive tasks that simulated flight operations such as changing the radio frequency based on air traffic control messages, balancing the fuel levels in simulated fuel tanks, and aiming a reticle in a designated moving target using the cyclic control. Cognitive load was defined by the frequency of events. Micromovements were defined by changes in the center of pressure (COP) of the seat pan and COP standard deviation. It was found that the high cognitive workloads had the highest NASA-TLX scores including mental demands, temporal demands, and effort. The neck area had the highest overall levels of discomfort followed by upper back. The highest standard deviation for COP shift and number of micromovements occurred for medium cognitive workloads. In conclusion, while there were some interesting trends, few trends reached a statistical significance due to high variability among subjects for the outcome variables.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Winners are not keepers: Characterizing household engagement, gains, and energy patterns in demand response using machine learning in the United States

Demand-response programs can help utilities manage rapidly evolving electric grids, but these programs are subject to the complexities of human behavior. This paper explores a novel method for uncovering heterogeneity in households. In this work, we use a machine-learning method known as a Conditional Inference Tree (c-tree) algorithm to categorize households based on their energy behavior characteristics collected via smart meters, and explore how this translates through into heterogeneity in their real-world response to a DR program. Using data from randomized controlled trial, we generate estimates of the changes in energy use caused by the program within each household group. Our results show that the c-tree approach differentiates households by their energy-use characteristics in a way that increases the spread in enrollment rates and critical peak reduction among household groups, compared with the spreads achieved via several conventional segmentation methods. Thus, the c-tree analysis enables the most tailored targeting of major potential energy savers and could provide the greatest increase in cost-effectiveness of household recruitment into DR programs. Our results also offer fresh insights into the relationships between household energy behavior characteristics – such as peak energy use and “structural winningness” (the ability to save money under a DR program without changing energy-use behaviors) – and household decisions about enrolling in DR programs and reducing energy use. Our research also demonstrates the potential of smart meter data, combined with machine learning and econometric methods, to provide significant value to utilities, program implementers, researchers, and other stakeholders.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2023

Range-wide population assessments for subalpine fir indicate widespread disturbance-driven decline

Subalpine forests in western North America are threatened by rapid climate change, increased activity by endemic and exotic insects and diseases, and changing wildfire regimes. The interactive effects of these stressors have resulted in pronounced population declines in many subalpine tree species; however, a systematic assessment of the status and trends of subalpine forests is lacking. Subalpine fir (Abies lasiocarpa) is a widespread species across the western United States, with documented population declines in many parts of its distribution. Here we use subalpine fir as an initial leverage point to build a more complete understanding of subalpine forest baseline conditions and responses to environmental change. Specifically, we leverage the USDA Forest Service Forest Inventory and Analysis (FIA) database to (1) ask how subalpine fir populations are changing across the species’ distribution in the western US, (2) assess the drivers of recent subalpine fir population trends, and (3) explore whether those changes imply generalized species-wide and/or system-wide decline. We found that subalpine fir abundance and basal area are declining concurrently across ~ 62% of the species’ distribution, and increasing across ~ 19%. Range-wide, we estimated 25.02 ± 2.74 % subalpine fir mortality between 2000 and 2009 and 2010–2019 FIA inventory periods, with higher mortality concentrated in the eastern Oregon Cascades, central Idaho, and parts of southern Colorado. High regeneration density did not predict positive population trajectories, which were instead associated with higher rates of adult recruitment. While the importance of different mortality agents varied substantially between ecoregions, 83.4% of total range-wide mortality was related to fire or biological disturbance. Declining subalpine fir basal area coincided with declines in the basal area of other co-occurring tree species in 39% of subalpine forest area, and with increases in conspecific basal area in 22% of forest area. Fire disturbance was the single largest cause of subalpine fir mortality; however, even where subalpine fir fire mortality was high, mortality among other species was primarily caused by insects. In conclusion, our results suggest that subalpine fir declines across large portions of the western United States are driven by forest disturbance, and that declines in subalpine fir populations may be indicative of negative change in subalpine forest systems broadly.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2021

A Framework for Patient-Centered Pathways of Care for Radiopharmaceutical Therapy: An ASTRO Consensus Document

Radiopharmaceutical therapy (RPT) is an area of projected growth and importance with several agents in clinical use, new agents in late-phase clinical trials, and many others under testing and development. This article proposes a framework for developing pathways of care that can be broadly applied to all RPTs, representing the current status of RPT. It suggests foundational elements for many pathways of care for patients with cancer and concludes with areas in active development and the future horizon for RPT treatment centers. Developing a framework for patient-centered pathways of care is a critical step in establishing RPT as standard therapy for patients with a diverse spectrum of cancers. This expected increase in RPT treatment options will affect a much larger population of patients with complex cancer. It will also require enhanced coordination and collaboration among appropriately qualified personnel with diverse expertise in image acquisition, image interpretation, quantitative imaging, dosimetry calculation, radiation quality assurance and safety as well as oncology care and RPT-induced sequelae and response assessment. The essential role of this evolving RPT care team within multidisciplinary oncology care is a cornerstone of this framework for a patient-centered pathway of care for RPT. Given the status of current RPT practice and the horizon for future applications, this patient-centered pathway of care guidance is timely and should help inform future clinical RPT practice paradigms. A task force was recruited from the Theranostic Working Group of the American Society for Radiation Oncology (ASTRO) in May 2019 with equal representation from the nuclear medicine community. The task force expanded on a framework that was originally conceived by the Working Group for patient-centered care. This framework was developed to incorporate the strengths of both radiation oncologists and nuclear medicine physicians. The manuscript was then developed by the task force and posted on the ASTRO website for a 6-week public comment period ending in July 2020. Comments were adjudicated, and the draft was sent to external organizations for potential endorsement. This document was sent to the ASTRO Board of Directors in October 2020 for approval.

62 RADIOLOGY AND NUCLEAR MEDICINE↗