For the Love of Radiation Oncology: A Resident Trainee Perspective
No abstract prepared.
62 RADIOLOGY AND NUCLEAR MEDICINE↗
SEARCH · Engineering Papers
Results for “MEDICAL PERSONNEL”
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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¡Aviso, Médicos!: The Effect of Direct Patient-Doctor Communication Cannot Be Overlooked
No abstract prepared.
62 RADIOLOGY AND NUCLEAR MEDICINE↗
Is Remote Learning as Effective as In-Person Learning for Contouring Education? A Prospective Comparison of Face-to-Face versus Online Delivery of the Anatomy and Radiology Contouring Bootcamp
The Anatomy and Radiology Contouring (ARC) Bootcamp was a face-to-face (F2F) intervention providing integrated education for radiation oncology (RO) residents and medical physicists. To increase access, we launched an online offering in 2019. We evaluated the effect of the online course on participants' knowledge acquisition, contouring skills, and self-confidence by comparing it with the F2F course.
62 RADIOLOGY AND NUCLEAR MEDICINE↗
Image transformers for classifying acute lymphoblastic leukemia
Cancer is the leading cause of death by disease in American children. Each year, nearly 16,000 children in the United States and over 300,000 children globally are diagnosed with cancer. Leukemia is a form of blood cancer that originates in the bone marrow and accounts for one-third of pediatric cancers. This disease occurs when the bone marrow contains 20% or more immature white blood cell blasts. Acute lymphoblastic leukemia is the most prevalent leukemia type found in children, with half of all annual cases in the U.S. diagnosed for subjects under 20 years of age. To diagnose acute lymphoblastic leukemia, pathologists often conduct a morphological bone marrow assessment. This assessment determines whether the immature white blood cell blasts in bone marrow display the correct morphological characteristics, such as size and appearance of nuclei. Pathologists also use immunophenotyping via multi-channel flow cytometry to test whether certain antigens are present on the surface of blast cells; the antigens are used to identify the cell lineage of acute lymphoblastic leukemia. These manual processes require well-trained personnel and medical professionals, thus being costly in time and expenses. Computerized decision support via machine learning can accelerate the diagnosis process and reduce the cost. Training a reliable classification model to distinguish between mature and immature white blood cells is essential to the decision support system. Here, we adopted the Vision Transformer model to classify white blood cells. The Vision Transformer achieved superb classification performance compared to state-of-the-art convolutional neural networks while requiring less computational resources for training. Additionally, the latent self-attention architecture provided attention maps for a given image, providing clues as to which portion(s) of the image were significant in decision-making. We applied the Vision Transformer model and a convolutional neural network model to an acute lymphoblastic leukemia classification dataset of 12,528 samples and achieved accuracies of 88.4% and 86.2%.
Cho, Priscilla↗
Small, low cost, artificial kidney
Disposable hemodialyzer is described that can be used at home by non-medically trained personnel. Short lengths of semipermeable membrane tubes are arranged in parallel, supported by plastic mesh and encased in epoxy at ends. Tubes are connected to input and output blood manifolds which are separated by dialysate chamber. Daily dialysis requires only two hours or less.
Lavender, A. R.↗
Microbiological surveillance of food handling at NASA-MSFC
A microbiological surveillance program of cafeterias and snack bars was conducted to supplement the inspections by NASA Medical Center personnel and to gather information for cafeteria management to pinpoint areas of possible contamination. The work conducted under the program from its inception in January, 1972, to its termination on September 15, 1972 is summarized. Ten food handling facilities were included in the surveillance at NASA-MSFC.
Beyerle, F. J.↗
Medical evaluations on the KC-135 1990 flight report summary
The medical investigations completed on the KC-135 during FY 1990 in support of the development of the Health Maintenance Facility and Medical Operations are discussed. The experiments are comprised of engineering evaluations of medical hardware and medical procedures. The investigating teams are made up of both medical and engineering personnel responsible for the development of medical hardware and medical operations. The hardware evaluated includes dental equipment, a coagulation analyzer, selected pharmaceutical aerosol devices, a prototype air/fluid separator, a prototype packaging and stowage system for medical supplies, a microliter metering system, and a workstation for minor surgical procedures. The results of these engineering evaluations will be used in the design of fleet hardware as well as to identify hardware specific training requirements.
Lloyd, Charles W.↗
Contracting Officer Technical Representative Briefing
This viewgraph presentation gives an overview of the Agency Occupational Health Program, including details on organizational and personnel changes, medical program standardization, programmatic status, policies, standards, and guides and resources, industrial hygiene and radiological health, assessment schedule and methodology, upcoming events, and the future of the program.
Gettleman, Alan↗
Safety in the operating theatre--part 1: interpersonal relationships and team performance
The authors examine the application of interpersonal human factors training on operating room (OR) personnel. Mortality studies of OR deaths and critical incident studies of anesthesia are examined to determine the role of human error in OR incidents. Theoretical models of system vulnerability to accidents are presented with emphasis on a systems approach to OR performance. Input, process, and outcome factors are discussed in detail.
Non-NASA Center↗
Improvements to the Ionizing Radiation Risk Assessment Program for NASA Astronauts
To perform dosimetry and risk assessment, NASA collects astronaut ionizing radiation exposure data from space flight, medical imaging and therapy, aviation training activities and prior occupational exposure histories. Career risk of exposure induced death (REID) from radiation is limited to 3 percent at a 95 percent confidence level. The Radiation Health Office at Johnson Space Center (JSC) is implementing a program to integrate the gathering, storage, analysis and reporting of astronaut ionizing radiation dose and risk data and records. This work has several motivations, including more efficient analyses and greater flexibility in testing and adopting new methods for evaluating risks. The foundation for these improvements is a set of software tools called the Astronaut Radiation Exposure Analysis System (AREAS). AREAS is a series of MATLAB(Registered TradeMark)-based dose and risk analysis modules that interface with an enterprise level SQL Server database by means of a secure web service. It communicates with other JSC medical and space weather databases to maintain data integrity and consistency across systems. AREAS is part of a larger NASA Space Medicine effort, the Mission Medical Integration Strategy, with the goal of collecting accurate, high-quality and detailed astronaut health data, and then securely, timely and reliably presenting it to medical support personnel. The modular approach to the AREAS design accommodates past, current, and future sources of data from active and passive detectors, space radiation transport algorithms, computational phantoms and cancer risk models. Revisions of the cancer risk model, new radiation detection equipment and improved anthropomorphic computational phantoms can be incorporated. Notable hardware updates include the Radiation Environment Monitor (which uses Medipix technology to report real-time, on-board dosimetry measurements), an updated Tissue-Equivalent Proportional Counter, and the Southwest Research Institute Radiation Assessment Detector. Also, the University of Florida hybrid phantoms, which are flexible in morphometry and positioning, are being explored as alternatives to the current NASA computational phantoms.
Semones, E. J.↗
Medical evaluations on the KC-135 1991 flight report summary
The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.
Lloyd, Charles W.↗
A review of criticality dosimetry at the Y-12 National Security Complex and practical importance of dose accuracy in emergency response
A nuclear criticality results in the emission of both neutron and gamma radiation and can produce doses to personnel near the event that exceed 0.1 Gy (10 rad). The primary purpose of nuclear accident dosimetry is to rapidly identify affected personnel in need of prompt medical treatment and to reassure personnel who have been only minimally exposed. While accurate dosimetry is desired, it must be recognized that dose determinations made from whole-body dosimeters or simple triage methods are very rough estimates and contain significant uncertainties. Even when accounting for factors like varying neutron energy spectra, mean photon energies, body orientation within the radiation field, and transient effects on dosimeter response, etc., the end value is a dosimetric quantity defined for very specific radiological conditions and determined within a simple phantom usually at a single depth. Of more importance is the biological response to the radiation, which will vary by person and can be affected by the individual’s radiation sensitivity, age, gender, mass, and underlying health conditions. The overall biological, person-specific response to a given dose cannot be precisely determined except by patient symptom observation and individual biological dosimetry (e.g. chromosome analysis, lymphocyte ratios, etc.). This work describes and discusses the criticality accident dosimetry program at the Y-12 National Security Complex, a United States Department of Energy National Nuclear Security Administration facility. In conclusion, the primary goals of the Y-12 accident dosimetry program are, among others, the rapid identification of significantly exposed persons, prompt routing of exposed workers for medical evaluation and treatment, and the ultimate processing of dosimeters to assign doses to personnel.
61 RADIATION PROTECTION AND DOSIMETRY↗
Exploration Medical System Demonstration
BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that allows for scalability, extensibility, and interoperability of data sources and data users. f. Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management. g. Provide a better standard of healthcare for crew members through reductions in the time required by crew and ground personnel to provide medical treatment and the number of crew errors experienced during treatment.
Rubin, D. A.↗
Medical Operational Challenges in the Expedition 16 Landing and Recovery
On April 19, 2008 the crew of Expedition 16 left the International Space Station and returned to earth via their Soyuz TMA-11 capsule after 192 days on orbit. Their capsule experienced the second consecutive and third ballistic reentry in the last 10 TMA recoveries and landed approximately 260 miles (420 km) from the prime landing site. Issues: The purpose of this presentation will be to describe, not only the typical medical operational challenges faced by Flight Surgeons recovering a long duration crew from space, but also address the unique challenges that existed with the Expedition 16 landing and crew recovery. Nominal Soyuz recovery challenges include remote recovery sites with crew exposures to sleep shifting and fatigue, dehydration, hypothermia and hyperthermia, and rotational, sustained, and impact g-forces. These environmental factors coupled with the patho-physiologic neuro-vestibular and orthostatic intolerance changes that occur secondary to the crews reintroduction into the earth s gravity field will be detailed. Additional challenges that were unique to this expedition included a ballistic reentry with higher g-loads, the presence of fire outside of the capsule on landing, a contingency medical event of a ground support personnel, and loss of communications with the crew just prior to landing and during recovery operations. Conclusions: In spite of these unique challenges the Russian Search and Rescue Forces and Medical Support personnel along with U.S. Medical Support performed well together. Possible improvements in training and coordination will be discussed.
Moynihan, S.↗
Performance Support Tools for Space Medical Operations
The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Human factors personnel at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground. This area of research involved the feasibility of Just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction were captured. Information needed by the FS during ISS mission support, especially for an emergency situation (e.g. fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS during an emergency, as well as procedures and information to be used after the emergency is resolved. Several walkthroughs of the prototype with FSs have been completed within a mockup of an ISS FS console. Feedback on the current tool design as well as recommendations for existing ISS FS displays were captured.
Byrne, Vicky E.↗
Medical Operations Support for ISS Operations - The Role of the BME Operations Team Leads
This slide presentation reviews the role of the biomedical flight controllers (BMEs), and BME Operations Team Leads (OTLs) in providing medical support for personnel on the International Space Station. This presentation will concentrate on role of the BME OTLs, who provide the integration function across the integration function across all Crew Health Care System (CHeCS) disciplines for operational products and medical procedures.
Janney, Rob↗
Predicting Postoperative Injury and Military Discharge Status After Knee Surgery in the US Army
Background: Researchers have assessed postoperative injury or disability predictors in the military setting but typically focused on 1 type of surgical procedure at a time, used relatively small sample sizes, or investigated mixed cohorts with civilian populations. Purpose: To identify the relationship between baseline variables and injury incidence or military discharge status in US Army soldiers after knee surgery. Study Design: Case-control study; Level of evidence, 3. Methods: Data were obtained from a repository containing personnel, performance, and medical records for all active-duty US Army soldiers. Multivariate logistic regressions were used to estimate the effects of numerous variables on postoperative injury or on medical discharge. Variable selection and model validation were conducted using the k-fold method. Results: A total of 7567 soldiers underwent knee surgery between 2017 and 2019. Meniscal procedures were the most common type of surgery (39%), and approximately 71% of the cohort had a postoperative injury. Significant predictors for sustaining a postoperative injury included having a previous nonknee injury (odds ratio [OR], 1.5), female sex (OR, 1.3), and Black race (OR, 1.2). Within 4 years after surgery, 17% of soldiers were discharged from the military because of knee-related disability. Significant predictors for discharge from duty included enlisted rank (OR, 2.3), recent fitness test failure (OR, 1.9), number of previous knee surgeries (OR, 1.7), and having a previous nonknee injury (OR, 1.6). Conclusion: After knee surgery, nearly three-fourths of the soldiers in this cohort sustained a postoperative injury and almost one-fifth of soldiers were medically discharged from the military within 4 years. This study identified variables that indicate statistically increased risk for these postoperative outcomes and highlighted potentially modifiable factors.
Orthopedics↗
NASA's life sciences program
NASA space missions from the Mercury through the Shuttle program have provided successively more data on the ability of humans to function in space for progressively longer periods of time. The Skylab program encouraged cooperation between medical and engineering personnel in the design of space suits, diet, food preparation, and cleanliness procedures and equipment, and the man-machine interface. Research is now concentrated on supporting man in space, evaluating the effects of the microgravity environment on humans, and modeling encounters with extraterrestrial life and the effects of human activities on terrestrial biota. Current levels of understanding of the physiological causes of human health problems produced by long-duration spaceflight are summarized. Experiments planned for the Shuttle, Spacelab, and the Space Station are outlined, noting the long-term goal of configuring the Space Station so that only food and hydrazine are needed to complete the life support system cycle.
Soffen, Gerald A.↗