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At least 19 records

Explainable Artificial Intelligence in Endocrinological Medical Research

Artificial Intelligence (AI) has been a part of the medical community for decades in the form of Clinical Decision Support Systems (CDSS) to aide physicians in diagnosis and categorization of patients (1). Recent years have seen a shift from expert-derived models to the integration of machine learning (ML) algorithms to drive the output of these AI systems due to the ability of ML models to more accurately make predictions by exploiting higher dimensional and often complex data. In many cases ML models gain their advantage in accuracy by capture complex and often non-linear relationships between features being used to make the prediction. However, the hype and excitement around these methods are tempered by the clinical utility of often black-box solutions driven by skepticism of results that are difficult for practitioners to not only interpret but explain to their patients (1-3). This skepticism is not unfounded as multiple examples of black-box solutions identifying incidental correlates as the key predictors have highlighted the potential bias in a training set, or reward system, that a ML model may exploit; for example a model discerning wolves from huskies based on snow in the background rather than features of the dogs (1, 4, 5).

Endocrinological, artificial intelligence, diabete↗

Quasiclassical Computations of Compton-Scattered Spectra

Quality X-ray sources are crucial to fundamental physics research, medical radiology, humanities research, and materials science. While synchrotron radiation (SR) facilities produce the state-of-the-art emissions with respect to brilliance and frequency tunability, the great expense required to build, maintain, and operate these structures greatly limits their accessibility to researchers. Much of the research conducted at SR facilities, however, may be conducted with inverse Compton sources (ICS). Accelerator-based Compton scattering light sources generate high-energy, high-brilliance emissions. Compton scattering is the process by which a photon scatters o? an electron. ICS offer an affordable, in-lab alternative to SR facilities. Even though SR facilities produce greater intensity emissions, Compton sources provide the same frequency tunability at the intensities suitable for the purposes of many researchers currently fighting for time at SR facilities, i.e., ICS provides intensities suitable for contrast imaging, X-ray fluorescence, X-ray-diffraction, and X-ray spectroscopy. The focus of this work is to create computational models to simulate Compton-scattered spectra. These models have been used to build a theoretical basis for methods of improving the quality of future Compton sources and to preform diagnostic analysis of existing light sources. The theoretical basis of each model is derived from first principles. The numerical methods employed by each model are defined. A full description of the various functionalities of each code will be addressed. Furthermore, an in-depth analysis of spectral bandwidth sources is discussed. The complex physics arising from an extremely high-intensity, nonlinear laser pulse is explored in detail. Methods of frequency modulation of the incident laser, i.e., a method for correcting the nonlinear broadening effects on the scattered spectrum, will also be discussed. The work will conclude with a an exploration of the ongoing research efforts regarding regimes of operation outside of the limits of these current models.

Johnson, Erik↗

A Simulation Modeling Approach to Optimizing Nuclear Waste Dispositioning

The dispositioning of nuclear waste generated at facilities across the country is an ongoing battle that affects us all. National laboratories and research centers dealing in medical research, clean energy, and other nuclear activities such as the Department of Energy (DOE) facilities face the need to properly manage and dispose of nuclear waste. A dynamic modeling solution would enable the DOE and others to make decisions on waste disposal and technological options. In doing so, this research explores modeling techniques using available data to address these situations. The focus being on developing an initial robust and adaptable discrete event model using the ExtendSim tool. This modeling effort will target the dispositioning of transuranic waste at the Savannah River National Laboratory (SRNL) which can be expanded to represent the current state of disposition process for waste generated at other DOE facilities. The model aims to assess resource allocation and waste processing options to stabilize productivity and cut the backlog of nuclear waste. By assessing the results of different scenarios, this research aims to provide actionable insights for the DOE. This approach has the potential to significantly improve the management of radioactive waste, offering the capability of evaluating options for optimizing the process for nuclear waste disposal. The findings of this study can serve as a valuable resource for decision-makers and other national laboratories, or research entities engaged in nuclear operations by enabling them to make more informed choices.

Andaverde, Alexis↗

Iraq/Afghanistan war lung injury reflects burn pits exposure

This descriptive case series retrospectively reviewed medical records from thirty-one previously healthy, war-fighting veterans who self-reported exposure to airborne hazards while serving in Iraq and Afghanistan between 2003 and the present. They all noted new-onset dyspnea, which began during deployment or as a military contractor. Twenty-one subjects underwent non-invasive pulmonary diagnostic testing, including maximum expiratory pressure (MEP) and impulse oscillometry (IOS). In addition, five soldiers received a lung biopsy; tissue results were compared to a previously published sample from a soldier in our Iraq Afghanistan War Lung Injury database and others in our database with similar exposures, including burn pits. We also reviewed civilian control samples (5) from the Stony Brook University database. Military personnel were referred to our International Center of Excellence in Deployment Health and Medical Geosciences, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell under the auspices of Northwell IRB: 17-0140-FIMR Feinstein Institution for Medical Research “Clinicopathologic characteristics of Iraq Afghanistan War Lung Injury.” We retrospectively examined medical records, including exposure data, radiologic imaging, and non-invasive pulmonary function testing (MGC Diagnostic Platinum Elite Plethysmograph) using the American Thoracic Society (ATS) standard interpretation based on Morgan et al., and for a limited cohort, biopsy data. Lung tissue, when available, was examined for carbonaceous particles, polycyclic aromatic hydrocarbons (Raman spectroscopy), metals, titanium connected to iron (Brookhaven National Laboratory, National Synchrotron Light Source II, Beamline 5-ID), oxidized metals, combustion temperature, inflammatory cell accumulation and fibrosis, neutrophil extracellular traps, Sirius red, Prussian Blue, as well as polarizable crystals/particulate matter/dust. Among twenty-one previously healthy, deployable soldiers with non-invasive pulmonary diagnostic tests, post-deployment, all had severely decreased MEP values, averaging 42% predicted. These same patients concurrently demonstrated abnormal airways reactance (X5Hz) and peripheral/distal airways resistance (D5–D20%) via IOS, averaging – 1369% and 23% predicted, respectively. These tests support the concept of airways hyperresponsiveness and distal airways narrowing, respectively. Among the five soldiers biopsied, all had constrictive bronchiolitis. We detected the presence of polycyclic aromatic hydrocarbons (PAH)—which are products of incomplete combustion—in the lung tissue of all five warfighters. All also had detectable titanium and iron in the lungs. Metals were all oxidized, supporting the concept of inhaling burned metals. Combustion temperature was consistent with that of burned petrol rather than higher temperatures noted with cigarettes. All were nonsmokers. Neutrophil extracellular traps were reported in two biopsies. Compared to our prior biopsies in our Middle East deployment database, these histopathologic results are similar, since all database biopsies have constrictive bronchiolitis, one has lung fibrosis with titanium bound to iron in fixed mathematical ratios of 1:7 and demonstrated polarizable crystals. These results, particularly constrictive bronchiolitis and polarizable crystals, support the prior data of King et al. (N. Engl. J. Med. 365:222–230, 2011) Soldiers in this cohort deployed to Iraq and Afghanistan since 2003, with exposure to airborne hazards, including sandstorms, burn pits, and improvised explosive devices, are at high risk for developing chronic clinical respiratory problems, including: (1) reduction in respiratory muscle strength; (2) airways hyperresponsiveness; and (3) distal airway narrowing, which may be associated with histopathologic evidence of lung damage, reflecting inhalation of burned particles from burn pits along with particulate matter/dust. Non-invasive pulmonary diagnostic tests are a predictor of burn pit-induced lung injury

36 MATERIALS SCIENCE↗

Recommended reporting items for epidemic forecasting and prediction research: The EPIFORGE 2020 guidelines

Background: The importance of infectious disease epidemic forecasting and prediction research is underscored by decades of communicable disease outbreaks, including COVID-19. Unlike other fields of medical research, such as clinical trials and systematic reviews, no reporting guidelines exist for reporting epidemic forecasting and prediction research despite their utility. We therefore developed the EPIFORGE checklist, a guideline for standardized reporting of epidemic forecasting research. Methods and findings: We developed this checklist using a best-practice process for development of reporting guidelines, involving a Delphi process and broad consultation with an international panel of infectious disease modelers and model end users. The objectives of these guidelines are to improve the consistency, reproducibility, comparability, and quality of epidemic forecasting reporting. The guidelines are not designed to advise scientists on how to perform epidemic forecasting and prediction research, but rather to serve as a standard for reporting critical methodological details of such studies. Conclusions: These guidelines have been submitted to the EQUATOR network, in addition to hosting by other dedicated webpages to facilitate feedback and journal endorsement.

60 APPLIED LIFE SCIENCES↗

Enhancing Radionuclide Production Capabilities at the Duke University Medical Center Cyclotron with a Focus on Astatine-211

Radionuclides play an important role in a diverse array of fields including physics, chemistry, agriculture, materials science, national security, medical research and patient care. Establishing a reliable domestic supply of key radionuclides is critical to our national competitiveness in these areas. Regarding medical applications, targeted alpha-particle therapy (TAT) has become of great interest to basic researchers and clinicians alike and is emerging as a valuable and cost-effective approach for cancer treatment. Unfortunately, progress in TAT, particularly with regard to its clinical translation, has been severely hampered by the limited availability of the most promising radionuclides at a reasonable cost, and with appropriate chemical and radiochemical purity. In this project, we have attempted to address this problem by focusing on production of the 7.2-h half-life α-particle emitter, 211 At, which has long been considered to be one of the most promising radionuclides for TAT. We note that he critical importance of improving the supply of 211 At in the United States was noted in the Funding Opportunity Announcement related to this project. At Duke University, we have a CS-30 cyclotron that is one of the few accelerators in the United States that has an alpha-particle beam that has enough energy to make useful quantities of 211 At. With this cyclotron, we have been able to produce more 211 At than anywhere else in the world because of our unique internal cyclotron target system. However, the CS-30 cyclotron is nearly 40 years old and was no longer reliable. In addition, its operation required considerable skill, largely because it had analog control systems, and vital parts including old-fashioned power supplies, were becoming unavailable. For these reasons, the current project was undertaken to evaluate all the subsystems of the CS-30 cyclotron and replace, repair, and update them. With help from our consultant, Ionetix, this has now been accomplished. We believe that because of this work, the CS-30 can reliably supply 211 At for basic research and clinical trials both at Duke and beyond.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Cyclotron resonance accelerators for industrial applications

Here, this paper describes novel configurations for cyclotron resonance acceleration of electrons and ions that have several attractive features including: a compact robust room-temperature single-cell RF cavity as the accelerator structure; and continuous high current accelerated un-bunched beam output with self-scanning, obviating need for a separate beam scanner. An electron accelerator version, the electron Cyclotron Resonance Accelerator (eCRA), is under development to be an efficient source for high power electron and x-ray beams for medical, research, sterilization, and National Security applications, so as to replace radioactive materials. An ion accelerator version, the ion Cyclotron Auto-Resonance Accelerator (iCARA) is described here, suggesting its potential to produce, as an example, a high-current multi-MeV beam of deuterons which could be highly competitive with that produced either with linacs or cyclotrons. Such a deuteron beam could produce a high flux of fast neutrons via deuteron stripping, for applications including the transmutation of used nuclear fuel, material studies relevant for a fusion reactor inner wall, tritium breeding and medical isotope production. For the high-current, high efficiency simulated performance for eCRA and iCARA as described in this paper, the particle beams produced may not exhibit the low emittance values that are important for most discovery research. Rather, the beams could be useful for industrial applications where higher emittance and some energy spread can be tolerated, in favor of high beam power.

43 PARTICLE ACCELERATORS↗

Photon Activation Analysis in Gallium, Nickel, and Vanadium

Here this research explored the development of the photonuclear production method of 67 Cu from 71 Ga as well as 47 Sc from 51 V. Both products serve as high-demand research medical radioisotopes. Furthermore, an understanding of these reactions is significant to fundamental nuclear physics and astrophysics. Bremsstrahlung flux was induced by an electron linac and a 1-mm tungsten radiator. Irradiation of gallium oxide powder, 98.78% pure 71 Ga, and a natural vanadium foil at 30.9 MeV and 100 W for 1 h produced 64.4 ± 0.4 Bq/W·s·kg of 67 Cu and 164 ± 3.1 Bq/W·s·kg of 47 Sc. A secondary irradiation with 99.6% pure 71 Ga and natural vanadium at 31.5 MeV and 100 W for 1.1 h produced 79.8 ± 0.9 Bq/W·s·kg of 67 Cu and 136 ± 7.2 Bq/W·s·kg of 47 Sc. The photoinduced activation is promising; however, further research into optimal geometry and power is required to maximize specific activity. Natural nickel was also irradiated to serve as a benchmark comparison. Effective cross sections for each reaction were inferred.

47Sc↗

Continuous assessment of metabolic activity of mitochondria using resonance Raman microspectroscopy

Dysfunctional mitochondrial activity can lead to a variety of different diseases. As such, there exists a need to quantify changes in mitochondria function as it relates to these specific diseased states. Here, we present the use of resonance Raman (RR) spectroscopy as a tool to determine changes in isolated mitochondrial activity. RR spectroscopy, using 532 nm as the excitation source, specifically provides information on the reduction and oxidation (RedOx) state of cytochrome c, which is determined by the activity of protein complexes in the electron transport chain. In this model, injection of the substrate succinate into the mitochondrial sample is used to drive the electron transport chain, which causes a subsequent change in cytochrome c RedOx state. This change in RedOx state is tracked by RR spectroscopy. We report this tool gives real-time information on the rise and fall of the amount of reduced cytochrome c within the mitochondrial sample, providing a method for rapid assessment of mitochondrial metabolism that has broad applications in both basic science and medical research.

59 BASIC BIOLOGICAL SCIENCES↗

Microstructure and microchemistry changes at U-10Mo fuel/AA6061 cladding interfaces with varying hot isostatic pressing conditions

Monolithic uranium - 10 wt.% molybdenum (U-10Mo) is a promising high-assay low-enriched uranium fuel system for nuclear reactors used in research, medical isotope production, and remote power applications. During manufacturing, AA6061 cladding is bonded to the U-10Mo fuel plate via hot isostatic pressing, during which diffusion and fuel/cladding chemical interaction occurs at plate edges. Furthermore, the microstructure and microchemistry changes that occur at fuel/cladding interfaces are important to understand as a function of process parameters to develop a reliable fuel fabrication process and to meet the desired specifications. Here, microstructural and microchemical changes are studied using complementary electron microscopy and atom probe tomography for two manufactured fuel plates with varied hot isostatic pressing (HIP) parameters. Results highlight that modifying thermomechanical processing parameters significantly changed the interaction layer thickness between U-10Mo and AA6061 by an order of magnitude. In addition to this the distribution and concentration of elements (i.e., Al, Si, Mg) from cladding to fuel was also investigated.

36 MATERIALS SCIENCE↗

Coupling a recurrent neural network to SPAD TCSPC systems for real-time fluorescence lifetime imaging

Fluorescence lifetime imaging (FLI) has been receiving increased attention in recent years as a powerful diagnostic technique in biological and medical research. However, existing FLI systems often suffer from a tradeoff between processing speed, accuracy, and robustness. Inspired by the concept of Edge Artificial Intelligence (Edge AI), we propose a robust approach that enables fast FLI with no degradation of accuracy. This approach couples a recurrent neural network (RNN), which is trained to estimate the fluorescence lifetime directly from raw timestamps without building histograms, to SPAD TCSPC systems, thereby drastically reducing transfer data volumes and hardware resource utilization, and enabling real-time FLI acquisition. We train two variants of the RNN on a synthetic dataset and compare the results to those obtained using center-of-mass method (CMM) and least squares fitting (LS fitting). Results demonstrate that two RNN variants, gated recurrent unit (GRU) and long short-term memory (LSTM), are comparable to CMM and LS fitting in terms of accuracy, while outperforming them in the presence of background noise by a large margin. To explore the ultimate limits of the approach, we derive the Cramer-Rao lower bound of the measurement, showing that RNN yields lifetime estimations with near-optimal precision. To demonstrate real-time operation, we build a FLI microscope based on an existing SPAD TCSPC system comprising a 32 x 32 SPAD sensor named Piccolo. Four quantized GRU cores, capable of processing up to 4 million photons per second, are deployed on the Xilinx Kintex-7 FPGA that controls the Piccolo. Powered by the GRU, the FLI setup can retrieve real-time fluorescence lifetime images at up to 10 frames per second. The proposed FLI system is promising and ideally suited for biomedical applications, including biological imaging, biomedical diagnostics, and fluorescence-assisted surgery, etc.

47 OTHER INSTRUMENTATION↗

Cross sections of 147–149 Sm( 6 Li,x) reactions for the production of 149 Tb for targeted alpha therapy

Terbium-149g (t 1/2 = 4.12 h) is of particular interest for targeted alpha therapy cancer treatment due to its ability to decay via both alpha and positron emission, making it a potential theranostic nuclide. Due to many challenges facing its production, there are limited facilities worldwide that have demonstrated the ability to produce this nuclide in quantities sufficient for medical research. Since the Cyclotron Institute at Texas A&M University is a specialized accelerator facility capable of accelerating a wide variety of ions, we are investigating production pathway options. One of the major challenges facing its production is the known co-production of the excited isomeric state, 149m Tb (t 1/2 = 4.1 min). However, this state does not decay to the ground state of 149g Tb, negating any potential contribution to its yield. Due to its short-half life, the cross section for the population of this state has never been measured. After calculating several potential reaction yields using predictive models, the reactions of 147–149 Sm( 6 Li,xn) 149 Tb were identified as candidates. Lithium-6 beams of varied energies between 45-65 MeV were impinged on enriched 147 Sm, 148 Sm, and 149 Sm targets at the Cyclotron Institute at Texas A&M University, and the reaction products were measured immediately following irradiation using high-purity germanium detectors, enabling detection of both 149m Tb and 149g Tb. Cross sections for all nuclides produced in sufficient activity in these reactions were also measured and reported here. We conclude that the population of 149m Tb is much preferred over population of the ground state for these 6 Li-induced reactions, and it is necessary to explore other options for 149g Tb production.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Comparison of Different Variants of the U.S. Army Occupational Physical Assessment Test

The U.S. Army Occupational Physical Assessment Test (OPAT) is a pre-enlistment physical employment screening assessment developed to place recruits and soldiers into Military Occupational Specialties (MOSs) based on their physical capabilities in order to optimize performance and limit injury. The OPAT consists of the seated power throw (SPT), strength deadlift (SDL), standing long jump, and interval aerobic run. During the scientific validation of the OPAT, two variants of the SPT and two variants of the SDL were used. Although the OPAT was validated using both variants for each test, U.S. Army scientists and policymakers have received queries regarding how these variants compare to each other. Therefore, the purpose of this study was to compare different variants of the SPT and SDL. Thirty-two participants (14 male and 18 female) between the ages of 18 and 42 years visited the laboratory on one occasion and performed two variants of the SPT (seated on the ground [the current OPAT standard] versus seated in a chair with a 35 cm seat height) and two variants of the SDL (using a hex-bar [the current OPAT standard] versus using paired dumbbells). Testing order for the different variants was randomized. The protocol was approved by the U.S. Army Medical Research and Development Command Institutional Review Board. Performing the SPT from a chair significantly (P < .05) increased performance when compared to performing the SPT from the ground (5.4 ± 1.3 m versus 5.0 ± 1.4 m, respectively). Values for the two SPT variants were correlated (tau = 0.90). Performing the SDL using the hex-bar significantly increased the maximal weight lifted when compared to performing the SDL using paired dumbbells (86.9 ± 18.4 kg versus 83.1 ± 18.0 kg, respectively). Values for the two SDL variants were correlated (tau = 0.83). Performing different variants of the SPT and SDL influenced the resulting score. Although these findings do not alter the administration or scoring of the OPAT, they do provide a valuable reference in the event of future inquiries regarding the development of the OPAT.

General & Internal Medicine↗

Comparative Performance of Three Eye-Tracking Devices in Detection of Mild Traumatic Brain Injury in Acute Versus Chronic Subject Populations

ABSTRACT Introduction Presently, traumatic brain injury (TBI) triage in field settings relies on symptom-based screening tools such as the updated Military Acute Concussion Evaluation. Objective eye-tracking may provide an alternative means of neurotrauma screening due to sensitivity to neurotrauma brain-health changes. Previously, the US Army Medical Research and Development Command Non-Invasive NeuroAssessment Devices (NINAD) Integrated Product Team identified 3 commercially available eye-tracking devices (SyncThink EYE-SYNC, Oculogica EyeBOX, NeuroKinetics IPAS) as meeting criteria toward being operationally effective in the detection of TBI in service members. We compared these devices to assess their relative performance in the classification of mild traumatic brain injury (mTBI) subjects versus normal healthy controls. Materials and Methods Participants 18 to 45 years of age were assigned to Acute mTBI, Chronic mTBI, or Control group per study criteria. Each completed a TBI assessment protocol with all 3 devices counterbalanced across participants. Acute mTBI participants were tested within 72 hours following injury whereas time since last injury for the Chronic mTBI group ranged from months to years. Discriminant analysis was undertaken to determine device classification performance in separating TBI subjects from controls. Area Under the Curves (AUCs) were calculated and used to compare the accuracy of device performance. Device-related factors including data quality, the need to repeat tests, and technical issues experienced were aggregated for reporting. Results A total of 63 participants were recruited as Acute mTBI subjects, 34 as Chronic mTBI subjects, and 119 participants without history of TBI as controls. To maximize outcomes, poorer quality data were excluded from analysis using specific criteria where possible. Final analysis utilized 49 (43 male/6 female, mean [x̅] age = 24.3 years, SD [s] = 5.1) Acute mTBI subjects, and 34 (33 male/1 female, x̅ age = 38.8 years, s = 3.9) Chronic mTBI subjects were age- and gender-matched as closely as possible with Control subjects. AUCs obtained with 80% of total dataset ranged from 0.690 to 0.950 for the Acute Group and from 0.753 to 0.811 for the Chronic mTBI group. Validation with the remaining 20% of dataset produced AUCs ranging from 0.600 to 0.750 for Acute mTBI group and 0.490 to 0.571 for the Chronic mTBI group. Conclusions Potential eye-tracking detection of mTBI, per training model outcomes, ranged from acceptable to excellent for the Acute mTBI group; however, it was less consistent for the Chronic mTBI group. The self-imposed targeted performance (AUC of 0.850) appears achievable, but further device improvements and research are necessary. Discriminant analysis models differed for the Acute versus Chronic mTBI groups, suggesting performance differences in eye-tracking. Although eye-tracking demonstrated sensitivity in the Chronic group, a more rigorous and/or longitudinal study design is required to evaluate this observation. mTBI injuries were not controlled for this study, potentially reducing eye-tracking assessment sensitivity. Overall, these findings indicate that while eye-tracking remains a viable means of mTBI screening, device-specific variability in data quality, length of testing, and ease of use must be addressed to achieve NINAD objectives and DoD implementation.

General & Internal Medicine↗

Using 3D Measurements from MRI to Improve VVUQ

Magnetic resonance velocimetry (MRV) is a diagnostic that can measure 3D, three-component turbulent velocity fields in arbitrarily complex flow configurations. The approach uses magnetic resonance imaging (MRI), which is a system commonly available in radiology departments or medical research centers. MRV acquires signal from hydrogen protons in water channel flows. Despite the obvious utility of the measurements for investigating a variety of flows, comparisons with computational fluid dynamic (CFD) simulations largely retain traditional metrics, comparing velocity profiles and planes at discrete regions within the flow rather than using the 3D nature of the measured field. In this effort, MRV was conducted in a simple water channel with six spanwise-centered periodic obstacles roughly shaped as cubes. At a fully turbulent Reynolds number of 15,000, the channel includes two flows: a main streamwise flow and, in the wake of the second obstacle, an injected flow oriented perpendicular to the streamwise flow. The flow geometry includes partial obstacles on the side walls and is inherently 3D because of the interaction of the two streams and the wake features, making the flow challenging to completely measure with traditional optical techniques. Aside from line profiles and planar comparisons, two 3D metrics are used to compare the data with a steady Reynolds-averaged Navier–Stokes (RANS) simulation result. A brief discussion about the comparison is provided, including comments about uncertainty.

Benson, Mike [ORNL] (ORCID:000000023210116X)↗

Proton-induced reactions on Fe, Cu, and Ti from threshold to 55 MeV

Theoretical models often differ significantly from measured data in their predictions of the magnitude of nuclear reactions that produce radionuclides for medical, research, and national security applications. In this paper, we compare a priori predictions from several state-of-the-art reaction modeling packages (CoH, EMPIRE, TALYS, and ALICE) to cross sections measured using the stacked-target activation method. The experiment was performed using the Lawrence Berkeley National Laboratory 88-Inch Cyclotron with beams of 25 and 55 MeV protons on a stack of iron, copper, and titanium foils. Thirty-four excitation functions were measured from 4–55 MeV, including the first measurement of the independent cross sections for nat Fe(p,x) 49,51 Cr, 51,52m,52g,56 Mn, and 58m,58g Co. All of the models, using default input parameters to assess their predictive capabilities, failed to reproduce the isomer-to-ground state ratio for reaction channels at compound and pre-compound energies, suggesting issues in modeling the deposition or distribution of angular momentum in these residual nuclei.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

The 6-minute walk test predicts mortality in a pulmonary nontuberculous mycobacteria-predominant bronchiectasis cohort

Background: Bronchiectasis is a chronic lung condition frequently associated with nontuberculous mycobacteria pulmonary (NTM) disease. Persons with these conditions are at increased risk of mortality. Patient reported outcome (PRO) instruments and the 6-minute walk test (6MWT) have been shown to predict mortality for several lung conditions, but these measures have not been fully evaluated for bronchiectasis and NTM. Methods: We conducted a retrospective cohort study among adult patients enrolled in a natural history study of bronchiectasis at the National Heart, Lung, and Blood Institute. Electronic medical records were queried for demographic, clinical, microbiologic, radiographic, and PRO instrument data: St. George’s Respiratory Questionnaire (SGRQ), Medical Research Council Dyspnea Scale, and the Pulmonary Symptom Severity Score (PSSS). The study baseline date was defined as the patient’s first visit after January 1st, 2015 with a SGRQ or 6MWT completed. Follow-up was defined as the interval between the study baseline visit and date of death or December 31st, 2019. Sex-stratified Cox proportional-hazards regression was conducted to identify predictors of mortality. Separate models were run for each PRO and 6MWT measure, controlling for age, body mass index (BMI), fibrocavitary disease status, and M. abscessus infection. Results: In multivariable Cox proportional-hazards regression models, the PSSS-severity (aHR 1.29, 95% CI 1.04–1.59), the 6MWT total distance walked (aHR 0.938, 95% CI 0.896–0.981) and distance saturation product (aHR 0.930, 95% CI 0.887–0.974) independently predicted mortality. In addition, BMI was significantly predictive of mortality in all models. Conclusions: The 6MWT and a PRO instrument capturing symptom severity are independently predictive of mortality in our cohort of bronchiectasis patients.

6-minute walk test↗

Development of a compact electron cyclotron resonance accelerator for industrial and security applications

We describe the development of a novel accelerator, an electron Cyclotron Resonance Accelerator (eCRA) [1], to produce high power electron beams and X-ray beams for medical, research, sterilization, and national security applications. The several attractive features of eCRA include: a compact robust room-temperature single-cell RF cavity as the accelerating structure; continuous ampere-level high current output; and production of a self-rastering electron beam, thus eliminating the need for a separate beam scanner. Progress on the eCRA development, including numerical simulation, engineering design, and on-going experimental efforts will be reported here.

43 PARTICLE ACCELERATORS↗