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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 181 records · Page 10

A standards perspective on genomic data reusability and reproducibility

Genomic and metagenomic sequence data provides an unprecedented ability to re-examine findings, offering a transformative potential for advancing research, developing computational tools, enhancing clinical applications, and fostering scientific collaboration. However, effective and ethical reuse of genomics data is hampered by numerous technical and social challenges. The International Microbiome and Multi’Omics Standards Alliance (IMMSA, https://www.microbialstandards.org/) and the Genomic Standards Consortium (GSC, https://gensc.org) hosted a 5-part seminar series “A Year of Data Reuse” in 2024 to explore challenges and opportunities of data reuse and reproducibility across disparate domains of the genomic sciences. Addressing these challenges will require a multifaceted approach, including common metadata reporting, clear communication, standardized protocols, improved data management infrastructure, ethical guidelines, and collaborative policies that prioritize transparency and accessibility. We offer strategies to enable responsible and technically feasible data reuse, recognition of data reproducibility challenges, and emphasizing the importance of cross-disciplinary efforts in the pursuit of open science and data-driven innovation.

59 BASIC BIOLOGICAL SCIENCES↗

Micrometer: Micromechanics transformer for predicting full field mechanical responses of heterogeneous materials

Predicting mechanical responses of heterogeneous materials across scales remains a significant challenge. Traditional computational methods often struggle with complex and multiscale nature of these materials, limiting their effectiveness in real-world applications. Here, in this paper, we introduce Micrometer, a vision transformer based deep learning model designed to predict full field mechanical responses of heterogeneous materials, bridging the gap between computer vision and solid mechanics problems. We show that Micrometer, trained on a large-scale high-resolution dataset of 2D fiber-reinforced composites, can achieve state-of-the-art performance in predicting microscale strain fields across a wide range of material properties and loading conditions. Our model demonstrates accuracy and computational efficiency in applications such as computational homogenization and multiscale modeling, reducing computational time by up to two orders of magnitude compared to conventional numerical solvers while maintaining less than 1 % errors in predicting macroscale stress fields. Furthermore, we showcase Micrometer’s adaptability through transfer learning experiments on new materials with limited data, highlighting its potential to tackle diverse scenarios in computational solid mechanics. These results represent a significant step towards AI-driven innovation in materials science, addressing the limitations of traditional numerical methods and paving the way for more efficient simulations of heterogeneous materials across various industrial applications.

Composite materials↗

Lifetime extension of legacy CEBAF LLRF hardware

A significant portion of the Low-Level Radio Frequency (LLRF) hardware in Jefferson Lab’s CEBAF is from the original construction of the facility using 1980’s CAMAC technology. Of the fifty-three zones in CEBAF, thirty-six of them are legacy hardware. The age of the legacy system has led to difficulties in maintaining the hardware due to parts going obsolete without suitable drop in replacements. Continued operation of the legacy system is required as the installation of LLRF 3.0 systems is costly and cannot be completed in a short period of time with the available resources. The most pressing failure in the legacy system was a failing buffer card, which is responsible for communication between the EPICs network and individual RF control modules. A new buffer card was designed as a transparent, drop in, replacement so that upgrades are simply a matter of swapping the existing legacy hardware. This buffer card upgrades a single point failure component and promises to extend the operable lifetime of CEBAF’s legacy systems.

Accelerator Physics↗

Reimagining How Flood Warnings Can Inform Decision‐Making and Community Actions

Society faces increasingly severe flood hazards, intensifying demand for flood early warning systems (FEWS) that deliver accurate and actionable information. However, most existing FEWS remain prediction‐centric, treating decision‐making as a downstream consumer of hazard forecasts while offering limited support for uncertainty interpretation, risk communication, and real‐world response. This Perspective presents a vision and blueprint for a novel inland FEWS‐decision‐making (FEWS‐DM) framework that repositions decision‐making as an equal partner in the forecasting process—not a passive recipient of its outputs. The framework is built on three tightly coupled, co‐evolving thrusts: Physical Science (T1), which advances flood prediction with quantified uncertainty informed by decision relevance; Human Science (T2), which incorporates psychology, behavior, and cultural and institutional context; and Decision Science (T3), which unifies physical predictions and human factors through principled, utility‐based decision support with end‐to‐end uncertainty management. Rather than treating T1 as a solved problem, FEWS‐DM recognizes that forecast development itself must be shaped by decision needs through continuous bidirectional feedback. We identify key scientific, behavioral, and operational challenges limiting such integration and discuss the enabling role of AI, while emphasizing human‐centered design and community feedback as essential for building trust and improving flood risk management.

54 ENVIRONMENTAL SCIENCES↗

Conditional diffusion machine-learning framework for mapping valence electron distribution from convergent beam electron diffraction

Quantitative convergent beam electron diffraction (CBED) enables determination of aspherical valence electron distributions through refinement of low-order structure factors, which are highly sensitive to chemical bonding and charge density variations. However, conventional quantitative CBED (QCBED) requires solving a highly nonlinear inverse problem with many coupled parameters, and computationally intensive dynamical diffraction calculations, making it time-consuming and difficult to apply to complex systems. More broadly, reconstructing charge density and orbital electron distribution from diffraction data has long been a central challenge in both x-ray and electron crystallography. Here, in this study, we introduce an artificial-intelligence (AI)-based framework that replaces traditional refinement with a data-driven inverse solver. Using a large synthetic CBED dataset generated by Bloch-wave simulations, we train a conditional diffusion model to directly infer crystal structural parameters and multipole density formalism parameters, and hence valence electron distributions, from CBED patterns alone. By learning from forward simulations across realistic parameter space, the model effectively solves the inverse problem. Compared with direct regression approaches, the diffusion-based framework provides posterior parameter distributions for rigorous uncertainty quantification while preserving quantitative fidelity and reducing analysis time by orders of magnitude. By eliminating the need for external single-crystal x-ray diffraction data and complex nonlinear refinement, this approach enables practical, high-throughput, and in situ quantitative CBED, enabling real-time mapping of valence electron distributions and their correlation with functional responses in quantum and energy materials.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗

An Advanced Machine Learning and Artificial Intelligence System for Demonstrating Radiation Regulatory Compliance in DOE Accelerator Facilities

In this Phase II proposal, Applied Research LLC (ARLLC), Thomas Jefferson National Accelerator Facility (Jefferson Lab), and Old Dominion University (ODU) propose the combination of domain knowledge (beam characteristics, fixed structural shielding, earthen burden (the soil and foliage added to the dome of the experimental halls as additional shielding), etc.), machine learning (ML) and/or artificial intelligence (AI) to correlate a variety of multi-modal onsite signals and the radiation fields seen in accessible areas of the accelerator site and the site boundary. The ML/AI will consider the complex influence of environmental parameters affecting the radon contribution of the measurements, focusing on actual data obtained from Jefferson Lab. In Phase I, the coded beam and location data were fed into a deep learning model to predict doses at several designated locations in Jefferson Lab’s facility. Moreover, a dense radiation map was generated using only a sparse collection of the samples in a facility. In Phase II, we will develop a software prototype containing a radiation prediction algorithm, dense radiation map algorithms, and background noise prediction algorithms, with actual data used to evaluate the prototype. This work will provide a framework for evaluation of radiation measurement results around the site based on learned responses. In addition, the proposed approach allows more granular mapping of radiation levels. Better understanding and communication of these levels is related to the overall approach in keeping doses to personnel ALARA.

43 PARTICLE ACCELERATORS↗

GenAI-Based Digital Twins Aided Data Augmentation Increases Accuracy in Real-Time Cokurtosis-Based Anomaly Detection of Wearable Data

Early detection of potential infectious disease outbreaks is crucial for developing effective interventions. In this study, we introduce advanced anomaly detection methods tailored for health datasets collected from wearables, offering insights at both individual and population levels. Leveraging real-world physiological data from wearables, including heart rate and activity, we developed a framework for the early detection of infection in individuals. Despite the availability of data from recent pandemics, substantial gaps remain in data collection, hindering method development. To bridge this gap, we utilized Wasserstein Generative Adversarial Networks (WGANs) to generate realistic synthetic wearable data, augmenting our dataset for training. Subsequently, we use these augmented datasets to implement a cokurtosis-based technique for anomaly detection in multivariate time-series data. Our approach includes a comprehensive assessment of uncertainties in synthetic data compared to the actual data upon which it was modeled, as well as the uncertainty associated with fine-tuning anomaly detection thresholds in physiological measurements. Through our work, we present an enhanced method for early anomaly detection in multivariate datasets, with promising applications in healthcare and beyond. This framework could revolutionize early detection strategies and significantly impact public health response efforts in future pandemics.

Data-Driven Digital Twins↗

Potential of Data Center Controls in Grid Services

The rapid proliferation of large data centers brings both challenges and opportunities for grid reliability. The data center resources and their potential flexibility have the potential to contribute resources to grid operations. Through capabilities like energy shifting and resource coordination, data centers can help reduce their net demand on the transmission network, as well as provide additional grid services to support reliable operation on the grid. While transient and long-term grid planning and operations are the scenarios that draw most attention, the quasi-steady state timeseries (QSTS) operation of data centers and grid bring interesting scenarios that can help evaluate the data center controls to aid grid services. This work is focused on modeling data centers for QSTS applications – incorporating the AI data center load profiles and building on the PNNL digital twin model for the thermal management loads to enable simulation studies to reveal the impact of data center controls on grid performance. This includes the integration of a QSTS battery and natural gas generator model to incorporate local resource impacts to the system. The simulation study is performed with a modified IEEE 24-Bus transmission system. Scenarios are focused on evaluating the data center load impacts on the transmission system and leveraging both data center and local generation controls to mitigate those impacts and provide additional grid services. The data center controls revealed the ability to contribute to two main kinds of grid services: preventing congestion on a weak grid by coordinating the data center resources with the collocated BESS and onsite generation; and the ability to help the grid operations during stressed times of operation like during a contingency. Leveraging these and other capabilities has the potential to help data centers become grid responsive assets, aiding in both their integration into the power system and grid reliability.

power grid simulation↗

Thermal property characterization of phase change materials in building applications: A systematic review of fundamentals, recent progress, and future directions

Phase change materials (PCMs) can reduce building peak loads and enable demand-responsive thermal energy storage (TES), but their deployment depends on reliable measurement and interpretation of thermal properties across laboratory, intermediate, and application scales. Here, this review systematically examines characterization methods, testing protocols, and recent advances for neat PCMs and PCM composites, emphasizing thermal conductivity, enthalpy-related properties (phase change temperature, latent heat, specific heat), and cycling stability. For thermal conductivity, we compare steady-state and transient techniques and note limitations when phase transition and contact resistance affect measurements. For enthalpy–temperature characterization, we discuss differential scanning calorimetry together with intermediate- and bulk-scale methods, including T-history, heat flow meter testing, and three-layer calorimetry (3LC), to generate application-relevant enthalpy–temperature profiles. Cycling stability is organized into four experimental families: thermoelectric–air, fully thermoelectric, water-bath, and in situ chamber approaches, with attention to separating reversible supercooling from true degradation such as phase segregation. We highlight emerging noncontact diagnostics, including infrared thermography and embedded sensing, for spatially resolved validation and multiscale interpretation. Finally, we review the growing use of AI and machine learning for property prediction, inverse characterization from experimental signals, and real-time state estimation in building-integrated TES. Key needs include harmonized protocols, interlaboratory benchmarking, uncertainty reporting, and metadata-rich datasets to accelerate reproducible PCM qualification for grid-flexible buildings.

AI↗

Systems Innovation: Modernization & Efficiencies for ESH&Q Reviews

Environmental compliance reviews at INL have traditionally been managed through fragmented systems, relying on multiple spreadsheets and manual processes. This inefficiency led to time-consuming status updates and redundant tasks, such as manually sending reminder emails and transferring data from Excel to the Environmental Review Process (ERP). Initial attempts to streamline these processes using Power Automate and Excel revealed significant limitations, necessitating a more comprehensive solution. To address these immediate inefficiencies, automated workflows were developed using Power Automate. These workflows were designed to send scheduled status update reminders and capture responses through standardized forms, with submitted data flowing directly into centralized Excel trackers. This automation reduced the administrative burden, improved data accuracy, and enabled faster, more consistent reporting. Specifically, email automation achieved a 65% efficiency gain, while data integration saw a 48% improvement, resulting in 91% of project statuses being updated within two months. Despite the improvements brought by Power Automate, the fragmented nature of the review processes persisted. To further enhance efficiency and accuracy, the Integrated Review Tool (IRT) was developed. The IRT aims to centralize review initiation and connect team systems, creating an interconnected data infrastructure that preserves team autonomy while enhancing overall efficiency. This tool automates email reminders, centralizes reviews, and streamlines data integration, significantly improving the accuracy and efficiency of environmental compliance reviews. The design and development of the IRT involved advanced systems methodology, process mapping, project management, and collaboration with subject matter experts. The minimum viable product design is 100% complete, and system development is currently underway, with expected outcomes including a centralized entry point for all ESH&Q reviews, automated routing, real-time tracking and analytics, AI integration, and a user-friendly interface. This project demonstrates the potential of leveraging automation and integrated systems to enhance efficiency, accuracy, and decision-making in environmental reporting and compliance processes at INL.

99 - GENERAL AND MISCELLANEOUS↗

Using Explainable Artificial Intelligence to Predict Perovskite Solar Cell Electrical Metastability from Operando Photoluminescence Images in Accelerated Stress Testing

Metal halide perovskite (MHP) solar cells exhibit a metastable response to bias governed by coupled ionic–electronic processes, complicating the conventional reciprocity relation between luminescence intensity and device open-circuit voltage (V oc ). This limits the use of luminescence as a diagnostic for device screening or accelerated stress testing, motivating new approaches that can interpret photoluminescence (PL) signals under nonequilibrium conditions. From the artificial intelligence perspective, we develop an explainable deep learning framework that integrates convolutional neural networks (CNN), long short-term memory (LSTM) layers, and an attention mechanism to learn spatiotemporal features from operando photoluminescence PL image sequences. The model achieves a mean absolute error of ±0.027 V in predicting open-circuit voltage transients and reduces extreme-tail errors by up to 78% compared to physics-based reciprocity calculations. Gradient-weighted Class Activation Mapping (Grad-CAM) provides interpretability by highlighting physically meaningful regions such as electrode edges and emergent defect features. From the engineering application perspective, this framework enables accurate, contactless prediction of device V oc and identification of degradation-relevant features during accelerated aging of perovskite solar cells. This approach demonstrates how explainable AI can enhance operando diagnostics and reliability analysis in photovoltaic devices under nonequilibrium conditions.

14 SOLAR ENERGY↗

Solving high-dimensional inverse problems using amortized likelihood-free inference with noisy and incomplete data

Here, we present a likelihood-free probabilistic inversion method based on normalizing flows for high-dimensional inverse problems. The proposed method is composed of two complementary networks: a summary network for data compression and an inference network for parameter estimation. The summary network encodes raw observations into a fixed-size vector of summary features, while the inference network generates samples of the approximate posterior distribution of the model parameters based on these summary features. The posterior samples are produced in a deep generative fashion by sampling from a latent Gaussian distribution and passing these samples through an invertible transformation. We construct this invertible transformation by sequentially alternating conditional invertible neural network and conditional neural spline flow layers. The summary and inference networks are trained simultaneously. We apply the proposed method to an inversion problem in groundwater hydrology to estimate the posterior distribution of the log-conductivity field conditioned on spatially sparse time-series observations of the system’s hydraulic head responses. The conductivity field is represented with 706 degrees of freedom in the considered problem. Comparison with the likelihood-based iterative ensemble smoother PEST-IES method demonstrates that the proposed method accurately estimates the parameter posterior distribution and the observations’ predictive posterior distribution at a fraction of the inference time of PEST-IES.

conditional invertible neural network↗

An artificial intelligence approach to onboard fault monitoring and diagnosis for aircraft applications

Real-time onboard fault monitoring and diagnosis for aircraft applications, whether performed by the human pilot or by automation, presents many difficult problems. Quick response to failures may be critical, the pilot often must compensate for the failure while diagnosing it, his information about the state of the aircraft is often incomplete, and the behavior of the aircraft changes as the effect of the failure propagates through the system. A research effort was initiated to identify guidelines for automation of onboard fault monitoring and diagnosis and associated crew interfaces. The effort began by determining the flight crew's information requirements for fault monitoring and diagnosis and the various reasoning strategies they use. Based on this information, a conceptual architecture was developed for the fault monitoring and diagnosis process. This architecture represents an approach and a framework which, once incorporated with the necessary detail and knowledge, can be a fully operational fault monitoring and diagnosis system, as well as providing the basis for comparison of this approach to other fault monitoring and diagnosis concepts. The architecture encompasses all aspects of the aircraft's operation, including navigation, guidance and controls, and subsystem status. The portion of the architecture that encompasses subsystem monitoring and diagnosis was implemented for an aircraft turbofan engine to explore and demonstrate the AI concepts involved. This paper describes the architecture and the implementation for the engine subsystem.

Schutte, P. C.↗

Diagnosing anomalies of spacecraft for space maintenance and servicing

Very often servicing of satellites is necessary to replace components which are responsible for anomalous behavior of satellite operations due to adverse interactions with the natural space environment. A major difficulty with this diagnosis is that those responsible for diagnosing these anomalies do not have the tools to assess the role of the space environment causing the anomaly. To address this issue, we have under development a new rule-based, expert system for diagnosing spacecraft anomalies. The knowledge base consists of over two-hundred rules and provides links to historical and environmental databases. Environmental causes considered are bulk charging, single event upsets (SEU), surface charging, and total radiation dose. The system's driver translates forward chaining rules into a backward chaining sequence, prompting the user for information pertinent to the causes considered. When the user selects the novice mode, the system automatically gives detailed explanations and descriptions of terms and reasoning as the session progresses, in a sense teaching the user. As such it is an effective tutoring tool. The use of heuristics frees the user from searching through large amounts of irrelevant information and allows the user to input partial information (varying degrees of confidence in an answer) or 'unknown' to any question. The system is available on-line and uses C Language Integrated Production System (CLIPS), an expert shell developed by the NASA Johnson Space Center AI Laboratory in Houston.

Lauriente, Michael↗

Sustainable Aviation Operations and the Role of Information Technology and Data Science: Background, Current Status and Future Directions

This paper reviews the achievements of the international community towards environmentally friendly aviation operations, also referred to as Sustainable Aviation Operations in the last 25 years and the aspirations and goals to limit the impact of aviation and climate in the future. The framework for achieving global progress is provided by the International Civil Aviation Organization. NASA and FAA supported research and development to advance ATM concepts, and implemented the technology, concepts, and procedures that were responsible for creating fuel efficient flights. Historically aviation operations have been analyzed using physics-based models and provide information for making operational decisions. Future developments in aviation operations require new concepts, procedure, modeling, and analysis techniques. There is an increasing interest in applying methods based on Machine Learning Techniques to problems in Air Traffic Management. Aviation operations involving many decision makers, multiple objectives, poor or unavailable physics-based models and the availability of a rich historical database provide opportunities to exploit the richness of data-driven methods. The promises and challenges in applying Machine Learning Techniques to Air Traffic Management are discussed in the paper along with the testing and trustworthiness required for adoption of the techniques in operations.

Sustainable Aviation, Data Science, Machine Learni↗

Sustainable Aviation Operations and the Role of Information Technology and Data Science: Background, Current Status and Future Directions

This paper reviews the achievements of the international community towards environmentally friendly aviation operations, also referred to as Sustainable Aviation Operations in the last 25 years and the aspirations and goals to limit the impact of aviation and climate in the future. The framework for achieving global progress is provided by the International Civil Aviation Organization. NASA and FAA supported research and development to advance ATM concepts, and implemented the technology, concepts, and procedures that were responsible for creating fuel efficient flights. Historically aviation operations have been analyzed using physics-based models and provide information for making operational decisions. Future developments in aviation operations require new concepts, procedure, modeling, and analysis techniques. There is an increasing interest in applying methods based on Machine Learning Techniques to problems in Air Traffic Management. Aviation operations involving many decision makers, multiple objectives, poor or unavailable physics-based models and the availability of a rich historical database provide opportunities to exploit the richness of data-driven methods. The promises and challenges in applying Machine Learning Techniques to Air Traffic Management are discussed in the paper along with the testing and trustworthiness required for adoption of the techniques in operations.

Sustainable Aviation, Data Science, Machine Learni↗

Retrospective Analog Year Analyses Using NASA Satellite Data to Improve USDA's World Agricultural Supply and Demand Estimates

The USDA World Agricultural Outlook Board (WAOB) is responsible for monitoring weather and climate impacts on domestic and foreign crop development. One of WAOB's primary goals is to determine the net cumulative effect of weather and climate anomalies on final crop yields. To this end, a broad array of information is consulted, including maps, charts, and time series of recent weather, climate, and crop observations; numerical output from weather and crop models; and reports from the press, USDA attach s, and foreign governments. The resulting agricultural weather assessments are published in the Weekly Weather and Crop Bulletin, to keep farmers, policy makers, and commercial agricultural interests informed of weather and climate impacts on agriculture. Because both the amount and timing of precipitation significantly affect crop yields, WAOB often uses precipitation time series to identify growing seasons with similar weather patterns and help estimate crop yields for the current growing season, based on observed yields in analog years. Historically, these analog years are visually identified; however, the qualitative nature of this method sometimes precludes the definitive identification of the best analog year. Thus, one goal of this study is to derive a more rigorous, statistical approach for identifying analog years, based on a modified coefficient of determination, termed the analog index (AI). A second goal is to compare the performance of AI for time series derived from surface-based observations vs. satellite-based measurements (NASA TRMM and other data).

Teng, William↗

Summary of Technical Interchange Meetings (TIMs) Designed to Enable Earth Independent Medical Operations (EIMO)

The Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program hosted a series of TIMs in 2023-2024 designed to stimulate discussion around specific topics with the goal of enabling EIMO. In context of the thematic constituent elements of EIMO, namely pre-mission planning, acute/emergent/prolonged medical decision making, supply/resource management and task load management, subject matter experts from industry, academia and government (NASA and other Agencies) provided valuable and actionable guidance and recommendations. Earth-based medical experts will remain indispensable for pre-mission planning, however, management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets to enable support of astronaut health and performance and reduce overall mission risk. Key to achieving these enhancements is providing an integrated data system platform capable of utilizing multiple data streams in concert with a variety of on-board databases and passive monitoring of video and wearable sensors to enable a multi-modal, agentic AI-based clinical decision support system (CDSS) to support crew medical officer (CMO) medical decision-making. The EIMO series of TIMs (I-V) have proven to be instructive and portend a significant paradigm shift will be necessary to maintain crew health and performance on exploration class missions. Importantly, since the expected paradigm shift will be significantly different from the methods of operation that have been employed for the majority of missions from the inception of human spaceflight to date, any proposed methods must be deployed in the setting of ongoing operations early and be “tested, reviewed and practiced” while reliable back-up is available to facilitate an Enterprise-wide level of comfort and acceptance. Serious constraints on data transmission coupled with a large and expanding universe of on-board medical informatics data streams will necessitate implementation of a CDSS to supplant the current reliance on support provided by ground-based SMEs. Establishment of trust in the system by CMO/crew and the ground-based medical support team will be essential. Co-development of a CDSS with industry partners will assure that state of the art tools can be employed, and industry efficiencies can be leveraged. Training regimens, materials and tools must evolve to be responsive (just-in-time training) and facilitate autonomous execution of procedures. Proficiency metrics should be established and be based on validated competencies or milestones as opposed to a prescribed number of training hours. Training should be prioritized for broad, translatable skills that have universal application across a variety of medical conditions. Repetition was deemed to be the key to achieving proficiency and emphasis should lie in procedural training which is known to extinguish more rapidly than diagnostic skills. Advanced tools, e.g., extended reality, can provide more realistic and effective training. Use of advanced probabilistic risk assessment tools will be essential to optimize the medical system capability while carefully balancing risk relative to mass/power/volume limitations. Importance of factoring use-life of medical supplies and maintaining awareness of redundancy and opportunity to re-purpose under off nominal situations was emphasized. Consideration of adopting optimized performance standards vs. “good-enough” performance thresholds is warranted. The use of legacy systems as opposed to creating new systems may be preferable. Managing task load and associated cognitive load will be essential to maintain operational safety and behavioral health. ExMC aspires to create a shared EIMO paradigm and strategic vision for advancing medical system design through novel technologies, training, protocols, and support capabilities, built upon the spirit of successful strategies and innovations over the past six decades of space medicine operations.

Jay Lemery↗