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At least 235 records · Page 13

Characterization of Infrasonic Signatures of Earth-Grazing Fireballs as Analogues to Hypersonic Vehicles (Final Report)

Accurate detection, discrimination, and characterization of high-altitude hypersonic events using infrasonic monitoring are critical to planetary defense and global strategic surveillance. This report synthesizes recent advances achieved through rigorous analysis of infrasonic signatures from natural meteoroids, emphasizing shallow entry-angle meteoroids as essentially proxies for artificial hypersonic systems. Meteoroids naturally encompass diverse velocities, trajectories, altitudes, and fragmentation behaviors, enabling systematic validation of empirical period–yield relationships, waveform morphology classifiers, and trajectory-induced back-azimuth deviation models. Integration of adaptive array-processing enhancements within Cardinal software further extends infrasonic detection sensitivity and signal classification reliability. Collectively these advances, based solely on infrasonic signatures or limited optical data, offer robust methodologies for distinguishing natural from artificial hypersonic sources, significantly reducing event geolocation uncertainties and refining source-function determination. The outcomes detailed herein lay foundational groundwork for improved global hypersonic event-surveillance frameworks, supporting improved security preparedness and informing strategic monitoring and defense policies.

54 ENVIRONMENTAL SCIENCES↗

Measuring 3D Profilometry of SAVY-4000 Nuclear Material Storage Containers: Novacam TubeInspect Capabilities Report

The SAVY-4000 container series is a general-purpose interim storage container for nuclear materials, developed and maintained by Los Alamos National Laboratory (LANL). It is the first vented, general-use nuclear material container to be demonstrated as meeting the requirements outlined in DOE M 441.1-1, the Nuclear Material Packaging Manual. Due to the challenging radiation, thermal, and corrosive storage conditions that the SAVY containers must endure, continuous surveillance techniques are employed to ensure the containers meet all safety standards and specifications. These inspections are typically performed by human operators, who check for issues such as corrosion, O-ring deterioration, corrosion, filter integrity, and potential manufacturing defects. However, human inspections alone are not sufficient, and automated inspection technologies, such as the ATIS system, as well as other automated systems are also utilized. The MicroCam TubeInspect, developed by Novacam Technologies Inc., is designed to address the challenges of understanding how manufacturing variations in the SAVY-4000 container series may affect performance. It is a 3D profilometry measurement system that enables detailed analysis of surface features, including defects, surface roughness, and manufacturing variations. This advanced tool significantly enhances rapid surveillance techniques for both pristine and used containers. In this study, container properties such as surface roughness, thickness, and geometric attributes like circularity are measured for SAVY-4000 containers. Artificially corroded or dented containers are examined to demonstrate the MicroCam's ability to quantify defects. A sensitivity analysis is also conducted, comparing the MicroCam results to those obtained using more precise instruments such as confocal microscopy. This comparison aims to provide valuable insights into container quality, durability, and potential improvements in manufacturing processes.

42 ENGINEERING↗

U.S. Department of Energy Office of Legacy Management 2024 Annual Site Inspection and Monitoring Report for Uranium Mill Tailings Radiation Control Act Title I Disposal Sites

This report, in fulfillment of a U.S. Nuclear Regulatory Commission (NRC) license requirement, presents the results of long-term surveillance and maintenance activities conducted by the U.S. Department of Energy (DOE) Office of Legacy Management (LM) in 2024. These activities occurred at the 19 uranium mill tailings disposal sites established under Title I of the Uranium Mill Tailings Radiation Control Act (UMTRCA) and verify that the UMTRCA Title I disposal sites remain in compliance with license requirements and Long-Term Surveillance Plans (LTSPs). Individual chapters for each site are available on the LM public website at https://energy.gov/lm/sites/lm-sites.

54 ENVIRONMENTAL SCIENCES↗

COVID-19–Related School Closures, United States, July 27, 2020–June 30, 2022

As part of a multiyear project that monitored illness-related school closures, we conducted systematic daily online searches during July 27, 2020–June 30, 2022, to identify public announcements of COVID-19–related school closures (COVID-SCs) in the United States lasting ≥1 day. We explored the temporospatial patterns of COVID-SCs and analyzed associations between COVID-SCs and national COVID-19 surveillance data. COVID-SCs reflected national surveillance data: correlation was highest between COVID-SCs and both new PCR test positivity (correlation coefficient [r] = 0.73, 95% CI 0.56–0.84) and new cases (r = 0.72, 95% CI 0.54–0.83) during 2020–21 and with hospitalization rates among all ages (r = 0.81, 95% CI 0.67–0.89) during 2021–22. The numbers of reactive COVID-SCs during 2020–21 and 2021–22 greatly exceeded previously observed numbers of illness-related reactive school closures in the United States, notably being nearly 5-fold greater than reactive closures observed during the 2009 influenza (H1N1) pandemic.

60 APPLIED LIFE SCIENCES↗

Identification and Characterization of ten Escherichia coli Strains Encoding Novel Shiga Toxin 2 Subtypes, Stx2n as Well as Stx2j, Stx2m, and Stx2o, in the United States

The sharing of genome sequences in online data repositories allows for large scale analyses of specific genes or gene families. This can result in the detection of novel gene subtypes as well as the development of improved detection methods. Here, we used publicly available WGS data to detect a novel Stx subtype, Stx2n in two clinical E. coli strains isolated in the USA. During this process, additional Stx2 subtypes were detected; six Stx2j, one Stx2m strain, and one Stx2o, were all analyzed for variability from the originally described subtypes. Complete genome sequences were assembled from short- or long-read sequencing and analyzed for serotype, and ST types. The WGS data from Stx2n- and Stx2o-producing STEC strains were further analyzed for virulence genes pro-phage analysis and phage insertion sites. Nucleotide and amino acid maximum parsimony trees showed expected clustering of the previously described subtypes and a clear separation of the novel Stx2n subtype. WGS data were used to design OMNI PCR primers for the detection of all known stx1 (283 bp amplicon), stx2 (400 bp amplicon), intimin encoded by eae (221 bp amplicon), and stx2f (438 bp amplicon) subtypes. These primers were tested in three different laboratories, using standard reference strains. An analysis of the complete genome sequence showed variability in serogroup, virulence genes, and ST type, and Stx2 pro-phages showed variability in size, gene composition, and phage insertion sites. The strains with Stx2j, Stx2m, Stx2n, and Stx2o showed toxicity to Vero cells. Stx2j carrying strain, 2012C-4221, was induced when grown with sub-inhibitory concentrations of ciprofloxacin, and toxicity was detected. Taken together, these data highlight the need to reinforce genomic surveillance to identify the emergence of potential new Stx2 or Stx1 variants. The importance of this surveillance has a paramount impact on public health. Per our description in this study, we suggest that 2017C-4317 be designated as the Stx2n type-strain.

59 BASIC BIOLOGICAL SCIENCES↗

Remote Sensing Low Signal-to-Noise-Ratio Target Detection Enhancement

In real-time remote sensing application, frames of data are continuously flowing into the processing system. The capability of detecting objects of interest and tracking them as they move is crucial to many critical surveillance and monitoring missions. Detecting small objects using remote sensors is an ongoing, challenging problem. Since object(s) are located far away from the sensor, the target’s Signal-to-Noise-Ratio (SNR) is low. The Limit of Detection (LOD) for remote sensors is bounded by what is observable on each image frame. In this paper, we present a new method, a “Multi-frame Moving Object Detection System (MMODS)”, to detect small, low SNR objects that are beyond what a human can observe in a single video frame. This is demonstrated by using simulated data where our technology-detected objects are as small as one pixel with a targeted SNR, close to 1:1. We also demonstrate a similar improvement using live data collected with a remote camera. The MMODS technology fills a major technology gap in remote sensing surveillance applications for small target detection. Our method does not require prior knowledge about the environment, pre-labeled targets, or training data to effectively detect and track slow- and fast-moving targets, regardless of the size or the distance.

47 OTHER INSTRUMENTATION↗

Feasibility Study of Millimeter Wave Radars For Safeguards Applications

Containment and surveillance are fundamental measures in nuclear safeguards. Techniques such as video surveillance and laser curtain for containment provide effective monitoring in areas where maintaining continuity of knowledge is required. These systems, however, can be susceptible to loss of monitoring capabilities under certain environmental conditions such as poor visibility (i.e. low light conditions, smoke, fog, etc.) or extended power loss past the duration that the backup power system is designed for. Brookhaven National Laboratory has been investigating the feasibility of millimeter waves (mmWave) as a new perimeter seal in which radio frequency waves in the range of 60-64 GHz are used to detect and monitor objects of interest. Signals in this frequency range are not susceptible to environmental conditions. For proof-of-concept tests, mmWave sensors from Texas Instruments (TI), specificallyIWR6843, are used in a test bed at BNL's Waste Management facility to simulate the operations at nuclear facilities. The unique design of TI mmWave sensors requires less memory and power consumption compared to counterpart systems. These devices are capable of exporting 3D point-cloud data, which is visualized graphically and compared to videos recorded at the same time to validate the performance of the mmWave sensor. A set of experiments were planned to test the feasibility of the mmWave in this application, including monitoring static containers in a storage area and detecting intrusions at the boundaries of the area. In addition, the experiments also identify potential blind spots relative to sensor position and utilize multiple operating sensors simultaneously to reduce or eliminate such blind spots. The optimal positioning of multiple sensors was determined for the experimental room configuration. In this paper, we will discuss the details of this novel perimeter sealing concept and present the test results.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗

Low power and privacy preserving sensor platform for occupancy detection

A low-cost, low-power, stand-alone sensor platform having a visible-range camera sensor, a thermopile array, a microphone, a motion sensor, and a microprocessor that is configured to perform occupancy detection and counting while preserving the privacy of occupants. The platform is programmed to extract shape/texture from images in spatial domain; motion from video in time domain; and audio features in frequency domain. Embedded binarized neural networks are used for efficient object of interest detection. The platform is also programmed with advanced fusion algorithms for multiple sensor modalities addressing dependent sensor observations. The platform may be deployed for (i) residential use in detecting occupants for autonomously controlling building systems, such as HVAC and lighting systems, to provide energy savings, (ii) security and surveillance, such as to detect loitering and surveil places of interest, (iii) analyzing customer behavior and flows, (iv) identifying high performing stores by retailers.

Velipasalar, Senem↗

Application of Margin-Based Methods to Assess System Health

Health management of complex systems such as nuclear power plants is an essential task to guarantee system reliability. This task can be greatly enhanced by constantly monitoring asset status and performances and process such data (through anomaly detection, diagnostic, and prognostic computational algorithms) to identify asset degradation trends and faulty states. While such information and data are typically available for many of the assets, they are not propagated from the asset to the system level in order to identify the most critical assets and prioritize maintenance and surveillance activities. The main reason is driven by the fact that current reliability modeling techniques are inadequate to process such information/data. This is due to the nature of these techniques which are based on the concept of failure rate/probability that do not serve an operational context where quantitative asset health information is available. Simply stated, current reliability techniques serve a run-to-failure operational setting and not a predictive maintenance one where the goal is to perform maintenance and surveillance activities only when they are needed based on asset health. The risk informed asset management (RIAM) project is focusing on the development of a different kind of reliability modeling techniques designed to adequately serve a predictive operational setting. Such reliability techniques move aways from a failure rate/probability to a margin-based mindset where margin is here used as a metric to quantify asset health based only on current and past operational experience of the asset under consideration. In addition, margin-based reliability techniques are able to propagate asset health information from the component to system level and provide importance measure to each asset. This report summarizes a recent activity performed in collaboration with plant modernization pathway designed to integrate monitoring data into margin-based reliability models. Such activity focuses on a specific system of an existing nuclear power plant where large amount of historic monitoring data is used to monitor asset and system health.

97 MATHEMATICS AND COMPUTING↗

Leveraging Environmental Monitoring Results from Department of Energy Sites for Research on the Food-Energy-Water Nexus

The Annual Site Environmental Report (ASER) from a U.S. Department of Energy (DOE) Site summarizes environmental data; environmental management performance; compliance with applicable DOE, federal, state, and local regulations; and restoration and surveillance monitoring programs. The Savannah River Site (SRS) produces ASERs that include results of monitoring mercury levels in fish samples obtained in the vicinity of SRS. Mercury is a toxic trace metal and the methylated organic form is a neurotoxin that bioaccumulates in the food web, endangering humans and other organisms. In United States, power plants are the largest source of mercury emissions. Research Objective: To determine the patterns of mercury levels in fish samples reported in the SRS environmental monitoring reports. We developed box plot visualizations to make sense of the data as well as identify fish species, dates and location with outlier mercury content. The integration and visual representation of multi-year datasets can support decision making processes on environmental compliance and environmental sustainability conducted at U.S. DOE Sites. We are constructing datasets from textual, image and multivariable data sources in the multi-year ASERs of the U.S. DOE Savannah River Site (SRS https://www.srs.gov/general/pubs/ERsum/index.html). The Fish Surveillance for mercury presents a case study for the intersection of food, energy and water systems. The dataset of 864 records (2008 and 2009) of mercury levels includes water location of fish, fish species, collection date and mercury content of fish sample. The patterns of mercury levels in the fish species as well as locations provide knowledge for further investigations. A research area for future studies is the composition of microbial communities in fish guts of varying levels of mercury.

54 ENVIRONMENTAL SCIENCES↗

Competing Interests and Creating Value - Balancing Durable and Enforceable Institutional Controls with Beneficial Reuse - 20320

US DOE LM has various real property interests at the 100 sites within its current portfolio, with an anticipated total of 127 sites within the next 5 years. Each site has its own narrative with respect to the real property assets. Since the regulatory time frame for long-term surveillance and maintenance activities at some sites can be in perpetuity, durable and effective instruments and documentation are necessary to support LM's unique mission as a federal land manager and steward. More than half of the sites currently in LM's inventory do not allow unrestricted use, and institutional controls (ICs) are required to limit human and environmental exposures to residual contamination. LM's Asset Management program balances protection of human health and the environment with a goal of optimizing its land portfolio through mitigation of risk, limiting liability, and creating value, whether tangible or intangible, in these types of assets. The IC layering strategy utilizes multiple types, restrictions, and legal authorities to protect human health and the environment. This layering strategy influences the transition of these properties into LM's portfolio to assess potential beneficial reuses. The LM's beneficial reuse program aims to repurpose former contaminated sites to restore the environment, protect the public health, revitalize communities, and spur economic growth. LM strives to create value in a perceived valueless asset and reevaluates and revisits the potential opportunities for these sites as long-term surveillance and maintenance activities are performed and objectives are achieved. Beneficial reuse also promotes protectiveness by ensuring activities are compatible with long-term maintenance and protection of public health and the environment as well as ensuring activities are environmentally sound by retaining good stewardship of natural resources. LM has recently revised both the Institutional Control Program Guidance and its Beneficial Reuse Management Plan to integrate the issues of land use with ICs, creating value in these impaired assets. This paper presents the following topics: (1) a general overview of LM's IC and beneficial reuse programs; (2) the unique aspects of each of these programs as a result of the multiple regulatory requirements and programs that affect LM sites; (3) case studies of LM sites to show examples of how LM created value while complying with the ICs and layering strategies; and (4) the most common challenges to beneficial reuses at LM sites and potential options for value creation in impaired assets. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

SUBTASK 1.6 – BASIN ELECTRIC CARBON STORAGE RESEARCH PROJECT: NOVEL MONITORING TECHNIQUES

The Energy & Environmental Research Center (EERC) conducted baseline activities associated with an applied research project at Basin Electric Power Cooperative’s (Basin’s) carbon capture and storage (CCS) site in Beulah, North Dakota, to establish novel carbon storage-monitoring techniques as commercial methods under Cooperative Agreement No. DE-FE0024233, Subtask 1.6. The following report summarizes the baseline activities performed and briefly describes the subsequent (operational monitoring) activities that have been proposed to the U.S. Department of Energy (DOE) as part of the overall project to develop and demonstrate novel monitoring techniques at North America’s largest permitted CCS operation. Dakota Gasification Company (DGC), a wholly owned subsidiary of Basin, owns and operates the Great Plains Synfuels Plant (GPSP) approximately 5 miles northwest of the town of Beulah, North Dakota (Figure 1). In 2023, DGC received approval from the North Dakota Industrial Commission (NDIC) to develop a storage facility on-site for injecting a stream of carbon dioxide (CO2) captured from GPSP. DGC will transport the captured CO2 stream with approximately 6.8 miles of transmission lines that extend north of GPSP and inject >1 million tonnes (MMt) of CO2 annually (>1 MMt/yr) over a 12-year period with up to six underground injection control (UIC) Class VI-compliant injection wells completed in the Broom Creek Formation, a predominantly sandstone reservoir and saline aquifer underlying GPSP. The Broom Creek Formation lies approximately 5900 feet (ft) below ground surface (bgs) at GPSP. The commercial scale (i.e., >1 MMt/yr) of DGC’s permitted carbon storage project is ideal for developing and testing the novel monitoring techniques included within Subtask 1.6. The goals of this project are to demonstrate 1) the cost-effectiveness of novel monitoring technologies included as part of this research, 2) technology capability for tracking the CO2 plume and/or associated pressure response in the subsurface and monitoring out-of-zone migration, and 3) compliance with UIC Class VI program requirements. The research activities proposed for the overall project include 1) design of an automated, integrated, modular (AIM) monitoring station; 2) time-lapse electromagnetic (EM) field surveys; 3) drone-based surveillance studies; 4) time-lapse monitoring with seismic methods; 5) advanced wellbore-monitoring methods; 6) deployment of an AIM monitoring network; 7) EM monitoring of CO2 with real-time data processing; 8) continued seasonal drone-based surveillance studies; 9) seismic monitoring with passive and active surveys; and 10) wellbore monitoring with nuclear magnetic resonance (NMR) for near-surface characterization. Completion of Activities 1.0–5.0 (baseline activities) are described in this report. Upon authorization of funding by DOE, the EERC will initiate Activities 6.0– 10.0 (operational monitoring activities). Current state-of-the-art (SOA) carbon storage-monitoring techniques require countless labor hours dedicated to the acquisition of data. Once data are gathered, these SOA techniques often rely on commercial facilities to process raw data from the field. However, it is anticipated that next-generation monitoring techniques, such as those being demonstrated, will lower acquisition footprints, be less operationally intensive, and improve data acquisition efficiencies. These new techniques are more conducive to the application of machine learning, artificial intelligence, and automation, thus providing a pathway for integration into active control systems, informing site operability, and improving the integration of data for future CCS projects across the United States. Additionally, reclaimed and active mining lands are present within the project site, creating a unique opportunity to demonstrate the effectiveness of remote sensing and surface-based geophysics monitoring techniques at similar project sites that may include disturbed, unconsolidated, or actively excavated near-surface environments. The efforts included in the overall project will produce necessary designs, learnings, and data acquired during the baseline and operational monitoring periods that are necessary for time-lapse demonstration and validation of the described monitoring techniques. In addition, it is anticipated that the monitoring technologies included in this study will be compliant with UIC Class VI requirements to enable the potential for implementation at other CCS sites across the United States.

42 ENGINEERING↗

Smoothing Lexis diagrams using kernel functions: A contemporary approach

Lexis diagrams are rectangular arrays of event rates indexed by age and period. Analysis of Lexis diagrams is a cornerstone of cancer surveillance research. Typically, population-based descriptive studies analyze multiple Lexis diagrams defined by sex, tumor characteristics, race/ethnicity, geographic region, etc. Inevitably the amount of information per Lexis diminishes with increasing stratification. Several methods have been proposed to smooth observed Lexis diagrams up front to clarify salient patterns and improve summary estimates of averages, gradients, and trends. In this article, we develop a novel bivariate kernel-based smoother that incorporates two key innovations. First, for any given kernel, we calculate its singular values decomposition, and select an optimal truncation point—the number of leading singular vectors to retain—based on the bias-corrected Akaike information criterion. Second, we model-average over a panel of candidate kernels with diverse shapes and bandwidths. The truncated model averaging approach is fast, automatic, has excellent performance, and provides a variance-covariance matrix that takes model selection into account. We present an in-depth case study (invasive estrogen receptor-negative breast cancer incidence among non-Hispanic white women in the United States) and simulate operating characteristics for 20 representative cancers. The truncated model averaging approach consistently outperforms any fixed kernel. Our results support the routine use of the truncated model averaging approach in descriptive studies of cancer.

60 APPLIED LIFE SCIENCES↗

Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow‐up through 2021

Background To determine if construction and trades workers formerly employed at US Department of Energy (DOE) nuclear weapons sites are at significant risk for occupational diseases, we studied the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed). Methods The cohort included 26,922 participants enrolled between 1998 and 2021 and 8367 deaths. Standardized mortality ratios were calculated based on US death rates. Cox models compared construction workers (n = 22,747; 7487 deaths) to two nonconstruction subpopulations: administrative, scientific and security workers (n = 1894; 330 deaths), and all other nonconstruction workers (n = 2218; 550 deaths). Results Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, lung, kidneys, and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease (COPD), asbestosis, transportation injuries, and other injuries, particularly accidental poisonings. There were 167 deaths from coronavirus disease 2019 (COVID-19), which was lower than expected using US death rates. Overall cause-specific mortality was significantly higher among construction workers than for internal comparison groups. Conclusions Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Apart from COVID-19 deaths, this update: (1) found that mortality among construction workers is significantly elevated compared to the US population and significantly higher than in the internal comparison populations, and (2) confirmed excess risk for these workers for first employment after 1990. Cancer mortality risks are similar to the cancers identified for DOE compensation from radiation exposures. In conclusion, the high lung cancer risk supports the value of early lung cancer detection. Continued medical surveillance is important.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

What a difference a delay makes! CT urogram: a pictorial essay

Purpose: The aim of this pictorial essay is to demonstrate several cases where the diagnosis would have been difficult or impossible without the excretory phase image of CT urography. Methods: A brief discussion of CT urography technique and dose reduction is followed by several cases illustrating the utility of CT urography. Results: CT urography has become the primary imaging modality for evaluation of hematuria, as well as in the staging and surveillance of urinary tract malignancies. CT urography includes a non-contrast phase and contrast-enhanced nephrographic and excretory (delayed) phases. While the three phases add to the diagnostic ability of CT urography, it also adds potential patient radiation dose. Several techniques including automatic exposure control, iterative reconstruction algorithms, higher noise tolerance, and split-bolus have been successfully used to mitigate dose. The excretory phase is timed such that the excreted contrast opacifies the urinary collecting system and allows for greater detection of filling defects or other abnormalities. Sixteen cases illustrating the utility of excretory phase imaging are reviewed. Conclusions: Excretory phase imaging of CT urography can be an essential tool for detecting and appropriately characterizing urinary tract malignancies, renal papillary and medullary abnormalities, CT radiolucent stones, congenital abnormalities, certain chronic inflammatory conditions, and perinephric collections.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Diagnosis, management, and follow-up of upper tract urothelial carcinoma: an interdisciplinary collaboration between urology and radiology

Upper tract urothelial carcinoma (UTUC) is a common and lethal malignancy. Patients diagnosed with this illness often face invasive workups, morbid therapies, and prolonged post-operative surveillance. UTUC represents approximately 5–10% of urothelial malignancies in the United States and affect 4600–7800 new patients annually. Various environmental exposures as well as smoking have been implicated in the development of UTUC. The diagnosis and workup of UTUC relies on heavily on imaging studies, a close working relationship between Urologists and Radiologists, and invasive procedures such as ureteroscopy. Treatments range from renal-sparing endoscopic surgery to radical extirpative surgery depending on the specific clinical situation. Follow-up is crucial as UTUC has a high recurrence rate. Here we review the epidemiology, diagnosis, management strategies, and follow-up of UTUC from an interdisciplinary perspective.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

The Role of Circulating Tumor Cells in Breast Cancer and Implications for Radiation Treatment Decisions

Tumor biomarkers are used routinely in oncology to assign risk categorization, screen and assist in diagnosis of malignancy, allow for prognostication and prediction of outcomes and treatment response, and allow for monitoring of patients after treatment completion. Although tissue-based biomarkers have a long history of use, the emergence of liquid-based biomarkers, including circulating tumor cells (CTCs), may soon revolutionize the management of patients with cancer. Here, we review the discovery of CTCs and their role as prognostic and predictive biomarkers, with an emphasis on breast cancer. We discuss the platforms for CTC enumeration and focus on studies using the only US Food and Drug Administration–approved platform for CTC enumeration (CellSearch). In addition, we examine the role of CTCs in women with metastatic, inflammatory, and nonmetastatic breast cancer, as well as the clinical evidence for their use as a surrogate for radiation treatment response as well as surveillance after treatment. Finally, we conclude by investigating ongoing clinical studies assessing CTCs as radiation response predictors and discuss unanswered questions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Estimating coccidioidomycosis endemicity while accounting for imperfect detection using spatio - temporal occupancy modeling

Coccidioidomycosis, or Valley fever, is an infectious disease caused by inhaling Coccidioides fungal spores. Incidence has risen in recent years, and it is believed the endemic region for Coccidioides is expanding in response to climate change. While Valley fever case data can help us understand trends in disease risk, using case data as a proxy for Coccidioides endemicity is not ideal because case data suffers from imperfect detection, including false positives (e.g., travel-related cases reported outside of endemic area) and false negatives (e.g., misdiagnosis or underreporting). Here we proposed a Bayesian, spatio-temporal occupancy model to relate monthly, county-level presence/absence data on Valley fever cases to latent endemicity of Coccidioides, accounting for imperfect detection. We used our model to estimate endemicity in the western United States. We estimated high probability of endemicity in southern California, Arizona, and New Mexico, but also in regions without mandated reporting, including western Texas, eastern Colorado, and southeastern Washington. We also quantified spatio-temporal variability in detectability of Valley fever, given an area is endemic to Coccidioides. We estimated an inverse relationship between lagged 3- and 9-month precipitation and case detection, and a positive association with agriculture. This work can help inform public health surveillance needs and identify areas that would benefit from mandatory case reporting.

60 APPLIED LIFE SCIENCES↗