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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 19 records
All sourcesNASA NTRSDOE OSTI
DOE OSTI2018

CAT: computer aided triage improving upon the Bayes risk through ε-refusal triage rules

Manual extraction of information from electronic pathology (epath) reports to populate the Surveillance, Epidemiology, and End Result (SEER) database is labor intensive. Systematizing the data extraction automatically using machine-learning (ML) and natural language processing (NLP) is desirable to reduce the human labor required to populate the SEER database and to improve the timeliness of the data. This enables scaling up registry efficiency and collection of new data elements. To ensure the integrity, quality, and continuity of the SEER data, the misclassification error of ML and NPL algorithms needs to be negligible. Current algorithms fail to achieve the precision of human experts who can bring additional information in their assessments. Differences in registry format and the desire to develop a common information extraction platform further complicate the ML/NLP tasks. The purpose of our study is to develop triage rules to partially automate registry workflow to improve the precision of the auto-extracted information. This paper presents a mathematical framework to improve the precision of a classifier beyond that of the Bayes classifier by selectively classifying item that are most likely to be correct. This results in a triage rule that only classifies a subset of the item. We characterize the optimal triage rule and demonstrate its usefulness in the problem of classifying cancer site from electronic pathology reports to achieve a desired precision. From the mathematical formalism, we propose a heuristic estimate for triage rule based on post-processing the soft-max output from standard machine learning algorithms. We show, in test cases, that the triage rule significantly improve the classification accuracy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Using AI Segmentation Models to Improve Foreign Body Detection and Triage from Ultrasound Images

Medical imaging can be a critical tool for triaging casualties in trauma situations. In remote or military medicine scenarios, triage is essential for identifying how to use limited resources or prioritize evacuation for the most serious cases. Ultrasound imaging, while portable and often available near the point of injury, can only be used for triage if images are properly acquired, interpreted, and objectively triage scored. Here, we detail how AI segmentation models can be used for improving image interpretation and objective triage evaluation for a medical application focused on foreign bodies embedded in tissues at variable distances from critical neurovascular features. Ultrasound images previously collected in a tissue phantom with or without neurovascular features were labeled with ground truth masks. These image sets were used to train two different segmentation AI frameworks: YOLOv7 and U-Net segmentation models. Overall, both approaches were successful in identifying shrapnel in the image set, with U-Net outperforming YOLOv7 for single-class segmentation. Both segmentation models were also evaluated with a more complex image set containing shrapnel, artery, vein, and nerve features. YOLOv7 obtained higher precision scores across multiple classes whereas U-Net achieved higher recall scores. Using each AI model, a triage distance metric was adapted to measure the proximity of shrapnel to the nearest neurovascular feature, with U-Net more closely mirroring the triage distances measured from ground truth labels. Overall, the segmentation AI models were successful in detecting shrapnel in ultrasound images and could allow for improved injury triage in emergency medicine scenarios.

47 OTHER INSTRUMENTATION↗
DOE OSTI2024

Applying queueing theory to evaluate wait-time-savings of triage algorithms

Abstract In the past decade, artificial intelligence (AI) algorithms have made promising impacts in many areas of healthcare. One application is AI-enabled prioritization software known as computer-aided triage and notification (CADt). This type of software as a medical device is intended to prioritize reviews of radiological images with time-sensitive findings, thus shortening the waiting time for patients with these findings. While many CADt devices have been deployed into clinical workflows and have been shown to improve patient treatment and clinical outcomes, quantitative methods to evaluate the wait-time-savings from their deployment are not yet available. In this paper, we apply queueing theory methods to evaluate the wait-time-savings of a CADt by calculating the average waiting time per patient image without and with a CADt device being deployed. We study two workflow models with one or multiple radiologists (servers) for a range of AI diagnostic performances, radiologist’s reading rates, and patient image (customer) arrival rates. To evaluate the time-saving performance of a CADt, we use the difference in the mean waiting time between the diseased patient images in the with-CADt scenario and that in the without-CADt scenario as our performance metric. As part of this effort, we have developed and also share a software tool to simulate the radiology workflow around medical image interpretation, to verify theoretical results, and to provide confidence intervals for the performance metric we defined. We show quantitatively that a CADt triage device is more effective in a busy, short-staffed reading setting, which is consistent with our clinical intuition and simulation results. Although this work is motivated by the need for evaluating CADt devices, the evaluation methodology presented in this paper can be applied to assess the time-saving performance of other types of algorithms that prioritize a subset of customers based on binary outputs.

Thompson, Yee Lam Elim (ORCID:0000000196537707)↗
DOE OSTI2024

Application of FISH based G2-PCC assay for the cytogenetic assessment of high radiation dose exposures: Potential implications for rapid triage biodosimetry

The main goal of this study is to test the utility of calyculin A induced G2-PCC assay as a biodosimetry triage tool for assessing a wide range of low and acute high radiation dose exposures of photons. Towards this initiative, chromosome aberrations induced by low and high doses of x-rays were evaluated and characterized in G2-prematurely condensed chromosomes (G2-PCCs) by fluorescence in situ hybridization (FISH) using human centromere and telomere specific PNA (peptide nucleic acid) probes. A dose dependent increase in the frequency of dicentric chromosomes was observed in the G2-PCCs up to 20 Gy of x-rays. The combined yields of dicentrics and rings in the G2-PCCs showed a clear dose dependency up to 20 Gy from 0.02/cell for 0.1 Gy to 14.98/cell for 20 Gy. Centric rings were observed more frequently than acentric ring chromosomes in the G2-PCCs at all the radiation doses from 1 Gy to 20 Gy. A head-to-head comparison was also performed by FISH on the yields of chromosome aberrations induced by different doses of x-rays (0 Gy -7.5 Gy) in colcemid arrested metaphase chromosomes and calyculin A induced G2-PCCs. In general, the frequencies of dicentrics, rings and acentric fragments were slightly higher in G2-PCCs than in colcemid arrested metaphase chromosomes at all the radiation doses, but the differences were not statistically significant. To reduce the turnaround time for absorbed radiation dose estimation, attempt was made to obtain G2-PCCs by reducing the culture time to 36 hrs. The absorbed doses estimated in x-rays irradiated (0,1,2 and 4 Gy) G2-PCCs after 36 hrs of culture were grossly like that of G2-PCCs and colcemid arrested metaphase chromosomes prepared after 48 hrs of culture. Our study indicates that the shortened version of calyculin A induced G2-PCC assay coupled with the FISH staining technique can serve as an effective triage biodosimetry tool for large-scale radiological/nuclear incidents.

Science & Technology - Other Topics↗
DOE OSTI2023

DOE Radiological Triage Program: Analyst Open Book Exam 2021

This document contains the open book exam for Radiological Triage Program Analysts for Los Alamos National Laboratory. "The following questions test your knowledge relevant to the DOE Radiological Triage program. There is no time limit, and you may use any reference materials or software you like. You may discuss with other analysts but please show your own work. Spectra are provided in electronic form. There are 10 questions and up to 1 point of extra credit is available. A score of 80% is required to pass. Please send your answers in any convenient form to Mercer@LANL.gov."

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗
DOE OSTI2023

DOE Radiological Triage Program Analyst Open Book Exam 2022

This document contains the 2022 open book examination for Radiological Triage Program Analysts for Los Alamos National Laboratory. "The following questions test your knowledge relevant to the DOE Radiological Triage program. There is no time limit, you may use any reference materials or software you like, and you may discuss with other analysts. No electronic spectra are provided or needed. Please send your answers in any convenient form to Mercer@LANL.gov. You may also take the exam using Survey Monkey (which will provide immediate feedback). A score of 80% is required to pass. There are 25 multiple-choice questions each worth 1 point."

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗
DOE OSTI2023

Epidemiologic Factors Supporting Triage of Infected Dog Patients Admitted to a Veterinary Hospital Biological Isolation and Containment Unit

The teaching hospital of the Faculty of Veterinary Medicine at the University of Lisbon hosts a Biological Isolation and Containment Unit (BICU) for the hospitalization of both confirmed and suspected animals of an infectious disease. This study targets the BICU dog population to identify and characterize the most frequent infectious diseases recorded in a 7-year period. Several epidemiologic factors were analyzed for their significance to triage infected cases. During the study period, 534 dogs were admitted, of which 263 (49.3%) had a confirmed infectious disease diagnosis: parvovirosis (49.4%; n = 130); leptospirosis (21.7%; n = 57); multidrug-resistant (MDR) bacterial infection; (10.6%; n = 28), and canine distemper (9.9%; n = 26). Several potential risk factors for these diseases were identified: age under 2 years old (p < 0.001), incomplete vaccination for parvovirosis (p < 0.001), age ≥ 10 years old (p < 0.001), and the presence of concomitant disorders for MDR-infected cases (p = 0.03). Logistic regression models were constructed to classify cases and controls. The sensitivity and specificity estimates were very high (>0.83) for parvovirosis, MDR, and distemper infections. A lower sensitivity (0.77) was obtained for identifying cases with leptospirosis. In conclusion, infectious diseases are frequent, hence, it is essential to decrease their occurrence through effective preventive measures such as vaccination. The constructed logistic models can also help in triaging admitted dogs with a potential infectious disease.

Machado, Inês Cunha (ORCID:0000000238151125)↗
DOE OSTI2020

Design and feasibility of a novel program of cervical screening in Nigeria: self-sampled HPV testing paired with visual triage

Background: Accelerated global control of cervical cancer would require primary prevention with human papillomavirus (HPV) vaccination in addition to novel screening program strategies that are simple, inexpensive, and effective. We present the feasibility and outcome of a community-based HPV self-sampled screening program. Methods: In Ile Ife, Nigeria, 9406 women aged 30–49 years collected vaginal self-samples, which were tested for HPV in the local study laboratory using Hybrid Capture-2 (HC2) (Qiagen). HPV-positive women were referred to the colposcopy clinic. Gynecologist colposcopic impression dictated immediate management; biopsies were taken when definite acetowhitening was present to produce a histopathologic reference standard of precancer (and to determine final clinical management). Retrospective linkage to the medical records identified 442 of 9406 women living with HIV (WLWH). Results: With self-sampling, it was possible to screen more than 100 women per day per clinic. Following an audio-visual presentation and in-person instructions, overall acceptability of self-sampling was very high (81.2% women preferring self-sampling over clinician collection). HPV positivity was found in 17.3% of women. Intensive follow-up contributed to 85.9% attendance at the colposcopy clinic. Of those referred, 8.2% were initially treated with thermal ablation and 5.6% with large loop excision of transformation zone (LLETZ). Full visibility of the squamocolumnar junction, necessary for optimal visual triage and ablation, declined from 68.5% at age 30 to 35.4% at age 49. CIN2+ and CIN3+ (CIN- Cervical intraepithelial neoplasia), including five cancers, were identified by histology in 5.9 and 3.2% of the HPV-positive women, respectively (0.9 and 0.5% of the total screening population), leading to additional treatment as indicated. The prevalences of HPV infection and CIN2+ were substantially higher (40.5 and 2.5%, respectively) among WLWH. Colposcopic impression led to over- and under-treatment compared to the histopathology reference standard. Conclusion: A cervical cancer screening program using self-sampled HPV testing, with colposcopic immediate management of women positive for HPV, proved feasible in Nigeria. Based on the collected specimens and images, we are now evaluating the use of a combination of partial HPV typing and automated visual evaluation (AVE) of cervical images to improve the accuracy of the screening program.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2017

The DOE Radiological Triage Program

The first line of defense in the nuclear emergency response mission often involves analysis of data provided to the NNSA’s Radiological Triage System* by personnel in the field.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗
DOE OSTI2019

DOE Triage& Field Techniques

This presentation details field collection methods and data package submission to USDOE Triage.

47 OTHER INSTRUMENTATION↗
DOE OSTI2021

Evaluation of Triage Methods for Criticality Accidents

Studies indicate that early identification of persons involved in and receiving high doses of radiation in accidents is key to providing life-saving medical treatment. Although the risk of criticality accidents is low the potential impact to workers is significant. For facilities that employ large numbers of workers a key element in the response to a radiological emergency is identifying personnel that received significant, and potentially harmful, doses. Also important is having the ability to screen large numbers of workers to identify persons that did not receive significant exposure so as to reduce the impact on emergency response efforts. At the Y-12 National Security Complex the focus on criticality accident response is the rapid triage of personnel in order to identify persons exposed to large radiation doses and to prioritize those persons receiving the highest exposures. Once identified personnel are transported to local medical facilities including the Radiation Emergency Assistance Center/Training Site (REAC/TS) for medical evaluation and treatment. The Y-12 external dosimetry program utilizes a number of techniques to identify and prioritize workers and these methods were evaluated at a criticality dosimetry intercomparison exercise. Finally, the methods used were shown to perform as intended and other sites may consider incorporating these methods into their accident dosimetry response procedures.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2023

Triage Exam, August 2006 (V.2.2)

The following questions test knowledge relevant to the DOE Radiological Triage and DHS Secondary Reachback programs. There is no time limit, and you may use any reference materials you like. Each question has only one best answer. There are 20 questions, and a score of 80% is required to pass.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2025

Development of a military-specific mesh-type computational phantom library and its application to internal dosimetry and in-field radiological triage screening

Estimates of organ-absorbed and committed doses to individuals exposed to radioactive materials via acute inhalation often rely on internal dose coefficients and detector responses from reference human computational models. To achieve more accurate dose assessments to United States Armed Forces service members exposed in-field, computational models with varying morphometric parameters representative of this population are necessary. The International Commission on Radiological Protection (ICRP) Publication 145 provides detailed mesh reference computational phantoms (MRCPs) for adult males and females, with morphometric parameters matched to the 50th percentile. Previously, these phantoms were 2D and 3D scaled to match desired height, mass, and secondary anthropomorphic parameters in the creation of the University of Florida / Memorial Sloan Kettering (UF/MSK) computational phantom library. To achieve body fat percentage targets required for accession into the US Armed Forces, muscle and fat volumes were adjusted accordingly, thus, creating the UF/Department of Defence computational phantom library presented in this study. A comprehensive library of mesh-type computational human phantoms was created, including 57 adult males and 49 adult females with morphometric parameters aligned with United States Armed Forces service members. Phantoms were restricted to a body mass index between 19 and 27.5, with body fat percentages below 26% for males and 36% for females. Specific absorbed fractions were computed for selected source and target combinations, demonstrating how variations in height and body mass influence energy absorption in target regions relative to the ICRP MRCPs. Radiation detector responses were also computed, revealing that higher body masses resulted in decreased registered counts in the detection volume. These findings highlight the importance of incorporating morphometric variability in computational phantoms to achieve more accurate dose assessments and radiation detection responses for United States Armed Forces service members who inhale radioactive materials in-field.

computational phantoms↗