Radiation Emergency Research Articles

Exploring the role of large language models in radiation emergency response

In recent times, the field of artificial intelligence (AI) has been transformed by the introduction of large language models (LLMs). These models, popularized by OpenAI’s GPT-3, have demonstrated the emergent capabilities of AI in comprehending and producing text resembling human language, which has helped them transform several industries. But its role has yet to be explored in the nuclear industry, specifically in managing radiation emergencies. The present work explores LLMs’ contextual awareness, natural language interaction, and their capacity to comprehend diverse queries in a radiation emergency response setting. In this study we identify different user types and their specific LLM use-cases in radiation emergencies. Their possible interactions with ChatGPT, a popular LLM, has also been simulated and preliminary results are presented. Drawing on the insights gained from this exercise and to address concerns of reliability and misinformation, this study advocates for expert guided and domain-specific LLMs trained on radiation safety protocols and historical data. This study aims to guide radiation emergency management practitioners and decision-makers in effectively incorporating LLMs into their decision support framework.

Alleviation of radiation combined skin injury in rat model by topical application of ascorbate formulation

Purpose This research endeavor was undertaken to elucidate the impact of an innovative ascorbate formulation on the regeneration process of full-thickness excision wounds in a rat model exposed to whole-body gamma irradiation, replicating conditions akin to combat or radiation emergency scenarios. Materials and Methods We established a comprehensive rat model by optimizing whole body γ-radiation doses (5–9 Gy) and full-thickness excision wound sizes (1–3 cm2) to mimic radiation combined injury (RCI). The developed RCI model was used to explore the healing potential of ascorbate formulation. The study includes various treatment groups (i.e., sham control, radiation alone, wound alone, radiation + wound, and radiation + wound + formulation). The ascorbate formulation was applied twice daily, with a 12-hour gap between each application, starting 1 hour after the initiation of the wound. The healing potential of the formulation in the RCI context was evaluated over 14 days through hematological, molecular, and histological parameters. Results The combination of a 5 Gy radiation dose and a 1 cm2 wound was identified as the optimal setting to develop the RCI model for subsequent studies. The formulation was used topically immediately following RCI, and then twice daily until complete healing. Treatment with the ascorbate formulation yielded noteworthy outcomes and led to a substantial reduction (p < .05) in the wound area, accelerated epithelialization periods, and an increased wound contraction rate. The formulation’s localized healing response improved organ weights, normalized blood parameters, and enhanced hematopoietic and immune systems. A gene expression study revealed the treatment up-regulated TGF-β and FGF, and down-regulated PDGF-α, TNF-α, IL-1β, IL-6, MIP-1α, and MCP-1 (p < .05). Histopathological assessments supported the formulation’s effectiveness in restoring cellular architecture and promoting tissue regeneration. Conclusion Topical application of the ascorbate formulation in RCI resulted in a significant improvement in delayed wound healing, leading to accelerated wound closure by mitigating the expression of inflammatory responses.

ACİL SERVİS PERSONELLERİNİN KİMYASAL, BİYOLOJİK, RADYASYON VE NÜKLEER ACİLLERE HAZIRLIK DÜZEYLERİNİN DEĞERLENDİRİLMESİ

Purpose: The aim of this study is to determine the chemical, biological, radiation, and nuclear (CBRN) emergency preparedness levels of emergency department (ED) personnel. Materials and Methods: This cross-sectional descriptive survey study was conducted with 49 emergency department personnel (emergency medicine specialists, emergency medicine research assistants, nurses, and nursing staffs) working in the ED of a university hospital through face-to-face. The questionnaire was created by the researchers and consisted of 5 demographic and 30 CBRN preparation information, 12 questions questioning the previous practice and educational status of CBRN subjects. The preparedness level of the participants was determined by evaluating the CBRN preparedness level responses. Results: The Cronbach's Alpha reliability index obtained for the CBRN scale was obtained as α=0,856 for the whole scale and this value shows that the reliability of the whole scale is at a good level. The mean preparedness level score of the ED personnel is 59,7 (min-max:24-81). The mean CBRN preparedness level score of emergency medicine specialists (38) was found to be lower than the other groups. The number of those who received training on CBRN situations and medical management of cases during their professional training (bachelor-master- doctorate education) is 18 (36,7%). Most of the participants didn’t participate in any CBRN exercise during their professional life (n=43, 87,8%). Conclusion: ED personnel's preparations for CBRN emergencies are insufficient. Their participation in training and exercises for the medical management of CBRN cases is low. Our study can be used as a tool to determine the CBRN preparations of ED personnel.

Knowledge, Attitude and Awareness of Oman Emergency Physicians and Residents Regarding Radiation Emergencies.

Radiological emergency preparedness and response are increasingly acknowledged as vital components of both emergency readiness and public health. Previous studies have shown that medical providers feel unprepared to respond to radiation incidents. The existing level of knowledge, attitudes, and awareness held by emergency medicine residents and physicians in Oman, remain unexplored. This study aims to evaluate the knowledge, attitude, and awareness level of emergency residents and physicians in Oman regarding the management of radiation emergencies. An electronic survey was distributed to 44 emergency residents and 57 emergency physicians. The response rate was 62.7% (N = 69/110). Notably, 62% reported no prior engagement in radiation emergency training. The majority of participants had neither employed nor received training in operating radiation detection devices. A significant gap in knowledge emerged, with the median self-reported knowledge score of 50/100. The majority of participants (59%) expressed a need for educational programs and materials. Our findings underscore the imperative for enhanced training in radiological incident preparedness for emergency medicine residents and physicians in Oman. The study reveals a clear necessity to bridge the existing gaps in knowledge and attitudes to bolster the readiness of health-care professionals to respond effectively to radiation emergencies.

Knowledge, Attitude and Awareness of Oman Emergency Physicians and Residents Regarding Radiation Emergencies - CORRIGENDUM.

Knowledge, Attitude and Awareness of Oman Emergency Physicians and Residents Regarding Radiation Emergencies - CORRIGENDUM.

Pediatric Medical Countermeasures: Antidotes and Cytokines for Radiological and Nuclear Incidents and Terrorism.

The war in Ukraine raises concerns for potential hazards of radiological and nuclear incidents. Children are particularly vulnerable in these incidents and may need pharmaceutical countermeasures, including antidotes and cytokines. Searches found no published study comparing pediatric indications and dosing among standard references detailing pediatric medications for these incidents. This study addresses this gap by collecting, tabulating, and disseminating this information to healthcare professionals caring for children. Expert consensus chose the following references to compare their pediatric indications and dosing of medical countermeasures for radiation exposure and internal contamination with radioactive materials: Advanced Hazmat Life Support (AHLS) for Radiological Incidents and Terrorism, DailyMed, Internal Contamination Clinical Reference, Medical Aspects of Radiation Incidents, and Medical Management of Radiological Casualties, as well as Micromedex, POISINDEX, and Radiation Emergency Medical Management (REMM). This is the first study comparing pediatric indications and dosing for medical countermeasures among commonly used references for radiological and nuclear incidents.

Cutaneous Radiation Injuries: REAC/TS Clinical Experience.

The Radiation Emergency Assistance Center/Training Site (REAC/TS) is one of the US Department of Energy (DOE)/National Nuclear Security Administration (NNSA) Nuclear Emergency Response Team (NEST) assets and has been responding to radiological incidents since 1976. REAC/TS is in the Oak Ridge Institute for Science and Education (ORISE). A critical part of the REAC/TS mission is to provide emergency response, advice, and consultation on injuries and illnesses caused from ionizing radiation. Fortunately, radiation injuries are not frequent, but when they occur, they are more likely to be cutaneous radiation injuries (CRI) or internal contamination. In this paper, we will review selected cases from the REAC/TS experience in order to illustrate cutaneous patterns of injury and treatment options.

CDC Division of Reproductive Health's Emergency Preparedness Resources and Activities for Radiation Emergencies: Public Health Considerations for Women's Reproductive Health.

Pregnant, postpartum, and lactating people, and infants have unique needs during public health emergencies, including nuclear and radiological incidents. This report provides information on the CDC Division of Reproductive Health's emergency preparedness and response activities to address the needs of women of reproductive age (aged 15-49 years), people who are pregnant, postpartum, or lactating, and infants during a radiation emergency. Highlighted preparedness activities include: (1) development of a quick reference guide to inform key questions about pregnant, postpartum, and lactating people, and infants during radiation emergencies; and (2) exercising the role of reproductive health experts during nuclear and radiological incident preparedness activities.

Application of portable liquid scintillation counter for on-field measurement of tritium in aqueous samples during radiation emergency

Screening of aqueous samples for 3H contamination is required to decide suitability of water intended for human consumption during radiation emergency. BARC, Trombay has recently procured Portable Triathler liquid scintillation counter as a screening tool for on-site response to radiation emergency. For this purpose, parameters like, different available scintillators, scintillator to sample ratio and influence of different capacity scintillation vials were optimized for 3H concentration measurement. The study indicated that for 7 mL vials, the optimized scintillator to sample ratio was 4:1 for Optiphase Hisafe II, Ultima Gold Ultra Low Level Tritium, Aqualight AB and Dioxane based scintillators whereas for Ultima Gold AB and Optiphase Hisafe III scintillators it was 3:1. In case of 20 mL vials, the ratio was optimized to 8:1 for all the above mentioned six scintillators. Additionally, the effect of applying counting efficiency using calibration curves generated using distilled water and that obtained using optimized scintillator to sample ratio in various spiked water samples was also studied. Results in 3H concentration (2000–5700 Bq/mL) indicate about ±10% deviation using both the methods for commercially available scintillators. However, in case of Dioxane based scintillator, the deviation was higher (20%). For analysis of 3H concentration ∼200 Bq/mL using commercially available scintillators results in higher deviation of about 21% due to unreliable quench indicating parameter for count rate less than 4000. The study indicated that calibration curves constructed using optimized parameters are universally applicable for determination of 3H concentration in wide variety of water samples.

The application of multi factor method in the site selection of reserve warehouse for nuclear and radiation emergency

This article explains the power generation of civilian nuclear power plants and the development trend of nuclear technology utilization. The construction of regional nuclear and radiation emergency monitoring material reserve warehouse (hereinafter referred to as the “reserve warehouse”) can ensure nuclear and radiation safety. According to the requirements for emergency monitoring of nuclear accidents and radiation accidents, the article summarizes several factors for site selection. The article conducts research on candidate locations for reserve warehouse and emergency monitoring demand location in China (hereinafter referred to as the “demand locations”). The multi factor method was applied to the location selection of reserve warehouses, and the following conclusions were obtained: (1) The multi factor method is feasible. It has high computational accuracy and fast speed. The site selection model has a significant optimization effect on the location of reserve warehouses. (2) The site selection model proves that the location of reserve warehouses need to consider multiple factors. When the number of reserves is 3–8, about 1–2 cities which is the location of nuclear power plants are selected as candidate cities. (3) When the number of reserve warehouse is 8, the maximum distance is less than 2400 km, meeting the distance limit set for nuclear and radiation emergency monitoring. Considering comprehensive road conditions and other factors, China needs to establish at least 5 reserve warehouses to achieve an emergency ideal situation with a maximum distance of 1600 km.

Some observations on perceptions of radiation risks in the context of nuclear power plant accidents.

As highlighted by public reactions to accidents at nuclear plants in the past, such as those that occurred in Chernobyl (1986) and Fukushima (2011), and from numerous opinion surveys, there are considerable differences or gaps between how the public and radiation experts perceive the risks from radiation. Even within the community of experts, radiation risk perception differences can be present. The reasons for differences in radiation risk perceptions between the public and experts are complex and involve sociological, ethical and behavioural aspects of society. This presents significant challenges to authorities in trying to improve radiation risk communications targeted at the public within the context of radiation emergency preparedness planning. Of particular importance is to make the communications more citizen-centred than heretofore by having meaningful two-way communications and dialogue with the public. It is emphasised that such strategies should take into account and address the significant mental health and socio-economic impacts of such accidents on affected populations. In particular, the mental health impacts are inadequately addressed by current international radiation protection recommendations reflecting their long established emphasis only on physical health effects. This approach is no longer acceptable or justified.

One-pot synthesis of ultra-stable polyvinylpyrrolidone-modified MnO2 nanoparticles for efficient radiation protection

Radiobiological damage can be caused by radiation, and easy preparation of long-term stable radioprotectors is helpful for timely and efficient response to radiation emergencies. This study develops an ultra-stable radioprotector for rapid nuclear emergency with a simple preparing method. First of all, polyvinylpyrrolidone-modified MnO2 nanoparticles (PVP-MnO2 NPs) are obtained by one-pot synthesis with ultra-stability (remaining for at least three years) and multiple free radical scavenging activities. In the synthesis process, PVP acts as a reducing agent, a surfactant (soft template), and a steric stabilizer. PVP-MnO2 NPs can improve the survival rates of irradiated cells by effectively scavenging free radicals and protecting DNA from radiation damage. Besides, PVP-MnO2 NPs can also prevent peripheral blood cell and organ damage induced by radiation, and improve the survival rate of irradiated mice. Finally, PVP-MnO2 NPs are mainly metabolized by liver and kidney in mice, and basically excreted 72 h after administration. These results indicate that PVP-MnO2 NPs exhibit good biosafety and radioprotection activity, which is significant for the development of radioprotection agents.

The new QST bioassay laboratory in Chiba, Japan.

Japan's National Institutes for Quantum Science and Technology (QST) was designated as the core radiation emergency medical support center by the country's Nuclear Regulation Authority (NRA) in 2019. One of the main missions of the QST is to maintain and improve its dose assessment capability for radiation-exposed individuals. Toward the goal of effectively fulfilling this mission, a new facility-the Dose Assessment Building for Advanced Radiation Emergency Medicine-was constructed at the Chiba base of the QST in 2020. An integrated bioassay laboratory was installed in this facility for assessing subjects' internal doses, along with a new integrated in vivo counter. The bioassay capability of the new laboratory is currently expected to screen 5-10 persons simultaneously assuming internal contamination with actinides such as Pu, Am/Cm and U, although this is dependent on the specific contamination circumstances.

Proliferation and apoptosis after whole-body irradiation: longitudinal PET study in a mouse model

PurposeA reliable method for regional in vivo imaging of radiation-induced cellular damage would be of great importance for the detection of therapy-induced injury to healthy tissue and the choice of adequate treatment of radiation emergency patients in both civilian and military events. This study aimed to investigate in a mouse model if positron emission tomography (PET) imaging with proliferation and apoptosis markers is potentially suitable for this purpose.MethodsFour groups, including twenty mice (wild-type C57BL/6) each, were whole-body irradiated with 0 Gy, 0.5 Gy, 1 Gy, and 3 Gy and examined by PET over a six-month period at defined time points. 3'-[18F]fluoro-3'-deoxythymidine ([18F]FLT) and 2-(5-[18F]fluoropentyl)-2-methyl malonic acid ([18F]ML-10) were used to visualise proliferation and apoptosis. Regional standard uptake values were compared with respect to irradiation dose over time. Histologic data and peripheral blood cell values were correlated with the PET results.ResultsThe hematopoietic bone marrow showed a significantly increased [18F]FLT signal at early time points after radiation exposure (day 3 and day 7). This correlated with blood parameters, especially leukocytes, and histological data. A significantly increased [18F]FLT signal also occurred in the gastrointestinal tract and thymus at early time points. An increased [18F]ML-10 signal related to irradiation doses was observed in the bone marrow on day 8, but there was a high variability of standard uptake values and no correlation with histological data.Conclusion[18F]FLT showed potential to visualise the extent, regional distribution and recovery from radiation-induced cellular damage in the bone marrow, gastrointestinal tract and thymus. The potential of [18F]FLT imaging to assess the extent of bone marrow affected by irradiation might be especially useful to predict the subsequent severity of hematopoietic impairment and to adapt the therapy of the bone marrow reserve. [18F]ML-10 PET proved to be not sensitive enough for the reliable detection of radiation induced apoptosis.

Medical preparedness and response for a nuclear or radiological emergency: an assessment study in selected hospitals of the ministry of health across Saudi Arabia

This study aimed to assess and improve the preparedness of selected hospitals in Saudi Arabia for nuclear and radiological emergencies. A team of experts developed and issued guidelines for radiation emergency response, selected 21 referral hospitals across the country, provided technical and logistical support, evaluated preparedness and provided recommendations for improvement. An evaluation process with four essential criteria (early detection of accidents, medical response team responsibilities, availability and accessibility of equipment and supplies, and training on the implementation of the emergency plan) and 50 sub-criteria was conducted, and hospitals’ preparedness was assessed. The initial assessment showed that most hospitals had a moderate level of preparedness, with an average overall score of 67.5%. Interventions were implemented through training workshops, guidelines, checklists, and feedback. The follow-up assessment showed that the intervention was highly effective in enhancing the preparedness of all hospitals, with an average overall score of 99.1%. All hospitals achieved the benchmark of 80% or higher in all four aspects, with 14 hospitals scoring 100% and the remaining seven hospitals requiring further technical support. The study concluded that the intervention was successful in improving the preparedness of health facilities for nuclear and radiological emergencies and recommended continuous monitoring and evaluation to maintain the high level of readiness.

The NERIS roadmap: research challenges in emergency preparedness, response and recovery

NERIS as a European Platform on Preparedness for Nuclear and Radiological Emergency Response and Recovery (EPR&amp;R) has developed a roadmap setting out the key research challenges for radiation emergency preparedness, response and recovery. Research projects in this field have been summarised to demonstrate how important areas of development have been identified and addressed. Radiation EPR&amp;R has a continuous need to evolve to meet societal demands, but also to keep pace with scientific and technological developments and opportunities and so the NERIS research priorities as published in the Strategic Research Agenda (SRA) are kept under review. Three challenge areas have been identified covering the topics of radiological impact assessment, protective action strategies and establishing a transdisciplinary and inclusive framework for emergency preparedness, response and recovery. The importance of these challenge areas and the underlying key topics for NERIS have been mapped across to the Joint Radiation Protection Roadmap developed by the consortium of European radiation research platforms known as MEENAS. The war in Ukraine triggered a new round of revision of the SRA that resulted in the identification of four topics as new or revised challenges for the NERIS community. These updated challenges are: (1) optimisation of management strategies for the transition and recovery phase, (2) uncertainty quantification, data assimilation and monitoring strategies, (3) inverse modelling, and (4) lessons identified from Ukraine and implications for emergency preparedness. These four areas will form the priority research areas for the NERIS community to help advance radiation emergency preparedness to meet current challenges and needs that have been identified.

Creating an automated system for monitoring emergency situations with a radiation factor in Bryansk region

The article describes the structure and composition of an automated emergency monitoring system (AEMS) with a radiation factor designed to perform prompt emergency rescue operations in radioactively contaminated territories (RCT) in Bryansk region and to localize emergency zones (EZ). The study analyzed scientifi publications and patents on radiation control and environmental monitoring in case of radiation emergencies. Territorial automated systems for monitoring radiation situations (ASMRS) and mobile means for monitoring radiation situations (RS) using unmanned aerial vehicles were explored. The integrated monitoring system for protecting the population (KSM-ZN), including in radioactively contaminated areas, in Bryansk region was described. Functions and structure of AEMS means were described. It was concluded that the AEMS can improve the effi ncy of response to radiation emergencies and decisionmaking in protecting the population and territory by transmitting real-time data on RS monitoring in the emergency zone and current assessment of the emergency and environmental situation for prompt notification about the danger.

Creating an automated system for monitoring emergency situations with a radiation factor in Bryansk region

The article describes the structure and composition of an automated emergency monitoring system (AEMS) with a radiation factor designed to perform prompt emergency rescue operations in radioactively contaminated territories (RCT) in Bryansk region and to localize emergency zones (EZ). The study analyzed scientifi publications and patents on radiation control and environmental monitoring in case of radiation emergencies. Territorial automated systems for monitoring radiation situations (ASMRS) and mobile means for monitoring radiation situations (RS) using unmanned aerial vehicles were explored. The integrated monitoring system for protecting the population (KSM-ZN), including in radioactively contaminated areas, in Bryansk region was described. Functions and structure of AEMS means were described. It was concluded that the AEMS can improve the effi ncy of response to radiation emergencies and decisionmaking in protecting the population and territory by transmitting real-time data on RS monitoring in the emergency zone and current assessment of the emergency and environmental situation for prompt notification about the danger.

Past, Present, and Future of Korea National Radiation Emergency Medicine Education

Introduction:In Korea, there are various medical and industrial researchers who use radiation as part of their research. But radiation can cause extensive long-term damage in case of an accident. Therefore, national-level policy and training for the response workforce have been established for a professional response. Since 2002, the KIRAMS has been providing emergency medical response education based on the five mandatory contents (including legislation, protection measures, and emergency medicine).Method:The training content can be divided into theoretical and practical courses. Early education included theoretical courses on cases of accidents and their effects on the human body, as well as practical courses on treatment for contaminated patients. The current education program offers group practice using a HPS and mobile learning. As for the future of national radiation emergency education, the paradigm of education will change with the fourth industrial revolution, the advancement of the IT industry, and the advent of the ‘untact’ era. Therefore, research and development on XR technology–based educational content that can overcome reality’s constraints, is being conducted. Simulation-based education courses to increase effectiveness and immersion will be implemented.Results:Currently, there are approximately 900 radiation emergency medical personnel, and more than 30 new and supplementary education contents are provided each year to improve their proficiency and response abilities. Approximately eight types of content using XR technology will be developed and tested (2021-2023) before being implemented in actual education programs (2024). Advancements in education reflecting special conditions, such as COVID-19, and technological advancements will continue indefinitely.Conclusion:Efforts are ongoing to improve the educational content and to train excellent radiation emergency medical personnel. With the implementation of XR technologies and new education trends, the future of national Korean radiation emergency medical education is expected to advance and diversify, and further improvements in the educational content can be expected.

Reinventing Medical Hazardous Materials Response for Radiological Emergencies: Building Resiliency in Emergency Medical Response Systems Through a Novel Approach to Education and Training

Introduction:The past three years have included multiple Public Health Emergencies of International Concern (PHEIC) and dramatically impacted all facets of Emergency Medical Response. During this time, simultaneous crises have demonstrated the value of the non-traditional responder in mitigating complex incidents. Current geopolitical climate has proliferated nuclear power and increases the necessity for readiness and awareness for radiological incidents. These are complex incidents a responder may face and requires even the lowest skilled practitioner to be fully engaged before special operations intervention.Limited research exists to determine whether current emergency medical services (EMS) training supplies the competency necessary to ensure safety of the prehospital provider during a radiological incident. Forthcoming research will investigate the effectiveness of this current training within the United States.Method:Survey data will be collected from multiple providers across the United States to evaluate their confidence level on two primary objectives during a radiological incident: competency of personal protective equipment donning and doffing, and management of contaminated patients.Data analyses of survey responses help drive future proposed educational activities that will be compliant with best practices set forth by organizations such as the United States Department of Health and Human Services Radiation Emergency Medical Management (REMM), the National Fire Protection Agency (NFPA), and Radiation Emergency Assistance Center/ Training Site (REAC/TS).Results:Data will be collected by survey responses to evaluate a diverse range of EMS services. Details such as skill level, type of EMS service, catchment of communities served, and their impressions upon the training will be analyzed.Conclusion:This is an ongoing project that will embrace the perspectives of the diverse group of delegates of WADEM throughout and become enriched through the organization's wealth of knowledge. Gaps highlighted during roll-out of this research can also be used to address logistics, doctrine, and policy shortfalls.