Program Requirements Research Articles

Developing a COVID-19 Vaccination Program for Seafarers in Cork

Introduction:The pandemic brought to the fore the importance of maritime transport as an essential sector for the continued delivery of critical supplies and global trade in times of crisis. Timely vaccination of seafarers secures their health and enables the chain of infection to be broken with the international propagation of the virus via maritime traffic. As part of the COVID-19 vaccination program, the Health Service Executive in conjunction with the Port of Cork company developed a unique pathway for seafarers to access COVID-19 vaccinations once they arrived in Cork.Method:An Excel template was developed by HSE and Port of Cork that would capture key information for seafarers to avail of vaccinations. Once data was captured by the ship's Captain, it was sent to the shipping agent and reviewed by the HSE South Emergency Management Office. Once the data was validated it was sent to the vaccination center so that the seafarer's details could be entered onto the system. Once confirmed, travel arrangements were made from the vessel to the vaccination clinic ensuring a safe staffing level remained on the vessel.Results:A total of 84 seafarers registered for the seafarer's vaccination program. 70 of these seafarers received one or more doses in Cork City Hall Vaccination Centre with the remainder having received one dose in pharmacies in Cork City.Conclusion:This joint initiative developed by the HSE Emergency Management Office and the Port of Cork, the first seafarer's COVID-19 vaccination program in Ireland, ensured seafarers were allowed to avail of a COVID-19 vaccination when they arrived at the Port of Cork. This highlights the requirement for future vaccination programs to consider and incorporate the requirements of seafarers acknowledging the essential role they play in the global supply chain.

Career-oriented foreign language teaching for secondary vocational education students

Introduction. Many secondary vocational education students express a desire to get higher education. At the same time, a foreign language can play an important career guidance role and contribute to the formation of students' professional identity. However, the implementation of career-oriented foreign language teaching is directly dependent on the approach used and the choice of the content of training. The purpose of the study is to develop a method for career-oriented foreign language teaching to secondary vocational education students. Materials and methods. The study involved students of the department of secondary vocational education at Derzhavin Tambov State University (Russian Federation). In addition to learning a foreign language according to program requirements, participants in the control group (N=30), who used the language for special purposes, and the experimental group (N=30), who used an integrated approach, studied career guidance materials. The objects of control were: grammar, active vocabulary, types of speech activity, foreign language professionally oriented integrative tasks. For data analysis, the Student's t-test method was used. Research results. Content and language integrated learning has proven to be effective incareer-oriented foreign language teaching to secondary vocational education students, as well as in mastering their grammar (t = 4.00; p ≤ 0.05), active vocabulary (t = 5.38; p ≤ 0, 05); speaking (t = 1.74; p ≤ 0.05), reading (t = 2.24; p ≤ 0.05), writing (t = 2.97; p ≤ 0.05), listening (t = 3.52; p ≤ 0.05), performing professionally oriented integrative tasks in a foreign language (t = 5.38; p ≤ 0.05). Conclusion. The novelty of the research lies in the creation of a methodology for career-oriented foreign language teachingto secondary vocational education students based on an integrated approach. The results obtained can be used in the development of methods for career-oriented foreign language teaching to undergraduate and graduate students, as well as secondary school students. Keywords: career guidance, professional identity, integrated approach, secondary professional education

Исследование WebAssembly и сравнение производительности с JavaScript

Over the long history of the Internet, JavaScript has been the primary programming language in web development. Because of its simple syntax and support in all popular browsers, the language has gained popularity among the developers. However, as computer power and user demands evolved, simple sites turned into the web applications that are full-fledged analogues of the desktop applications. As capabilities grew, so did the performance requirements of such programs. Browser engines have developed ways to optimize the code they run, and intense competition between browsers has contributed to a qualitative increase in performance. Despite all the ways to increase the speed of execution of JavaScript code, the main stopping factor was the dynamic typing of the language. Because of dynamic typing, the browser engine needs to check each time the program is executed whether the variable is an integer, a float, or any other valid type. Thus, each JavaScript instruction has to go through several type checks and conversions, which slows down the execution. This led to the idea of using languages with strict typing, which could compensate for this drawback. But the browser engines cannot execute the code of other languages, that is why there appeared the technology WebAssembly. It allows writing code in languages with static typing, and then parses it into 
 a more native and machine-readable format, which speeds up execution of programs compared to JavaScript. The technology is cross-platform and supports the main programming languages: C++, C, Java, C#. WebAssembly is also implemented using JavaScript, which allows to use the concise JavaScript syntax and computing power of WebAssembly together.

The Importance of Supporting Lactation in the Workplace

In 2019 the Accreditation Council for Graduate Medical Education (ACGME) updated its Common Program Requirements to include requirement I.D.2.c), which supports lactation at work. The requirements state institutions must provide “clean and private facilities for lactation that have refrigeration capabilities, with proximity appropriate for safe patient care”.3 The FLSA (Fair Labor Standards Act) had already placed some protections for lactation, employers included under the FLSA must provide lactating persons protected time and space for up to a year.4 And in 2022 the FLSA was amended to include the Providing Urgent Maternal Protections (PUMP) Act. The PUMP act expands lactation support to cover more workers, states that employers must provide space that is not a bathroom, allow for reasonable break times, and protections against harassment or retaliation regarding lactation time.4,5 These rules and regulations are critical to supporting women and parents in the workplace and creating an equitable and diverse environment.

Position Paper: SGIM Sex- and Gender-Based Women's Health Core Competencies.

Women's health care has evolved significantly since it was first acknowledged as an integral part of internal medicine training more than two decades ago. To update and clarify core competencies in sex- and gender-based women's health for general internists, the Society of General Internal Medicine (SGIM) Women and Medicine Commission prepared the following Position Paper, approved by the SGIM council in 2023. Competencies were developed using several sources, including the 2021 Accreditation Council for Graduate Medical Education Program Requirements for Internal Medicine and the 2023 American Board of Internal Medicine Certification Examination Blueprint. These competencies are relevant to the care of patients who identify as women, as well as gender-diverse individuals to whom these principles apply. They align with pivotal advances in women's health and acknowledge the changing context of patients' lives, reaffirming the role of general internal medicine physicians in providing comprehensive care to women.

Self-Reported Depression and Anxiety among Graduate Students during the COVID-19 Pandemic: Examining Risk and Protective Factors

Depression and anxiety among students in higher education are well-established public health concerns with rates that have steadily increased over the past several decades. The global COVID-19 pandemic caused a need for rapid transition on campuses to online learning, a disruption of research, and uncertainty about meeting program requirements and employment. Graduate students often feel overlooked at the best of times and the potential for the pandemic to worsen this perception cannot be understated. This study examined the rates of self-reported depressive and anxiety symptoms among graduate students who were located at the national epicenter of the COVID-19 pandemic in the United States in the spring of 2020. Demographic characteristics, loneliness, and coping to determine potential risk and protective factors were also examined. A comprehensive online survey was created including the University of California Los Angeles (UCLA) 3-Item Loneliness Scale, the Patient Health Questionnaire Depression Scale (PHQ-9), and the Generalized Anxiety Disorder scale (GAD-7). Descriptive statistics, Pearson’s chi-squared test, Spearman’s correlation, and unadjusted and adjusted multivariable logistic ordinal regression models were used to describe the sample and to assess factors associated with depression and anxiety. 341 surveys were analyzed; respondents had a mean age of 31.88, 68% were female, 63% were White, and 23% identified as lesbian/gay/bisexual. Approximately 89% of students reported moderate-severe depression, and 76% moderate-severe anxiety. Risk factors associated with depression (p < 0.05) were being “sometimes’ lonely”, “often/always lonely”, and time spent searching COVID-19 information. Emotional support, having children, and perceived emotional/mental health were protective against depression (p < 0.05). Risk factors associated with anxiety were “‘often/always lonely”, identifying as lesbian/gay/bisexual, and time searching COVID-19 information. Coping, having children, being born outside of the U.S., and perceived emotional/mental health were protective against anxiety (p < 0.05). Based on study findings, it is recommended that universities include more focused interventions for graduate students in consideration of their unique personal and professional needs. Graduate students are part of the emerging professional workforce and as such employers are also advised to integrate wellness and mental health programs and interventions into their employee assistance programs.

Symbiosis as a method in architectural morphology in the beginning of the ХХІ century

This article explores the processes of form making, which relate to the design of the overall shape and mass, volume of a building or group of buildings, usually carried out in the early stages of the architectural design process. They involve the creation of physical or digital models that are used to explore different options for forming and iterations of them. Architects use a number of specific form making techniques, which are divided into types and subtypes according to their building properties. This paper aims to study the concept of building form creation based on biological principles of forming and interaction between certain morphological types: commensalism, mutualism, and parasitism. The search for forms in architecture is a process of research and identification of the most suitable form for a building or structure, taking into account functional, aesthetic and environmental requirements. It is an iterative process that involves the analysis and synthesis of information from various sources, including context, program requirements. The theory of architectural morphology includes the concepts of commensalism, mutualism, and parasitism as methods of finding form.
 Biological analogues in architectural form-making reflect the idea of using biological principles and mechanisms to create new methods of design and form-making. One such method is symbiotic architecture, a design concept based on the idea of a mutually beneficial interaction between buildings and their environment. This concept is based on the idea of symbiosis, where different organisms work together and benefit from each other.
 In the context of formwork, symbiotic architecture can take many forms and manifest itself in different aspects of formwork design. In this work, the main attention is paid to the form-forming aspect of design.

Use of the Digital Assistant Vigo in the Home Environment for Stroke Recovery: Focus Group Discussion With Specialists Working in Neurorehabilitation

There is a lack of resources for the provision of adequate rehabilitation after a stroke, thus creating a challenge to provide the necessary high-quality, patient-centered, and cost-efficient rehabilitation services at a time when they are needed the most. Tablet-based therapeutic programs present an alternative way to access rehabilitation services and show a new paradigm for providing therapeutic interventions following a stroke anytime and anywhere. The digital assistant Vigo is an artificial intelligence-based app that provides an opportunity for a new, more integrative way of carrying out a home-based rehabilitation program. Considering the complexity of the stroke recovery process, factors such as a suitable population, appropriate timing, setting, and the necessary patient-specialist support structure need to be thoroughly researched. There is a lack of qualitative research exploring the perspectives of professionals working in neurorehabilitation of the content and usability of the digital tool for the recovery of patients after a stroke. The aim of this study is to identify the requirements for a tablet-based home rehabilitation program for stroke recovery from the perspective of a specialist working in stroke rehabilitation. The focus group study method was chosen to explore specialists' attitudes, experience, and expectations related to the use of the digital assistant Vigo as a home-based rehabilitation program for stroke recovery in domains of the app's functionality, compliance, usability, and content. In total, 3 focus groups were conducted with a participant count of 5-6 per group and the duration of the discussion ranging from 70 to 80 minutes. In total, 17 health care professionals participated in the focus group discussions. The participants represented physiotherapists (n=7, 41.2%), occupational therapists (n=7, 41.2%), speech and language therapists (n=2, 11.8%), and physical medicine and rehabilitation physicians (n=1, 5.9%). Audio and video recordings of each discussion were created for further transcription and analysis. In total, 4 themes were identified: (1) the clinician's views on using Vigo as a home-based rehabilitation system, (2) patient-related circumstances facilitating and limiting the use of Vigo; (3) Vigo's functionality and use process (program creation, individual use, remote support); and (4) complementary and alternative Vigo use perspectives. The last 3 themes were divided further into 10 subthemes, and 2 subthemes had 2 sub-subthemes each. Health care professionals expressed a positive attitude toward the usability of the Vigo app. It is important that the content and use of the app be coherent with the aim to avoid (1) misunderstanding its practical use and the need for integration in practice and (2) misusing the app. In all focus groups, the importance of close involvement of rehabilitation specialists in the process of app development and research was highlighted.

“Participate or Perish”: Reckoning with the time bind of graduate student life

This article revisits a graduate course I taught between 2005 and 2014, ENGLISH 779--The Times We Live In, in light of the temporal stresses of graduate student life. Thinking with Donald C. Goellnicht's 1993 article, “From novitiate culture to market economy: the professionalization of graduate students,” alongside the more recent work of several graduate students (Blanchard, Wilks and Vogan 2022, Brown 2022; Stoneman 2012; Tootonsab 2022), the article explores the increasing pressure on graduate students to engage in and record activities that are “off-the-clock” of program requirements. In particular, the article considers the contradictory celebration of graduate students' participation in extra-curricular activities that challenge the temporal dynamics of capitalism and colonialism while those dynamics continue to define performance expectations within their graduate programs. Recognizing the complicity of faculty members in exacerbating temporal stress by encouraging the incorporation of extra-curricular activism into the timelines of graduate programs, the article concludes by considering ways to revise ENGLISH 779--The Times We Live in to address more honestly, if not to loosen, the time binds of graduate student life.

Optimizing the Performance of Commercial Demand Response Aggregator Using the Risk-Averse Function of Information-Gap Decision Theory

Power systems face challenges with regard to handling the high penetration of renewable energies, including energy intermittency and fluctuations, which are not present in conventional electricity systems. Various flexibility models have been developed to address these fluctuations, including demand-side flexibility, which offers a practical solution with which to overcome these challenges in all demand sectors, including the commercial sector. This paper proposes a new structure for the participation of the commercial sector in the electricity market to integrate and coordinate the consumption of the commercial sector. Unlike previous studies that had commercial consumers participate in the electricity market individually and sometimes fail to meet the requirements for flexibility programs, this study adopts a commercial aggregator to enhance the responsiveness of commercial systems. The proposed structure includes a mathematical model for commercial systems, e.g., shopping centers, with responsive ventilation systems to achieve demand flexibility. The study also uses the information-gap decision theory to address time-based commercial demand response planning from 24 h ahead to near real time. Moreover, a multi-layered structure is proposed to integrate the flexibility of shopping centers from the demand side to the supply side through a newly invented commercial demand response aggregator. The proposed approach was implemented in the New York electricity market, and the results show that it provides demand flexibility for up to 18% of the nominal level of electricity consumption compared to the traditional system. The paper aims to present a responsive structure for commercial systems, addressing the challenges of integrating renewable energies with the electricity system.

Abstract 4625: A comprehensive guided workflow for highplex imaging, tissue segmentation, and multiplex cellular phenotyping for tumor microenvironment analysis

Abstract The growth in cancer immunotherapy agents requires an understanding of the immune contexture of the tumor microenvironment (TME). Understanding immune contexture requires multiplex staining, imaging, and analysis to obtain multi-marker phenotypes of specific cells and analyze their biodistribution in the TME. Imaging Mass Cytometry™ (IMC) is the method of choice for single-step staining and highplex imaging of FFPE tissues. FFPE tissue is autofluorescent, which limits the utility of immunofluorescence methods. Lung and colorectal tissue (and bone, skin, etc) are highly autofluorescent, and therefore good targets for IMC. However, developments in analysis software for highplex imagery have not kept pace with imaging advances. We present a comprehensive workflow designed specifically for highplex image analysis, covering tissue segmentation, cell segmentation based on IMC DNA images, cellular phenotyping, and spatial analyses. Lung and colorectal tissue sections with a 30-marker IMC panel of structural, tumor, stroma, immune cell, and immune activation markers were imaged (Hyperion+™, Standard BioTools). Highplex image analysis (Phenoplex™, Visiopharm) was performed as a multi-step workflow in a single software package that includes: conversion of IMC images to pyramidal format; easy visualization methods for displaying different marker subsets; a paint-to-train algorithm for tissue segmentation (into tumor, stroma, blood vessels, etc.); deep-learning-based nuclear segmentation pre-trained on IMC DNA channels; cellular phenotyping based on thresholds based on visual assessment of positivity; spatial biodistribution metrics for cell populations; and a flexible set of outputs for downstream analysis. Tissue segmentation was used to divide the tissue into tumor, stromal, and tumor margin regions, and these regions were used to compare the immune contexture through a series of t-SNE images partitioned by spatial region. We demonstrate that a simple analysis workflow can be used for highplex images of different tissue types by users with no programming knowledge. Visualization templates for the marker subsets and the pre-trained IMC nuclear segmentation are reusable. A new tissue segmentation algorithm for each tissue type is required, as are new thresholds for biomarker positivity. Spatial biodistribution metrics, heatmaps and partitioned t-SNE plots were generated for each tissue type with a minimum of work. Highplex IMC imaging of lung and colorectal tumor samples is a simple and effective means of obtaining high-parameter images without interfering autofluorescence. Having a comprehensive workflow for the analysis of this complex data makes obtaining useful results from highplex images more accessible to biologists and immunologists by circumventing the requirement for expert programming for each specific application. Citation Format: Brenna O'Neill, Smriti Kala, Sam Lim, Clinton Hupple, Nina Lane, Rasmus Norre Sorensen, Rasmus A. Lyngby, Alessandro Massaro, Andreas Hussing, Jeppe Thagaard, Johan Dore-Hansen, James Robert Mansfield. A comprehensive guided workflow for highplex imaging, tissue segmentation, and multiplex cellular phenotyping for tumor microenvironment analysis. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4625.

COVID‐19 and employment relief programs: A tale of spatially blind policies for a spatially driven pandemic

AbstractWe use the case of Chile to analyze the effectiveness of a spatially blind employment relief program (hereafter referred to as the LPE program) established by the Chilean government and implemented during the COVID‐19 pandemic. Chile is an interesting case because on the one hand its nonpharmaceutical interventions were spatially driven by health indicators based on small geographical areas; hence, producing sizeable regional and temporal variation of the local conditions induced by the COVID‐19 pandemic. On the other hand, the LPE program was designed and implemented nationally without distinction of local labor market or pandemic conditions, and each firm could decide whether to enroll in the program. By exploiting the spatial‐temporal variation of exogenously imposed lockdowns and using a difference‐in‐differences panel data framework, we find that the LPE program was only effective for a group of regions in the country but, more importantly, that the LPE program was less effective during lockdowns. Moreover, the requirements of the LPE program were vague and did not target specific populations or entities. Consequently, our results suggest that women, informal and small firm workers, and most economic sectors throughout the country were less able to take advantage of the benefits of this program.

Analysis and Optimization of Automotive Self-Priming Door Lock Closing Sound

<div>With higher customer expectations and advances in vehicular technology, automotive functions and operations are becoming more intelligent. Electric self-priming door locks fulfil the automatic closing and locking of side doors, hatchback doors, sliding doors, liftgates, decklids, etc. They are widely implemented into high-end models for the elegance of soft closing. In the list of perceived vehicle qualities, door-closing sound quality has been one of the important customer concerns in the market. In comparison to conventional door locks, electric self-priming door locks add another dimension to the development of sound quality for noise, vibration, and harshness (NVH) efforts. In this article, the characteristics of door-closing sound involving self-priming door lock mechanisms are analyzed and illustrated. Human perception of different sounds from the self-priming door lock working process is ranked by subjective evaluations. For typical door closing sounds associated with the self-priming lock mechanisms, i.e., the motor sound and rebound sound, real-case examples are discussed. A case of the buzzing noise issue due to the self-priming lock on a hatchback door is also presented. In these cases, the correlation between the sounds and the structure of the self-priming door locks is investigated and the root causes of the encountered issues are identified. The door closing sound quality associated with the self-priming door locks is improved in each case to meet the program requirements. In the particular cases presented in this work, the analysis involves psychoacoustic metrics for sound quality study originally. It is found later that sound pressure level can address the encountered issues, and thus only sound pressure level results are included.</div>

How Consistent are International Rotations Between Plastic Surgery Training Programs?

All 101 integrated and independent plastic surgery program directors/coordinators were asked to participate. The survey identified the requirements and details of existing international rotations. In total, 57 programs responded (56% response rate) to the survey. An estimated 54% of all programs offered international rotations to their residents, and 94% of these programs obtained institutional approval. Additionally, 69% of these programs have received national approval. Institutional requirements for programs to provide international rotations vary significantly across institutions, which results in disparate experiences for residents and poses potential risks to international partners. This study will help promote transparency regarding international rotation requirements and better equip faculty to enhance international rotations that cater to the needs of the institution, residents, and most importantly, the host countries.

The next phase in patient safety education: Towards a standardized, tools-based pathology patient safety curriculum: A call to action from the Association of Pathology Chairs' Residency Program Directors Section Training Residents in Patient Safety Workgroup

Patient safety education is a mandated Common Program Requirement of the Accreditation Council for Graduate Medical Education and for the Royal College of Physicians and Surgeons of Canada in all medical residency and fellowship programs. Although many hospitals and healthcare environments have general patient safety education tools for trainees, few to none focus on the unique training milieu of pathologists, including a mix of highly automated and manual error-prone processes, frequent multiplicity of events, and lack of direct patient relationships for error disclosure. We established a national Association of Pathology Chairs-Program Directors Section Workgroup focused on patient safety education for pathology trainees entitled Training Residents in Patient Safety (TRIPS). TRIPS included diverse representatives from across the United States, as well as representatives from pathology organizations including the American Board of Pathology, the American Society for Clinical Pathology, the United States and Canadian Academy of Pathology, the College of American Pathologists, and the Society to Improve Diagnosis in Medicine. Objectives of the workgroup included developing a standardized patient safety curriculum, designing teaching and assessment tools, and refining them with pilot sites. Here we report the establishment of TRIPS as well as data from national needs assessment of Program Directors across the country, who confirmed the need for a standardized patient safety curriculum.

World Federation of Orthodontists guidelines for postgraduate orthodontic education.

Advanced dental education programs in orthodontics and dentofacial orthopedics require an extensive and comprehensive evidence-based experience, which must be representative of the current didactic and technical advancements. Over the past 25 years, the World Federation of Orthodontists (WFO) has placed emphasis in the support for the recognized orthodontic specialty training programs in every region of the world. In its early years, the WFO developed general principles for specialty education that culminated in the first comprehensive curriculum recommendations, i.e., the WFO Guidelines for Postgraduate Orthodontic Education, which was published in February 2009. In view of the significant changes in the specialty of orthodontics, the WFO has revised and updated its previous document to reflect the expanded scope and demands of current orthodontic education and practice. The members of the task force participated in a thorough revision of the guidelines and created a new document that takes into consideration the didactic, clinical, and the appropriate physical facilities to provide clinical care, study, and research areas. Although it is recognized that there will be variations in teaching and faculty assets, as well as facilities, access to materials, and equipment, the aim of the WFO Educational Guidelines is to provide the minimum program requirements necessary to provide orthodontic specialty residents the educational experience that prepares them to deliver the best level of orthodontic treatment for their patients. It is recommended that these guidelines be used universally by orthodontic specialty program educators and related educational, scientific, and administrative institutions to evaluate and compare their curriculum to a world standard.

Developing and Evaluating a Novel Educational Intensive Care Unit Wall Map

Developing and Evaluating a Novel Educational Intensive Care Unit Wall Map

Bayesian latent-class modelling of quarantine testing procedures for American Bison (Bison bison) in the Greater Yellowstone Area to determine Brucella abortus freedom.

American bison (Bison bison) quarantine protocols were established to prevent transmission of brucellosis outside the Greater Yellowstone Area, while allowing for distribution of wild bison for conservation and cultural purposes. Quarantine standards require rigorous testing over 900 days which has led to the release of over 200 bison to Native American tribes. Standards were evaluated using 15 years of laboratory and management data to minimize the burden of testing and increase the number of brucellosis-free bison available for distribution. All bison (n = 578) from Yellowstone National Park were corralled by the National Park Service and United States Department of Agriculture. A statistical and management evaluation of the bison quarantine program was performed. Bayesian latent-class modeling was used to predict the probability of nondetection of a seroreactor at various time points, as well as the probability of seroconversion by days in quarantine. At 300 days, 1 in 1,000 infected bison (0.0014 probability) would not be detected but could potentially seroconvert; the seroconversion model predicted 99.9% would seroconvert by day 294, and 12.8% of bison enrolled in quarantine would seroconvert over time. Using a 300-day quarantine period, it would take 30 years to potentially miss 1 seroreactor out of over 8,000 bison enrolled in the quarantine program. Reducing the quarantine program requirements from over 900 days to 300 days would allow management of quarantined bison in coordination with seasonal movement of bison herds and triple the number of brucellosis-free bison available for distribution.

Considering the Effects of the Dobbs Decision on Clinical Training and Practice and on the Lives of Medical Professionals.

Considering the Effects of the Dobbs Decision on Clinical Training and Practice and on the Lives of Medical Professionals.

Flight photon counting electron multiplying charge coupled device development for the Roman Space Telescope coronagraph instrument

We describe the development of flight electron multiplying charge coupled devices (EMCCDs) for the photon-counting camera system of a coronagraph instrument (CGI) to be flown on the 2.4-m Nancy Grace Roman Space Telescope. Roman is a NASA flagship mission that will study dark energy and dark matter, and search for exoplanets with a planned launch in the mid-2020s. The CGI is intended to demonstrate technologies required for high-contrast imaging and spectroscopy of exoplanets, such as high-speed wavefront sensing and pointing control, adaptive optics with deformable mirrors, and ultralow noise signal detection with photon counting, visible-sensitive (350 to 950 nm) detectors. The camera system is at the heart of these demonstrations and is required to sense both faint and bright targets (10 − 4 − 107 counts-s − 1) adaptively at up to 1000 frames-s − 1 to provide the necessary feedback to the instrument control loops. The system includes two identical cameras, one to demonstrate faint light scientific capability, and the other to provide high-speed real-time sensing of instrument pointing disturbances. Our program at the Jet Propulsion Laboratory (Pasadena, California, United States) has evaluated the low-signal performance of radiation-damaged commercial EMCCD sensors and used those measurements as a basis for targeted radiation hardening modifications developed in partnership with the Open University (Milton Keynes, United Kingdom) and Teledyne-e2v (Chelmsford, United Kingdom). A pair of EMCCDs with test features was then developed and their low signal performance is reported here. The program has resulted in the development of a flight version of the EMCCD with low signal performance improved by more than a factor of three over the commercial one after exposure to 2.6 × 109 protons-cm − 2 (10 MeV equivalent). The flight EMCCD sensors are contributed by ESA through a contract with Teledyne-e2v (Chelmsford, United Kingdom). We will describe the program requirements, sensor design, test results and metrics used to evaluate photon counting performance.