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Jelsema, Casey

Publications and source records attributed to Jelsema, Casey.

6 records
All sourcesNASA NTRSDOE OSTI
DOE OSTI2023

Safety and efficacy of peripheral nerve blocks to treat refractory headaches after aneurysmal subarachnoid hemorrhage – A pilot observational study

Objectives: Headache after aneurysmal subarachnoid hemorrhage (HASH) is common, severe, and often refractory to conventional treatments. Current treatment standards include medications including opioids, until the pain is mitigated. Peripheral nerve blocks (PNBs) may be an effective therapeutic option for HASH. We conducted a small before-and-after study of PNBs to determine safety, feasibility, and efficacy in treatment of HASH. Methods: We conducted a pilot before-and-after observational study and collected data for 5 patients in a retrospective control group and 5 patients in a prospective intervention PNB group over a 12-month period. All patients received a standard treatment of medications including acetaminophen, magnesium, gabapentin, dexamethasone and anti-spasmodics or anti-emetics as needed. Patients in the intervention group received bilateral greater occipital, lesser occipital, and supraorbital PNBs in addition to medications. The primary outcome was pain severity, measured by Numeric pain rating scale (NPRS). All patients were followed for 1 week following enrollment. Results: The mean ages in the PNB group and control group were 58.6 and 57.4, respectively. One patient in the control group developed radiographic vasospasm. Three patients in both groups had radiographic hydrocephalus and IVH, requiring external ventricular drain (EVD) placement. The PNB group had an average reduction in mean raw pain score of 2.76 (4.68, 1.92 p = 0.024), and relative pain score by 0.26 (0.48, 0.22 p = 0.026), compared to the control group. The reduction occurred immediately after PNB administration. Conclusion: PNB can be a safe, feasible and effective treatment modality for HASH. Further investigations with a larger sample size are warranted.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Gemma V&V/UQ/Credibility Activities: FY2020 Progress

This report describes the credibility activities undertaken in support of Gemma code development in FY20, which include Verification & Validation (V&V), Uncertainty Quantification (UQ), and Credibility process application. The main goal of these activities is to establish capabilities and process frameworks that can be more broadly applied to new and more advanced problems as the Gemma code development effort matures. This will provide Gemma developers and analysts with the tools needed to generate credibility evidence in support of Gemma predictions for future use cases. The FY20 Gemma V&V/UQ/Credibility activities described in this report include experimental uncertainty analysis, the development and use of methods for optimal design of computer experiments, and the development of a framework for validation. These initial activities supported the development of broader credibility planning for Gemma that continued into FY21.

97 MATHEMATICS AND COMPUTING↗
NASA NTRS2018

Past and Future Drought in Mongolia

The severity of recent droughts in semiarid regions is increasingly attributed to anthropogenic climate change, but it is unclear whether these moisture anomalies exceed those of the past and how past variability compares to future projections. On the Mongolian Plateau, a recent decade-long drought that exceeded the variability in the instrumental record was associated with economic, social, and environmental change. We evaluate this drought using an annual reconstruction of the Palmer Drought Severity Index (PDSI) spanning the last 2060 years in concert with simulations of past and future drought through the year 2100 CE. We show that although the most recent drought and pluvial were highly unusual in the last 2000 years, exceeding the 900-year return interval in both cases, these events were not unprecedented in the 2060-year reconstruction, and events of similar duration and severity occur in paleoclimate, historical, and future climate simulations. The Community Earth System Model (CESM) ensemble suggests a drying trend until at least the middle of the 21st century, when this trend reverses as a consequence of elevated precipitation. Although the potential direct effects of elevated CO2 on plant water use efficiency exacerbate uncertainties about future hydroclimate trends, these results suggest that future drought projections for Mongolia are unlikely to exceed those of the last two millennia, despite projected warming.

drought projection↗