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NASA NTRS2002

Advanced Ultrasonic Diagnosis of Extremity Trauma: The Faster Exam

Ultrasound is of prO)len accuracy in abdominal and thoracic trauma and may be useful to diagnose extremity injury in situations where radiography is not available such as military and space applications. We prospectively evaluated the utility of extremity , ultrasound performed by trained, non-physician personnel in patients with extremity trauma, to simulate remote aerospace or military applications . Methods: Patients with extremity trauma were identified by history, physical examination, and radiographic studies. Ultrasound examination was performed bilaterally by nonphysician personnel with a portable ultrasound device using a 10-5 MHz linear probe, Images were video-recorded for later analysis against radiography by Fisher's exact test. The average time of examination was 4 minutes. Ultrasound accurately diagnosed extremity, injury in 94% of patients with no false positive exams; accuracy was greater in mid-shaft locations and least in the metacarpa/metatarsals. Soft tissue/tendon injury was readily visualized . Extremity ultrasound can be performed quickly and accurately by nonphysician personnel with excellent accuracy. Blinded verification of the utility of ultrasound in patients with extremity injury should be done to determine if Extremity and Respiratory evaluation should be added to the FAST examination (the FASTER exam) and verify the technique in remote locations such as military and aerospace applications.

Dulchavsky, S. A.↗

NASA NTRS2004

Extraterrestrial Hemorrhage Control: Terrestrial Developments in Technique, Technology, and Philosophy with Applicability to Traumatic Hemorrhage in Space

Managing injury and illness during long duration space flight limits efforts to explore beyond low earths orbit. Traumatic injury may be expected to occur in space and is a frequent cause of preventable deaths, often related to uncontrolled or ongoing hemorrhage (H). Such bleeding causes 40% of terrestrial injury mortality. Current guidelines emphasize early control of H compared to intravenous infusions. Recent advances in surgical and critical care may be applicable to trauma care in space, with appropriate considerations of the extreme logistical and personnel limitations. Methods: Recent developments in technique, resuscitation fluids, hemoglobin (Hb) substitutes, hemostatic agents, interventional angiography, damage control principles, and concepts related to suspended animation were reviewed. Results: H associated with instability frequently requires definitive intervention. Direct pressure should be applied to all compressible bleeding, but novel approaches are required for intracavitary noncompressible bleeding. Intravenous hemostatic agents such as recombinant Factor VII may facilitate hemostasis especially when combined with a controlled hypotension approach. Both open and laparoscopic techniques could be used in weightlessness, but require technical expertise not likely to be available. Specific rehearsed invasive techniques such as laparotomy with packing, or arterial catherterization with with robotic intravascular embolization might be considered . Hemodynamic support, thermal manipulation, or pharmacologic induction of a state of metabolic down regulation for whole body preservation may be appropriate. Hypertonic saline, with or without dextran, may temporize vascular support and decrease reperfusion injury, with less mass than other solutions. Hb substitutes have other theoretical advantages. Conclusions: Terrestrial developments suggest potential novel strategies to control H in space, but will required a coordinated program of evaluation and training to evaluate.

Kirkpatrick, Andrew↗

NASA NTRS2014

HEMODOSE: A Set of Multi-parameter Biodosimetry Tools

There continues to be important concerns of the possibility of the occurrence of acute radiation syndromes following nuclear and radiological terrorism or accidents that may result in mass casualties in densely populated areas. To guide medical personnel in their clinical decisions for effective medical management and treatment of the exposed individuals, biological markers are usually applied to examine radiation induced biological changes to assess the severity of radiation injury to sensitive organ systems. Among these the peripheral blood cell counts are widely used to assess the extent of radiation induced bone marrow (BM) injury. This is due to the fact that hematopoietic system is a vulnerable part of the human body to radiation damage. Particularly, the lymphocyte, granulocyte, and platelet cells are the most radiosensitive of the blood elements, and monitoring their changes after exposure is regarded as a practical and recommended laboratory test to estimate radiation dose and injury. In this work we describe the HEMODOSE web tools, which are built upon solid physiological and pathophysiological understanding of mammalian hematopoietic systems, and rigorous coarse-grained biomathematical modeling and validation. Using single or serial granulocyte, lymphocyte, leukocyte, or platelet counts after exposure, these tools can estimate absorbed doses of adult victims very rapidly and accurately to assess the severity of BM radiation injury. Some patient data from historical accidents are utilized as examples to demonstrate the capabilities of these tools as a rapid point-of-care diagnostic or centralized high-throughput assay system in a large-scale radiological disaster scenario. HEMODOSE web tools establish robust correlations between the absorbed doses and victim's various types of blood cell counts not only in the early time window (1 or 2 days), but also in very late phase (up to 4 weeks) after exposure.

Hu, Shaowen↗

NASA NTRS2014

Validation of the 5th and 95th Percentile Hybrid III Anthropomorphic Test Device Finite Element Model

NASA spacecraft design requirements for occupant protection are a combination of the Brinkley criteria and injury metrics extracted from anthropomorphic test devices (ATD's). For the ATD injury metrics, the requirements specify the use of the 5th percentile female Hybrid III and the 95th percentile male Hybrid III. Furthermore, each of these ATD's is required to be fitted with an articulating pelvis and a straight spine. The articulating pelvis is necessary for the ATD to fit into spacecraft seats, while the straight spine is required as injury metrics for vertical accelerations are better defined for this configuration. The requirements require that physical testing be performed with both ATD's to demonstrate compliance. Before compliance testing can be conducted, extensive modeling and simulation are required to determine appropriate test conditions, simulate conditions not feasible for testing, and assess design features to better ensure compliance testing is successful. While finite element (FE) models are currently available for many of the physical ATD's, currently there are no complete models for either the 5th percentile female or the 95th percentile male Hybrid III with a straight spine and articulating pelvis. The purpose of this work is to assess the accuracy of the existing Livermore Software Technology Corporation's FE models of the 5th and 95th percentile ATD's. To perform this assessment, a series of tests will be performed at Wright Patterson Air Force Research Lab using their horizontal impact accelerator sled test facility. The ATD's will be placed in the Orion seat with a modified-advanced-crew-escape-system (MACES) pressure suit and helmet, and driven with loadings similar to what is expected for the actual Orion vehicle during landing, launch abort, and chute deployment. Test data will be compared to analytical predictions and modelling uncertainty factors will be determined for each injury metric. Additionally, the test data will be used to further improve the FE model, particularly in the areas of the ATD neck components, harness, and suit and helmet effects.

Lawrence, C.↗

NASA NTRS2020

Occupant Response Analysis of a Full-Scale Crash Test of a Fokker F28 Fellowship Aircraft

In this report, the capability of component fuselage testing and finite element models (FEMs) to predict occupant injury risk when applied to full-scale aircraft crash testing was evaluated. Component level and full-scale crash tests of a Fokker-F28 aircraft were performed in conjunction with representative FEM simulations. Lumbar spine injury risk, calculated through Anthropomorphic Test Device (ATD) outputs measured in the full-scale test, was compared with predictions made by component level testing and simulations. A quantitative assessment of FEM prediction accuracy was made using the International Organization for Standardization (ISO) Technical Report (TR) 16250 curve comparison methodology. Lumbar load injury risk measured in the full-scale test configuration was found to be significantly higher than in the component tests performed. The FEM provided a closer prediction of occupant injury risk than component testing but exhibited limitations in the multi-axis load environment. This work will help inform the application of component testing and FEM simulation when used to evaluate aircraft crashworthiness.

Jacob B Putnam↗

NASA NTRSDate not supplied

EVA SPACESUIT INCIDENCE TRACKING

INTRODUCTION: Extravehicular Activity (EVA)suit-related injuries to crew during training and inflight operations are not uncommon. Systematic tracking of these issues has waxed and waned throughout NASA’s history. Given two new EVA suits in development and an increase in EVA training, the need for dutiful recording of this data is critical. The Suited User Incident Tracking System (SUITS) was developed in the last decade to track all suited exposures, recording exposure details and any related issues, pains, or injuries that arise. METHODS: SUITS data collected from 2017 to 2022 was analyzed for issue frequency and severity for each body location and plotted to visualize where issues were occurring. Clustering techniques using a k-modes approach were also applied to the data set to generate profiles of populations that experienced issues in the suit, and populations that did not. RESULTS:A key finding from SUITS is that discomfort and pain observed in the new planetary spacesuits are occurring in new body locations than those experienced in the microgravity space suit (Extravehicular Mobility Unit (EMU)).To date, the lower body and torso regions account for most pain reports in planetary spacesuits whereas most reports in EMU were shoulders and hands. DISCUSSION:SUITS will continue to be used to capture exposures for all suit types. As training suit availability improves and training cadence increases in preparation for planetary missions, it is critical to capture and assess all suit incidences. Further, a Suited Anomaly Assessment Team (SAAT) consisting of a broad range of EVA stakeholders was formed to share and act on SUITS data with the goal of developing robust solutions to issues/injuries as they arise. Understanding the types and locations of injuries that occur during suited operations will help inform future work related to EVA fitness training requirements, suit design, and modeling efforts to avoid injury. LEARNING OBJECTIVES: 1. Systematic tracking of suited exposures and issues is critical for understanding the complex interaction between the human and the EVA spacesuit. 2. As EVA suit issues/injuries arise it is important to share that data with a broad group to ensure robust strategies are developed.

N Newby↗

NASA NTRS2023

Modeling and Simulation Credibility Assessments of Whole-Body Finite Element Computational Models for Use in NASA Extravehicular Activity Applications

Computational finite element (FE) models are used in suited astronaut injury risk assessments; however, these models’ verification, validation, and credibility (VV&C) procedures for simulating injuries in altered gravity environments are limited. Our study conducts VV&C assessments of THUMS and Elemance whole-body FE models for predicting suited astronaut injury biomechanics using eight credibility factors, as per NASA-STD-7009A. Credibility factor ordinal scores are assigned by reviewing existing documentation describing VV&C practices, and credibility sufficiency thresholds are assigned based on input from subject matter experts. Our results show the FE models are credible for suited astronaut injury investigation in specific ranges of kinematic and kinetic conditions correlating to highway and contact sports events. Nevertheless, these models are deficient when applied outside these ranges. Several credibility elevation strategies are prescribed to improve models’ credibility for the NASA-centric application domain.

Finite Element↗

NASA NTRS2023

Modeling and simulation credibility assessments of whole-body finite element computational models for use in NASA extravehicular activity applications

Finite Element↗

NASA NTRSDate not supplied

Extravehicular Activity on the Lunar Surface: Mapping Mitigation Risk Consequence for Crew Needing Assistance or Rescue

Extravehicular activity (EVA) on the lunar surface presents unique risks to crew with possibility for injury. Without appropriate assistance or rescue capability, inability to nominally ambulate and return to a lander, especially during early Artemis missions, could have catastrophic consequences. Mapping likelihood and consequence safety risk associated with identified injury scenarios establishes a baseline from which to assess potential mitigation solutions to ensure crew health and safety. Causes leading to the need for incapacitated crew rescue (ICR) during EVA on the lunar surface were previously identified and classified using an ICR/Acute Injury scenario spectrum. Severe scenarios are those when the affected astronaut requires either partial or full continuous assistance from the rescuer. Evaluation of these continual reliance conditions included calculating event probabilities (likelihoods) associated with an early Artemis mission and mapping them to established Exploration System Directorate (ESD) probability thresholds; safety consequences were analyzed and correlated to defined ESD personnel safety categories. These resulting likelihood and consequence values served as a baseline for assessing risk reduction of three mitigation capabilities: crew assistance (rescuer crew) only, walking assist devices, and a wheeled transport device. Of the twenty-five continual reliance conditions, ten were evaluated as “catastrophic” (Level 5, loss of life) during EVA on the lunar surface with probabilities ranging from moderate to very low during an early Artemis mission. Crew assistance only and walking assist devices showed similar potential for risk reduction, with four of the ten causes decreasing to Level 4. A wheeled transport device further increased risk reduction with six of the ten conditions decreasing to Level 4. Given the catastrophic consequence of several identified conditions, assessments should be performed to determine the feasibility of mitigation capabilities. It is currently unknown whether a rescuer astronaut could effectively provide continuous assistance to enable both crew to return safely to the lander from the standpoint of both suit geometry and human performance. Although resulting in an increase in resources, providing a wheeled transport provides the highest risk reduction potential, and walking assist devices may have prevention as well as mitigation benefits.

lunar surface↗

NASA NTRS1975

Project BIOCORE /M212/, a biological cosmic ray experiment - Procedures, summary, and conclusions

The primary objective of the experiment was to determine whether a specific portion of the high Z-high energy (HZE) galactic cosmic ray particle spectrum, especially particles with Z no less than 6, can produce microscopically visible injury of brain and eye tissues. Pocket mice (Perognathus longimembris), obtained from the California desert, were selected as the biological target. Five of these mice were flown on Apollo XVII. Not only the brain and eyes but also many other tissues of these animals were studied for evidence of cosmic ray particle damage. The lack of prior experimental evidence as to the character of the potential injury induced by HZE particles required reliance on the physical characteristics of particle radiation in ascertaining the probable nature of the injury. These characteristics and the key aspects of the experiment are summarized in this paper. Subsequent articles in this special supplement give details of the biological, engineering, and dosimetric aspects of BIOCORE together with the results.

Haymaker, W.↗

NASA NTRS1980

Response of citrus and other selected plant species to simulated HCL - acid rain

Mature valencia orange trees were sprayed with hydrochloric acid solutions (pH 7.8, 2.0, 1.0, and 0.5) in the field at the full bloom stage and at one month after fruit set. Potted valencia orange and dwarf citrus trees, four species of plants native to Merritt Island, and four agronomic species were exposed to various pH levels of simulated acid rain under controlled conditions. The acid rain was generated from dilutions of hydrochloric acid solutions or by passing water through an exhaust generated by burning solid rocket fuel. The plants were injured severely at pH levels below 1.0, but showed only slight injury at pH levels of 2.0 and above. Threshold injury levels were between 2.0 and 3.0 pH. The sensitivity of the different plant species to acid solutions was similar. Foliar injury symptoms were representative of acid rain including necrosis of young tissue, isolated necrotic spots or patches, and leaf abscission. Mature valencia orange trees sprayed with concentrations of 1.0 pH and 0.5 pH in the field had reduced fruit yields for two harvests after the treatment. All experimental trees were back to full productivity by the third harvest after treatment.

Knott, W. M.↗

NASA NTRS1981

Safety evaluation methodology for advanced coal extraction systems

Qualitative and quantitative evaluation methods for coal extraction systems were developed. The analysis examines the soundness of the design, whether or not the major hazards have been eliminated or reduced, and how the reduction would be accomplished. The quantitative methodology establishes the approximate impact of hazards on injury levels. The results are weighted by peculiar geological elements, specialized safety training, peculiar mine environmental aspects, and reductions in labor force. The outcome is compared with injury level requirements based on similar, safer industries to get a measure of the new system's success in reducing injuries. This approach provides a more detailed and comprehensive analysis of hazards and their effects than existing safety analyses.

Zimmerman, W. F.↗

NASA NTRS1982

Health and safety evaluation of a modified tunnel borer design for application to single entry coal mine development

A health and safety analysis of a single entry coal tunnel borer system is given. The results of the health analysis indicated that while the tunnel borer design offered improvements in dust control through the use of water sprays, a higher face ventilation rule, and the application of spalling rather than the conventional grinding process, it interjected an additional mutagen and toxic compound into the environment through the use of shotcrete. The tunnel borer system easily conformed with the prescribed fatality limit, but exceeded the required limits for disabling and overall injuries. It also exhibited projected disabling and overall injury rates considerably higher than existing continuous mining injury rates. Consequently, the tunnel borer system was not considered an advanced system.

Zimmerman, W. F.↗

NASA NTRS1988

Detecting air pollution stress in southern California vegetation using Landsat Thematic Mapper band data

Landsat Thematic Mapper (TM) and aircraft-borne Thematic Mapper simulator (TMS) data were collected over two areas of natural vegetation in southern California exposed to gradients of pollutant dose, particularly in photochemical oxidants: the coastal sage scrub of the Santa Monica Mountains in the Los Angeles basin, and the yellow pine forests in the southern Sierra Nevada. In both situations, natural variations in canopy closure, with subsequent exposure of understory elements (e.g.,rock or soil, chaparral, grasses, and herbs), were sufficient to cause changes in spectral variation that could obscure differences due to visible foliar injury symptoms observed in the field. TM or TMS data are therefore more likely to be successful in distinguishing pollution injury from background variation when homogeneous communities with closed canopies are subjected to more severe pollution-induced structural and/or compositional change. The present study helps to define the threshold level of vegetative injury detectable by TM data.

Westman, Walter E.↗

NASA NTRS1991

Microgravity testing a surgical isolation containment system for Space Station use

Anticipated hazards for crewmembers in future long term space flights may result in a variety of injuries including trauma and burns. Management of these injuries will require special techniques because of the lack of gravity, limitations of space and environmental restrictions. A small surgical isolation containment system was developed and tested in microgravity. The chamber provided both protection of the injury and of the cabin environment and is felt to be the most effective means of trauma and burn care in future Health Maintenance Facilities planned for prolonged space exposure.

Markham, Sanford M.↗

NASA NTRS1994

Experiment K-7-29: Connective Tissue Studies: Rodent Tissue Repair: Skeletal Muscle - Part 3

Myofiber injury-repair was studied in the rat gastrocnemius following a crush injury to the lower leg prior to flight in order to understand if the regenerative responses of muscles are altered by the lack of gravitational forces during Cosmos 2044 flight. After 14 days of flight, the gastrocnemius muscle was removed from the 5 injured flight rodents and various Earth-based treatment groups for comparison. The Earth-based animals consisted of three groups of five rats with injured muscles from a simulated, tail-suspended, and vivarium as well as an uninjured basal group. The gastrocnemius muscle from each was evaluated by histochemical and immunohistochemical techniques to document myofiber, vascular, and connective tissue alterations following injury. In general the repair process was somewhat similar in all injured muscle samples with regard to extracellular matrix organization and myofiber regeneration. Small and large myofibers were present with a newly organized extracellular matrix indicative of myogenesis and muscle regeneration. In the tail-suspended animals, a more complete repair was observed with no enlarged area of non-muscle cells or matrix material visible. In contrast, the muscle samples from the flight animals were less well differentiated with more macrophages and blood vessels in the repair region but small myofibers and proteoglycans, nevertheless, were in their usual configuration. Thus, myofiber repair did vary in muscles from the different groups, but for the most part, resulted in functional muscle tissue.

Stauber, W.↗

NASA NTRS1997

Endothelial Cell Morphology and Migration are Altered by Changes in Gravitational Fields

Endothelial cell migration is important to vascular wall regeneration following injury or stress. However, the mechanism(s) governing this response is not well understood. The microgravity environment of space may complicate the response of these cells to injury. To date, there are no reports in this area. We examined how bovine aortic (BAEC) and pulmonary (BPEC) endothelial cells respond to denudation injury under hypergravity (HGrav) and simulated microgravity (MGrav), using image analysis. In 10% FBS, the migration of confluent BAEC and BPEC into the denuded area was not affected by HGrav or MGrav. However, in low FBS (0.5%), signficantly retarded migration under MGrav, and increased migration under HGrav was found. MGrav also decreased the migration of postconfluent BPEC while HGrav showed no difference. Both MGrav and HGrav strongly decreased the migration of postconfluent BAEC. Also, both cell lines showed significant morphological changes by scanning electron microscopy. These studies indicate that endothelial cell function is affected by changes in gravity.

Melhado, Caroline↗

NASA NTRS1997

Computer Supported Indexing: A History and Evaluation of NASA's MAI System

Computer supported indexing systems may be categorized in several ways. One classification scheme refers to them as statistical, syntactic, semantic or knowledge-based. While a system may emphasize one of these aspects, most systems actually combine two or more of these mechanisms to maximize system efficiency. Statistical systems can be based on counts of words or word stems, statistical association, and correlation techniques that assign weights to word locations or provide lexical disambiguation, calculations regarding the likelihood of word co-occurrences, clustering of word stems and transformations, or any other computational method used to identify pertinent terms. If words are counted, the ones of median frequency become candidate index terms. Syntactical systems stress grammar and identify parts of speech. Concepts found in designated grammatical combinations, such as noun phrases, generate the suggested terms. Semantic systems are concerned with the context sensitivity of words in text. The primary goal of this type of indexing is to identify without regard to syntax the subject matter and the context-bearing words in the text being indexed. Knowledge-based systems provide a conceptual network that goes past thesaurus or equivalent relationships to knowing (e.g., in the National Library of Medicine (NLM) system) that because the tibia is part of the leg, a document relating to injuries to the tibia should he indexed to LEG INJURIES, not the broader MeSH term INJURIES, or knowing that the term FEMALE should automatically be added when the term PREGNANCY is assigned, and also that the indexer should be prompted to add either HUMAN or ANIMAL. Another way of categorizing indexing systems is to identify them as producing either assigned- or derived-term indexes.

Silvester, June P.↗