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At least 199 records · Page 11

Economic evaluation of the Hepatitis C virus elimination program in the country of Georgia, 2015 to 2017

Abstract Background and Aims In 2015, the country of Georgia launched an elimination program aiming to reduce the prevalence of Hepatitis C virus (HCV) infection by 90% from 5.4% prevalence (~150 000 people). During the first 2.5 years of the program, 770 832 people were screened, 48 575 were diagnosed with active HCV infection, and 41 483 patients were treated with direct‐acting antiviral (DAA)‐based regimens, with a >95% cure rate. Methods We modelled the incremental cost‐effectiveness ratio (ICER) of HCV screening, diagnosis and treatment between April 2015 and November 2017 compared to no treatment, in terms of cost per quality‐adjusted life year (QALY) gained in 2017 US dollars, with a 3% discount rate over 25 years. We compared the ICER to willingness‐to‐pay (WTP) thresholds of US$4357 (GDP) and US$871 (opportunity cost) per QALY gained. Results The average cost of screening, HCV viremia testing, and treatment per patient treated was $386 to the provider, $225 to the patient and $1042 for generic DAAs. At 3% discount, 0.57 QALYs were gained per patient treated. The ICER from the perspective of the provider including generic DAAs was $2285 per QALY gained, which is cost‐effective at the $4357 WTP threshold, while if patient costs are included, it is just above the threshold at $4398/QALY. All other scenarios examined in sensitivity analyses remain cost‐effective except for assuming a shorter time horizon to the end of 2025 or including the list price DAA cost. Reducing or excluding DAA costs reduced the ICER below the opportunity‐cost WTP threshold. Conclusions The Georgian HCV elimination program provides valuable evidence that national programs for scaling up HCV screening and treatment for achieving HCV elimination can be cost‐effective.

Tskhomelidze, Irina↗

Systems identification and application systems development for monitoring the physiological and health status of crewmen in space

The use of automated, analytical techniques to aid medical support teams is suggested. Recommendations are presented for characterizing crew health in terms of: (1) wholebody function including physiological, psychological and performance factors; (2) a combination of critical performance indexes which consist of multiple factors of measurable parameters; (3) specific responses to low noise level stress tests; and (4) probabilities of future performance based on present and periodic examination of past performance. A concept is proposed for a computerized real time biomedical monitoring and health care system that would have the capability to integrate monitored data, detect off-nominal conditions based on current knowledge of spaceflight responses, predict future health status, and assist in diagnosis and alternative therapies. Mathematical models could play an important role in this approach, especially when operating in a real time mode. Recommendations are presented to update the present health monitoring systems in terms of recent advances in computer technology and biomedical monitoring systems.

Leonard, J. I.↗

Case-based approach to handling aircraft malfunctions

Reasoning about physical systems in operation is a difficult task, and any attempt to automate the process must overcome the problems of modeling normal behavior, diagnosing faults, and predicting future behavior. This paper describes a prototypical case-based reasoner (CBR) that operates in the domain of in-flight fault diagnosis and prognosis of aviation subsystems, particularly jet engines. The reasoner operates on the observation that the ability of a CBR program to reason about physical systems can be significantly enhanced by the addition to the CBR program of a model of the physical system to describe the system's structural, functional, and causal behavior.

Karamouzis, Stamos T.↗

Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics

BACKGROUND: Despite much recent interest in quantification of heart rate variability (HRV), the prognostic value of conventional measures of HRV and of newer indices based on nonlinear dynamics is not universally accepted. METHODS AND RESULTS: We have designed algorithms for analyzing ambulatory ECG recordings and measuring HRV without human intervention, using robust methods for obtaining time-domain measures (mean and SD of heart rate), frequency-domain measures (power in the bands of 0.001 to 0.01 Hz [VLF], 0.01 to 0.15 Hz [LF], and 0.15 to 0.5 Hz [HF] and total spectral power [TP] over all three of these bands), and measures based on nonlinear dynamics (approximate entropy [ApEn], a measure of complexity, and detrended fluctuation analysis [DFA], a measure of long-term correlations). The study population consisted of chronic congestive heart failure (CHF) case patients and sex- and age-matched control subjects in the Framingham Heart Study. After exclusion of technically inadequate studies and those with atrial fibrillation, we used these algorithms to study HRV in 2-hour ambulatory ECG recordings of 69 participants (mean age, 71.7+/-8.1 years). By use of separate Cox proportional-hazards models, the conventional measures SD (P<.01), LF (P<.01), VLF (P<.05), and TP (P<.01) and the nonlinear measure DFA (P<.05) were predictors of survival over a mean follow-up period of 1.9 years; other measures, including ApEn (P>.3), were not. In multivariable models, DFA was of borderline predictive significance (P=.06) after adjustment for the diagnosis of CHF and SD. CONCLUSIONS: These results demonstrate that HRV analysis of ambulatory ECG recordings based on fully automated methods can have prognostic value in a population-based study and that nonlinear HRV indices may contribute prognostic value to complement traditional HRV measures.

Non-NASA Center↗

Data coverage assessment on neural network based digital twins for autonomous control system

We report in a recently developed Nearly Autonomous Management and Control (NAMAC) system, neural networks (NNs) are used to develop digital twins for diagnosis (DT-Ds). However, NNs are not usually considered extrapolation models and may result in large errors if they are applied to unseen data outside the training data (uncovered). In this study, we propose a data coverage assessment (DCA) to determine if the NN-based DT-Ds are extrapolated based on their epistemic uncertainty. The uncertainty quantification algorithms and uncertainty thresholds are selected based on the confusion matrix of classifying evaluation data into covered or uncovered data. To demonstrate the adaptability of the proposed framework, we applied it to a basic feedforward neural network and a more advanced recurrent neural network based on a more nonlinear database. Case studies show that the proposed framework can distinguish unseen data for both basic and advanced applications with proper uncertainty quantification algorithms and thresholds.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Effects of Substance Use and Antisocial Personality on Neuroimaging-Based Machine Learning Prediction of Schizophrenia

Abstract Background and hypothesis Neuroimaging-based machine learning (ML) algorithms have the potential to aid the clinical diagnosis of schizophrenia. However, literature on the effect of prevalent comorbidities such as substance use disorder (SUD) and antisocial personality (ASPD) on these models’ performance has remained unexplored. We investigated whether the presence of SUD or ASPD affects the performance of neuroimaging-based ML models trained to discern patients with schizophrenia (SCH) from controls. Study design We trained an ML model on structural MRI data from public datasets to distinguish between SCH and controls (SCH = 347, controls = 341). We then investigated the model’s performance in two independent samples of individuals undergoing forensic psychiatric examination: sample 1 was used for sensitivity analysis to discern ASPD (N = 52) from SCH (N = 66), and sample 2 was used for specificity analysis to discern ASPD (N = 26) from controls (N = 25). Both samples included individuals with SUD. Study results In sample 1, 94.4% of SCH with comorbid ASPD and SUD were classified as SCH, followed by patients with SCH + SUD (78.8% classified as SCH) and patients with SCH (60.0% classified as SCH). The model failed to discern SCH without comorbidities from ASPD + SUD (AUC = 0.562, 95%CI = 0.400–0.723). In sample 2, the model’s specificity to predict controls was 84.0%. In both samples, about half of the ASPD + SUD were misclassified as SCH. Data-driven functional characterization revealed associations between the classification as SCH and cognition-related brain regions. Conclusion Altogether, ASPD and SUD appear to have effects on ML prediction performance, which potentially results from converging cognition-related brain abnormalities between SCH, ASPD, and SUD.

99 GENERAL AND MISCELLANEOUS↗

NO(x) Concentrations in the Upper Troposphere as a Result of Lightning

Upper tropospheric NO(x) controls, in part, the distribution of ozone in this greenhouse-sensitive region of the atmosphere. Many factors control NO(x) in this region. As a result it is difficult to assess uncertainties in anthropogenic perturbations to NO from aircraft, for example, without understanding the role of the other major NO(x) sources in the upper troposphere. These include in situ sources (lightning, aircraft), convection from the surface (biomass burning, fossil fuels, soils), stratospheric intrusions, and photochemical recycling from HNO3. This work examines the separate contribution to upper tropospheric "primary" NO(x) from each source category and uses two different chemical transport models (CTMS) to represent a range of possible atmospheric transport. Because aircraft emissions are tied to particular pressure altitudes, it is important to understand whether those emissions are placed in the model stratosphere or troposphere and to assess whether the models can adequately differentiate stratospheric air from tropospheric air. We examine these issues by defining a point-by-point "tracer tropopause" in order to differentiate stratosphere from troposphere in terms of NO(x) perturbations. Both models predict similar zonal average peak enhancements of primary NO(x) due to aircraft (approx. = 10-20 parts per trillion by volume (pptv) in both January and July); however, the placement of this peak is primarily in a region of large stratospheric influence in one model and centered near the level evaluated as the tracer tropopause in the second. Below the tracer tropopause, both models show negligible NO(x) derived directly from the stratospheric source. Also, they predict a typically low background of 1 - 20 pptv NO(x) when tropospheric HNO3 is constrained to be 100 pptv of HNO3. The two models calculate large differences in the total background NO(x) (defined as the source of NO(x) from lightning + stratosphere + surface + HNO3) when using identical loss frequencies for NO(x). This difference is primarily due to differing treatments of vertical transport. An improved diagnosis of this transport that is relevant to NO(x) requires either measurements of a surface-based tracer with a substantially shorter lifetime than Rn-222 or diagnosis and mapping of tracer correlations with different source signatures. Because of differences in transport by the two models we cannot constrain the source of NO(x) from lightning through comparison of average model concentrations with observations of NO(x).

Penner, Joyce E.↗

Probabilistic Prognosis of Non-Planar Fatigue Crack Growth

Quantifying the uncertainty in model parameters for the purpose of damage prognosis can be accomplished utilizing Bayesian inference and damage diagnosis data from sources such as non-destructive evaluation or structural health monitoring. The number of samples required to solve the Bayesian inverse problem through common sampling techniques (e.g., Markov chain Monte Carlo) renders high-fidelity finite element-based damage growth models unusable due to prohibitive computation times. However, these types of models are often the only option when attempting to model complex damage growth in real-world structures. Here, a recently developed high-fidelity crack growth model is used which, when compared to finite element-based modeling, has demonstrated reductions in computation times of three orders of magnitude through the use of surrogate models and machine learning. The model is flexible in that only the expensive computation of the crack driving forces is replaced by the surrogate models, leaving the remaining parameters accessible for uncertainty quantification. A probabilistic prognosis framework incorporating this model is developed and demonstrated for non-planar crack growth in a modified, edge-notched, aluminum tensile specimen. Predictions of remaining useful life are made over time for five updates of the damage diagnosis data, and prognostic metrics are utilized to evaluate the performance of the prognostic framework. Challenges specific to the probabilistic prognosis of non-planar fatigue crack growth are highlighted and discussed in the context of the experimental results.

Leser, Patrick E.↗

Development of a Discrepancy Checker for the Digital Twin in a Supervisory Control System for a Thermal Energy Delivery System

Defined as a virtual representation of a physical object, process, or service, and used to support real-world decision-making, a digital twin (DT) can be utilized to combine classical and novel frameworks in sensors, state predictions, and multi-input/multi-output systems, and to enable optimal autonomous operations. However, a DT’s usefulness largely depends on its ability to adequately mirror the state of its physical counterpart, and this adequacy should be reflected by the level of uncertainty in the underlying simulation models when estimating and predicting quantities of interest (QOIs). Moreover, simulation models in a DT may involve multiple fidelities of representations—ranging from physics-based models to data-driven ones—but classical uncertainty quantification (UQ) methods struggle to handle numerous uncertainty sources, nor are they designed for real-time applications. This work presents a UQ-based discrepancy checking and diagnosis tool for a DT-based supervisory control system applied to a thermal energy delivery system (TEDS) at Idaho National Laboratory. The discrepancy checker was developed using metadata from an automated DT development process, and these metadata included different combinations of physical model forms and model parameters, training data and hyperparameters for surrogate models, and design parameters for supervisory control systems. Next, correlations between the uncertainty results and the metadata were established and then applied to the DT operations. The discrepancy checker evaluates the discrepancies between model predictions from virtual and sensor measurements and backtraces them to the corresponding major sources of uncertainty. The discrepancy checker showed reasonable performance in detecting discrepancies and diagnosing sources of uncertainty in testing scenarios.

22 - GENERAL STUDIES OF NUCLEAR REACTORS↗

Discovering a reaction–diffusion model for Alzheimer’s disease by combining PINNs with symbolic regression

Misfolded tau proteins play a critical role in the progression and pathology of Alzheimer's disease. Recent studies suggest that the spatio-temporal pattern of misfolded tau follows a reaction-diffusion type equation. However, the precise mathematical model and parameters that characterize the progression of misfolded protein across the brain remain incompletely understood. Here, we use deep learning and artificial intelligence to discover a mathematical model for the progression of Alzheimer's disease using longitudinal tau positron emission tomography from the Alzheimer's Disease Neuroimaging Initiative database. Specifically, we integrate physics informed neural networks (PINNs) and symbolic regression to discover a reaction-diffusion type partial differential equation for tau protein misfolding and spreading. First, we demonstrate the potential of our model and parameter discovery on synthetic data. Then, we apply our method to discover the best model and parameters to explain tau imaging data from 46 individuals who are likely to develop Alzheimer's disease and 30 healthy controls. Our symbolic regression discovers different misfolding models f(c) for two groups, with a faster misfolding for the Alzheimer's group, f(c) = 0.23c 3 – 1.34c 2 + 1.11c, than for the healthy control group, f(c) = –c 3 + 0.62c 2 + 0.39c. Our results suggest that PINNs, supplemented by symbolic regression, can discover a reaction-diffusion type model to explain misfolded tau protein concentrations in Alzheimer's disease. Furthermore, we expect our study to be the starting point for a more holistic analysis to provide image-based technologies for early diagnosis, and ideally early treatment of neurodegeneration in Alzheimer's disease and possibly other misfolding-protein based neurodegenerative disorders.

60 APPLIED LIFE SCIENCES↗

Experimental analysis of computer system dependability

This paper reviews an area which has evolved over the past 15 years: experimental analysis of computer system dependability. Methodologies and advances are discussed for three basic approaches used in the area: simulated fault injection, physical fault injection, and measurement-based analysis. The three approaches are suited, respectively, to dependability evaluation in the three phases of a system's life: design phase, prototype phase, and operational phase. Before the discussion of these phases, several statistical techniques used in the area are introduced. For each phase, a classification of research methods or study topics is outlined, followed by discussion of these methods or topics as well as representative studies. The statistical techniques introduced include the estimation of parameters and confidence intervals, probability distribution characterization, and several multivariate analysis methods. Importance sampling, a statistical technique used to accelerate Monte Carlo simulation, is also introduced. The discussion of simulated fault injection covers electrical-level, logic-level, and function-level fault injection methods as well as representative simulation environments such as FOCUS and DEPEND. The discussion of physical fault injection covers hardware, software, and radiation fault injection methods as well as several software and hybrid tools including FIAT, FERARI, HYBRID, and FINE. The discussion of measurement-based analysis covers measurement and data processing techniques, basic error characterization, dependency analysis, Markov reward modeling, software-dependability, and fault diagnosis. The discussion involves several important issues studies in the area, including fault models, fast simulation techniques, workload/failure dependency, correlated failures, and software fault tolerance.

Iyer, Ravishankar, K.↗

Software Testbed for Developing and Evaluating Integrated Autonomous Subsystems

To implement fault tolerant autonomy in future space systems, it will be necessary to integrate planning, adaptive control, and state estimation subsystems. However, integrating these subsystems is difficult, time-consuming, and error-prone. This paper describes Intelliface/ADAPT, a software testbed that helps researchers develop and test alternative strategies for integrating planning, execution, and diagnosis subsystems more quickly and easily. The testbed's architecture, graphical data displays, and implementations of the integrated subsystems support easy plug and play of alternate components to support research and development in fault-tolerant control of autonomous vehicles and operations support systems. Intelliface/ADAPT controls NASA's Advanced Diagnostics and Prognostics Testbed (ADAPT), which comprises batteries, electrical loads (fans, pumps, and lights), relays, circuit breakers, invertors, and sensors. During plan execution, an experimentor can inject faults into the ADAPT testbed by tripping circuit breakers, changing fan speed settings, and closing valves to restrict fluid flow. The diagnostic subsystem, based on NASA's Hybrid Diagnosis Engine (HyDE), detects and isolates these faults to determine the new state of the plant, ADAPT. Intelliface/ADAPT then updates its model of the ADAPT system's resources and determines whether the current plan can be executed using the reduced resources. If not, the planning subsystem generates a new plan that reschedules tasks, reconfigures ADAPT, and reassigns the use of ADAPT resources as needed to work around the fault. The resource model, planning domain model, and planning goals are expressed using NASA's Action Notation Modeling Language (ANML). Parts of the ANML model are generated automatically, and other parts are constructed by hand using the Planning Model Integrated Development Environment, a visual Eclipse-based IDE that accelerates ANML model development. Because native ANML planners are currently under development and not yet sufficiently capable, the ANML model is translated into the New Domain Definition Language (NDDL) and sent to NASA's EUROPA planning system for plan generation. The adaptive controller executes the new plan, using augmented, hierarchical finite state machines to select and sequence actions based on the state of the ADAPT system. Real-time sensor data, commands, and plans are displayed in information-dense arrays of timelines and graphs that zoom and scroll in unison. A dynamic schematic display uses color to show the real-time fault state and utilization of the system components and resources. An execution manager coordinates the activities of the other subsystems. The subsystems are integrated using the Internet Communications Engine (ICE). an object-oriented toolkit for building distributed applications.

Testbed↗

Assessing Global and Local Radiative Feedbacks Based on AGCM Simulations for 1980–2014/2017

In order to avoid contamination of unobservable and uncertain effective radiative forcing (ERF) on the diagnosis of radiative feedbacks based on short-term climate variability, we verify the Kernel-Gregory feedback calculation method using atmospheric model experiments with prescribed ERF. We show that both clear-sky radiative fluxes and all-sky radiative feedbacks have a closure between model simulations and kernel derivations. A near-zero global mean net cloud feedback is found in the simulation with prescribed ERF, which results in a more negative global net climate feedback, -2 W m -2 K -1 . Consistent with AMIP6 ensemble mean results, the lapse rate feedback is the largest contributor among all feedbacks to temperature amplification over the three poles (Arctic, Antarctic and Tibetan Plateau), followed by surface albedo feedback and Planck feedback deviation from its global mean. Except for the higher surface albedo feedback in the Antarctic, other feedbacks are almost same between the Arctic and Antarctic.

54 ENVIRONMENTAL SCIENCES↗

An Integrated Architecture for On-Board Aircraft Engine Performance Trend Monitoring and Gas Path Fault Diagnostics

Aircraft engine performance trend monitoring and gas path fault diagnostics are closely related technologies that assist operators in managing the health of their gas turbine engine assets. Trend monitoring is the process of monitoring the gradual performance change that an aircraft engine will naturally incur over time due to turbomachinery deterioration, while gas path diagnostics is the process of detecting and isolating the occurrence of any faults impacting engine flow-path performance. Today, performance trend monitoring and gas path fault diagnostic functions are performed by a combination of on-board and off-board strategies. On-board engine control computers contain logic that monitors for anomalous engine operation in real-time. Off-board ground stations are used to conduct fleet-wide engine trend monitoring and fault diagnostics based on data collected from each engine each flight. Continuing advances in avionics are enabling the migration of portions of the ground-based functionality on-board, giving rise to more sophisticated on-board engine health management capabilities. This paper reviews the conventional engine performance trend monitoring and gas path fault diagnostic architecture commonly applied today, and presents a proposed enhanced on-board architecture for future applications. The enhanced architecture gains real-time access to an expanded quantity of engine parameters, and provides advanced on-board model-based estimation capabilities. The benefits of the enhanced architecture include the real-time continuous monitoring of engine health, the early diagnosis of fault conditions, and the estimation of unmeasured engine performance parameters. A future vision to advance the enhanced architecture is also presented and discussed

Simon, Donald L.↗

Sensor-based fault diagnosis in a flight expert system

A prototype of a knowledge-based flight expert system (FLES) has been developed to assist airplane pilots in monitoring, analyzing, and diagnosing faults and to provide support in reducing the pilot's own mistakes. A sensor simulation model has been developed to provide FLES with the airplane status information during the diagnostic process. The simulator is based partly on the Advanced Concept System (ACS), a future-generation airplane, and partly on the Boeing 737, an existing airplane. The architecture of FLES contains several subsystems. One of the major subsystems performs fault diagnosis in the electrical system of the ACS. This paper describes the mechanism and functionality of the automatic diagnosis performed in this expert system.

Ali, M.↗

Design for testability and diagnosis at the system-level

The growing complexity of full-scale systems has surpassed the capabilities of most simulation software to provide detailed models or gate-level failure analyses. The process of system-level diagnosis approaches the fault-isolation problem in a manner that differs significantly from the traditional and exhaustive failure mode search. System-level diagnosis is based on a functional representation of the system. For example, one can exercise one portion of a radar algorithm (the Fast Fourier Transform (FFT) function) by injecting several standard input patterns and comparing the results to standardized output results. An anomalous output would point to one of several items (including the FFT circuit) without specifying the gate or failure mode. For system-level repair, identifying an anomalous chip is sufficient. We describe here an information theoretic and dependency modeling approach that discards much of the detailed physical knowledge about the system and analyzes its information flow and functional interrelationships. The approach relies on group and flow associations and, as such, is hierarchical. Its hierarchical nature allows the approach to be applicable to any level of complexity and to any repair level. This approach has been incorporated in a product called STAMP (System Testability and Maintenance Program) which was developed and refined through more than 10 years of field-level applications to complex system diagnosis. The results have been outstanding, even spectacular in some cases. In this paper we describe system-level testability, system-level diagnoses, and the STAMP analysis approach, as well as a few STAMP applications.

Simpson, William R.↗

IoT-Based Comfort Control and Fault Diagnostics System for Energy-Efficient Homes

This project studies an Internet of Things (IoT)-based comfort control and fault diagnostics system (referred as iComfort in this report) for energy-efficient homes. The system delivers an occupant-comfort-oriented thermal environment adaptive to fault scenarios and achieves HVAC energy savings in a cost-effective and straightforward way. This smart iComfort home system consists of the following key features. 1) Cost-effectiveness and scalability of the entire hardware and software system: The system includes low-cost temperature, humidity, and airflow sensors, and a Raspberry Pi-based local hub that interfaces with the cloud and IoT-enabled devices. The cost is low, not only for sensors, but also the costs associated with sensor installation, system setup and commissioning, data communication and storage, and data analytics (e.g., the development of automated fault detection and diagnosis (AFDD), as well as adaptive control strategies that are both computationally efficient and practical to implement). 2) Energy performance and user satisfaction: The system delivers user satisfaction and energy savings. This includes a) ease of use, b) optimal occupant thermal comfort, and c) accurate system feedback (e.g., low false alarm of AFDD strategies). 3) Favorable demonstrated prototype performance: The prototype tested at the Pacific Northwest National Laboratory (PNNL) Lab Homes demonstrates the accuracy of fault detections and diagnoses and shows thermal comfort improvement and energy savings through adaptive and optimal HVAC operations.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Fifth Conference on Artificial Intelligence for Space Applications

The Fifth Conference on Artificial Intelligence for Space Applications brings together diverse technical and scientific work in order to help those who employ AI methods in space applications to identify common goals and to address issues of general interest in the AI community. Topics include the following: automation for Space Station; intelligent control, testing, and fault diagnosis; robotics and vision; planning and scheduling; simulation, modeling, and tutoring; development tools and automatic programming; knowledge representation and acquisition; and knowledge base/data base integration.

Odell, Steve L.↗