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DOE OSTI2022

Cutaneous and local radiation injuries

The threat of a large-scale radiological or nuclear (R/N) incident looms in the present-day climate, as noted most recently in an editorial in Scientific American (March 2021). These large-scale incidents are infrequent but affect large numbers of people. Smaller-scale R/N incidents occur more often, affecting smaller numbers of people. There is more awareness of acute radiation syndrome (ARS) in the medical community; however, ionising radiation-induced injuries to the skin are much less understood. Here, this article will provide an overview of radiation-induced injuries to the skin, deeper tissues, and organs. The history and nomenclature; types and causes of injuries; pathophysiology; evaluation and diagnosis; current medical management; and current research of the evaluation and management are presented. Cutaneous radiation injuries (CRI) or local radiation injuries (LRI) may lead to cutaneous radiation syndrome, a sub-syndrome of ARS. These injuries may occur from exposure to radioactive particles suspended in the environment (air, soil, water) after a nuclear detonation or an improvised nuclear detonation (IND), a nuclear power plant incident, or an encounter with a radioactive dispersal or exposure device. These incidents may also result in a radiation-combined injury; a chemical, thermal, or traumatic injury, with radiation exposure. Skin injuries from medical diagnostic and therapeutic imaging, medical misadministration of nuclear medicine or radiotherapy, occupational exposures (including research) to radioactive sources are more common but are not the focus of this manuscript. Diagnosis and evaluation of injuries are based on the scenario, clinical picture, and dosimetry, and may be assisted through advanced imaging techniques. Research-based multidisciplinary therapies, both in the laboratory and clinical trial environments, hold promise for future medical management. Great progress is being made in recognising the extent of injuries, understanding their pathophysiology, as well as diagnosis and management; however, research gaps still exist.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2022

Hip Abductor Strength Asymmetry: Relationship to Upper Extremity Injury in Professional Baseball Players

Background: Hip strength is an important factor for control of the lumbo-pelvic-hip complex. Deficits in hip strength may affect throwing performance and contribute to upper extremity injuries. Hypothesis: Deficits in hip abduction isometric strength would be greater in those who sustained an upper extremity injury and hip strength would predict injury incidence. Study Design: Prospective cohort study. Level of Evidence: Level 3. Methods: Minor League baseball players (n = 188, age = 21.5 ± 2.2 years; n = 98 pitchers; n = 90 position players) volunteered. Hip abduction isometric strength was assessed bilaterally with a handheld dynamometer in side-lying position, expressed as torque using leg length (N·m). Hip abduction strength asymmetry was represented by [(trail leg/lead leg) × 100]. Overuse or nontraumatic throwing arm injuries were prospectively tracked. Poisson regression models were used to estimate relative risk ratios associated with hip asymmetry; confounders, including history of prior overuse injury in the past year, were included. Results: Hip abduction asymmetry ranged from 0.05% to 57.5%. During the first 2 months of the season, 18 players (n = 12 pitchers) sustained an upper extremity injury. In pitchers, for every 5% increase in hip abduction asymmetry, there was a 1.24 increased risk of sustaining a shoulder or elbow injury. No relationship between hip abduction strength and injury was observed for position players. Conclusion: Hip abduction asymmetry in pitchers was related to subsequent upper extremity injuries. The observed risk ratio indicates that hip abduction asymmetry may contribute a significant but small increased risk of injury. Clinical Relevance: Hip abduction muscle deficits may affect pitching mechanics and increase arm stress. Addressing hip asymmetry deficits that exceed 5% may be beneficial in reducing upper extremity injury rates in pitchers.

Sport Sciences↗

NASA NTRSDate not supplied

Credibility Assessment and Evaluation of the Astronaut Musculoskeletal Boot/Ankle Injury Scenario Using Open SIM(TM) Computational Modeling

The musculoskeletal system of astronauts is subject to physiological changes, potentially leading to injuries due to the exposure to different gravitational environments experienced during spaceflight. These injuries can occur while an astronaut is performing an extravehicular activity (EVA) in space, on lunar or planetary surfaces or while wearing a spacesuit during terrestrial training for an EVA. One area of concern are injuries occurring at the feet and ankles due to a poor fit of the spacesuit boot. These injuries can occur if the boot does not support the ankle sufficiently and the astronaut steps awkwardly, twisting the ankle or foot, during an EVA. The OpenSimTM software can assess EVA induced musculoskeletal injuries for muscle strains, ligament injuries and joint injuries. A modeling and simulation credibility assessment of the OpenSim musculoskeletal modeling and simulation procedures, applied to the boot/ankle injury scenario injury mechanisms that may occur while carrying out tasks in these environments, is performed. These modeling and simulation credibility assessments give information on the credibility of the model’s use in simulating foot/ankle related injury mechanisms.

C A Gallo↗

NASA NTRS2025

Modeling and Simulation Credibility Assessments of Musculoskeletal Computational Models for Simulating Astronaut Injuries Due to a Poor Spacesuit Fit

The musculoskeletal (MS) system of astronauts is subject to physiological changes, potentially leading to injuries due to the exposure to different gravitational environments experienced during spaceflight. These injuries can occur while an astronaut is performing an Extravehicular Activity (EVA) in space, on lunar or planetary surfaces or while wearing a spacesuit during terrestrial training for an EVA. The OpenSim MS modeling software can assess EVA induced MS injury mechanisms such as muscle strains, ligament injuries and joint injuries. One area of concern, since there are only a few different spacesuit sizes with limited adjustability, is the possibility of a poorly fitting spacesuit. This can cause unnatural joint motions and torques resulting in various MS injuries. A credibility assessment of the OpenSim modeling and simulation procedures is performed per NASA-STD-7009A to provide information on the credibility of the model’s use in simulating EVA related injury mechanisms. The credibility assessment evaluated various OpenSim models against the following eight credibility factors: data pedigree, input pedigree, code verification, solution verification, conceptual validation, referent validation, results uncertainty and results robustness (sensitivity). The models evaluated for EVA injuries will require additional credibility factor analysis and upgrades to the model features, such as adding ligaments to a whole-body model, to reliably predict and analyze the EVA injuries expected to occur due to a poor spacesuit fit. The degree of elevation strategy required to increase the credibility assessment scores will depend on the model complexity and the injury mechanism.

Christopher A. Gallo↗

NASA NTRS2024

Modeling and Simulation Credibility Assessments of Musculoskeletal Computational Models for Simulating Astronaut Injuries Due to a Poor Spacesuit Fit

Christopher A Gallo↗

DOE OSTI2021

Activation of the CaR-CSE/H2S pathway confers cardioprotection against ischemia-reperfusion injury

Ischemia-reperfusion (I/R) injury is a multifactorial process triggered when an organ is subjected to transiently reduced blood supply. The result is a cascade of pathological complications and organ damage due to the production of reactive oxygen species following reperfusion. The present study aims to evaluate the role of activated calcium-sensing receptor (CaR)-cystathionine γ-lyase (CSE)/hydrogen sulfide (H2S) pathway in I/R injury. Firstly, an I/R rat model with CSE knockout was constructed. Transthoracic echocardiography, TTC and HE staining were performed to determine the cardiac function of rats following I/R Injury, followed by TUNEL staining observation on apoptosis. Besides, with the attempt to better elucidate how CaR-CSE/H2S affects I/R, in-vitro culture of human coronary artery endothelial cells (HCAECs) was conducted with gadolinium chloride (GdCl3, a CaR agonist), H{sub 2}O{sub 2}, siRNA against CSE (siCSE), or W7 (a CaM inhibitor). The interaction between CSE and CaM was subsequently detected. Plasma oxidative stress indexes, H2S and CSE, and apoptosis-related proteins were all analyzed following cell apoptosis. We found that H2S elevation led to the improvement whereas CSE knockdown decreased cardiac function in rats with I/R injury. Moreover, oxidative stress injury in I/R rats with CSE knockout was aggravated, while the increased expression of H2S and CSE in the aortic tissues resulted in alleviated the oxidative stress injury. Moreover, increased H2S and CSE levels were found to inhibit cell apoptotic ability in the aortic tissues after I/R injury, thus attenuating oxidative stress injury, accompanied by inhibited expression of apoptosis-related proteins. In HCAECs following oxidative stress treatment, siCSE and CaM inhibitor were observed to reverse the protection of CaR agonist. Coimmunoprecipitation assay revealed the interaction between CSE and CaM. Taken together, all above-mentioned data provides evidence that activation of the CaR-CSE/H2S pathway may confer a potent protective effect in cardiac I/R injury.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Infant burn injuries related to water heating for powdered infant formula preparation

Guidance for preparing powdered infant formula (PIF) helps to ensure it meets the nutritional needs of infants and is safe to consume. Among safety concerns is Cronobacter sakazakii contamination which can lead to serious infections and death. PIF preparation guidance varies; there is a lack of consensus on whether there is a need to boil water to inactivate potential Cronobacter and for how long to let the water cool before reconstitution. We sought to quantify the burden of burn injuries among infants related to water heating for PIF preparation. Estimating this burden may help inform preparation recommendations. Burn injuries among infants <18 months of age were identified from 2017 to 2019 National Electronic Injury Surveillance System data collected from sampled hospital emergency departments. Injuries were classified as related to PIF water heating, potentially related to PIF water heating but with undetermined causation, related to other infant feeding aspects, or unrelated to infant formula or breast milk feeding. Unweighted case counts for each injury classification were determined. Across sampled emergency departments, 7 PIF water heating injuries were seen among the 44,395 injuries reported for infants <18 months. No reported PIF water heating injuries were fatal, but 3 required hospitalization. Another 238 injuries potentially related to PIF water heating but with undetermined causation were also seen. Preparation guidance should consider both the potential risk for Cronobacter infection and the potential risk for burns.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2022

The impact of bilateral injuries on the pathophysiology and functional outcomes of volumetric muscle loss

Volumetric muscle loss (VML)—defined as the irrecoverable loss of skeletal muscle tissue with associated persistent functional deficits—is among the most common and highly debilitating combat-related extremity injuries. This is particularly true in cases of severe polytrauma wherein multiple extremities may be involved as a result of high energy wounding mechanisms. As such, significant investment and effort has been made toward developing a clinically viable intervention capable of restoring the form and function of the affected musculature. While these investigations conducted to date have varied with respect to the species, breed, and sex of the chosen pre-clinical in-vivo model system, the majority of these studies have been performed in unilateral injury models, an aspect which may not fully exemplify the clinical representation of the multiply injured patient. Furthermore, while various components of the basal pathophysiology of VML (e.g., fibrosis and inflammation) have been investigated, relatively little effort has focused on how the pathophysiology and efficacy of pro-regenerative technologies is altered when there are multiple VML injuries. Thus, the purpose of this study was two-fold: (1) to investigate if/how the pathophysiology of unilateral VML injuries differs from bilateral VML injuries and (2) to interrogate the effect of bilateral VML injuries on the efficacy of a well-characterized regenerative therapy, minced muscle autograft (MMG). In contrast to our hypothesis, we show that bilateral VML injuries exhibit a similar systemic inflammatory response and improved muscle functional recovery, compared to unilateral injured animals. Furthermore, MMG treatment was found to only be effective at promoting an increase in functional outcomes in unilateral VML injuries. The findings presented herein add to the growing knowledge base of the pathophysiology of VML, and, importantly, reiterate the importance of comprehensively characterizing preclinical models which are utilized for early-stage screening of putative therapies as they can directly influence the translational research pipeline.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Cdk5 mediates rotational force-induced brain injury

Abstract Millions of traumatic brain injuries (TBIs) occur annually. TBIs commonly result from falls, traffic accidents, and sports-related injuries, all of which involve rotational acceleration/deceleration of the brain. During these injuries, the brain endures a multitude of primary insults including compression of brain tissue, damaged vasculature, and diffuse axonal injury. All of these deleterious effects can contribute to secondary brain ischemia, cellular death, and neuroinflammation that progress for weeks, months, and lifetime after injury. While the linear effects of head trauma have been extensively modeled, less is known about how rotational injuries mediate neuronal damage following injury. Here, we developed a new model of repetitive rotational head trauma in rodents and demonstrated acute and prolonged pathological, behavioral, and electrophysiological effects of rotational TBI (rTBI). We identify aberrant Cyclin-dependent kinase 5 (Cdk5) activity as a principal mediator of rTBI. We utilized Cdk5-enriched phosphoproteomics to uncover potential downstream mediators of rTBI and show pharmacological inhibition of Cdk5 reduces the cognitive and pathological consequences of injury. These studies contribute meaningfully to our understanding of the mechanisms of rTBI and how they may be effectively treated.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Predicting Postoperative Injury and Military Discharge Status After Knee Surgery in the US Army

Background: Researchers have assessed postoperative injury or disability predictors in the military setting but typically focused on 1 type of surgical procedure at a time, used relatively small sample sizes, or investigated mixed cohorts with civilian populations. Purpose: To identify the relationship between baseline variables and injury incidence or military discharge status in US Army soldiers after knee surgery. Study Design: Case-control study; Level of evidence, 3. Methods: Data were obtained from a repository containing personnel, performance, and medical records for all active-duty US Army soldiers. Multivariate logistic regressions were used to estimate the effects of numerous variables on postoperative injury or on medical discharge. Variable selection and model validation were conducted using the k-fold method. Results: A total of 7567 soldiers underwent knee surgery between 2017 and 2019. Meniscal procedures were the most common type of surgery (39%), and approximately 71% of the cohort had a postoperative injury. Significant predictors for sustaining a postoperative injury included having a previous nonknee injury (odds ratio [OR], 1.5), female sex (OR, 1.3), and Black race (OR, 1.2). Within 4 years after surgery, 17% of soldiers were discharged from the military because of knee-related disability. Significant predictors for discharge from duty included enlisted rank (OR, 2.3), recent fitness test failure (OR, 1.9), number of previous knee surgeries (OR, 1.7), and having a previous nonknee injury (OR, 1.6). Conclusion: After knee surgery, nearly three-fourths of the soldiers in this cohort sustained a postoperative injury and almost one-fifth of soldiers were medically discharged from the military within 4 years. This study identified variables that indicate statistically increased risk for these postoperative outcomes and highlighted potentially modifiable factors.

Orthopedics↗

NASA NTRS2005

Extravehicular mobility unit training and astronaut injuries

BACKGROUND: Astronaut spacewalk training can result in a variety of symptom complaints and possible injuries. This study quantified and characterized signs, symptoms, and injuries resulting from extravehicular activity spacesuit training at NASA's Neutral Buoyancy Laboratory, Johnson Space Center, Houston, TX, immersion facility. METHODS: We identified the frequency and incidence of symptoms by location, mechanisms of injury, and effective countermeasures. Recommendations were made to improve injury prevention, astronaut training, test preparation, and training hardware. At the end of each test, a questionnaire was completed documenting signs and symptoms, mechanisms of injury, and countermeasures. RESULTS: Of the 770 tests, there were 190 in which suit symptoms were reported (24.6%). There were a total of 352 reported suit symptom comments. Of those symptoms, 166 were in the hands (47.16%), 73 were in the shoulders (20.7%), and 40 were in the feet (11.4%). Others ranged from 6.0% to 0.28%, respectively, from the legs, arms, neck, trunk, groin, and head. Causal mechanisms for the hands included moisture and hard glove contacts resulting in fingernail injuries; in the shoulders, hard contact with suit components and strain mechanisms; and in the feet, hard boot contact. The severity of symptoms was highest in the shoulders, hands, and feet. CONCLUSIONS: Most signs and symptoms were mild, self-limited, of brief duration, and were well controlled by available countermeasures. Some represented the potential for significant injury with consequences affecting astronaut health and performance. Correction of extravehicular activity training-related injuries requires a multidisciplinary approach to improve prevention, medical intervention, astronaut training, test planning, and suit engineering.

Non-programmatic↗

NASA NTRS2013

Estimated Probability of a Cervical Spine Injury During an ISS Mission

Introduction: The Integrated Medical Model (IMM) utilizes historical data, cohort data, and external simulations as input factors to provide estimates of crew health, resource utilization and mission outcomes. The Cervical Spine Injury Module (CSIM) is an external simulation designed to provide the IMM with parameter estimates for 1) a probability distribution function (PDF) of the incidence rate, 2) the mean incidence rate, and 3) the standard deviation associated with the mean resulting from injury/trauma of the neck. Methods: An injury mechanism based on an idealized low-velocity blunt impact to the superior posterior thorax of an ISS crewmember was used as the simulated mission environment. As a result of this impact, the cervical spine is inertially loaded from the mass of the head producing an extension-flexion motion deforming the soft tissues of the neck. A multibody biomechanical model was developed to estimate the kinematic and dynamic response of the head-neck system from a prescribed acceleration profile. Logistic regression was performed on a dataset containing AIS1 soft tissue neck injuries from rear-end automobile collisions with published Neck Injury Criterion values producing an injury transfer function (ITF). An injury event scenario (IES) was constructed such that crew 1 is moving through a primary or standard translation path transferring large volume equipment impacting stationary crew 2. The incidence rate for this IES was estimated from in-flight data and used to calculate the probability of occurrence. The uncertainty in the model input factors were estimated from representative datasets and expressed in terms of probability distributions. A Monte Carlo Method utilizing simple random sampling was employed to propagate both aleatory and epistemic uncertain factors. Scatterplots and partial correlation coefficients (PCC) were generated to determine input factor sensitivity. CSIM was developed in the SimMechanics/Simulink environment with a Monte Carlo wrapper (MATLAB) used to integrate the components of the module. Results: The probability of generating an AIS1 soft tissue neck injury from the extension/flexion motion induced by a low-velocity blunt impact to the superior posterior thorax was fitted with a lognormal PDF with mean 0.26409, standard deviation 0.11353, standard error of mean 0.00114, and 95% confidence interval [0.26186, 0.26631]. Combining the probability of an AIS1 injury with the probability of IES occurrence was fitted with a Johnson SI PDF with mean 0.02772, standard deviation 0.02012, standard error of mean 0.00020, and 95% confidence interval [0.02733, 0.02812]. The input factor sensitivity analysis in descending order was IES incidence rate, ITF regression coefficient 1, impactor initial velocity, ITF regression coefficient 2, and all others (equipment mass, crew 1 body mass, crew 2 body mass) insignificant. Verification and Validation (V&V): The IMM V&V, based upon NASA STD 7009, was implemented which included an assessment of the data sets used to build CSIM. The documentation maintained includes source code comments and a technical report. The software code and documentation is under Subversion configuration management. Kinematic validation was performed by comparing the biomechanical model output to established corridors.

Brooker, John E.↗

NASA NTRS2014

FY13 High Performance EVA Glove (HPEG) Collaboration: Glove Injury Data Mining Effort - Training Data Overview

From the time hand-intensive tasks were first created for EVAs, discomforts and injuries have been noted.. There have been numerous versions of EVA gloves for US crew over the past 50 years, yet pain and injuries persist. The investigation team was tasked with assisting in a glove injury assessment for the High Performance EVA Glove (HPEG) project.center dot To aid in this assessment, the team was asked to complete the following objectives: - First, to develop the best current understanding of what glove-related injuries have occurred to date, and when possible, identify the specific mechanisms that caused those injuries - Second, to create a standardized method for comparison of glove injury potential from one glove to another. center dot The overall goal of the gloved hand injury assessment is to utilize ergonomics in understanding how these glove injuries are occurring, and to propose mitigations to current designs or design changes in the next generation of EVA gloves.

Reid, Christopher↗

DOE OSTI2021

Localizing Clinical Patterns of Blast Traumatic Brain Injury Through Computational Modeling and Simulation

Blast traumatic brain injury is ubiquitous in modern military conflict with significant morbidity and mortality. Yet the mechanism by which blast overpressure waves cause specific intracranial injury in humans remains unclear. Reviewing of both the clinical experience of neurointensivists and neurosurgeons who treated service members exposed to blast have revealed a pattern of injury to cerebral blood vessels, manifested as subarachnoid hemorrhage, pseudoaneurysm, and early diffuse cerebral edema. Additionally, a seminal neuropathologic case series of victims of blast traumatic brain injury (TBI) showed unique astroglial scarring patterns at the following tissue interfaces: subpial glial plate, perivascular, periventricular, and cerebral gray-white interface. The uniting feature of both the clinical and neuropathologic findings in blast TBI is the co-location of injury to material interfaces, be it solid-fluid or solid-solid interface. This motivates the hypothesis that blast TBI is an injury at the intracranial mechanical interfaces. In order to investigate the intracranial interface dynamics, we performed a novel set of computational simulations using a model human head simplified but containing models of gyri, sulci, cerebrospinal fluid (CSF), ventricles, and vasculature with high spatial resolution of the mechanical interfaces. Simulations were performed within a hybrid Eulerian—Lagrangian simulation suite (CTH coupled via Zapotec to Sierra Mechanics). Because of the large computational meshes, simulations required high performance computing resources. Twenty simulations were performed across multiple exposure scenarios—overpressures of 150, 250, and 500 kPa with 1 ms overpressure durations—for multiple blast exposures (front blast, side blast, and wall blast) across large variations in material model parameters (brain shear properties, skull elastic moduli). All simulations predict fluid cavitation within CSF (where intracerebral vasculature reside) with cavitation occurring deep and diffusely into cerebral sulci. These cavitation events are adjacent to high interface strain rates at the subpial glial plate. Larger overpressure simulations (250 and 500kPa) demonstrated intraventricular cavitation—also associated with adjacent high periventricular strain rates. Additionally, models of embedded intraparenchymal vascular structures—with diameters as small as 0.6 mm—predicted intravascular cavitation with adjacent high perivascular strain rates. The co-location of local maxima of strain rates near several of the regions that appear to be preferentially damaged in blast TBI (vascular structures, subpial glial plate, perivascular regions, and periventricular regions) suggest that intracranial interface dynamics may be important in understanding how blast overpressures leads to intracranial injury.

59 BASIC BIOLOGICAL SCIENCES↗

NASA NTRS2004

Results from an Investigation into Extra-Vehicular Activity (EVA) Training Related Shoulder Injuries

The number and complexity of extravehicular activities (EVAs) required for the completion and maintenance of the International Space Station (ISS) is unprecedented. The training required to successfully complete this magnitude of space walks presents a real risk of overuse musculoskeletal injuries to the EVA crew population. There was mounting evidence raised by crewmembers, trainers, and physicians at the Johnson Space Center (JSC) between 1999 and 2002 that suggested a link between training in the Neutral - Buoyancy Lab (NBL) and the several reported cases of shoulder injuries. The short- and long-term health consequences of shoulder injury to astronauts in training as well as the potential mission impact associated with surgical intervention to assigned EVA crew point to this as a critical problem that must be mitigated. Thus, a multi-directorate tiger team was formed in December of 2002 led by the EVA Office and Astronaut Office at the JSC. The primary objectives of this Tiger Team were to evaluate the prevalence of these injuries and substantiate the relationship to training in the NBL with the crew person operating in the EVA Mobility Unit (EMU). Between December 2002 and June of 2003 the team collected data, surveyed crewmembers, consulted with a variety of physicians, and performed tests. The results of this effort were combined with the vast knowledge and experience of the Tiger Team members to formulate several findings and over fifty recommendations. This paper summarizes those findings and recommendations as well as the process by which these were determined. The Tiger Team concluded that training in the NBL was directly linked to several major and minor shoulder injuries that had occurred. With the assistance of JSC flight surgeons, outside consultants, and the lead crewmember/physician on the team, the mechanisms of injury were determined. These mechanisms were then linked to specific aspects of the hardware design, operational techniques, and the training environment. During the 1999 to 2003 time frame many variables converged to make it impossible to determine with any accuracy which one or two root causes were primarily involved. Therefore a broad range of recommendations was established to prevent future injury to crewmembers training in the NBL in the near term. Many of these recommendations are lessons learned that are essentially timeless and therefore should be passed on to future EVA endeavors to ensure that hardware designs and operational techniques utilized in the future consider the demands of training on the human body here on earth.

Johnson, Brian J.↗

NASA NTRS2011

Shoulder Injuries in US Astronauts Related to EVA Suit Design

Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain anthropometric body types should conduct NBL EVA training in the pivoted HUT.

Scheuring, R. A.↗

NASA NTRS2014

Data Mining of Historical Human Data to Assess the Risk of Injury due to Dynamic Loads

The NASA Occupant Protection Group is charged with ensuring crewmembers are protected during all dynamic phases of spaceflight. Previous work with outside experts has led to the development of a definition of acceptable risk (DAR) for space capsule vehicles. The DAR defines allowable probability rates for various categories of injuries. An important question is how to validate these probabilities for a given vehicle. One approach is to impact test human volunteers under projected nominal landing loads. The main drawback is the large number of subject tests required to attain a reasonable level of confidence that the injury probability rates would meet those outlined in the DAR. An alternative is to mine existing databases containing human responses to impact. Testing an anthropomorphic test device (ATD) at the same human‐exposure levels could yield a range of ATD responses that would meet DAR. As one aspect of future vehicle validation, the ATD could be tested in the vehicle's seat and suit configuration at nominal landing loads and compared with the ATD responses supported by the human data set. This approach could reduce the number of human‐volunteer tests NASA would need to conduct to validate that a vehicle meets occupant protection standards. METHODS: The U.S. Air Force has recorded hundreds of human responses to frontal, lateral, and spinal impacts at many acceleration levels and pulse durations. All of this data are stored on the Collaborative Biomechanics Data Network (CBDN), which is maintained by the Wright Patterson Air Force Base (WPAFB). The test device for human occupant restraint (THOR) ATD was impact tested on WPAFB's horizontal impulse accelerator (HIA) matching human‐volunteer exposures on the HIA to 5 frontal and 3 spinal loading conditions. No human injuries occurred as a result of these impact conditions. Peak THOR response variables for neck axial tension and compression, and thoracic‐spine axial compression were collected. Maximal chest deflection was determined from motion capture video of the impact test. HIC‐ 15 and BRIC were calculated from head acceleration responses. Given the number of human subjects for each test condition a confidence interval of injury probability will be obtained. RESULTS: Results will be discussed in terms of injury‐risk probability estimates based on the human data set evaluated. Also, gaps in the data set will be identified. These gaps could be one of two types. One is areas where additional THOR testing would increase the comparable human data set, thereby improving confidence in the injury probability rate. The other is where additional human testing would assist in obtaining information on other acceleration levels or directions. DISCUSSION: The historical human data showed validity of the THOR ATD for supplemental testing. The historical human data are limited in scope, however. Further data are needed to characterize the effects of sex, age, anthropometry, and deconditioning due to spaceflight on risk of injury

Wells, Jesica↗

NASA NTRSDate not supplied

Study of Advanced Occupant Models to Quantify Injury Risk for eVTOL Vehicles

Urban transportation is currently evolving from traditional ground-based vehicles (cars, taxis, and buses) to include air-based electric vertical take-off and landing (eVTOL) vehicles which can be utilized for on-demand transportation, cargo transport, and emergency services. These new eVTOL vehicles are designed to be small, lightweight, and able to operate autonomously without user intervention. Safety is a big part of eventual eVTOL adoption, however gaps in the consideration of safety features exist. Anthropomorphic test devices (ATDs) are used in aerospace crashworthiness standards to quantify occupant injury risk and develop improved safety designs for emergency landing situations, but the ATDs currently used in aircraft certification requirements were developed many decades ago. Developments have occurred over the years involving ATD technology, which includes a host of newer and more biofidelic ATDs such as the Test Device for Human Occupant Restraint (THOR). Increased computing power has also allowed for detailed computational human body models (HBMs) to be created, such as the Global Human Body Model Consortium (GHBMC). This study aims to assess the capability of both HBMs and new ATD designs to identify injury mechanisms within eVTOL relevant emergency landing conditions. Finite element (FE) analysis was used to expand upon full-scale and seat level impact testing conducted by researchers at the National Aeronautics and Space Administration (NASA) to look at effects of occupant model configurations on prediction of injury. The GHBMC HBM and THOR ATD models were simulated in the seat level test conditions to characterize differences between these advanced assessment tools and traditional ATDs in the isolated seat loading environment. Results identified key differences in the responses from each of the models utilized and compared their impact response in head, neck, and spinal injury metrics. The THOR model identified potential risks for head injuries due to head impacts on the seat, however it predicted lower spinal loads than the other occupant surrogates. The GHBMC showed distinctly different biomechanical responses compared to the ATD. The GHBMC model is much more deformable than the ATDs and it exhibited higher distribution of forces and increased sensitivity to the duration of acceleration pulses. Both models incorporated into this study identified key mechanisms for injury that should be considered for passenger safety in the development of these novel aircraft. In addition, this study demonstrated the value of FE modeling for running a variety of complex human surrogates to identify potential injury mechanisms for consideration in regulation and development of new aircraft. Continued research in this field to improve validation these models will only lead to safer aircraft and more comprehensive safety measures.

Crashworthiness↗