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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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29 records · Page 2
All sourcesNASA NTRSDOE OSTI
DOE OSTI2024

Type 1 Diabetes Genetic Risk in 109,954 Veterans With Adult-Onset Diabetes: The Million Veteran Program (MVP)

OBJECTIVE To characterize high type 1 diabetes (T1D) genetic risk in a population where type 2 diabetes (T2D) predominates. RESEARCH DESIGN AND METHODS Characteristics typically associated with T1D were assessed in 109,594 Million Veteran Program participants with adult-onset diabetes, 2011–2021, who had T1D genetic risk scores (GRS) defined as low (0 to <45%), medium (45 to <90%), high (90 to <95%), or highest (≥95%). RESULTS T1D characteristics increased progressively with higher genetic risk (P < 0.001 for trend). A GRS ≥90% was more common with diabetes diagnoses before age 40 years, but 95% of those participants were diagnosed at age ≥40 years, and their characteristics resembled those of individuals with T2D in mean age (64.3 years) and BMI (32.3 kg/m2). Compared with the low-risk group, the highest-risk group was more likely to have diabetic ketoacidosis (low GRS 0.9% vs. highest GRS 3.7%), hypoglycemia prompting emergency visits (3.7% vs. 5.8%), outpatient plasma glucose <50 mg/dL (7.5% vs. 13.4%), a shorter median time to start insulin (3.5 vs. 1.4 years), use of a T1D diagnostic code (16.3% vs. 28.1%), low C-peptide levels if tested (1.8% vs. 32.4%), and glutamic acid decarboxylase antibodies (6.9% vs. 45.2%), all P < 0.001. CONCLUSIONS Characteristics associated with T1D were increased with higher genetic risk, and especially with the top 10% of risk. However, the age and BMI of those participants resemble those of people with T2D, and a substantial proportion did not have diagnostic testing or use of T1D diagnostic codes. T1D genetic screening could be used to aid identification of adult-onset T1D in settings in which T2D predominates.

Yang, Peter K. (ORCID:0000000193796981)↗
NASA NTRS1999

A Comparison of Cilostazol and Pentoxifylline for Treating Intermittent Claudication

A randomized, double-blind, placebo-controlled, parallel-group, phase III multicenter trial was performed to evaluate the relative efficacy and safety of cilostazol and pentoxifylline. The study included 54 outpatient vascular clinics, including sites at Air Force, Veterans Affairs, tertiary care, and university hospitals in the United States. Of 922 consenting patients, 698 met the inclusion criteria, were randomized, and received treatment with either cilostazol 100 mg P0 twice a day, pentoxifylline 400 mg PO 3 times a day, or placebo. Treatment was double-dummy to ensure study blindness. Efficacy was primarily established by maximal walking distance (MWD), measured with constant-speed, variable-grade treadmill testing, assessed at baseline and at 4, 8, 12, 16, 20, and 24 weeks. Mean MWD of cilostazol-treated patients (n=227) was significantly improved at every visit compared with patients who received pentoxifylline (n=232) or placebo (n=239). After 24 weeks of cilostazol, mean MWD increased 53.9% (107.3 m) from baseline, and the effect had not plateaued. This was better (P < 0.001) than the 30.4% (64.4 m) MWD improvement with pentoxifylline. MWD improvement with pentoxifylline was similar (P = 0.82) to that of placebo (64.7 m). Deaths and serious adverse event rates were similar in each group. Common side effects included headache (27.8% with cilostazol, 11.2% with pentoxifylline, 11.7% with placebo), palpitations (17.2% with cilostazol, 2.2% with pentoxifylllne, 1.3% with placebo), and abnormal stools. Cilostazol was significantly better than pentoxifylline or placebo for increasing walking distances; pentoxifylline was no better than placebo.

Dawson, David L.↗
NASA NTRS2003

Development of a Multi-Channel, High Frequency QRS Electrocardiograph

With the advent of the ISS era and the potential requirement for increased cardiovascular monitoring of crewmembers during extended EVAs, NASA flight surgeons would stand to benefit from an evolving technology that allows for a more rapid diagnosis of myocardial ischemia compared to standard electrocardiography. Similarly, during the astronaut selection process, NASA flight surgeons and other physicians would also stand to benefit from a completely noninvasive technology that, either at rest or during maximal exercise tests, is more sensitive than standard ECG in identifying the presence of ischemia. Perhaps most importantly, practicing cardiologists and emergency medicine physicians could greatly benefit from such a device as it could augment (or even replace) standard electrocardiography in settings where the rapid diagnosis of myocardial ischemia (or the lack thereof) is required for proper clinical decision-making. A multi-channel, high-frequency QRS electrocardiograph is currently under development in the Life Sciences Research Laboratories at JSC. Specifically the project consisted of writing software code, some of which contained specially-designed digital filters, which will be incorporated into an existing commercial software program that is already designed to collect, plot and analyze conventional 12-lead ECG signals on a desktop, portable or palm PC. The software will derive the high-frequency QRS signals, which will be analyzed (in numerous ways) and plotted alongside of the conventional ECG signals, giving the PC-viewing clinician advanced diagnostic information that has never been available previously in all 12 ECG leads simultaneously. After the hardware and software for the advanced digital ECG monitor have been fully integrated, plans are to use the monitor to begin clinical studies both on healthy subjects and on patients with known coronary artery disease in both the outpatient and hospital settings. The ultimate goal is to get the technology out into the clinical world, where it has the potential to save lives.

DePalma, Jude L.↗
NASA NTRS1998

Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations. A cost-effectiveness analysis

BACKGROUND: Continuous-loop event recorders are widely used for the evaluation of palpitations, but the optimal duration of monitoring is unknown. OBJECTIVE: To determine the yield, timing, and incremental cost-effectiveness of each week of event monitoring for palpitations. DESIGN: Prospective cohort study. PATIENTS: 105 consecutive outpatients referred for the placement of a continuous-loop event recorder for the evaluation of palpitations. MEASUREMENTS: Diagnostic yield, incremental cost, and cost-effectiveness for each week of monitoring. RESULTS: The diagnostic yield of continuous-loop event recorders was 1.04 diagnoses per patient in week 1, 0.15 diagnoses per patient in week 2, and 0.01 diagnoses per patient in week 3 and beyond. Over time, the cost-effectiveness ratio increased from $98 per new diagnosis in week 1 to $576 per new diagnosis in week 2 and $5832 per new diagnosis in week 3. CONCLUSIONS: In patients referred for evaluation of palpitations, the diagnostic yield of continuous-loop event recording decreases rapidly after 2 weeks of monitoring. A 2-week monitoring period is reasonably cost-effective for most patients and should be the standard period for continuous-loop event recording for the evaluation of palpitations.

NASA Discipline Cardiopulmonary↗
NASA NTRS1993

Earthbound applications for NASA's physician workstation

The dream of a space probe to Mars or an astronaut colony on the moon persists. Despite years of setbacks and delays, NASA continues to lay the foundation for a new frontier in space. The necessity of a self contained health maintenance facility is an integral part of this stellar venture. As a subsystem of this health maintenance facility, the physician or astronaut workstation was envisioned as the vehicle of interface between the computer resources of the space station and the care provider. Our efforts to define and build this interface have resulted in a series of programs which can now be tested and refined using earth-based applications. The modules which have dual-use application from the NASA workstation include: patient scheduling and master patient index, pharmacy, laboratory, medical library, problem list/progress notes, and digital medical records. Our current plan is to develop these tools as objects that can be assembled in a variety of configurations. This will allow the technology to be used by the private sector where each doctor can select the starting point of his outpatient office system and add modules as he makes progress in system integration and training.

NASA Discipline Number 70-30↗
NASA NTRS2004

A Look from the Inside

NASA's Hubble Space Telescope has given the world amazing images of the distant stars, planets, and galaxies. The cutting-edge imaging technology that enhances the Hubble images also extends its benefits to life here on Earth, from deciphering previously unreadable portions of the Dead Sea Scrolls to improving digital mammographies for advanced cancer detection. This imaging technology is now helping physicians to perform micro-invasive arthroscopic surgery, which is the visual examination of an interior joint such as the knee. In 1997, NASA's Glenn Research Center signed a Space Act Agreement with Micro Medical Devices, Inc. (MMD), a medical device engineering company that licenses miniature surgical devices. At that time, MMD was in the process of developing a new micro-endoscope. This tool enables surgeons to view what is happening inside the body on a screen, eliminating the need for a more invasive diagnostic procedure. The images from the micro-endoscope needed to be extremely clear, a challenge with the tool s small size. The images also needed to be viewed in real time to allow surgeons to see what was happening in the body at that very moment. MMD established Clear Image Technology, LLC, of Elyria, Ohio, to commercialize the miniature endoscope. Clear Image Technology then partnered with Arthrotek, Inc., a sports medicine subsidiary of Biomet, Inc., to introduce the tool to the commercial market as the InnerVue[TM] Diagnostic Scope System. The InnerVue system is designed for use in a diagnostic environment, such as an office or outpatient service, to evaluate conditions within a joint. While the InnerVue scope is primarily being applied to the knee and shoulder, other small joints such as the wrist, elbow, and ankle are being investigated. A physician can use the system alone or in conjunction with magnetic resonance imaging (MRI) to determine the next treatment step for each patient. The procedure can be more accurate than MRI, particularly with diagnosing cartilage and articular surface damage and assessing arthritis severity.

Source record↗
NASA NTRS2009

Rashes and Exanthems on Long Duration Space Flights

INTRODUCTION: As NASA expands its human space exploration to the Moon, Mars and beyond, it will be presented with many challenges, not the least of which will be dealing with medical conditions, which on earth are simple, but take on new levels of complexity in space habitats. Skin conditions exemplify this complexity. METHODS AND RESULTS: While skin conditions account for 7 % of outpatient presentations to a primary care provider in the United States, NASA Longitudinal Study of Astronaut Health (LSAH) database indicates that cutaneous manifestations are significantly prevalent on-orbit. Reviewing this data for US astronauts, there have been 90 total cases of skin rashes during 27.34 person-years of spaceflight, or 3.29 cases/person. Specifically, STS-1 though 114 had 56 cases, ISS Expeditions 1 though 13 had 7 cases, Mir had 4 cases, Skylab had 5 cases and the Apollo program had 18 cases. If there was a period of 24 hours or more between rashes in the same crewmember, this was counted as an additional case. DISCUSSION: This prevalence is likely due, in some part, to constraints of hygiene and to immunologic changes that occur. The stresses of microgravity and austere Earth environments such as the Antarctic, submarine and military deployments, no doubt, similarly contribute to cutaneous reactions; but the difference of the environments are significant enough to warrant further study and discussion. This paper will discuss rashes, exanthems, and cutaneous reactions in space habitats; it will address diagnosis, causation, mitigation and treatment of skin conditions seen on orbit, to date, with a look to anticipating what may be seen with larger crews on future extended duration expeditions.

Ilscus, L.S.↗
NASA NTRS2009

Hubble Systems Optimize Hospital Schedules

Don Rosenthal, a former Ames Research Center computer scientist who helped design the Hubble Space Telescope's scheduling software, co-founded Allocade Inc. of Menlo Park, California, in 2004. Allocade's OnCue software helps hospitals reclaim unused capacity and optimize constantly changing schedules for imaging procedures. After starting to use the software, one medical center soon reported noticeable improvements in efficiency, including a 12 percent increase in procedure volume, 35 percent reduction in staff overtime, and significant reductions in backlog and technician phone time. Allocade now offers versions for outpatient and inpatient magnetic resonance imaging (MRI), ultrasound, interventional radiology, nuclear medicine, Positron Emission Tomography (PET), radiography, radiography-fluoroscopy, and mammography.

Source record↗
NASA NTRSDate not supplied

Market Survey 2020: Commercial Clinical Decision Support Systems and Wellness Tools

For long-duration, deep space exploration missions, current methods for managing and supporting crew health and medical conditions will be unsuitable. Communication and data transmission lags will necessitate the use of a sophisticated clinical decision support system (CDSS) that will tailor diagnosis and treatment guidance that is context-sensitive for anticipated astronaut health, wellness, and medical conditions. A variety of clinical decision support (CDS) and wellness tools (WT) are currently available in the commercial market and a broad-brush survey of this market can provide an initial impression of the current state of the art which, in turn, can inform the roadmap of NASA deep space CDSS development and associated requirements. Such a survey was undertaken during the first six months of 2020 using directed convenience sampling to obtain information provided by vendors on their websites; both commercially available CDS and WT (such as those used to track and monitor nutrition, exercise, and sleep) were included. Areas assessed were item type (e.g., software/application, device); primary purpose of the item (e.g., diagnostic support, nutrition tracking); additional purposes (if any); reported features, capabilities, and functionality; setting of use (e.g., inpatient, outpatient); intended user (e.g., clinician, patient); location and sources of data/information used or produced by the item; integration with patient electronic health record (EHR); compliance with interoperability ontologies and standards (e.g., Health Level 7 [HL7], Systematized Nomenclature of Medicine – Clinical Terminology [SNOMED-CT]); and whether the item is knowledge-based (derived from research findings) or non-knowledge-based (derived through artificial intelligence, machine learning, advanced probability and statistics), among others. Ninety-seven (97) vendor websites describing 196 CDS and 73 WT (269 total) were reviewed and coded. The primary purpose of the majority of CDS reviewed is diagnosis or diagnosis/treatment/drug decision support—targeted for clinician use— and the primary purpose of the majority of WT reviewed is the monitoring of different health metrics, most often through the use of a biosensor device (e.g., blood pressure)—targeted for patient use. Very few CDS or WT appear to comply with major international interoperability standards or can be integrated with a patient’s EHR data. None consider contextual factors, such as conditions of the physical environment (e.g., CO2 levels). The majority of CDS and WT reviewed are non-knowledge, cloud- or web-based applications or software. Forty-three (43) major findings were identified and the implications those findings have for NASA will be discussed. Example major findings include: CDS-WT capabilities range from diagnosis to treatment applications, CDS-WT may be wearable or non-wearable and are technologically advanced and only a few CDS-WT tools referenced compliance to ensure interoperability, among other findings. Recommendations will also be offered that will help to address ExMC Gap, Medical-701: Enhance medical capabilities within an exploration medical system.

market survey↗
DOE OSTI2025

Cross‐Cultural Validation of the Binge Eating Disorder Screener‐7 ( BEDS ‐7) Across 42 Countries

ABSTRACT Objective This study aimed to evaluate the reliability and validity of the Binge Eating Disorder Screener‐7 (BEDS‐7) across 42 countries and 26 languages, assessing its reliability and validity as a screening tool for binge‐eating disorder (BED) in diverse cultural contexts. Specifically, it sought to enhance early recognition of BED symptoms in primary care settings globally, contributing to a standardized framework for assessing BED. Method The International Sex Survey, a cross‐sectional online study, was conducted in 42 countries and 26 languages. A diverse community sample of 82,243 participants, aged 18 years or older, completed the BEDS‐7 and measures of sexuality, mental health, substance use, and sociodemographic characteristics. Confirmatory factor analyses and tests of measurement invariance were employed to evaluate the reliability and validity of the BEDS‐7 across languages, countries, genders, and sexual orientations. Results The BEDS‐7 demonstrated scalar factorial invariance across languages and countries, indicating consistent factor loadings and item intercepts. In contrast, the screener showed residual invariance across gender and sexual orientation groups, supporting its robustness across these demographics. Kruskal–Wallis tests revealed significant differences in BED symptoms across languages, countries, genders, and sexual orientations, with the highest BED scores observed among queer, pansexual, and gender‐diverse individuals. The BEDS‐7 also demonstrated adequate reliability (Cronbach's alpha > 0.80) and moderate criterion validity. Discussion The findings provide further evidence of the reliability and validity of the BEDS‐7 as a potential screening tool for identifying probable cases of BED globally, facilitating early intervention in primary care settings.

Gewirtz‐Meydan, Ateret [School of Social Work, Fac↗
DOE OSTI2021

The predictive skill of convolutional neural networks models for disease forecasting

In this paper we investigate the utility of one-dimensional convolutional neural network (CNN) models in epidemiological forecasting. Deep learning models, in particular variants of recurrent neural networks (RNNs) have been studied for ILI (Influenza-Like Illness) forecasting, and have achieved a higher forecasting skill compared to conventional models such as ARIMA. In this study, we adapt two neural networks that employ one-dimensional temporal convolutional layers as a primary building block—temporal convolutional networks and simple neural attentive meta-learners—for epidemiological forecasting. We then test them with influenza data from the US collected over 2010-2019. We find that epidemiological forecasting with CNNs is feasible, and their forecasting skill is comparable to, and at times, superior to, plain RNNs. Thus CNNs and RNNs bring the power of nonlinear transformations to purely data-driven epidemiological models, a capability that heretofore has been limited to more elaborate mechanistic/compartmental disease models.

59 BASIC BIOLOGICAL SCIENCES↗