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NASA NTRS2013

Probabilistic Modeling of the Renal Stone Formation Module

The Integrated Medical Model (IMM) is a probabilistic tool, used in mission planning decision making and medical systems risk assessments. The IMM project maintains a database of over 80 medical conditions that could occur during a spaceflight, documenting an incidence rate and end case scenarios for each. In some cases, where observational data are insufficient to adequately define the inflight medical risk, the IMM utilizes external probabilistic modules to model and estimate the event likelihoods. One such medical event of interest is an unpassed renal stone. Due to a high salt diet and high concentrations of calcium in the blood (due to bone depletion caused by unloading in the microgravity environment) astronauts are at a considerable elevated risk for developing renal calculi (nephrolithiasis) while in space. Lack of observed incidences of nephrolithiasis has led HRP to initiate the development of the Renal Stone Formation Module (RSFM) to create a probabilistic simulator capable of estimating the likelihood of symptomatic renal stone presentation in astronauts on exploration missions. The model consists of two major parts. The first is the probabilistic component, which utilizes probability distributions to assess the range of urine electrolyte parameters and a multivariate regression to transform estimated crystal density and size distributions to the likelihood of the presentation of nephrolithiasis symptoms. The second is a deterministic physical and chemical model of renal stone growth in the kidney developed by Kassemi et al. The probabilistic component of the renal stone model couples the input probability distributions describing the urine chemistry, astronaut physiology, and system parameters with the physical and chemical outputs and inputs to the deterministic stone growth model. These two parts of the model are necessary to capture the uncertainty in the likelihood estimate. The model will be driven by Monte Carlo simulations, continuously randomly sampling the probability distributions of the electrolyte concentrations and system parameters that are inputs into the deterministic model. The total urine chemistry concentrations are used to determine the urine chemistry activity using the Joint Expert Speciation System (JESS), a biochemistry model. Information used from JESS is then fed into the deterministic growth model. Outputs from JESS and the deterministic model are passed back to the probabilistic model where a multivariate regression is used to assess the likelihood of a stone forming and the likelihood of a stone requiring clinical intervention. The parameters used to determine to quantify these risks include: relative supersaturation (RS) of calcium oxalate, citrate/calcium ratio, crystal number density, total urine volume, pH, magnesium excretion, maximum stone width, and ureteral location. Methods and Validation: The RSFM is designed to perform a Monte Carlo simulation to generate probability distributions of clinically significant renal stones, as well as provide an associated uncertainty in the estimate. Initially, early versions will be used to test integration of the components and assess component validation and verification (V&V), with later versions used to address questions regarding design reference mission scenarios. Once integrated with the deterministic component, the credibility assessment of the integrated model will follow NASA STD 7009 requirements.

kidney stones↗

NASA NTRS1992

Time to detection of circulating microbubbles as a risk factor for symptoms of altitude decompression sickness

This study investigated the association between time at onset of circulating microbubbles (CMB) and symptoms of altitude decompression sickness (DCS), using Cox proportional hazard regression models. The study population consisted of 125 individuals who participated in direct ascent, simulated extravehicular activities profiles. Using individual CMB status as a time-dependent variable, we found that the hazard for symptoms increased significantly (at the end of 180 min at altitude) in the presence of CMB (Hazard Ratio = 29.59; 95 percent confidence interval (95 percent CI) = 7.66-114.27), compared to no CMB. Further examination was conducted on the subgroup of individuals who developed microbubbles during the test (n = 49), by using Cox regression. Individuals with late onset of CMB (greater than 60 min at altitude) showed a significantly reduced risk of symptoms (hazard ratio = 0.92; 95 percent CI = 0.89-0.95), compared to those with early onset (equal to or less than 60 min), while controlling for other risk factors. We conclude that time to detection of circulating microbubbles is an independent determinant of symptoms of DCS.

Kumar, K. V.↗

NASA NTRS2016

NASA Astronaut Urinary Conditions Associated with Spaceflight

INTRODUCTION: Spaceflight is associated with many factors which may promote kidney stone formation, urinary retention, and/or Urinary Tract Infection (UTI). According to ISS mission predictions supplied by NASA's Integrated Medical Model, kidney stone is the second and sepsis (urosepsis as primary driver) the third most likely reason for emergent medical evacuation from the International Space Station (ISS). METHODS: Inflight and postflight medical records of NASA astronauts were reviewed for urinary retention, UTI and kidney stones during Mercury, Gemini, Apollo, Mir, Shuttle, and ISS expeditions 1-38. RESULTS: NASA astronauts have had 7 cases of kidney stones in the 12 months after flight. Three of these cases occurred within 90 to 180 days after landing and one of the seven cases occurred in the first 90 days after flight. There have been a total of 16 cases (0.018 events per person-flights) of urinary retention during flight. The event rates per mission are nearly identical between Shuttle and ISS flights (0.019 vs 0.021 events per person-flights). In 12 of the 16 cases, astronauts had taken at least one space motion sickness medication. Upon further analysis, it was determined that the odds of developing urinary retention in spaceflight is 3 times higher among astronauts who took promethazine. The female to male odds ratio for inflight urinary retention is 11:14. An astronaut with urinary retention is 25 times more likely to have a UTI with a 17% infection rate per mission. There have been 9 reported UTIs during spaceflight. DISCUSSION: It is unclear if spaceflight carries an increased post-flight risk of kidney stones. Regarding urinary retention, the female to male odds ratio is higher during flight compared to the general population where older males comprise almost all cases due to prostatic hypertrophy. This female prevalence in spaceflight is even more concerning given the fact that there have been many more males in space than females. Terrestrial medications with a known side effect of urinary retention are also associated with urinary retention during flight. However, not all cases of urinary retention surrounded medication use inflight. It is also known that UTI is a terrestrial cause of urinary retention. Furthermore, the treatment of urinary retention with a urinary catheter may be more likely to initiate a UTI in space than on the ground, as aseptic techniques can be particularly challenging with an inexperienced provider in a free-floating environment. Inflight urinary retention and UTI have proven to be highly associated and urinary risks should be considered collectively when planning for space flight.

Law, Jennifer↗

NASA NTRS2011

Tissue Doppler Imaging Combined with Advanced 12-Lead ECG Analysis Might Improve Early Diagnosis of Hypertrophic Cardiomyopathy in Childhood

Optimization of early diagnosis of childhood hypertrophic cardiomyopathy (HCM) is essential in lowering the risk of HCM complications. Standard echocardiography (ECHO) has shown to be less sensitive in this regard. In this study, we sought to assess whether spatial QRS-T angle deviation, which has shown to predict HCM in adults with high sensitivity, and myocardial Tissue Doppler Imaging (TDI) could be additional tools in early diagnosis of HCM in childhood. Methods: Children and adolescents with familial HCM (n=10, median age 16, range 5-27 years), and without obvious hypertrophy but with heredity for HCM (n=12, median age 16, range 4-25 years, HCM or sudden death with autopsy-verified HCM in greater than or equal to 1 first-degree relative, HCM-risk) were additionally investigated with TDI and advanced 12-lead ECG analysis using Cardiax(Registered trademark) (IMED Co Ltd, Budapest, Hungary and Houston). Spatial QRS-T angle (SA) was derived from Kors regression-related transformation. Healthy age-matched controls (n=21) were also studied. All participants underwent thorough clinical examination. Results: Spatial QRS-T angle (Figure/ Panel A) and septal E/Ea ratio (Figure/Panel B) were most increased in HCM group as compared to the HCM-risk and control groups (p less than 0.05). Of note, these 2 variables showed a trend toward higher levels in HCM-risk group than in control group (p=0.05 for E/Ea and 0.06 for QRS/T by ANOVA). In a logistic regression model, increased SA and septal E/Ea ratio appeared to significantly predict both the disease (Chi-square in HCM group: 9 and 5, respectively, p less than 0.05 for both) and the risk for HCM (Chi-square in HCM-risk group: 5 and 4 respectively, p less than 0.05 for both), with further increased predictability level when these 2 variables were combined (Chi-square 10 in HCM group, and 7 in HCM-risk group, p less than 0.01 for both). Conclusions: In this small material, Tissue Doppler Imaging and spatial mean QRS-T angle deviation, particularly when combined, appear to be sensitive in predicting the risk for developing childhood HCM. Large-scale, prospective studies are needed to confirm this hypothesis.

Femlund, E.↗

NASA NTRS1994

The 7.5K lbf thrust engine preliminary design for Orbit Transfer Vehicle

This document summarizes the preliminary design of the Aerojet version of the Orbit Transfer Vehicle main engine. The concept of a 7500 lbf thrust LO2/GH2 engine using the dual expander cycle for optimum efficiency is validated through power balance and thermal calculations. The engine is capable of 10:1 throttling from a nominal 2000 psia to a 200 psia chamber pressure. Reservations are detailed on the feasibility of a tank head start, but the design incorporates low speed turbopumps to mitigate the problem. The mechanically separate high speed turbopumps use hydrostatic bearings to meet engine life requirements, and operate at sub-critical speed for better throttling ability. All components were successfully packaged in the restricted envelope set by the clearances for the extendible/retractable nozzle. Gimbal design uses an innovative primary and engine out gimbal system to meet the +/- 20 deg gimbal requirement. The hydrogen regenerator and LOX/GH2 heat exchanger uses the Aerojet platelet structures approach for a highly compact component design. The extendible/retractable nozzle assembly uses an electric motor driven jack-screw design and a one segment carbon-carbon or silicide coated columbium nozzle with an area ratio, when extended, of 1430:1. A reliability analysis and risk assessment concludes the report.

Hayden, Warren R.↗

NASA NTRS1995

Psychosocial correlates of immune responsiveness and illness episodes in US Air Force Academy cadets undergoing basic cadet training

This study examined psychosocial correlates of immune function and illness in 89 male first-year US Air Force Academy cadets. A psychosocial questionnaire was administered to cadets prior to their arrival at the academy and was readministered during cadet orientation and during the stressful environment of Basic Cadet Training (BCT). Immune responsiveness was analyzed by PHA-, PMA-, or anti-CD3-stimulated thymidine uptake in mononuclear leucocytes. Illness episodes were assessed via medical chart review and self-reported symptoms. There were significant increases in distress levels as cadets entered BCT. No psychosocial measure assessed prior to arrival at the academy predicted level of PHA-, PMA-, and anti-CD3-stimulated thymidine uptake or risk of illness. However, hostility levels reported during BCT predicted risk of illness in the four weeks following psychosocial assessment (odds ratio = 7.1; 95% confidence interval: 1.4-36.1). Elevated response to environmental stressors and lower well-being levels also predicted impending illness, but only in the cohort of cadets who had not contracted food poisoning prior to assessment during BCT (OR = 9.3, CI = 1.9-46.7; OR = 0.09, CI = 0.02-0.53). These results suggest that self-report measures of hostility, response to environmental stressors and well-being may be useful predictors of impending illness episodes in males encountering high stress environments.

NASA Discipline Regulatory Physiology↗

NASA NTRS2018

Integrated NTP Vehicle Radiation Design

The development of a nuclear thermal propulsion stage requires consideration for radiation emitted from the nuclear reactor core. Applying shielding mass is an effective mitigating solution, but a better alternative is to incorporate some mitigation strategies into the propulsion stage and crew habitat. In this way, the required additional mass is minimized and the mass that must be applied may in some cases be able to serve multiple purposes. Strategies for crew compartment shielding are discussed that reduce dose from both engine and cosmic sources, and in some cases may also serve to reduce life support risks by permitting abundant water reserves. Early consideration for integrated mitigation solutions in a crewed nuclear thermal propulsion (NTP) vehicle will enable reduced radiation burden from both cosmic and nuclear sources, improved thrust-to-weight ratio or payload capacity by reducing 'dead mass' of shielding, and generally support a more robust risk posture for a NTP-powered Mars mission by permitting shorter trip times and increased water reserves

Caffrey, Jarvis↗

NASA NTRS2018

Integrated NTP Vehicle Radiation Design

Caffrey, Jarvis A.↗

NASA NTRS2011

Biological Based Risk Assessment for Space Exploration

Exposures from galactic cosmic rays (GCR) - made up of high-energy protons and high-energy and charge (HZE) nuclei, and solar particle events (SPEs) - comprised largely of low- to medium-energy protons are the primary health concern for astronauts for long-term space missions. Experimental studies have shown that HZE nuclei produce both qualitative and quantitative differences in biological effects compared to terrestrial radiation, making risk assessments for cancer and degenerative risks, such as central nervous system effects and heart disease, highly uncertain. The goal for space radiation protection at NASA is to be able to reduce the uncertainties in risk assessments for Mars exploration to be small enough to ensure acceptable levels of risks are not exceeded and to adequately assess the efficacy of mitigation measures such as shielding or biological countermeasures. We review the recent BEIR VII and UNSCEAR-2006 models of cancer risks and their uncertainties. These models are shown to have an inherent 2-fold uncertainty as defined by ratio of the 95% percent confidence level to the mean projection, even before radiation quality is considered. In order to overcome the uncertainties in these models, new approaches to risk assessment are warranted. We consider new computational biology approaches to modeling cancer risks. A basic program of research that includes stochastic descriptions of the physics and chemistry of radiation tracks and biochemistry of metabolic pathways, to emerging biological understanding of cellular and tissue modifications leading to cancer is described.

Cucinotta, Francis A.↗

NASA NTRS2000

Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography

Identification of thrombus-related mechanical prosthetic valve dysfunction (MPVD) has important therapeutic implications. We sought to develop an algorithm, combining clinical and echocardiographic parameters, for prediction of thrombus-related MPVD in a series of 53 patients (24 men, age 52 +/- 16 years) who had intraoperative diagnosis of thrombus or pannus from 1992 to 1997. Clinical and echocardiographic parameters were analyzed to identify predictors of thrombus and pannus. Prevalence of thrombus and diagnostic yields relative to the number of predictors were determined. There were 22 patients with thrombus, 19 patients with pannus, and 12 patients with both. Forty-two of 53 masses were visualized using transesophageal echocardiography (TEE), including 29 of 34 thrombi or both thrombi and panni and 13 of 19 isolated panni. Predictors of thrombus or mixed presentation include mobile mass (p = 0.009), attachment to occluder (p = 0.02), elevated gradients (p = 0.04), and an international normalized ratio of < or = 2.5 (p = 0.03). All 34 patients with thrombus or mixed presentation had > or = 1 predictor. The prevalence of thrombus in the presence of < or = 1, 2, and > or = 3 predictors is 14%, 69%, and 91%, respectively. Thus, TEE is sensitive in the identification of abnormal mass in the setting of MPVD. An algorithm based on clinical and transesophageal echocardiographic predictors may be useful to estimate the likelihood of thrombus in the setting of MPVD. In the presence of > or = 3 predictors, the probability of thrombus is high.

NASA Discipline Cardiopulmonary↗

NASA NTRS1995

Bell Helicopter Advanced Rotocraft Transmission (ART) program

Future rotorcraft transmissions require key emerging material and component technologies using advanced and innovative design practices in order to meet the requirements for a reduced weight to power ratio, a decreased noise level, and a substantially increased reliability. The specific goals for the future rotorcraft transmission when compared with a current state-of-the-art transmission (SOAT) are: (1) a 25 percent weight reduction; (2) a 10 dB reduction in the transmitted noise level; and (3) a system reliability of 5000 hours mean-time-between-removal (MTBR) for the transmission. This report summarizes the work conducted by Bell Helicopter Textron, Inc. to achieve these goals under the Advanced Rotorcraft Transmission (ART) program from 1988 to 1995. The reference aircraft selected by BHTI for the ART program was the Tactical Tiltrotor which is a 17,000 lb gross weight aircraft. A tradeoff study was conducted comparing the ART with a Selected SOAT. The results showed the ART to be 29 percent lighter and up to 13 dB quieter with a calculated MTBR in excess of 5000 hours. The results of the following high risk component and material tests are also presented: (1) sequential meshing high contact ratio planetary with cantilevered support posts; (2) thin dense chrome plated M50 NiL double row spherical roller planetary bearings; (3) reduced kinematic error and increased bending strength spiral bevel gears; (4) high temperature WE43 magnesium housing evaluation and coupon corrosion tests; (5) flexure fatigue tests of precision forged coupons simulating precision forged gear teeth; and (6) flexure fatigue tests of plasma carburized coupons simulating plasma carburized gear teeth.

Henry, Zachary S.↗

NASA NTRS2005

Computational Simulations and the Scientific Method

As scientific simulation software becomes more complicated, the scientific-software implementor's need for component tests from new model developers becomes more crucial. The community's ability to follow the basic premise of the Scientific Method requires independently repeatable experiments, and model innovators are in the best position to create these test fixtures. Scientific software developers also need to quickly judge the value of the new model, i.e., its cost-to-benefit ratio in terms of gains provided by the new model and implementation risks such as cost, time, and quality. This paper asks two questions. The first is whether other scientific software developers would find published component tests useful, and the second is whether model innovators think publishing test fixtures is a feasible approach.

Kleb, Bil↗

NASA NTRS1994

Review of 5 years of a combined dietary and physical fitness intervention for control of serum cholesterol

A chart review covering the first 5 years of clinical experience with a combined dietary and exercise intervention program for the reduction of hypercholesterolemia at the National Aeronautics and Space Administration headquarters demonstrated the program's success in maintaining high-density lipoprotein cholesterol (HDL-C) levels while significantly lowering total serum cholesterol levels. This combined program also resulted in improved ratios of total serum cholesterol to HDL-C and lowered levels of low-density lipoprotein cholesterol, thus further reducing the risk for cardiovascular disease. The National Aeronautics and Space Administration Cardiovascular Risk Reduction Program was developed after it was determined that although dietary intervention alone improved total cholesterol levels, it often resulted in a more than proportionate decrease in HDL-C and a worsening of the ratio of cholesterol to HDL-C. An approach was needed that would positively affect all factors of the lipid profile. The findings from the program indicate that reduction of cardiovascular risk can be accomplished easily and effectively at the worksite through dietary intervention, personal monitoring, and a reasonable exercise program.

Exercise↗

NASA NTRS2000

Assessing quality in cardiac surgery: why this is necessary in the twenty-first century

The cost and high-profile nature of coronary surgery means that this is an area of close public scrutiny. As much pioneering work in data collection and risk analyses has been carried out by cardiac surgeons, substantial information exists and the correct interpretation of that data is identified as an important issue. This paper considers the background and history of risk-adjustment in cardiac surgery, the uses of quality data, examines the observed/expected mortality ratio and looks at issues such as cost and reactions to outliers. The conclusion of the study is that the continuation of accurate data collection by the whole operative team and a strong commitment to constantly improving quality is crucial to its meaningful application.

Review↗

NASA NTRS2017

It's All Relative: A Validation of Radiation Quality Comparison Metrics

The difference between high-LET and low-LET radiation is quantified by a measure called relative biological effectiveness (RBE). RBE is defined as the ratio of the dose of a reference radiation to that of a test radiation to achieve the same effect level, and thus, is described either as an iso-effector dose-to-dose ratio. A single dose point is not sufficient to calculate an RBE value; therefore, studies with only one dose point usually calculate an effect-to-effect ratio. While not formally used in radiation protection, these iso-dose values may still be informative. Shuryak, et al 2017 investigated the use of an iso-dose metric termed "radiation effects ratio" (RER) and used both RBE and RER to estimate high-LET risks. To apply RBE or RER to risk prediction, the selected metric must be uniquely defined. That is, the calculated value must be consistent within a model given a constant set of constraints and assumptions, regardless of how effects are defined using statistical transformations from raw endpoint data. We first test the RBE and the RER to determine whether they are uniquely defined using transformations applied to raw data. Then, we test whether both metrics can predict heavy ion response data after simulated effect size scaling between human populations or when converting animal to human endpoints.

Chappell, Lori J.↗

NASA NTRS2011

Sequential Probability Ratio Test for Collision Avoidance Maneuver Decisions Based on a Bank of Norm-Inequality-Constrained Epoch-State Filters

Sequential probability ratio tests explicitly allow decision makers to incorporate false alarm and missed detection risks, and are potentially less sensitive to modeling errors than a procedure that relies solely on a probability of collision threshold. Recent work on constrained Kalman filtering has suggested an approach to formulating such a test for collision avoidance maneuver decisions: a filter bank with two norm-inequality-constrained epoch-state extended Kalman filters. One filter models 1he null hypothesis 1ha1 the miss distance is inside the combined hard body radius at the predicted time of closest approach, and one filter models the alternative hypothesis. The epoch-state filter developed for this method explicitly accounts for any process noise present in the system. The method appears to work well using a realistic example based on an upcoming highly-elliptical orbit formation flying mission.

Carpenter, J. R.↗

NASA NTRS1978

Energy efficient engine: Preliminary design and integration studies

Parametric design and mission evaluations of advanced turbofan configurations were conducted for future transport aircraft application. Economics, environmental suitability and fuel efficiency were investigated and compared with goals set by NASA. Of the candidate engines which included mixed- and separate-flow, direct-drive and geared configurations, an advanced mixed-flow direct-drive configuration was selected for further design and evaluation. All goals were judged to have been met except the acoustic goal. Also conducted was a performance risk analysis and a preliminary aerodynamic design of the 10 stage 23:1 pressure ratio compressor used in the study engines.

Johnston, R. P.↗

NASA NTRSDate not supplied

Marin County Wildland Fires: Examining Fuel Load and Land Cover Change to Inform Fire Prevention and Suppression Decisions in Marin County, CA

Heightened occurrence of severe wildfires in the Western United States is increasing the need to better understand regions of high potential wild fire severity and develop methodologies for identifying the best locations for fuels reduction and active wildfire suppression, especially in populated regions such as Marin County, California. Marin County, located in the San Francisco Bay Area, has had significant development in the wildland-urban interface and periods of highly wildfire-prone conditions. The NASA DEVELOP team collaborated with Fire Foundry, a Marin-based fire service work force development program, to develop new models to assist with fire management. Using data from Sentinel-2A, Planet Scope, ECOSTRESS, a county-wide LiDAR mapping effort, Landsat 7 Enhanced Thematic Mapper (ETM+), and Landsat 8 Operational Land Imager (OLI), the team developed several input data layers to three models evaluating wild fire severity. One model performed a suitability analysis with weights based on scientific literature, another utilized machine learning based on past fires in Marin and neighboring Sonoma County to predict the difference normalized burn ratio, and the third inputted data layers into the Flam Map tool, which outputs risk categories. The team compared model outputs and, using the best-fit model, performed fuzzy logic analysis to identify specific locations where a fire break could be constructed to interrupt the progress of an active fire. These tools were proven useful and will assist partners in preparing for and managing an active wildfire event.

Suhani Dalal↗