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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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NASA NTRS1990

Prediction of functional aerobic capacity without exercise testing

The purpose of this study was to develop functional aerobic capacity prediction models without using exercise tests (N-Ex) and to compare the accuracy with Astrand single-stage submaximal prediction methods. The data of 2,009 subjects (9.7% female) were randomly divided into validation (N = 1,543) and cross-validation (N = 466) samples. The validation sample was used to develop two N-Ex models to estimate VO2peak. Gender, age, body composition, and self-report activity were used to develop two N-Ex prediction models. One model estimated percent fat from skinfolds (N-Ex %fat) and the other used body mass index (N-Ex BMI) to represent body composition. The multiple correlations for the developed models were R = 0.81 (SE = 5.3 ml.kg-1.min-1) and R = 0.78 (SE = 5.6 ml.kg-1.min-1). This accuracy was confirmed when applied to the cross-validation sample. The N-Ex models were more accurate than what was obtained from VO2peak estimated from the Astrand prediction models. The SEs of the Astrand models ranged from 5.5-9.7 ml.kg-1.min-1. The N-Ex models were cross-validated on 59 men on hypertensive medication and 71 men who were found to have a positive exercise ECG. The SEs of the N-Ex models ranged from 4.6-5.4 ml.kg-1.min-1 with these subjects.(ABSTRACT TRUNCATED AT 250 WORDS).

Oxygen Consumption↗
NASA NTRSDate not supplied

TOWARD A METHOD FOR SCALING HUMAN BODY MODELS IN AN IMU-BASED WORKFLOW

BACKGROUND Scaled biomechanical models can more accurately inform crew health decisions when tailored to the wide range of astronaut sizes. One component to improve scaling of existing models to better represent each unique astronaut’s size is the individual length scaling of limbs. Traditionally, these lengths are determined by motion capture or manual measurement. A new method is herein proposed for length scaling which can be done by measuring linear and angular accelerations at a desired point during isolated motion around a point of rotation, then calculating the distance between the desired point and point of rotation. When an Inertial Measurement Unit (IMU) device is placed at the distal point of a limb, the isolated motion is about that limb’s proximal joint. For example, to measure forearm length, an IMU is placed at the wrist, the point of rotation is at the elbow, and the isolated motion is forearm flexion and extension. These calculated lengths are then used to scale models to each unique astronaut’s size, thereby improving the applicability of the model. This method of scaling limb segments can be used for any limb that has an easily defined proximal joint for the limb to rotate around including hands, arms, legs, feet. Utilizing IMUs for data collection also provides the synergistic ability to record data without a dedicated space in a room with many cameras, therefore reducing the data collection footprint, or record data where optical motion capture is not possible, such as inside a spacesuit. METHODS AND RESULTS To test this method, upper body data collection was performed with 5 Xsens DOT IMUs on a single subject. IMUs consist of an accelerometer, a gyroscope, and a magnetometer which collect linear acceleration, angular velocity, and magnetic fluctuations, respectively. Before any ground-based laboratory collection, the magnetic fluctuations are used to correct the heading of the IMU in space relative to the Earth’s magnetic field. The direct measurement of angular velocity is integrated to calculate angular acceleration. Then the linear acceleration ( a ) and angular acceleration (α) are solved using r = at/α to calculate the radius, which in this case is the distance between the IMU and the point of rotation (i.e., segment length). The IMU must be placed at the most distal point of the limb being measured (i.e., ankle if measuring lower leg length) and the test plan must consist of an isolated motion about that limb’s proximal joint (i.e., knee flexion and extension if measuring lower leg length). The distances (radii) calculated at every time interval were filtered (bandpass filter keeping 5th-90th percentile data) to eliminate outliers and spurious data that occur when the isolated motion was stopped or nearly stopped. The remaining distances were averaged, resulting in the calculated limb length. Scaling factors were then computed by dividing the calculated limb length by the unscaled model’s length. These scale factors are plugged into the Scale Tool in OpenSim [1,2] to apply the scaling to the OpenSim Full Body Rajagopal Model [3,4]. Manual measurements of limb lengths were taken before data collection started and used for comparing against the calculated lengths. The Anthropometric Survey of US Army Personnel (ANSUR II) [5] was also used as a third source of reference for limb length measurements. The following measurements were retrieved from the subject before data collection: 34.5 cm from L1 to C7 (thorax), 25.7 cm from C7 Joint Center (JC) to head vertex (neck and head), 36.3 cm from shoulder JC to elbow JC (humerus), 29.5 cm from elbow JC to wrist JC (forearm), and 16.2 cm from clavicle to acromion (clavicle). Of those five, forearm and humerus lengths were calculated using this proposed method to obtain preliminary results. The forearm length after filtering and averaging was calculated to be 37.6 cm. This is a 28% overestimation from the measured forearm length (29.5 cm). The humerus length after filtering and averaging was calculated to be 47.8 cm. This is a 31% difference from the measured subject length (36.3 cm). Sources of error include imperfect isolated motion (method currently expects that motion should be perfectly circular in a 2D plane, include no rotation of the IMU, and be relatively smooth; a more secure IMU attachment method will help), unrefined filter techniques (removed highest and lowest values with 20% high and low pass filters and no smoothing filters), arbitrary removal of stopped or near stopped data (kept data for only a short range before and after the angular velocity peaking), and a more representative method for removing gravitational acceleration is needed (current method is to zero all accelerations against a baseline taken just before the isolated motion which does not account for the gravitational acceleration changed due to IMU rotation during movement). Addressing these error sources will improve the accuracy of the limb length calculation. Next steps include creating a method for whole-body scaling estimation using individual limb scale factors. Continued pursuit of these techniques is expected to enable acquiring anthropometric information using only IMUs in real-time.

E. K. Marecki↗
NASA NTRS2000

Shape-dependent control of cell growth, differentiation, and apoptosis: switching between attractors in cell regulatory networks

Development of characteristic tissue patterns requires that individual cells be switched locally between different phenotypes or "fates;" while one cell may proliferate, its neighbors may differentiate or die. Recent studies have revealed that local switching between these different gene programs is controlled through interplay between soluble growth factors, insoluble extracellular matrix molecules, and mechanical forces which produce cell shape distortion. Although the precise molecular basis remains unknown, shape-dependent control of cell growth and function appears to be mediated by tension-dependent changes in the actin cytoskeleton. However, the question remains: how can a generalized physical stimulus, such as cell distortion, activate the same set of genes and signaling proteins that are triggered by molecules which bind to specific cell surface receptors. In this article, we use computer simulations based on dynamic Boolean networks to show that the different cell fates that a particular cell can exhibit may represent a preprogrammed set of common end programs or "attractors" which self-organize within the cell's regulatory networks. In this type of dynamic network model of information processing, generalized stimuli (e.g., mechanical forces) and specific molecular cues elicit signals which follow different trajectories, but eventually converge onto one of a small set of common end programs (growth, quiescence, differentiation, apoptosis, etc.). In other words, if cells use this type of information processing system, then control of cell function would involve selection of preexisting (latent) behavioral modes of the cell, rather than instruction by specific binding molecules. Importantly, the results of the computer simulation closely mimic experimental data obtained with living endothelial cells. The major implication of this finding is that current methods used for analysis of cell function that rely on characterization of linear signaling pathways or clusters of genes with common activity profiles may overlook the most critical features of cellular information processing which normally determine how signal specificity is established and maintained in living cells. Copyright 2000 Academic Press.

Review↗
NASA NTRS2003

Age affects severity of venous gas emboli on decompression from 14.7 to 4.3 psia

INTRODUCTION: Variables that define who we are, such as age, weight and fitness level influence the risk of decompression sickness (DCS) and venous gas emboli (VGE) from diving and aviation decompressions. We focus on age since astronauts that perform space walks are approximately 10 yr older than our test subjects. Our null hypothesis is that age is not statistically associated with the VGE outcomes from decompression to 4.3 psia. METHODS: Our data are from 7 different NASA tests where 188 men and 50 women performed light exercise at 4.3 psia for planned exposures no less than 4 h. Prebreathe (PB) time on 100% oxygen ranged from 150-270 min, including ascent time, with exercise of different intensity and length being performed during the PB in four of the seven tests with 150 min of PB. Subjects were monitored for VGE in the pulmonary artery using a Doppler ultrasound bubble detector for a 4-min period every 12 min. There were six design variables; the presence or absence of lower body adynamia and five PB variables; plus five concomitant variables on physical characteristics: age, weight height, body mass index, and gender that were available for logistic regression (LR). We used LR models for the probability of DCS and VGE, and multinomial logit (ML) models for the probability of Spencer VGE Grades 0-IV at exposure times of 61, 95, 131, 183 min, and for the entire exposure. RESULTS: Age was significantly associated with VGE in both the LR and ML models, so we reject the null hypothesis. Lower body adynamia was significant for all responses. CONCLUSIONS: Our selection of tests produced a wide range of the explanatory variables, but only age, lower body adynamia, height, and total PB time was helpful in various combinations to model the probability of DCS and VGE.

Clinical Trial↗
NASA NTRS2001

Peripheral leukocyte subpopulations and catecholamine levels in astronauts as a function of mission duration

OBJECTIVE: The objective of this study was to determine the effects of spaceflight duration on immune cells and their relationship to catecholamine levels. METHODS: Eleven astronauts who flew aboard five different US Space Shuttle flights ranging in duration from 4 to 16 days were studied before launch and after landing. RESULTS: Consistent with prior studies, spaceflight was associated with a significant increase in the number of circulating white blood cells (p <.01), including neutrophils (p <.01), monocytes (p <.05), CD3+CD4+ T-helper cells (p <.05), and CD19+ B cells (p <.01). In contrast, the number of CD3-CD16+56+ natural killer cells was decreased (p <.01). Plasma norepinephrine levels were increased at landing (p <.01) and were significantly correlated with the number of white blood cells (p <.01), neutrophils (p <.01), monocytes (p <.01), and B cells (p <.01). Astronauts who were in space for approximately 1 week showed a significantly larger increase on landing in plasma norepinephrine (p =.02) and epinephrine (p =.03) levels, as well as number of circulating CD3+CD4+ T-helper cells (p <.05) and CD3+CD8+ T-cytotoxic cells (p <.05) as compared with astronauts in space for approximately 2 weeks. CONCLUSIONS: The data suggest that the stress of spaceflight and landing may lead to a sympathetic nervous system-mediated redistribution of circulating leukocytes, an effect potentially attenuated after longer missions.

Flight Experiment↗
NASA NTRSDate not supplied

Volumetric Assessment of UPRITE Exercises From Marker-Based Motion Capture

BACKGROUND Lack of volumetric data on full-body movement of exercises presents a challenge to ensuring the fit of crew member’s full range of motion on the International Space Station (ISS). The Upright Proprioception Retention via In-flight Training and Evaluation (UPRITE) is a sensorimotor countermeasure device designed for maintaining crew members’ proprioception in a microgravity environment. A footplate—attached to a static base—rotates in two degrees of freedom (pitch and roll) up to a 20 deg angle. An initial volumetric assessment assuming an upright standing posture produced a cone-like shape with a narrow bottom and wide top. Such general volumetric assessments risk creating an overly conservative volume estimate, taking up more space than is necessary on the already limited interior space of the ISS, and neglecting necessary volume due to oversimplifying assumptions. Rather, higher-fidelity volumetric assessments offer more comprehensive insights in an environment where every area counts. The main objective of this work is to provide the spatial parameters of exercises on the UPRITE such that it is placed on the ISS according to its volumetric demands or that usage is adjusted to fit the available space. METHODS In 2023, a data collection was performed originally to inform loads and dynamics of system use and was recently leveraged for volumetric assessment. Three human subjects representing different body types (~63-76 inches in stature) performed a variety of board manipulations using UPRITE with body weight offload. The test collected the 3D positional data of a modified full-body Plug-in Gait marker set [1] via a 16-camera OptiTrack MoCap system. After processing – filling marker gaps and trimming data – in OptiTrack Motive, the recorded marker location data, which included device markers, was exported to a readable trajectory file. To accurately represent the full volume defining landmarks, additional markers were digitally added to an unscaled Modified Full Body Model [2]. The model was then scaled according to its subject parameters upon which an inverse kinematics analysis was performed. A custom plugin yielded model marker location data files. Volumetric analyses were performed on the recorded trajectory and model trajectory files using a custom Python-built tool that extracted the marker location data and plotted it in a 3D space. Concerned with only the maximum volume of the motion, a 3D convex hull analysis was applied to the plot, extracting the vertices or external points of the eventual 3D CAD output, dubbed aptly as a “volume shell”. This overall approach was based on guidance in a NASA-STD-3001 Technical Brief [3]. RESULTS AND DISCUSSION Batch volumetric assessment on the exercises for each subject was performed, producing high-fidelity volume shells in minimal time. Preliminary results highlighted the value in higher-fidelity volumes based on collected data when possible. For example, revolving a single posture in the cone assessment would not have sufficiently captured a single leg stance; rather, it would need to involve swinging the leg both forward and back. Additional observations and the maximal dimensions of the volumes, including those based on scaled data for ISS anthropometric requirements, will be presented at the Human Research Program Investigator’s Workshop. CONCLUSIONS While this work’s primary objective was for the UPRITE-to-ISS integration, the tool built to conduct this analysis has wide applications for future exercise systems as an informational tool for optimal device placement. The tool and its findings also have implications for exercise device design and spacecraft interior considerations on Gateway, the Lunar Pressurized Rover, and beyond. REFERENCES [1] Bell, C. A., et al. (2023) Recent Improvements and Verification of a Full Body Model in OpenSim. NASA Human Research Program Investigator’s Workshop. https://ntrs.nasa.gov/citations/20230001080 [2] Lostroscio, K., et al (2023) The Digital Astronaut Simulation. AHFE International Conference on Human Factors in Design, Engineering, and Computing for All. [3] Exercise Overview. (2023) NASA-STD-3001 Technical Brief. https://www.nasa.gov/wp-content/uploads/2023/12/ochmo-tb-031-exercise-overview.pdf?emrc=9d454c?emrc=9d454c

L D Quinto↗
NASA NTRS1999

Late ophthalmological complications after total body irradiation in non-human primates

PURPOSE: To investigate the long-term effects of total body irradiation (TBI) on the incidence and time course of ocular complications. MATERIALS AND METHODS: Rhesus monkeys treated with TBI photon doses up to 8.5 Gy and proton doses up to 7.5 Gy were studied at intervals up to 25 years post-irradiation. They were compared with control groups with a similar age distribution. Cataract formation and ocular fundus lesions were scored according to a standardized protocol. Fluorescein angiography and histopathology was performed in selected animals. RESULTS: Cataract formation occurred after a latent period of 3-5 years. Significant cataract induction was observed for photon-doses of 8 and 8.5 Gy and beyond 20 years after proton irradiation. The severity of the lesions represents significant impairment of vision and would require cataract surgery if similar results occurred in human bone marrow transplant patients. Fluorescein angiography demonstrated a normal pattern of retinal vessels in 13 out of 14 animals (93%) from the irradiated group and in eight out of nine animals (89%) from the control group. No additional lesions apart from age-related degenerative changes could be demonstrated. Histological evaluation revealed no radiation-associated vasculopathy. CONCLUSIONS: Radiation alone for doses up to 8.5 Gy of photons does not carry a potential risk for fundus pathology, whereas clinically important cataract induction should be anticipated within 5 years after photon doses of 8.0 and 8.5 Gy and proton doses in excess of 2.5 Gy.

NASA Discipline Radiation Health↗
NASA NTRS1997

Image processing for improved eye-tracking accuracy

Video cameras provide a simple, noninvasive method for monitoring a subject's eye movements. An important concept is that of the resolution of the system, which is the smallest eye movement that can be reliably detected. While hardware systems are available that estimate direction of gaze in real-time from a video image of the pupil, such systems must limit image processing to attain real-time performance and are limited to a resolution of about 10 arc minutes. Two ways to improve resolution are discussed. The first is to improve the image processing algorithms that are used to derive an estimate. Off-line analysis of the data can improve resolution by at least one order of magnitude for images of the pupil. A second avenue by which to improve resolution is to increase the optical gain of the imaging setup (i.e., the amount of image motion produced by a given eye rotation). Ophthalmoscopic imaging of retinal blood vessels provides increased optical gain and improved immunity to small head movements but requires a highly sensitive camera. The large number of images involved in a typical experiment imposes great demands on the storage, handling, and processing of data. A major bottleneck had been the real-time digitization and storage of large amounts of video imagery, but recent developments in video compression hardware have made this problem tractable at a reasonable cost. Images of both the retina and the pupil can be analyzed successfully using a basic toolbox of image-processing routines (filtering, correlation, thresholding, etc.), which are, for the most part, well suited to implementation on vectorizing supercomputers.

NASA Discipline Space Human Factors↗
NASA NTRSDate not supplied

Spaceborne Lidar Retrievals of PM2.5 for Air Quality Studies and Applications

Fine particulate matter (PM2.5) substantially contributes to air pollution and negatively affects human health. While many studies have investigated the use of passive column-integrated aerosol optical depth to infer surface PM2.5, the use of lidar observations for air quality characterization is not nearly as extensive. Lidar measurements are critical, however, due to the vertical aerosol information they provide, including near the surface. In this presentation, we first provide an overview of various lidar-based approaches for estimating PM2.5 concentrations and then discuss how lidar measurements can assist other air quality applications. For example, estimates of PM2.5 have been obtained in a physics-based approach through CALIOP near-surface aerosol extinction retrievals, assumptions on the mass extinction efficiency, and incorporating other parameters (an aerosol hygroscopic growth factor and PM2.5/PM10 ratio). Application of this algorithm over the contiguous United States (CONUS) from 2006 to 2018 yielded larger PM2.5 values over the eastern and western CONUS (~10-15 μg/m³) and lower PM2.5 levels in the central CONUS (~5 μg/m³). These spatial patterns were similar to those from gridded PM2.5 concentrations obtained through in situ measurements at ground stations operated by the US Environmental Protection Agency. In another approach, the Cloud Aerosol Transport System (CATS) lidar was used with the Goddard Earth Observing System (GEOS) model in a 1D ensemble-based variational technique to obtain PM2.5 over the US and Europe, and the spatial patterns of the CATS/GEOS based PM2.5 concentrations generally captured those from surface stations (with corresponding hourly EPA PM2.5 vs CATS PM2.5 statistics of R=0.4 and bias=1.5 μg/m³). In our recent work, as part of the Models, In situ, and Remote sensing of Aerosols (MIRA) Working Group, we have applied both the CALIOP and CATS/GEOS based approaches over the highly polluted country of India during the post-monsoon season (September-October 2016). We derived elevated levels of two-month mean PM2.5 (~100 μg/m³) in northern India, especially near New Delhi. These high PM2.5 concentrations in the Indo-Gangetic plain are driven in large part from the seasonal burning of crop residue and meteorological conditions typical at this time of the year, such as low wind speeds and a shallow boundary layer. While the satellite-derived PM2.5 moderately replicates (R = ~0.7-0.9) the spatial variability in the two-month mean of surface in situ PM2.5 from monitoring sites operated by the Central and State Pollution Control Boards, we show results from specific scenes for which there are large deviations between the satellite-derived PM2.5 and in situ measurements. Other current work on this topic focuses on developing PM2.5 estimates using airborne high spectral resolution lidar measurements through machine learning regression algorithms and involves several parameters (e.g., aerosol extinction, color ratio, lidar ratio). Application of this method over major metropolitan areas in the US and Asia have resulted in high correlations (R = 0.93) with surface measurements. This airborne lidar approach can be adapted to spaceborne lidar measurements, and all three of these approaches can be applied to ESA’s EarthCARE Atmospheric Lidar instrument, setting the stage for the future Cloud Aerosol Lidar for Global Scale Observations of the Ocean-Land Atmosphere System (CALIGOLA) mission. Ultimately, beyond estimates of PM2.5, the aerosol vertical distribution from lidars can benefit studies involving passive sensor approaches for PM2.5 proxies (including from geostationary satellites), wildfire smoke plume injection heights, volcanic emissions (e.g., ash height retrievals), and aerosol/air quality model assimilation, evaluation, and forecasts.

Travis D Toth↗
NASA NTRS1999

Blood flow dynamics in heart failure

BACKGROUND: Exercise intolerance in heart failure (HF) may be due to inadequate vasodilation, augmented vasoconstriction, and/or altered muscle metabolic responses that lead to fatigue. METHODS AND RESULTS: Vascular and metabolic responses to rhythmic forearm exercise were tested in 9 HF patients and 9 control subjects (CTL) during 2 protocols designed to examine the effect of HF on the time course of oxygen delivery versus uptake (protocol 1) and on vasoconstriction during exercise with 50 mm Hg pressure about the forearm to evoke a metaboreflex (protocol 2). In protocol 1, venous lactate and H+ were greater at 4 minutes of exercise in HF versus CTL (P<0.05) despite similar blood flow and oxygen uptake responses. In protocol 2, mean arterial pressure increased similarly in each group during ischemic exercise. In CTL, forearm blood flow and vascular conductance were similar at the end of ischemic and ambient exercise. In HF, forearm blood flow and vascular conductance were reduced during ischemic exercise compared with the ambient trial. CONCLUSIONS: Intrinsic differences in skeletal muscle metabolism, not vasodilatory dynamics, must account for the augmented glycolytic metabolic responses to moderate-intensity exercise in class II and III HF. The inability to increase forearm vascular conductance during ischemic handgrip exercise, despite a normal pressor response, suggests that enhanced vasoconstriction of strenuously exercising skeletal muscle contributes to exertional fatigue in HF.

NASA Discipline Cardiopulmonary↗
NASA NTRS2017

Biomechanical Modeling Analysis of Loads Configuration for Squat Exercise

INTRODUCTION: Long duration space travel will expose astronauts to extended periods of reduced gravity. Since gravity is not present to assist loading, astronauts will use resistive and aerobic exercise regimes for the duration of the space flight to minimize loss of bone density, muscle mass and aerobic capacity that occurs during exposure to a reduced gravity environment. Unlike the International Space Station (ISS), the area available for an exercise device in the next generation of spacecraft for travel to the Moon or to Mars is limited and therefore compact resistance exercise device prototypes are being developed. The Advanced Resistive Exercise Device (ARED) currently on the ISS is being used as a benchmark for the functional performance of these new devices. Biomechanical data collection and computational modeling aid the device design process by quantifying the joint torques and the musculoskeletal forces that occur during exercises performed on the prototype devices. METHODS The computational models currently under development utilize the OpenSim [1] software platform, consisting of open source code for musculoskeletal modeling, using biomechanical input data from test subjects for estimation of muscle and joint loads. The OpenSim Full Body Model [2] is used for all analyses. The model incorporates simplified wrap surfaces, a new knee model and updated lower body muscle parameters derived from cadaver measurements and magnetic resonance imaging of young adults. The upper body uses torque actuators at the lumbar and extremity joints. The test subjects who volunteer for this study are instrumented with reflective markers for motion capture data collection while performing squat exercising on the Hybrid Ultimate Lifting Kit (HULK) prototype device (ZIN Technologies, Middleburg Heights, OH). Ground reaction force data is collected with force plates under the feet, and device loading is recorded through load cells internal to the HULK. Test variables include the applied device load and the dual cable long bar or single cable T-bar interface between the test subject and the device. Data is also obtained using free weights with the identical loading for a comparison to the resistively loaded exercise device trials. The data drives the OpenSim biomechanical model, which has been scaled to match the anthropometrics of the test subject, to calculate the body loads. RESULTS Lower body kinematics, joint moments, joint forces and muscle forces are obtained from the OpenSim biomechanical analysis of the squat exercises under different loading conditions. Preliminary results from the model for the loading conditions will be presented as will hypotheses developed for follow on work.

Human Factors Engineering↗
NASA NTRS2002

Survival after aortic valve replacement for severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction

OBJECTIVE: We sought to assess whether aortic valve replacement (AVR) among patients with severe aortic stenosis (AS), severe left ventricular (LV) dysfunction and a low transvalvular gradient (TVG) is associated with improved survival. BACKGROUND: The optimal management of patients with severe AS with severe LV dysfunction and a low TVG remains controversial. METHODS: Between 1990 and 1998, we evaluated 68 patients who underwent AVR at our institution (AVR group) and 89 patients who did not undergo AVR (control group), with an aortic valve area < or = 0.75 cm(2), LV ejection fraction < or = 35% and mean gradient < or = 30 mm Hg. Using propensity analysis, survival was compared between a cohort of 39 patients in the AVR group and 56 patients in the control group. RESULTS: Despite well-matched baseline characteristics among propensity-matched patients, the one- and four-year survival rates were markedly improved in patients in the AVR group (82% and 78%), as compared with patients in the control group (41% and 15%; p < 0.0001). By multivariable analysis, the main predictor of improved survival was AVR (adjusted risk ratio 0.19, 95% confidence interval 0.09 to 0.39; p < 0.0001). The only other predictors of mortality were age and the serum creatinine level. CONCLUSIONS: Among select patients with severe AS, severe LV dysfunction and a low TVG, AVR was associated with significantly improved survival.

NASA Discipline Cardiopulmonary↗
NASA NTRS2002

The effect of repeated altitude exposures on the incidence of decompression sickness

INTRODUCTION: Repeated altitude exposures in a single day occur during special operations parachute training, hypobaric chamber training, unpressurized flight, and extravehicular space activity. Inconsistent and contradictory information exists regarding the risk of decompression sickness (DCS) during such hypobaric exposures. HYPOTHESIS: We hypothesized that four short exposures to altitude with and without ground intervals would result in a lower incidence of DCS than a single exposure of equal duration. METHODS: The 32 subjects were exposed to 3 different hypobaric exposures--condition A: 2 h continuous exposure (control); condition B: four 30-min exposures with descent/ascent but no ground interval between the exposures; condition C: four 30-min exposures with descent/ascent and 60 min of ground interval breathing air between exposures. All exposures were to 25,000 ft with 100% oxygen breathing. Subjects were observed for symptoms of DCS, and precordial monitoring of venous gas emboli (VGE) was accomplished with a SONOS 1000 echo-imaging system. RESULTS: DCS occurred in 19 subjects during A (mean onset 70+/-29 min), 7 subjects in B (60+/-34 min), and 2 subjects in C (40+/-18 min). There was a significant difference in DCS incidence between B and A (p = 0.0015) and C and A (p = 0.0002), but no significant difference between B and C. There were 28 cases of VGE in A (mean onset 30+/-23 min), 21 in B (41+/-35 min), and 21 in C (41+/-32 min) with a significant onset curve difference between B and A and between C and A, but not between B and C. Exposure A resulted in four cases of serious respiratory/neurological symptoms, while B had one and C had none. All symptoms resolved during recompression to ground level. CONCLUSION: Data indicate that repeated simulated altitude exposures to 25,000 ft significantly reduce DCS and VGE incidence compared with a single continuous altitude exposure.

Non-NASA Center↗
NASA NTRS2002

Enhancement of preoxygenation for decompression sickness protection: effect of exercise duration

INTRODUCTION: Since strenuous exercise for 10 min during preoxygenation was shown to provide better protection from decompression sickness (DCS) incidence than resting preoxygenation, a logical question was: would a longer period of strenuous exercise improve protection even further? HYPOTHESIS: Increased strenuous exercise duration during preoxygenation increases DCS protection. METHODS: There were 60 subjects, 30 men and 30 women, who were exposed to 9,144 m (4.3 psia) for 4 h while performing mild, upper body exercise. Before the exposures, each subject performed three preoxygenation profiles on different days in balanced order: a 90-min resting preoxygenation control; a 240-min resting preoxygenation control; and a 90-min preoxygenation including exercise during the first 15 min. The subjects were monitored at altitude for venous gas emboli (VGE) with an echo-imaging system and observed for signs and symptoms of DCS. RESULTS: There were no significant differences in occurrence of DCS following any of the three preoxygenation procedures. Results were also comparable to an earlier report of 42% DCS with a 60-min preoxygenation including a 10-min exercise. There was no difference between VGE incidence in the comparison of protection offered by a 90-min preoxygenation with or without 13 min of strenuous exercise. The DCS incidence following a 240-min resting preoxygenation, 40%, was higher than observed during NASA studies and nearly identical with the earlier 42% DCS after a 60-min preoxygenation including exercise during the first 10 min. CONCLUSION: The protection offered by a 10 min exercise in a 60-min preoxygenation was not increased with extension of the preoxygenation exercise period to 15 min in a 90-min preoxygenation, indicating an upper time limit to the beneficial effects of strenuous exercise.

NASA Discipline Environmental Health↗
NASA NTRS1998

Heart rate dynamics in patients with stable angina pectoris and utility of fractal and complexity measures

Dynamic analysis techniques may uncover abnormalities in heart rate (HR) behavior that are not easily detectable with conventional statistical measures. However, the applicability of these new methods for detecting possible abnormalities in HR behavior in various cardiovascular disorders is not well established. Conventional measures of HR variability were compared with short-term (< or = 11 beats, alpha1) and long-term (> 11 beats, alpha2) fractal correlation properties and with approximate entropy of RR interval data in 38 patients with stable angina pectoris without previous myocardial infarction or cardiac medication at the time of the study and 38 age-matched healthy controls. The short- and long-term fractal scaling exponents (alpha1, alpha2) were significantly higher in the coronary patients than in the healthy controls (1.34 +/- 0.15 vs 1.11 +/- 0.12 [p <0.001] and 1.10 +/- 0.08 vs 1.04 +/- 0.06 [p <0.01], respectively), and they also had lower approximate entropy (p <0.05), standard deviation of all RR intervals (p <0.01), and high-frequency spectral component of HR variability (p <0.05). The short-term fractal scaling exponent performed better than other heart rate variability parameters in differentiating patients with coronary artery disease from healthy subjects, but it was not related to the clinical or angiographic severity of coronary artery disease or any single nonspectral or spectral measure of HR variability in this retrospective study. Patients with stable angina pectoris have altered fractal properties and reduced complexity in their RR interval dynamics relative to age-matched healthy subjects. Dynamic analysis may complement traditional analyses in detecting altered HR behavior in patients with stable angina pectoris.

NASA Discipline Cardiopulmonary↗
NASA NTRS2001

Soluble TNF-alpha receptor 1 and IL-6 plasma levels in humans subjected to the sleep deprivation model of spaceflight

BACKGROUND: The extent to which sleep loss may predispose astronauts to a state of altered immunity during extended space travel prompts evaluation with ground-based models. OBJECTIVE: We sought to measure plasma levels of selected cytokines and their receptors, including the putative sleep-regulation proteins soluble TNF-alpha receptor (sTNF-alpha R) I and IL-6, in human subjects undergoing 2 types of sleep deprivation during environmental confinement with performance demands. METHODS: Healthy adult men (n = 42) were randomized to schedules that varied in severity of sleep loss: 4 days (88 hours) of partial sleep deprivation (PSD) involving two 2-hour naps per day or 4 days of total sleep deprivation (TSD). Plasma samples were obtained every 6 hours across 5 days and analyzed by using enzyme-linked immunoassays for sTNF-alpha RI, sTNF-alpha RII, IL-6, soluble IL-2 receptor, IL-10, and TNF-alpha. RESULTS: Interactions between the effects of time and sleep deprivation level were detected for sTNF-alpha RI and IL-6 but not for sTNF-alpha RII, soluble IL-2 receptor, IL-10, and TNF-alpha. Relative to the PSD condition, subjects in the TSD condition had elevated plasma levels of sTNF-alpha RI on day 2 (P =.04), day 3 (P =.01), and across days 2 to 4 of sleep loss (P =.01) and elevated levels of IL-6 on day 4 (P =.04). CONCLUSIONS: Total sleep loss produced significant increases in plasma levels of sTNF-alpha RI and IL-6, messengers that connect the nervous, endocrine, and immune systems. These changes appeared to reflect elevations of the homeostatic drive for sleep because they occurred in TSD but not PSD, suggesting that naps may serve as the basis for a countermeasures approach to prolonged spaceflight.

Non-NASA Center↗
NASA NTRS2000

Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction

BACKGROUND: Preliminary data suggest that the analysis of R-R interval variability by fractal analysis methods may provide clinically useful information on patients with heart failure. The purpose of this study was to compare the prognostic power of new fractal and traditional measures of R-R interval variability as predictors of death after acute myocardial infarction. METHODS AND RESULTS: Time and frequency domain heart rate (HR) variability measures, along with short- and long-term correlation (fractal) properties of R-R intervals (exponents alpha(1) and alpha(2)) and power-law scaling of the power spectra (exponent beta), were assessed from 24-hour Holter recordings in 446 survivors of acute myocardial infarction with a depressed left ventricular function (ejection fraction </=35%). During a mean+/-SD follow-up period of 685+/-360 days, 114 patients died (25.6%), with 75 deaths classified as arrhythmic (17.0%) and 28 as nonarrhythmic (6.3%) cardiac deaths. Several traditional and fractal measures of R-R interval variability were significant univariate predictors of all-cause mortality. Reduced short-term scaling exponent alpha(1) was the most powerful R-R interval variability measure as a predictor of all-cause mortality (alpha(1) <0.75, relative risk 3.0, 95% confidence interval 2.5 to 4.2, P<0.001). It remained an independent predictor of death (P<0.001) after adjustment for other postinfarction risk markers, such as age, ejection fraction, NYHA class, and medication. Reduced alpha(1) predicted both arrhythmic death (P<0.001) and nonarrhythmic cardiac death (P<0.001). CONCLUSIONS: Analysis of the fractal characteristics of short-term R-R interval dynamics yields more powerful prognostic information than the traditional measures of HR variability among patients with depressed left ventricular function after an acute myocardial infarction.

Non-NASA Center↗
NASA NTRS2002

T wave alternans threshold late after repair of tetralogy of Fallot

INTRODUCTION: Sustained microvolt-level T wave alternans (TWA) is a marker of increased risk for malignant ventricular arrhythmia. There is a significant risk of arrhythmia and sudden death after repair of congenital heart disease. The aim of this study was to determine the prevalence and characteristics of TWA after repair of tetralogy of Fallot (TOF). METHODS AND RESULTS: TWA was evaluated during bicycle exercise in 49 subjects who had consecutively undergone transatrial-transpulmonary repair. Median values for age, age at repair, and follow-up duration were 14.9 years (11.5-20.8), 1.6 years (0.2-4.9), and 11.6 years (9.4-17.2), respectively. All patients were in New York Heart Association functional class I and were asymptomatic. Median QRS duration was 120 msec (80-150). Sustained TWA was detected in 7 (23%) of 31 subjects with adequate tests. In these 7 subjects, median onset heart rate (HR) was 120 (98-155). Median HR threshold as a percentage of predicted maximum HR (220 - age) was 58% (48-77). Sustained TWA prevalence was not significantly different compared with normal subjects (7/31 vs 9/83; P = 0.1). Onset HR in the TOF group was significantly lower [mean (SD) of 122 (20) vs 139 (12), P < 0.05]. In the TOF group with sustained TWA, the TWA occurred in 4 of 7 at <60% predicted maximum HR versus 1 of 9 normal subjects (P < 0.05); 3 of 7 had onset HR <120 versus 0 of 9 normal subjects (P < 0.03). There was no significant difference in age, gender, transannular patch use, restrictive right ventricular physiology, QRS duration, QTc, QT/QRS dispersion, or nonsustained ventricular tachycardia in subjects with or those without sustained TWA. CONCLUSION: The onset HR for sustained TWA is significantly lower after repair of TOF. Further study is required to determine whether this represents an increased risk for arrhythmia in this patient group.

Non-NASA Center↗