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Assessing the Added Value of Miniature X-Ray in the Setting of Portable Ultrasound in Spaceflight

INTRODUCTION: Point-of-care ultrasound (POCUS) has become the standard of care for imaging diagnosis and management in low-Earth Orbit (LEO) spaceflight and it has long been hypothesized that POCUS will also be the standard of care for exploration spaceflight. However, like the trajectory for which ultrasound became more portable and user-friendly, the mass, volume, and power requirements of radiography devices for both diagnostic and therapeutic applications have also been dramatically reduced. This study seeks to determine the clinical utility and added value of miniature x-ray (XR) for the diagnosis and management of each of the 119 conditions within NASA Exploration Medical Capability’s IMPACT Condition List (ICL) given that the medical system is presumed to already be carrying a handheld portable POCUS device. METHODS: For each condition, a team of reviewers performed a rapid systematic literature review seeking sensitivity and specificity data for both handheld portable ultrasound and miniature XR. When there was a paucity of data, subject matter expertise and clinical experience was added to semi-quantitatively score the added value of miniature XR, given an US was already available for both diagnosis and management. Diagnostic utility of a modality for a condition was evaluated in the setting of both the best- and worst-case scenario definitions included and defined by the ICL. Evidence tracing and quality of evidence scores were also recorded. RESULTS/DISCUSSION: Conditions for which it was determined that miniature XR added diagnostic or therapeutic value are provided in this presentation. Previously presented work by our team has demonstrated that XR provides diagnostic and management capabilities that are hypothesized to complement or surpass ultrasound for over one-third of medical conditions that may arise during exploration spaceflight (i.e., diagnosis of injuries to the axial skeleton, teeth, and lungs as well as management of orthopedic reductions, endotracheal tube placement, and drain placement confirmation). In the setting of known inclusion of a handheld portable POCUS device, there remains significant added value of portable miniature XR. Whether or not this added clinical benefit is worth the mass, volume, and power requirements of the radiography system remains yet unknown and is the focus of future work. LEARNING OBJECTIVES: 1) Understand the value of ultrasound and radiography in the diagnosis and management of medical comorbidities that may arise in exploration spaceflight; 2) Understand the medical conditions of highest concern on exploration class missions for which miniature x-ray may provide added value to portable ultrasound.

J G Steller

Assessing the Added Value of Miniature X-Ray in the Setting of US in Spaceflight

INTRODUCTION: Point-of-care ultrasound (POCUS) has become the standard of care for imaging diagnosis and management in lowEarth Orbit (LEO) spaceflight and it has long been hypothesized that POCUS will also be the standard of care for exploration spaceflight. However, like the trajectory for which ultrasound became more portable and user-friendly, the mass, volume, and power requirements of radiography devices for both diagnostic and therapeutic applications have also been dramatically reduced. This study seeks to determine the clinical utility and added value of miniature x-ray (XR) for the diagnosis and management of each of the 119 conditions within NASA Exploration Medical Capability’s IMPACT Condition List (ICL) given that the medical system is presumed to already be carrying a handheld portable POCUS device. METHODS: For each condition, a team of reviewers performed a rapid systematic literature review seeking sensitivity and specificity data for both handheld portable ultrasound and miniature XR. When there was a paucity of data, subject matter expertise and clinical experience was added to semi-quantitatively score the added value of miniature XR, given an US was already available for both diagnosis and management. Diagnostic utility of a modality for a condition was evaluated in the setting of both the best- and worst-case scenario definitions included and defined by the ICL. Evidence tracing and quality of evidence scores were also recorded. RESULTS/DISCUSSION: Conditions for which it was determined that miniature XR added diagnostic or therapeutic value are provided in this presentation. Previously presented work by our team has demonstrated that XR provides diagnostic and management capabilities that are hypothesized to complement or surpass ultrasound for over one-third of medical conditions that may arise during exploration spaceflight (i.e., diagnosis of injuries to the axial skeleton, teeth, and lungs as well as management of orthopedic reductions, endotracheal tube placement, and drain placement confirmation). In the setting of known inclusion of a handheld portable POCUS device, there remains significant added value of portable miniature XR. Whether or not this added clinical benefit is worth the mass, volume, and power requirements of the radiography system remains yet unknown and is the focus of future work. LEARNING OBJECTIVES: 1) Understand the value of ultrasound and radiography in the diagnosis and management of medical comorbidities that may arise in exploration spaceflight; 2) Understand the medical conditions of highest concern on exploration class missions for which miniature x-ray may provide added value to portable ultrasound.

Jon Steller

The value of assessing pulmonary venous flow velocity for predicting severity of mitral regurgitation: A quantitative assessment integrating left ventricular function

Although alteration in pulmonary venous flow has been reported to relate to mitral regurgitant severity, it is also known to vary with left ventricular (LV) systolic and diastolic dysfunction. There are few data relating pulmonary venous flow to quantitative indexes of mitral regurgitation (MR). The object of this study was to assess quantitatively the accuracy of pulmonary venous flow for predicting MR severity by using transesophageal echocardiographic measurement in patients with variable LV dysfunction. This study consisted of 73 patients undergoing heart surgery with mild to severe MR. Regurgitant orifice area (ROA), regurgitant stroke volume (RSV), and regurgitant fraction (RF) were obtained by quantitative transesophageal echocardiography and proximal isovelocity surface area. Both left and right upper pulmonary venous flow velocities were recorded and their patterns classified by the ratio of systolic to diastolic velocity: normal (>/=1), blunted (<1), and systolic reversal (<0). Twenty-three percent of patients had discordant patterns between the left and right veins. When the most abnormal patterns either in the left or right vein were used for analysis, the ratio of peak systolic to diastolic flow velocity was negatively correlated with ROA (r = -0.74, P <.001), RSV (r = -0.70, P <.001), and RF (r = -0.66, P <.001) calculated by the Doppler thermodilution method; values were r = -0.70, r = -0.67, and r = -0.57, respectively (all P <.001), for indexes calculated by the proximal isovelocity surface area method. The sensitivity, specificity, and predictive values of the reversed pulmonary venous flow pattern for detecting a large ROA (>0.3 cm(2)) were 69%, 98%, and 97%, respectively. The sensitivity, specificity, and predictive values of the normal pulmonary venous flow pattern for detecting a small ROA (<0.3 cm(2)) were 60%, 96%, and 94%, respectively. However, the blunted pattern had low sensitivity (22%), specificity (61%), and predictive values (30%) for detecting ROA of greater than 0.3 cm(2) with significant overlap with the reversed and normal patterns. Among patients with the blunted pattern, the correlation between the systolic to diastolic velocity ratio was worse in those with LV dysfunction (ejection fraction <50%, r = 0.23, P >.05) than in those with normal LV function (r = -0.57, P <.05). Stepwise linear regression analysis showed that the peak systolic to diastolic velocity ratio was independently correlated with RF (P <.001) and effective stroke volume (P <.01), with a multiple correlation coefficient of 0.71 (P <.001). In conclusion, reversed pulmonary venous flow in systole is a highly specific and reliable marker of moderately severe or severe MR with an ROA greater than 0.3 cm(2), whereas the normal pattern accurately predicts mild to moderate MR. Blunted pulmonary venous flow can be seen in all grades of MR with low predictive value for severity of MR, especially in the presence of LV dysfunction. The blunted pulmonary venous flow pattern must therefore be interpreted cautiously in clinical practice as a marker for severity of MR.

Non-NASA Center

Assessing the Economic Value of Underground Thermal Storage for Hybrid Geothermal Power

Solutions are needed to address resource adequacy in the electric power system for highly decarbonized systems. The storage duration, the length of time a storage device can provide continuous output at its rated capacity, must be sufficient to receive full credit toward resource adequacy. Longer peaks and high fractions of variable renewable generation have increased the required duration to potentially seasonal durations. Underground Thermal Energy Storage (UTES) can be adapted to a hybrid storage power plant or heating and cooling applications to satisfy the need for long-duration storage. In this study, we use the Renewable Energy Deployment System (ReEDS) capacity expansion model to evaluate the increase in value for an enhanced geothermal system (EGS) resources by adding UTES. In modeled scenarios, using geothermal without storage as a baseline we compare the increase in economic value for plants with a range of storage characteristics. The added value of a hybrid storage plant changes depending on assumptions including the length of storage duration, efficiency, and ability to charge storage from the grid during periods of low energy prices. Relating proposed characteristics for geothermal UTES hybrids to the modeled economic value provides insight into economically viable costs for developing UTES as well as what combination of technology characteristics and future energy and policy assumptions drive significant value increases.

capacity expansion model

A Class of Sparse Johnson–Lindenstrauss Transforms and Analysis of their Extreme Singular Values

The Johnson–Lindenstrauss (JL) lemma is a powerful tool for dimensionality reduction in modern algorithm design. The lemma states that any set of high-dimensional points in a Euclidean space can be projected into lower dimensions while approximately preserving pairwise Euclidean distances. Random matrices satisfying this lemma are called JL transforms (JLTs). Inspired by existing $s$-hashing JLTs with exactly $s$ nonzero elements on each column, the present work introduces an ensemble of sparse matrices encompassing so-called $s$-hashing-like matrices whose expected number of nonzero elements on each column is $s$. The independence of the sub-Gaussian entries of these matrices and the knowledge of their exact distribution play an important role in their analyses. Using properties of independent sub-Gaussian random variables, these matrices are demonstrated to be JLTs, and their smallest nontrivial singular values and largest singular values are estimated nonasymptotically using a technique from geometric functional analysis. As the dimensions of the matrix grow to infinity, these singular values are proved to converge almost surely to fixed quantities (by using the universal Bai–Yin law) and in distribution to the Gaussian orthogonal ensemble Tracy–Widom law after proper rescalings. Understanding the behaviors of extreme singular values is important in general because they are often used to define a measure of stability of matrix algorithms. For example, JLTs were recently used in derivative-free optimization algorithmic frameworks to select random subspaces in which are constructed random models or poll directions to achieve scalability, and hence estimating their smallest singular value in particular helps determine the dimension of these subspaces.

97 MATHEMATICS AND COMPUTING

RAIS Generic Soil Background Values

The RAIS offers two approaches to background screening: generic and site-specific. The Generic Background Values tool (https://rais.ornl.gov/tools/bg_search.php) contains generic soil background values for selected metals. These values can be applied to any area across the U.S. Users can compare these values against local background data or supplement an existing background value dataset. Results can be downloaded in .xlsx format.

Dolislager, Fred [Oak Ridge National Laboratory (O

Optimal control theory for non-scalar-valued performance criteria

The theory of optimal control for nonscalar-valued performance criteria is discussed. In the space, where the performance criterion attains its value, the relations better than, worse than, not better than, and not worse than are defined by a partial order relation. The notion of optimality splits up into superiority and non-inferiority, because worse than is not the complement of better than, in general. A superior solution is better than every other solution. A noninferior solution is not worse than any other solution. Noninferior solutions have been investigated particularly for vector-valued performance criteria. Superior solutions for non-scalar-valued performance criteria attaining their values in abstract partially ordered spaces are emphasized. The main result is the infimum principle which constitutes necessary conditions for a control to be a superior solution to an optimal control problem.

Gerring, H. P.

Photovoltaics as a terrestrial energy source. Volume 2: System value

Assumptions and techniques employed by the electric utility industry and other electricity planners to make estimates of the future value of photovoltaic (PV) systems interconnected with U.S. electric utilities were examined. Existing estimates of PV value and their interpretation and limitations are discussed. PV value is defined as the marginal private savings accruing to potential PV owners. For utility-owned PV systems, these values are shown to be the after-tax savings in conventional fuel and capacity displaced by the PV output. For non-utility-owned (distributed) systems, the utility's savings in fuel and capacity must first be translated through the electric rate structure (prices) to the potential PV system owner. Base-case estimates of the average value of PV systems to U.S. utilities are presented. The relationship of these results to the PV Program price goals and current energy policy is discussed; the usefulness of PV output quantity goals is also reviewed.

Smith, J. L.

Low NOx heavy fuel combustor concept program addendum: Low/mid heating value gaseous fuel evaluation

The combustion performance of a rich/quench/lean (RQL) combustor was evaluated when operated on low and mid heating value gaseous fuels. Two synthesized fuels were prepared having lower heating values of 10.2 MJ/cu m. (274 Btu/scf) and 6.6 MJ/cu m (176 Btu/scf). These fuels were configured to be representative of actual fuels, being composed primarily of nitrogen, hydrogen, carbon monoxide, and carbon dioxide. A liquid fuel air assist fuel nozzle was modified to inject both of the gaseous fuels. The RQL combustor liner was not changed from the configuration used when the liquid fuels were tested. Both gaseous fuels were tested over a range of power levels from 50 percent load to maximum rated power of the DDN Model 570-K industrial gas turbine engine. Exhaust emissions were recorded for four power level at several rich zone equivalence ratios to determine NOx sensitivity to the rich zone operating point. For the mid Btu heating value gas, ammonia was added to the fuel to simulate a fuel bound nitrogen type gaseous fuel. Results at the testing showed that for the low heating value fuel NOx emissions were all below 20 ppmc and smoke was below a 10 smoke number. For the mid heating value fuel, NOx emissions were in the 50 to 70 ppmc range with the smoke below a 10 smoke number.

Novick, A. S.

Efficient load measurements using singular value decomposition

Various basic research was performed on efficient load measurement estimation techniques for aircraft structure analysis. An overview is presented of the load measurement problem. Two basic equivalent approaches to load measurement evaluations were considered. Under approach 1, the load values are modeled as depending linearly on the measured values. Under approach 2, the measured values depend linearly on the load values. By using the modern Singular Value Decomposition method, it was shown that under all conditions of the number of loads and number of gages, approach 1 is equivalent to approach 2. By using the conventional normal equation (linear regression) approach, approach 1 is only valid when the number of loads is equal to or greater than the number of gages, while approach 2 is the reverse. Furthermore, except for the case of the number of loads equals the number of gages, the load prediction formulas under the two approaches are not equivalent.

Yao, Kung

Fractal distributions of stress and strength and variations of b-value

A two-dimensional planar fault zone on which the difference between stress and strength follows a fractal distribution is simulated to study the variation of the frequency-magnitude b-value under different distributions of heterogeneities and ambient stress levels. It is suggested that earthquakes occur in regions where this difference exceeds a specified value and that the size of these regions is a measure of the magnitude of the associated earthquake. A systematic variation in b-value is observed. It is found that the b-value has a positive correlation with the fractal dimension of the distribution and is inversely related to the ambient stress level. Observational data are compared with the simulation, showing that the observed b-value variation before and during earthquake sequences is a result of changes in both the ambient stress level and in the fractal dimension of the stress-strength distribution.

Huang, J.

The G value in plasma and radiation chemistry

The application of the G-value concept to plasma chemistry is considered. A general formula which expresses the G value for a general reaction in terms of experimentally controllable parameters is derived by applying simple gas-dynamic theory to a plasma reactor with straight walls. The formula expresses the G value as a function of the electrical power absorbed, the fraction of molecules transformed, and the flow rate of the gas entering the reactor. The formula was applied to the ammonia plasma radio-frequency discharge data of d'Agostino et al. (1981); the results showed that the G(-NH3) value lies in the range of 6.0-20 molecules/100 eV, depending on the conditions. This similarity of the G(-NH3) value with Peterson's (1974) range 2.7-10 found for the gas-phase radiolysis of ammonia, suggests that there might be a common reaction mechanism initiated by inelastic electron-molecule collisions.

Baird, James K.

High-Moisture Diet for Laboratory Rats: Complete Blood Counts, Serum Biochemical Values, and Intestinal Enzyme Activity

Rats were fed an irradiated high-moisture diet (KSC-25) with or without access to a water bottle. Physiologic values were compared between these two groups and a group of rats fed a purified diet. Hematologic and serum biochemical values, urine specific gravity, and intestinal enzyme activities were determined from samples collected from the three groups of rats. Sprague Dawley rats (n=32) fed the irradiated high-moisture diet with or without a water bottle were the test animals. Rats (n=16) fed an irradiated purified diet and water provided via a water bottle were the control group. The purified diet formulation, modified AIN-76A, is a commonly used purified diet for laboratory rodents. All rats remained alert and healthy throughout the study. A comparison of the physiologic values of rats in this study with reported normal values indicated that all of the rats in the study were in good health. Significant differences (P less than 0.05) of the physiologic values from each rat group are reported.

Battles, August H.

A New Approach to Extreme Value Estimation Applicable to a Wide Variety of Random Variables

Designing reliable structures requires an estimate of the maximum and minimum values (i.e., strength and load) that may be encountered in service. Yet designs based on very extreme values (to insure safety) can result in extra material usage and hence, uneconomic systems. In aerospace applications, severe over-design cannot be tolerated making it almost mandatory to design closer to the assumed limits of the design random variables. The issue then is predicting extreme values that are practical, i.e. neither too conservative or non-conservative. Obtaining design values by employing safety factors is well known to often result in overly conservative designs and. Safety factor values have historically been selected rather arbitrarily, often lacking a sound rational basis. To answer the question of how safe a design needs to be has lead design theorists to probabilistic and statistical methods. The so-called three-sigma approach is one such method and has been described as the first step in utilizing information about the data dispersion. However, this method is based on the assumption that the random variable is dispersed symmetrically about the mean and is essentially limited to normally distributed random variables. Use of this method can therefore result in unsafe or overly conservative design allowables if the common assumption of normality is incorrect.

Holland, Frederic A., Jr.

The Use of Absolute-Value Terms in Regression Modeling of Multi-Piece Force Balances

Different aspects of the use of absolute-value terms in regression models of the electrical outputs of multi-piece force balance calibration data are discussed. First, characteristics of a variety of regression model term combinations with absolute-value terms are reviewed that are currently used in the aerospace testing community to fit the gage outputs of a balance. Then, a semi-empirical test is presented that quantifies bidirectional characteristics of the balance bridge outputs. Several diagnostic methods are discussed to assess the severity of near-linear dependencies between regressors of models with absolute-value terms. In particular, connections between the linear, absolute-value, quadratic, signed quadratic, and cubic terms are studied in greater detail. Data from an automated calibration of NASAs MK29B force balance are used to illustrate the most important observations and results. Rules of thumb that variance-inflation factors be less than 10 must be relaxed when using absolute-value terms to describe bidirectional balances.

calibration analysis

On Expected Value Strong Controllability

The Probabilistic Simple Temporal Network (PSTN) generalizes Simple Temporal Networks with Uncertainty (STNUs) by introducing probability distributions over the timing of uncontrollable timepoints. PSTNs are controllable if there is a strategy to execute the controllable timepoints while bounding the risk of violating any constraint to a small value. If this risk bound can't be satisfied, PSTNs are not considered controllable. We introduce the Expected Value Probabilistic SimpleTemporal Network (EPSTN), which extends PSTNs by including a benefit to the satisfaction of temporal constraints. We study the problem of Expected Value Strong Controllability (EvSC) of EPSTNs, which seeks a schedule maximizing the expected value of satisfied constraints. We solve the EvSC problem by extending a previously developed linear program, combined with search over constraints to violate at execution time. We describe conditions under which the solution to this linear program is the maximum expected value schedule. We then show how to search for constraints to discard, using the linear program at the core of the search. While the general problem is shown to be exponential, we conclude by providing several methods to bound the complexity of search.

Planning

Valuing EV Managed Charging for Bulk Power Systems

When and where electric vehicle (EV) charging occurs has significant implications for power systems supporting widespread EV adoption, especially with high shares of wind and solar generation. This study extends previous works by leveraging detailed simulation models for EV adoption, EV use, EV charging, and bulk power system operations, and by linking them with methods for describing charging flexibility at both the individual vehicle and aggregate levels. This technical potential study focuses on how the value of EV managed charging (EVMC) changes depending on charging flexibility type (within-charging session or within-week scheduling), dispatch mechanism (direct load control or one of several price-based mechanisms), and managed charging participation rate. We show that naively aggregating EV charging flexibility from individual vehicles into megawatt-scale resources grossly overestimates the flexibility of the fleet, because such aggregate models can unrealistically pair, e.g., one already-fully-charged vehicle's ability to increase load with another already-charging vehicle's ability to accept more charge, effectively requesting a charging rate that is infeasible for the latter vehicle. We find per-vehicle bulk system value is highest at low participation rates for all dispatch mechanisms. Factoring in production cost savings, avoided firm capacity savings, and combustion-related power sector emissions savings, we estimate the value of EVMC at low participation rates (5%) to be $33/vehicle-year to $69/vehicle-yr for within-session charging flexibility and $40/vehicle-yr to $120/vehicle-yr for within-week charging flexibility in an envisioned 2038 New England power system and monetary value reported in 2016 U.S. dollars. At 100% participation, per-vehicle value declines to $25/vehicle-yr to $31/vehicle-yr for within-session charging flexibility and to $29/vehicle-yr to $36/vehicle-yr for within-week charging flexibility; however, 100% participation yields the highest total system savings.

ADVANCED PROPULSION SYSTEMS

A computational analysis of effective R-values of buried ducts – the dynamic performance of buried ducts

Here, this paper evaluates the thermal performance of ducts partially or fully buried in loose-fill attic insulation. The overall thermal resistance between the ducts and the attic is referred to as an effective R-value. This paper shows a strong dependency of assumed attic temperature on the effective R-value. Based on the results, the effective R-value can be about twice as much with an attic temperature of 130 °F [54.4 °C], compared to when the attic temperature is 80 °F [26.7 °C]. Thus, this paper provides a polynomial regression equation based on a large set of simulations to determine the effective R-value of buried ducts depending on attic temperature and whether the HVAC system runs in cooling or heating mode. Further, the work presented in this paper investigated the potential impact of convective airflow within the attic insulation, particularly around the ducts. The analysis was based on computational fluid dynamics (CFD) and indicated that convectional forces are presented around the exterior surface of the ducts, but with negligible impact on the overall heat balance between the duct and the attic space.

97 MATHEMATICS AND COMPUTING