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At least 91 records · Page 5

CpG ODN D35 improves the response to abbreviated low-dose pentavalent antimonial treatment in non-human primate model of cutaneous leishmaniasis

Cutaneous leishmaniasis (CL) affects the lives of 0.7–1 million people every year causing lesions that take months to heal. These lesions can result in disfiguring scars with psychological, social and economic consequences. Antimonials are the first line of therapy for CL, however the treatment is lengthy and linked to significant toxicities; further, its efficacy is variable and resistant parasites are emerging. Shorter or lower dose antimonial treatment regimens, which would decrease the risk of adverse events and improve patient compliance, have shown reduced efficacy and further increase the risk emergence of antimonial-resistant strains. The progression of lesions in CL is partly determined by the immune response it elicits, and previous studies showed that administration of immunomodulatory type D CpG ODNs, magnifies the immune response to Leishmania and reduces lesion severity in nonhuman primates (NHP) challenged with Leishmania major or Leishmania amazonensis. Here we explored whether the addition of a single dose of immunomodulating CpG ODN D35 augments the efficacy of a short-course, low-dose pentavalent antimonial treatment regimen. Results show that macaques treated with D35 plus 5mg/kg sodium stibogluconate (SbV ) for 10 days had smaller lesions and reduced time to re-epithelization after infection with Leishmania major. No toxicities were evident during the studies, even at doses of D35 10 times higher than those used in treatment. Critically, pentavalent antimonial treatment did not modify the ability of D35 to induce type I IFNs. The findings support the efficacy of D35 as adjuvant therapy for shorter, low dose pentavalent antimonial treatment.

59 BASIC BIOLOGICAL SCIENCES↗

New machine protection system at the Spallation Neutron Source – design process and performance analysis

A New Machine Protection System (MPS) at the Spallation Neutron Source (SNS) was developed and implemented on µTCA-based hardware platforms. The system monitors more than 2500 field inputs and shuts off the beam within 10 µs if adverse events occur. We will present system level design process of various firmware and software components as well as the system integration into EPICS environment. The performance analysis of the MPS after two SNS run cycles will also be presented.

Bobrek, Miljko [ORNL] (ORCID:0000000332763451)↗

Stewardship Considerations for Nevada FFACO Corrective Action Units Closed through the EM NV Soils Activity based on Monitoring of Radionuclide Transport

This report summarizes the EM NV/DRI work with the intent of conveying this information to the long-term land managers who will assume responsibility as EM NV completes its environmental restoration mission. A brief description of each of the six evaluated Soils Activity sites is provided, which is followed by a discussion of the findings regarding radionuclide transport learned at the sites. The implications of these findings are examined for site management, routine monitoring, and monitoring during potentially adverse events. Possible mitigation actions are also identified. The appendices provide a more detailed examination of the conditions under which radionuclide transport occurs at these sites.

54 ENVIRONMENTAL SCIENCES↗

AGGREGATE: dAta-driven modelinG preservinG contRollable dEr for outaGe mAnagemenT and rEsiliency (Final Report)

The AGGREGATE project team successfully developed and validated various modules for outage management. Brief summaries of each module are provided to showcase their strength for outage management and restoration for a distribution system with a high penetration of connected distribution energy resources (DERs). In recent years, inverter-based DERs have been widely deployed in distribution system. A most of behind-the-meter (BTM) solar power generation is not visible to the utility. The data-driven DER and load estimation modules are using machine learning (ML) and artificial intelligence (AI) to manage this issue, which provides an opportunity for distribution system operators (DSOs) to operate systems and make decisions in real-time for a distribution system with a high penetration of DERs deployed. Also, the estimated DER and true load can be further leveraged in network aggregation and cold-load pick up estimation for reducing the computing complexity and providing for fast restoration. After load demand and DER power generations have been estimated, the information will support topology and state estimation (SE). The topology estimation module demonstrated the viability of mixed integer linear programming (MILP) formulation to estimate the most likely operational radial topology and outage sections using power flow measurements, historical/estimated load and DERs data and smart meter ping measurements. Formulation includes continuous (power flow, load and DERs data) and binary measurements (smart meter ping measurements) in a single formulation. Errors in continuous data and binary data are modeled as normal distribution and Bernoulli distribution, respectively. In the future distribution grid, the power injection from controllable DERs will be essential for efficient and resilient grid operation. However, determining the optimal DER injections and restoration actions is dependent on knowledge of the system states. State estimation (SE), already the cornerstone of transmission energy management systems, will become commonplace in distribution management systems as more measurements become available from deployment of automated metering infrastructure (AMI). Observability analysis is the first step in SE, as it determines the sufficiency of the available measurements for accurately estimating the current system states. A new type of pseudo-measurement called a Correlational Measurement (CM) is introduced in this module, to enhance the observability of the system to enable more accurate SE. CMs encapsulate knowledge of correlation between demand patterns for similar classes of loads as well as injection patterns for same-technology renewable DERs. During grid contingency scenarios, DERs have been traditionally disconnected, without any fault ride-through capabilities. However, with new regulations and better technology, it is feasible for these resources to contribute to the grid’s restoration after an adverse event and hence enhance resilience. The controllability module proposes a two-step restoration scheme for the power system restoration process by leveraging additional degrees of freedom in power electronics interfaced DERs for mitigating voltage problems. In a resilience mode without the utility system, the distribution grid relies on DERs to serve critical load. In such a severe event with multiple faults on the distribution feeders, actuation of various protective devices (PDs) divides the distribution system into electrical islands. The undetected actuated PDs due to fault current contributions from DERs can delay the restoration process, thereby reducing the system resilience. The Advanced Outage Management (AOM) and the Advanced Feeder Restoration (AFR) modules developed in this project provide improved system resilience with multiple DERs. AOM identifies the faulted sections and actuated PDs in a distribution system with DERs by incorporating smart meter data. The most credible outage scenario including fault locations, PD actuations, and fault indicator (FI) failures is identified by a set of binary integer linear programming incorporating hypotheses. The AFR module serves to restore a distribution system with available energy resources taking into consideration the availability of utility sources and DERs. By partitioning the system into islands, critical load will be served with the available generation resources within islands based on the solution of a MILP. When the utility systems become available, the optimal path will be determined by a spanning tree search algorithm that reconnects these islands back to substations and restores the remaining load. The transmission and distribution (T&D) co-simulation module was used to validate the effect of a control action performed on the distribution side assets as it propagates to the transmission side. This ensures that the control action performed results in a feasible operating point on both the transmission and the distribution system. In addition to validation, the team used the T&D co-simulation module to demonstrate how distribution system assets can be used to mitigate issues on the transmission system. Specifically, the team demonstrated that appropriate switching operations on the distribution side can alleviate the line overload condition on the transmission side without causing new operational constraint violations.

24 POWER TRANSMISSION AND DISTRIBUTION↗

Current and Future Work on Wound Contamination by Alpha Emitters at Los Alamos [Slides]

Our team calculated ‘clinical decision levels’ at which treatment may be warranted (i.e., bioassay and wound measurements which correspond to specific dose thresholds). The actual risk to the patient corresponding to this dose threshold is uncertain – the CED may not tell the whole story. We recently reviewed LANL medical records to characterize adverse events associated with treatment. Future work should include medical records from other institutions and a review and analysis of data to quantify benefit of treatment with a focus on the question, "What factors predict whether treatment will be beneficial?"

61 RADIATION PROTECTION AND DOSIMETRY↗

Best Practices for Grid Communications

As the grid evolves, the communications architecture will need to evolve with it. That architecture affords a structured means by which the evolving complexities of the modern electric grid can be managed. This document provides best practices that can be implemented in the grid of today and evolve towards the grid and grid architecture of the future. The evolving grid and its control communications increasingly rely on commercial communications providers and a variety of technologies, from wireless (e.g., 5G, microwave, Wi-Fi) to wireline (fiber, copper) to radio communications (P25, other repeater-based systems), and all these communications systems rely on electric power. A reliable and resilient grid must account for this complex set of interdependencies in its planning activities, especially those involving restoration and recovery. The participation of all relevant parties in both planning and exercising of plans can prevent unexpected conditions that impede the reliable operation and recovery of the grid. Best practices for grid communications include using a Network Management System to document the operational state, define and monitor baselines, detect changes, and accelerate response to abnormalities. If transitioning from SONET to IP/packet-based systems, translating grid requirements into communications requirements for latency, bandwidth and throughput, IP packet delay variation, packet loss, and availability should inform and drive technology planning and selection as well as that communication system’s Quality of Service (QoS) policies and Service Level Agreements (SLAs). Secure and reliable timing is another key component of a reliable and resilient grid that can operate through adverse events. A trusted internal NTP configuration, an integrated and diverse timing delivery system, optimizing the timing architecture based on the transport technologies of the communications system, and using established standards can deliver the level of timing accuracy required by a range of time-sensitive power system applications.

24 POWER TRANSMISSION AND DISTRIBUTION↗

The MHC Associated Peptide Proteomics assay is a useful tool for the non-clinical assessment of immunogenicity

The propensity of therapeutic proteins to elicit an immune response, poses a significant challenge in clinical development and safety of the patients. Assessment of immunogenicity is crucial to predict potential adverse events and design safer biologics. In this study, we employed MHC Associated Peptide Proteomics (MAPPS) to comprehensively evaluate the immunogenic potential of re-engineered variants of immunogenic FVIIa analog (Vatreptacog Alfa). Our finding revealed the correlation between the protein sequence affinity for MHCII and the number of peptides identified in a MAPPS assay and this further correlates with the reduced T-cell responses. Moreover, MAPPS enable the identification of “relevant” T cell epitopes and may contribute to the development of biologics with lower immunogenic potential.

59 BASIC BIOLOGICAL SCIENCES↗

Evaluation of intracoronary hemodynamics identifies perturbations in vorticity

Coronary artery disease (CAD) is highly prevalent and associated with adverse events. Challenges have emerged in the treatment of intermediate coronary artery stenoses. These lesions are often interrogated with fractional flow reserve (FFR) testing to determine if a stenosis is likely to be causative for ischemia in a cardiac territory. This invasive test requires insertion of a pressure wire into a coronary vessel. Recently computational fluid dynamics (CFD) has been used to noninvasively assess fractional flow reserve in vessels reconstructed from medical imaging data. However, many of these simulations are unable to provide additional information about intravascular hemodynamics, including velocity, endothelial shear stress (ESS), and vorticity. We hypothesized that vorticity, which has demonstrated utility in the assessment of ventricular and aortic diseases, would also be an important hemodynamic factor in CAD. Three-dimensional (3D), patient-specific coronary artery geometries that included all vessels >1 mm in diameter were created from angiography data obtained from 10 patients who underwent diagnostic angiography and FFR testing (n = 9). A massively parallel CFD solver (HARVEY) was used to calculate coronary hemodynamic parameters including pressure, velocity, ESS, and vorticity. These simulations were validated by comparing velocity flow fields from simulation to both velocities derived from in vitro particle image velocimetry and to invasively acquired pressure wire-based data from clinical testing. There was strong agreement between findings from CFD simulations and particle image velocimetry experimental testing (p < 0.01). CFD-FFR was also highly correlated with invasively measured FFR (ρ = 0.77, p = 0.01) with an average error of 5.9 ± 0.1%. CFD-FFR also had a strong inverse correlation with the vorticity (ρ = -0.86, p = 0.001). Simulations to determine the effect of the coronary stenosis on intravascular hemodynamics demonstrated significant differences in velocity and vorticity (both p < 0.05). Further evaluation of an angiographically normal appearing non-FFR coronary vessel in patients with CAD also demonstrated differences in vorticity when compared with FFR vessels (p < 0.05). The use of highly accurate 3D CFD-derived intravascular hemodynamics provides additional information beyond pressure measurements that can be used to calculate FFR. Vorticity is one parameter that is modified by a coronary stenosis and appears to be abnormal in angiographically normal vessels in patients with CAD, highlighting a possible use-case in preventative screening for early coronary disease.

59 BASIC BIOLOGICAL SCIENCES↗

Tracing and Forecasting Metabolic Indices of Cancer Patients Using Patient-Specific Deep Learning Models

We develop a patient-specific dynamical system model from the time series data of the cancer patient’s metabolic panel taken during the period of cancer treatment and recovery. The model consists of a pair of stacked long short-term memory (LSTM) recurrent neural networks and a fully connected neural network in each unit. It is intended to be used by physicians to trace back and look forward at the patient’s metabolic indices, to identify potential adverse events, and to make short-term predictions. When the model is used in making short-term predictions, the relative error in every index is less than 10% in the L ∞ norm and less than 6.3% in the L 1 norm in the validation process. Once a master model is built, the patient-specific model can be calibrated through transfer learning. As an example, we obtain patient-specific models for four more cancer patients through transfer learning, which all exhibit reduced training time and a comparable level of accuracy. This study demonstrates that this modeling approach is reliable and can deliver clinically acceptable physiological models for tracking and forecasting patients’ metabolic indices.

60 APPLIED LIFE SCIENCES↗

T Cells Contribute to Pathological Responses in the Non-Targeted Rat Heart following Irradiation of the Kidneys

Heart disease is a significant adverse event caused by radiotherapy for some cancers. Identifying the origins of radiogenic heart disease will allow therapies to be developed. Previous studies showed non-targeted effects manifest as fibrosis in the non-irradiated heart after 120 days following targeted X-irradiation of the kidneys with 10 Gy in WAG/RijCmcr rats. To demonstrate the involvement of T cells in driving pathophysiological responses in the out-of-field heart, and to characterize the timing of immune cell engagement, we created and validated a T cell knock downrat on the WAG genetic backgrou nd. Irradiation of the kidneys with 10 Gy of X-rays in wild-type rats resulted in infiltration of T cells, natural killer cells, and macrophages after 120 days, and none of these after 40 days, suggesting immune cell engagement is a late response. The radiation nephropathy and cardiac fibrosis that resulted in these animals after 120 days was significantly decreased in irradiated T cell depleted rats. We conclude that T cells function as an effector cell in communicating signals from the irradiated kidneys which cause pathologic remodeling of non-targeted heart.

60 APPLIED LIFE SCIENCES↗

Risk analysis of computer system designs

Adverse events during implementation can affect final capabilities, schedule and cost of a computer system even though the system was accurately designed and evaluated. Risk analysis enables the manager to forecast the impact of those events and to timely ask for design revisions or contingency plans before making any decision. This paper presents a structured procedure for an effective risk analysis. The procedure identifies the required activities, separates subjective assessments from objective evaluations, and defines a risk measure to determine the analysis results. The procedure is consistent with the system design evaluation and enables a meaningful comparison among alternative designs.

Vallone, A.↗

A Comparison of Cilostazol and Pentoxifylline for Treating Intermittent Claudication

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

Dawson, David L.↗

Distribution of Causes in Selected US Aviation Accident Reports Between 1996 and 2003

This paper describes the results of an independent analysis of the probable and contributory causes of selected aviation accidents in the United States between 1996 and 2003. The purpose of the study was to assess the comparative frequency of a variety of causal factors in the reporting of these adverse events. Although our results show that more of these high consequence accidents were attributed to human error than to any other single factor, a large number of reports also mentioned wider systemic issues, including the managerial and regulatory context of aviation operations. These wider issues are more likely to appear as contributory rather than primary causes in this set of accident reports.

Holloway, C. M.↗

'Systemic Failures' and 'Human Error' in Canadian TSB Aviation Reports Between 1996 and 2002

This paper describes the results of an independent analysis of the primary and contributory causes of aviation accidents in Canada between 1996 and 2003. The purpose of the study was to assess the comparative frequency of a range of causal factors in the reporting of these adverse events. Our results suggest that the majority of these high consequence accidents were attributed to human error. A large number of reports also mentioned wider systemic issues, including the managerial and regulatory context of aviation operations. These issues are more likely to appear as contributory rather than primary causes in this set of accident reports.

Holloway, C. M.↗

Strategies for Small Volume Resuscitation: Hyperosmotic-Hyperoncotic Solutions, Hemoglobin Based Oxygen Carriers and Closed-Loop Resuscitation

Introduction: Logistic constraints on combat casualty care preclude traditional resuscitation strategies which can require volumes and weights 3 fold or greater than hemorrhaged volume. We present a review of quantitative analyses of clinical and animal data on small volume strategies using 1) hypertonic-hyperosmotic solutions (HHS); 2) hemoglobin based oxygen carriers (HBOCs) and 3) closed-loop infusion regimens.Methods and Results: Literature searches and recent queries to industry and academic researchers have allowed us to evaluate the record of 81 human HHS studies (12 trauma trials), 19 human HBOCs studies (3trauma trials) and two clinical studies of closed-loop resuscitation.There are several hundreds animal studies and at least 82 clinical trials and reports evaluating small volume7.2%-7.5% hypertonic saline (HS) most often combined with colloids, e.g., dextran (HSD) or hetastarch(HSS). HSD and HSS data has been published for 1,108 and 392 patients, respectively. Human studies have documented volume sparing and hemodynamic improvements. Meta-analyses suggest improved survival for hypotensive trauma patients treated with HSD with significant reductions in mortality found for patients with blood pressure < 70 mmHg, head trauma, and penetrating injury requiring surgery. HSD and HSS have received regulatory approval in 14 and 3 countries, respectively, with 81,000+ units sold. The primary reported use was head injury and trauma resuscitation. Complications and reported adverse events are surprisingly rare and not significantly different from other solutions.HBOCs are potent volume expanders in addition to oxygen carriers with volume expansion greater than standard colloids. Several investigators have evaluated small volume hyperoncotic HBOCs or HS-HBOC formulations for hypotensive and normotensive resuscitation in animals. A consistent finding in resuscitation with HBOCs is depressed cardiac output. There is some evidence that HBOCs more efficiently unload oxygen from plasma hemoglobin as well as facilitate RBC unloading. We analyzed one volunteer study, 15 intraoperative trials, and 3 trauma studies using HBOCs. Perioperative studies generally suggest ability to deliver oxygen, but one trauma trial using HBOCs (HemAssist) for treatment of trauma resulted in a dramatic increase in mortality, while an intraoperative trauma study using Polyheme demonstrated reductions in blood use and lower mortality compared to historic controls of patients refusing blood. Transfusion reductions with HBOC use have been modest. Two HBOCs (Hemopure and Polyheme) are now in new or planned large-scale multicenter prehospital trials of trauma treatment. A new implementation of small volume resuscitation is closed-loop resuscitation (CLR), which employs microprocessors to titrate just enough fluid to reach a physiologic target . Animal studies suggest less risk of rebleeding in uncontrolled hemorrhage and a reduction in fluid needs with CLR. The first clinical application of CLR was treatment of burn shock and the US Army. Conclusions: Independently sponsored civilian trauma trials and clinical evaluations in operational combat conditions of different small volume strategies are warranted.

Kramer, George C.↗

Lightning Pin Injection Testing on MOSFETS

Lightning transients were pin-injected into metal-oxide-semiconductor field-effect transistors (MOSFETs) to induce fault modes. This report documents the test process and results, and provides a basis for subsequent lightning tests. MOSFETs may be present in DC-DC power supplies and electromechanical actuator circuits that may be used on board aircraft. Results show that unprotected MOSFET Gates are susceptible to failure, even when installed in systems in well-shielded and partial-shielded locations. MOSFET Drains and Sources are significantly less susceptible. Device impedance decreased (current increased) after every failure. Such a failure mode may lead to cascading failures, as the damaged MOSFET may allow excessive current to flow through other circuitry. Preliminary assessments on a MOSFET subjected to 20-stroke pin-injection testing demonstrate that Breakdown Voltage, Leakage Current and Threshold Voltage characteristics show damage, while the device continues to meet manufacturer performance specifications. The purpose of this research is to develop validated tools, technologies, and techniques for automated detection, diagnosis and prognosis that enable mitigation of adverse events during flight, such as from lightning transients; and to understand the interplay between lightning-induced surges and aging (i.e. humidity, vibration thermal stress, etc.) on component degradation.

Ely, Jay J.↗

A Collaborative Web-Based Approach to Planning Research, Integration, and Testing Using a Wiki

The National Aeronautics and Space Administration Integrated Vehicle Health Management program touches on many different research areas while striving to enable the automated detection, diagnosis, prognosis, and mitigation of adverse events at the aircraft and system level. At the system level, the research focus is on the evaluation of multidisciplinary integrated methods, tools, and technologies for achieving the program goal. The participating program members form a diverse group of government, industry, and academic researchers. The program team developed the Research and Test Integration Plan in order to track significant test and evaluation activities, which are important for understanding, demonstrating, and communicating the overall project state and project direction. The Plan is a living document, which allows the project team the flexibility to construct conceptual test scenarios and to track project resources. The Plan also incorporates several desirable feature requirements for Plan users and maintainers. A wiki has proven to be the most efficient and effective means of implementing the feature requirements for the Plan. The wiki has proven very valuable as a research project management tool, and there are plans to expand its scope.

Delaney, Michael M.↗

Assessment of the State of the Art of Integrated Vehicle Health Management Technologies as Applicable to Damage Conditions

A survey of literature from academia, industry, and other Government agencies assessed the state of the art in current integrated vehicle health management (IVHM) aircraft technologies. These are the technologies that are used for assessing vehicle health at the system and subsystem level. This study reports on how these technologies are employed by major military and commercial platforms for detection, diagnosis, prognosis, and mitigation. Over 200 papers from five conferences from the time period of 2004 to 2009 were reviewed. Over 30 of these IVHM technologies are then mapped into the 17 different adverse event damage conditions identified in a previous study. This study illustrates existing gaps and opportunities for additional research by the NASA IVHM Project.

Reveley, Mary S.↗