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At least 163 records · Page 9

Understanding Competing Risks

Highlights: • Clinicians and researchers need to be cognizant of competing risks (ie, the occurrence of an event that precludes future development of the outcome of interest). • Censoring is appropriate when a patient being censored at a particular time (eg, owing to loss to follow-up) is deemed to have approximately the same future risk of developing the outcome of interest as patients still being followed, and when the reason for censoring is not related to events of interest. • Censoring is not appropriate in many scenarios; for example, a dead patient can never develop a future cancer recurrence or late effect. • Kaplan-Meier (KM) analysis is commonly used for a time-to-event analysis when the primary outcome (eg, overall survival) has no meaningful competing risk and censoring is appropriate. Cox proportional hazards modeling can be used for multivariable analysis to examine the association between covariates and the primary outcome. • In the presence of competing events, incorrect use of the KM analysis will likely lead to an overestimation of the risk of the outcome of interest and biased estimates from both univariable and multivariable analyses. Therefore, KM usually should not be used to determine local recurrence risk because humanity is always at risk for dying, which is a competing risk. • A competing risk analysis is therefore most appropriate when there are competing events to the primary outcome of interest. The most commonly used multivariable model in these situations is the Fine-Gray model. • Many fundamental questions in radiation oncology—local and regional recurrence, treatment-related toxicity—are best addressed using competing risk methodologies.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Impact of Diabetes and Insulin Use on Prognosis in Patients With Resected Pancreatic Cancer: An Ancillary Analysis of NRG Oncology RTOG 9704

Diabetes mellitus (DM) has been proposed to be tumorigenic; however, prior studies of the association between DM and survival are conflicting. The goal of this ancillary analysis of RTOG 9704, a randomized controlled trial of adjuvant chemotherapy in pancreatic cancer, was to determine the prognostic effects of DM and insulin use on survival.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Fitness factors impacting survival of a subsurface bacterium in contaminated groundwater

Many factors contribute to the ability of a microbial species to persist when encountering complexly contaminated environments, including time of exposure, the nature and concentration of contaminants, availability of nutritional resources, and possession of a combination of appropriate molecular mechanisms needed for survival. Herein we sought to identify genes that are most important for survival of Gram-negative Enterobacteriaceae in contaminated groundwater environments containing high concentrations of nitrate and metals using the metal-tolerant Oak Ridge Reservation isolate, Pantoea sp. MT58 (MT58). Survival fitness experiments in which a randomly barcoded transposon insertion (RB-TnSeq) library of MT58 was exposed directly to contaminated Oak Ridge Reservation groundwater samples from across a nitrate and mixed metal contamination plume were used to identify genes important for survival with increasing exposure times and concentrations of contaminants, and availability of a carbon source. Genes involved in controlling and using carbon, encoding transcriptional regulators, and related to Gram-negative outer membrane processes were among those found to be important for survival in contaminated Oak Ridge Reservation groundwater. A comparative genomics analysis of 75 Pantoea genus strains allowed us to further separate the survival determinants into core and non-core genes in the Pantoea pangenome, revealing insights into the survival of subsurface microorganisms during contaminant plume intrusion.

59 BASIC BIOLOGICAL SCIENCES↗

Total Dose Survivability of Hubble Electronic Components

A total dose analysis for exposure of electronic parts at the box level is presented for the Hubble Space Telescope. This was done using solid angle sectoring/3-dimensional ray trace and Monte Carlo radiation transport simulations. Results are discussed in terms of parts that are potential total dose concerns.

Monte Carlo radiation transport simulation↗

Development of a prediction model for radiotherapy response among patients with head and neck squamous cell carcinoma based on the tumor immune microenvironment and hypoxia signature

Abstract Introduction The immune system and hypoxia are major factors influencing radiosensitivity in patients with different cancer types. This study aimed at developing a model to predict radiotherapy response in patients with head and neck squamous cell carcinoma (HNSCC) based on the tumor immune microenvironment and hypoxia signature. Materials and Methods We first evaluated the hypoxia status and tumor immune microenvironment in the Cancer Genome Atlas (TCGA) cohort by using transcriptomic data. Differentially expressed genes (DEGs) were identified between the “high immunity and low hypoxia” and “low immunity and high hypoxia” groups and those DEGs significantly associated with disease‐specific survival in the univariate Cox regression analysis were selected as the prognostic DEGs. We selected the immune hypoxia–related genes (IHRGs) by intersecting prognostic DEGs with immune and hypoxia gene sets. We used the IHRGs to train a multivariate Cox regression model in the TCGA cohort, based on which we calculated the IHRG prognostic index (IHRGPI) for each patient and validated its efficacy in predicting radiotherapy response in the Gene Expression Omnibus cohorts. Furthermore, we explored potential mechanisms and effective combinational treatment strategies for different IHRGPI groups. Results Five IHRGs were used to construct the IHRGPI, which was used to dichotomize the cohorts. The patients with lower IHRGPI showed a better radiotherapy response across different cohorts and endpoints, including overall survival, progression‐free survival, and recurrence‐free survival ( p < 0.05). Patients with higher IHRGPI showed greater hypoxia and lesser immune cell infiltration. A lower IHRGPI indicated a better immunotherapy response, while a higher IHRGPI indicated a better chemotherapy response. Conclusions IHRGPI is promising for predicting radiotherapy response and guiding combinational treatment strategies in patients with HNSCC.

Zhu, Guang‐Li↗

Analysis of strain gage reliability in F-100 jet engine testing at NASA Lewis Research Center

A reliability analysis was performed on 64 strain gage systems mounted on the 3 rotor stages of the fan of a YF-100 engine. The strain gages were used in a 65 hour fan flutter research program which included about 5 hours of blade flutter. The analysis was part of a reliability improvement program. Eighty-four percent of the strain gages survived the test and performed satisfactorily. A post test analysis determined most failure causes. Five failures were caused by open circuits, three failed gages showed elevated circuit resistance, and one gage circuit was grounded. One failure was undetermined.

Holanda, R.↗

Identification of drug repurposing candidates for amyotrophic lateral sclerosis using electronic health records: a retrospective cohort study

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with a life expectancy of only 3–5 years and few approved treatments. To identify drug repurposing candidates for the treatment of ALS, we analysed the electronic health records (EHRs) of a large cohort of military veterans with ALS. We analysed the EHRs of individuals in the US Veterans Health Administration (VHA) database who were diagnosed with ALS between Jan 1, 2009 and Dec 31, 2019 to assess medication effects. Individuals without recorded prescriptions after the date of diagnosis were excluded. Two sets of criteria were applied to ascertain exposure. Exposure criteria A were met if the dispense date or the end date of the medication was within 12 months of ALS diagnosis and the end date was at least 6 months after the dispense date. Exposure criteria B were met if there were at least two dispenses within 6 months before diagnosis and 12 months after diagnosis. Propensity score-matched control groups were generated on the basis of confounders included in the EHR, with methodology of potential outcomes used to infer treatment effects. The primary outcome was death. A standard Cox proportional hazards analysis was done to assess association with survival. Survival was defined as the time from diagnosis date recorded in the EHR to death reported in the Department for Veterans Affairs Vital Status File. Follow-up survival time was censored on Dec 31, 2020, for those alive on this date. Downstream protein targets of drugs with clinically significant effects were analysed using the protein–protein interaction networks-based algorithm PathFX. The EHRs of 11 003 individuals with ALS in the VHA database were appropriate for analysis. 162 medications with treatment groups of 30 or more individuals were identified. Among these 162 medications, 27 were associated with statistically significant changes (≥0·1) in the hazard ratio (HR) for death. 18 of the medications were associated with a reduced HR for death (prolonged survival), and nine were associated with an increased HR for death (reduced survival). Drugs associated with reduced HR included HMG-CoA reductase inhibitors (simvastatin, pravastatin, lovastatin, and atorvastatin), PDE5 inhibitors (vardenafil and sildenafil), and α-adrenergic antagonists (tamsulosin and terazosin). The medications associated with an increased HR were drugs used either in the management of clinical features of ALS associated with poor outcomes or in end-of-life care. PathFx analysis identified a complex of proteins interacting with several of the identified drugs. To our knowledge, this analysis is the largest EHR-based study for identifying drug repurposing candidates for ALS. We identified several drugs that warrant further assessment as therapeutic options in ALS, as well as a protein network complex that might serve as a therapeutic target for ALS.

Reimer, Richard J. [Stanford Univ., CA (United Sta↗

Columbia Crew Survival Investigation Report

NASA commissioned the Columbia Accident Investigation Board (CAIB) to conduct a thorough review of both the technical and the organizational causes of the loss of the Space Shuttle Columbia and her crew on February 1, 2003. The accident investigation that followed determined that a large piece of insulating foam from Columbia s external tank (ET) had come off during ascent and struck the leading edge of the left wing, causing critical damage. The damage was undetected during the mission. The CAIB's findings and recommendations were published in 2003 and are available on the web at http://caib.nasa.gov/. NASA responded to the CAIB findings and recommendations with the Space Shuttle Return to Flight Implementation Plan. Significant enhancements were made to NASA's organizational structure, technical rigor, and understanding of the flight environment. The ET was redesigned to reduce foam shedding and eliminate critical debris. In 2005, NASA succeeded in returning the space shuttle to flight. In 2010, the space shuttle will complete its mission of assembling the International Space Station and will be retired to make way for the next generation of human space flight vehicles: the Constellation Program. The Space Shuttle Program recognized the importance of capturing the lessons learned from the loss of Columbia and her crew to benefit future human exploration, particularly future vehicle design. The program commissioned the Spacecraft Crew Survival Integrated Investigation Team (SCSIIT). The SCSIIT was asked to perform a comprehensive analysis of the accident, focusing on factors and events affecting crew survival, and to develop recommendations for improving crew survival for all future human space flight vehicles. To do this, the SCSIIT investigated all elements of crew survival, including the design features, equipment, training, and procedures intended to protect the crew. This report documents the SCSIIT findings, conclusions, and recommendations.

Source record↗

Dynamic fatigue of a lithia-alumina-silica glass-ceramic

A dynamic fatigue study was performed on a Li2O-Al2O3-SiO2 glass-ceramic in order to assess its susceptibility to delayed failure. Fracture mechanics techniques were used to analyze the results for the purpose of making lifetime predictions for optical elements made from this material. The material has reasonably good resistance (N = 20) to stress corrosion in ambient conditions. Analysis also indicated the elements should survive applied stresses incurred during grinding and polishing operations.

Tucker, Dennis S.↗

Design and performance oof space station photovoltaic radiators

The design and performance of the Space Station Freedom Photovoltaic (PV) Power Module Thermal Control System radiators is presented. The PV Radiator is of a single phase pumped loop design using liquid ammonia as the coolant. Key design features are described, including the base structure, deployment mechanism, radiator panels, and two independent coolant loops. The basis for a specific mass of 7.8 kg/sqm is discussed, and methods of lowering this number for future systems are briefly described. Key performance paramters are also addressed. A summary of test results and analysis is presented to illustrate the survivability of the radiator in the micrometeoroid and orbital debris environment. A design criterion of 95% probability of no penetration of both fluid loops over a 10 year period is shown to be met. Methods of increasing the radiator survivability even further are presented. Thermal performance is also discussed, including a comparison of modeling predictions with existing test results. Degradation in thermal performance due to exposure to atomic oxygen and ultraviolet radiation in the low Earth orbit environment is presented. The structural criteria to which the radiator is designed are also briefly addressed. Finally, potential design improvements are discussed.

White, K. Alan↗

Various Analyses of Structures and Systems Pertaining to Optical Communications

The Optical Communications Group intends to experiment with a 2 by 2 meter Fresnel lens to determine its likelihood as an alternative to focusing mirrors for optical communications. The lens was delivered in four sections. A support structure was required for the lens in order to hold the four sections in a single flat plane with an adjustable degree angle. In order to use the 200-in. Hale telescope for optical communications purposes, an optical filter membrane must used to pass the communications wavelength while blocking sunlight wavelengths. This filter must withstand wind gusts of up to 50 miles per hour. Stress analysis predicts that the membrane will survive with a safety factor greater than two. The methods used were verified by pressure testing the material. Mechanical and thermodynamic analyses were performed on a simple Golay cell in order to optimize its dimensions for best performance. Flexures are examined as an inexpensive alternative to traditional methods for kinematically constraining a 1.5-meter spherical mirror.

Petersen, Collin W.↗

A Risk Analysis Tool for Estimating the Risk of Electrical Failures Due to Human Induced Defects

Aerospace electrical systems are required to withstand and adequately operate in extremely harsh environments that include, for example, high radiation exposure, temperature extremes, intense vibrational stress and drastic temperature cycling. The nature of aerospace electronics also demands high reliability since, with very few exceptions, there is no chance for hardware servicing or repairs. Common risk mitigation techniques for this type of situation are to perform a Reliability Analysis of the system throughout the development cycle, and to use electrical components that are regarded as “high reliability” because of additional controls and requirements applied in their design, manufacturing and testing. Unfortunately, studies have shown that even though these techniques are used, many systems fail to meet mission requirements well before the predicted lifetimes. This paper presents the analysis of failures of electrical parts, experienced during various stages of system development, at NASA Goddard Space Flight Center, Greenbelt MD, between the years 2001 and 2013. These components were subjected to qualification, screening and testing in which the goal was to ensure that the components would survive the stresses of the mission. The analysis categorizes failures by part type and failure mechanisms. One of the results of the analysis was the realization that a surprising proportion of failures experienced during system integration and testing were caused by human error (i.e. human induced defect). Further analysis included the determination of root failure mechanisms and any influencing factors contributing to these failures. The major causes of these defects were attributed to electrostatic damage (ESD), electrical overstress (EOS), mechanical overstress (MOS), and thermal overstress (TOS). Finally, the study proposes a risk analysis tool which incorporates these major causes for the failures, termed error-producing conditions (EPCs), and a proportionality factor representing the number of each type of failure that has occurred at the facility under study. These factors are quantified and used to communicate the risk of human induced defects for the assembly, integration and testing of space hardware based on the system’s electrical parts list. The new risk identification can trigger risk-mitigating actions more effectively, based on the presence of component categories or other hazardous conditions that have a history of failure due to human error.

Majewicz, Peter J.↗

Cosmic evolution of non-topological solitons, paper 1

Nontopological solitons are stable field configurations which may be formed in a primordial phase transition. Their cosmic evolution is studied, and the possibility that such objects could contribute significantly to the energy density of the Universe is examined. As the Universe cools, initially all but the largest lumps evaporate into free particles; those which survive may subsequently enter a brief accretion phase before they freeze out at a final size. Although the minimum critical charges which survive depend on particle masses and couplings, researchers develop an analysis which applies to a wide class of models. In most cases, solitons of moderate size survive the evaporation process only if there is a significant charge asymmetry or if they form at a temperature well below their binding energy per charge.

Frieman, Joshua A.↗

Designing for auto safety

Safety design features in the motor vehicle and highway construction fields result from systems analysis approach to prevent or lessen death, injury, and property damage results. Systems analysis considers the prevention of crashes, increased survivability in crashes, and prompt medical attention to injuries as well as other postcrash salvage measures. The interface of these system elements with the driver, the vehicle, and the environment shows that action on the vehicle system produces the greatest safety payoff through design modifications. New and amended safety standards developed through hazard analysis technique improved accident statistics in the 70'; these regulations include driver qualifications and countermeasures to identify the chronic drunken driver who is involved in more than two-thirds of all auto deaths.

Elwood T. Driver↗

Introduction of the Space Shuttle Columbia Accident, Investigation Details, Findings and Crew Survival Investigation Report

As the Space Shuttle Program comes to an end, it is important that the lessons learned from the Columbia accident be captured and understood by those who will be developing future aerospace programs and supporting current programs. Aeromedical lessons learned from the Accident were presented at AsMA in 2005. This Panel will update that information, closeout the lessons learned, provide additional information on the accident and provide suggestions for the future. To set the stage, an overview of the accident is required. The Space Shuttle Columbia was returning to Earth with a crew of seven astronauts on 1Feb, 2003. It disintegrated along a track extending from California to Louisiana and observers along part of the track filmed the breakup of Columbia. Debris was recovered from Littlefield, Texas to Fort Polk, Louisiana, along a 567 statute mile track; the largest ever recorded debris field. The Columbia Accident Investigation Board (CAIB) concluded its investigation in August 2003, and released their findings in a report published in February 2004. NASA recognized the importance of capturing the lessons learned from the loss of Columbia and her crew and the Space Shuttle Program managers commissioned the Spacecraft Crew Survival Integrated Investigation Team (SCSIIT) to accomplish this. Their task was to perform a comprehensive analysis of the accident, focusing on factors and events affecting crew survival, and to develop recommendations for improving crew survival, including the design features, equipment, training and procedures intended to protect the crew. NASA released the Columbia Crew Survival Investigation Report in December 2008. Key personnel have been assembled to give you an overview of the Space Shuttle Columbia accident, the medical response, the medico-legal issues, the SCSIIT findings and recommendations and future NASA flight surgeon spacecraft accident response training. Educational Objectives: Set the stage for the Panel to address the investigation, medico-legal issues, the Spacecraft Crew Survival Integrated Investigation Team report and training for accident response.

Chandler, Michael↗

Regolith Particle Erosion of Material in Aerospace Environments

This paper studies the effect of exposing thermal control S13GP:6N/LO-I white paint, Kapton flex cable, fiber optic cable, HEPA filter, and M55J graphite composite to high-velocity regolith environment that spacecraft landing on Mars are commonly exposed to. Due to the similarity between the Mars 2020 Rover design and Mars Science Laboratory design, it is expected that the Mars 2020 rover will be exposed to a similar high-speed regolith environment that the Mars Science Laboratory was exposed to. This environment is replicated to test the survivability of susceptible materials. The testing is performed at the University of Dayton Research Institute in Dayton, Ohio. The experiments expose different materials to basaltic–like particles ranging in size from approximately 40 μm to 2 cm, at velocities ranging from 19 m/s to 250 m/s, with varied particle fluxes (measured in mg/cm2). Depending on the size of the particle used, the particles can either embed in or erode the material. Posttest analysis shows that all materials tested will survive the expected environment observed during the Mars 2020 landing event. Some materials are tested to failure in order to better characterize material response. Materials that fail in some test scenarios include the paint, fiber optic cable, and the graphite composite. After being exposed to regolith, the α/ε ratio of the paint increased by ~37% due to particles embedding in the paint. Darkening of the paint can negatively affect thermal control of the rover. With high particle mass fluxes, the paint eventually degraded enough to expose the aluminum substrate. When impacted by a 1.5 cm particle traveling at 20 m/s, the fiber optic cable did not sever, but the impact did cause the cable to deform enough to crack the glass, which resulted in a significant increase in attenuation, rendering the cable unable to transmit data. The graphite composite also failed when exposed to high particle fluxes. All of the observed failures occurred for test cases above the expected landing environment with significant margin. Tests performed beyond the requirements help characterize how well these materials will survive in even more extreme environments for future missions.

Abid, Mohamed↗

UARS Re-Entry Prediction and Analysis

The National Aeronautics and Space Administration (NASA) deployed the Upper Atmosphere Research Satellite (UARS) from the Space Shuttle payload bay during the STS-48 mission in September, 1991. The 5700 kg satellite was decommissioned in December, 2005 and was maneuvered into a lower altitude orbit to shorten its on-orbit lifetime to reduce the probability of a debris producing accidental collision. The satellite reentered the Earth s atmosphere over the Pacific Ocean on September 24, 2011. Analysis by NASA s Orbital Debris Program Office using the ORSAT software predicted that approximately two dozen fragments from UARS would survive reentry to reach the ground. This presentation will discuss the reentry predictions made in the days prior to the reentry and compare the UARS reentry with other historical reentries. It will also present the results of the ORSAT analysis showing predicted surviving reentry objects

Stansbery, Eugene G.↗