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At least 19 records

Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

Currently there are several physiological monitoring requirements for Extravehicular Activity (EVA) in the Human-Systems Interface Requirements (HSIR) document, including continuous heart rhythm monitoring. However, it is not known whether heart rhythm monitoring in the lunar surface space suit is a necessary capability for lunar surface operations or in launch/landing suit the event of a cabin depressurization enroute to or from the moon. Methods: Current US astronaut corps demographic information was provided to an expert panel of cardiovascular medicine experts, including specialists in electrophysiology, exercise physiology, interventional cardiology and arrhythmia. This information included averages for male/female age, body mass index (BMI), blood pressure, cholesterol, inflammatory markers, echocardiogram, ranges for coronary artery calcium (CAC) scores for long duration astronauts, and ranges for heart rate (HR) and metabolic (MET) rates obtained during microgravity and lunar EVA. Results: The panel determined that no uncontrolled hazard was likely to occur in the suit during lunar surface or contingency microgravity ops that would require ECG monitoring in the highly screened US astronaut population. However having the capability for rhythm monitoring inside the vehicle (IVA) was considered critical to manage an astronaut in distress. Discussion: Heart rate (HR) monitoring alone allows effective monitoring of astronaut health and function. Consequently, electrocardiographic (ECG) monitoring capability as a clinical tool is not essential in the lunar or launch/landing space suit. However, the panel considered that rhythm monitoring could be useful in certain clinical situations, it was not considered required for safe operations. Also, lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG (derived 12- lead) for IVA medical assessments.

Scheuring, Richard A.↗

Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

There are currently several physiological monitoring requirements for EVA in the Human-Systems Interface Requirements (HSIR) document. There are questions as to whether the capability to monitor heart rhythm in the lunar surface space suit is a necessary capability for lunar surface operations. Similarly, there are questions as to whether the capability to monitor heart rhythm during a cabin depressurization scenario in the launch/landing space suit is necessary. This presentation seeks to inform space medicine personnel of recommendations made by an expert panel of cardiovascular medicine specialists regarding in-suit ECG heart rhythm monitoring requirements during lunar surface operations. After a review of demographic information and clinical cases and panel discussion, the panel recommended that ECG monitoring capability as a clinical tool was not essential in the lunar space suit; ECG monitoring was not essential in the launch/landing space suit for contingency scenarios; the current hear rate monitoring capability requirement for both launch/landing and lunar space suits should be maintained; lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG for IVA medical assessments; and, exercise stress testing for astronaut selection and retention should be changed from the current 85% maximum heart rate limit to maximal, exhaustive 'symptom-limited' testing to maximize diagnostic utility as a screening tool for evaluating the functional capacity of astronauts and their cardiovascular health.

Scheuring, Richard A.↗

Big Data and Cloud Computing Expert Panel

This talk is a brief introduction to the exploratory cloud prototypes currently underway within ESDIS and the implications of cloud technologies on existing systems.

NGAP↗

Development of Training Materials for Pathologists to Provide Machine Learning Validation Data of Tumor-Infiltrating Lymphocytes in Breast Cancer

The High Throughput Truthing project aims to develop a dataset for validating artificial intelligence and machine learning models (AI/ML) fit for regulatory purposes. The context of this AI/ML validation dataset is the reporting of stromal tumor-infiltrating lymphocytes (sTILs) density evaluations in hematoxylin and eosin-stained invasive breast cancer biopsy specimens. After completing the pilot study, we found notable variability in the sTILs estimates as well as inconsistencies and gaps in the provided training to pathologists. Using the pilot study data and an expert panel, we created custom training materials to improve pathologist annotation quality for the pivotal study. We categorized regions of interest (ROIs) based on their mean sTILs density and selected ROIs with the highest and lowest sTILs variability. In a series of eight one-hour sessions, the expert panel reviewed each ROI and provided verbal density estimates and comments on features that confounded the sTILs evaluation. We aggregated and shaped the comments to identify pitfalls and instructions to improve our training materials. From these selected ROIs, we created a training set and proficiency test set to improve pathologist training with the goal to improve data collection for the pivotal study. We are not exploring AI/ML performance in this paper. Instead, we are creating materials that will train crowd-sourced pathologists to be the reference standard in a pivotal study to create an AI/ML model validation dataset. The issues discussed here are also important for clinicians to understand about the evaluation of sTILs in clinical practice and can provide insight to developers of AI/ML models.

60 APPLIED LIFE SCIENCES↗

The Pathway to a Safe and Effective Spaceflight Medication Formulary: Expert Review Panel Recommendations

Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

Daniels, V. R.↗

Independent Technical Assessment of NASA and External Quantum Sensing Capability

The recent FY 2020 federal Research and Development Budget Priorities memo addresses the leadership need in Quantum Information Science (QIS) directing agencies to “prioritize QIS research and development (R&D), which will build the technical and scientific base necessary to explore the next generation of QIS theory, devices, and applications.” Quantum Sensing (QS) is an integral part of QIS. NASA is a key part of the directive to forward American space exploration and commercialization by providing “capabilities that have broad potential applications in space and on Earth.” QS provides an arena for NASA to demonstrate leadership in both areas of the administrative directive. QS uses quantum properties to achieve unprecedented measurement sensitivity and performance, including quantum-enhanced methodologies that outperform their classical counterparts. Typical quantum sensors exploit techniques such as atomic systems, matter waves, quantum entanglement, quantum superposition of states, quantum illumination methods, and manipulation of photons and atoms, in general. Guided by advancements in our ability to generate, manipulate, and control quantum systems, the emerging quantum sensing technologies promise unrivalled sensitivity, resolution, and precision, potentially leading to game-changing applications. Significant gains include technologies important for a range of NASA missions such as remote sensing, in situ measurements, metrology, interferometry, quantum communication, ranging, imaging, radar and lidar receivers, and gravity measurements. NASA Engineering and Safety Center has convened an independent external panel, comprising of Quantum Sensing Experts from Government, DoD, academia, and Federally funded Research and Development Center to conduct an independent technical assessment of the agency's capabilities in Quantum Sensing to understand NASA's internal needs and competencies related to Quantum Sensing and compare agency capabilities with those available externally including industry, academia, and other government agencies. The outcomes of the assessment will help the agency in establishing appropriate strategies and investments to develop and maintain the state-of-the-art sensing competence and capabilities required to meet the agency’s future needs. The External Experts Panel (EEP) is collaborating with HQ, various NASA Center and the representatives in the NASA Quantum Sensing Community of Practice (QS CoP), a part of NASA Sensors and Instrumentation Technical Fellow Technical Discipline Team, in obtaining common, current understanding of agency mission needs where QS can be an important enabler for future needs, and any programs, projects, assets, and technologists working in QS. The EEP organized a Quantum Sensing Workshop of practitioners from industry, academia, other government agencies, external experts, and interested NASA personnel to gather the assessment information. EEP also conducted information gathering on the industry at large, educational institutions, and other government agency research efforts for capture in the assessment database. At the conclusion of this assessment, EEP team will develop findings and conclusions describing NASA’s capabilities for the mission needs, NASA's relative position on new, enabling technologies, and an analysis of the gaps that may present any risks to near-term or far-term mission needs. This presentation will give details of the NASA and External Quantum Sensing Assessment outcomes, findings, observations, and its recommendation to NASA as how it can advance Quantum Sensing technologies and techniques for its science and explorations related missions.

External Quantum Sensing Capability↗

A Review of Monitoring Technologies for Trace Air Contaminants in the International Space Station

NASA issued a Request For Information (RFI) to identify technologies that might be available to monitor a list of air pollutants in the ISS atmosphere. After NASA received responses to the RFI, an expert panel was assembled to hear presentations from 9 technology proponents. The goal of the panel was to identify technologies that might be suitable for replacement of the current Volatile Organics Analyzer (VOA) within several years. The panelists consisted of 8 experts in analytical chemistry without any links to NASA and 7 people with specific expertise because of their roles in NASA programs. Each technology was scored using a tool that enabled rating of many specific aspects of the technology on a 4-point system. The maturity of the technologies ranged from well-tested instrument packages that had been designed for space applications and were nearly ready for flight to technologies that were untested and speculative in nature. All but one technology involved the use of gas chromatography for separation, and there were various detectors proposed including several mass spectrometers and ion mobility spectrometers. In general there was a tradeoff between large systems with considerable capability to address the target list and smaller systems that had much more limited capability.

James, John T.↗

A WOUND CARE AND INTRAVENOUS ACCESS SUMMIT FOR ON-ORBIT CARE

Wound care issues and the ability to establish intravenous (IV) access among injured or ill crew members are a source of concern for NASA flight surgeons. Indeed, the microgravity environment and the remote nature of the International Space Station (ISS) pose unique challenges in diagnosing and treating an injured astronaut. Therefore, it is necessary to identify and adapt the best evidence based terrestrial practices regarding wound care, hemostasis, and IV access for use on the ISS. Methods: A panel of consultants was convened to evaluate the adequacy of the current ISS in-flight medical system for diagnosis and treatment of wounds and establishing IV access by a nonclinician crew medical officer. Participants were acknowledged experts in terrestrial wound care and/or operational medicine. Prior to the meeting, each panelist was encouraged to participate in a pre-summit online forum. Results: Eight external experts participated in a face-to-face meeting held at NASA-Johnson Space Center. Recommendations were made to augment the space station pharmacopoeia, as well as current wound care diagnostic, therapeutic, and deorbit criteria protocols. Additionally, suggestions were offered regarding IV access techniques and devices for use in the microgravity environment. Discussion: The results of the expert panel provide an evidence-based approach to the diagnosis and care of wounds in an injured astronaut on aboard the ISS. The results of the panel underscored the need for further research in wound therapy and IV access devices.

Scheuring, R.↗

The Making of a Self-Neglect Severity Scale

Research in elder self-neglect has lagged behind that of other forms of mistreatment, despite the fact that self-neglect is the most common allegation reported to Adult Protective Service agencies throughout the US. The lack of a gold-standard to measure self-neglect has hampered efforts to study this phenomenon. Researchers designed the Self-neglect Severity Scale (SSS) based on interviews with Adult Protective Service workers and a national expert panel. The SSS is based on observation and interview and is administered in the home to include an environmental assessment. It was piloted, extensively field tested and then revised. The CREST SSS was developed using survey data and consultation with experts in the field. This instrument utilizes observer ratings, interview responses, and assesses subjects physical and environmental domains. It also assesses functional status as it relates to health and safety issues. After field and pilot testing the SSS was finalized and is currently undergoing reliability and validity testing. The CREST SSS was developed as a state scale to provide a common language for describing cases of self-neglect. It is the first self-neglect severity scale available to researchers. If found to be both reliable and valid it can be used in future intervention studies.

Smith, Scott M.↗

Astronaut Medical Selection and Flight Medicine Care During the Shuttle ERA 1981 to 2011

The NASA Shuttle Program began with congressional budget approval in January 5, 1972 and the launch of STS-1 on April 12, 1981 and recently concluded with the landing of STS-135 on July 21, 2011. The evolution of the medical standards and care of the Shuttle Era Astronauts began in 1959 with the first Astronaut selection. The first set of NASA minimal medical standards were documented in 1977 and based on Air Force, Navy, Department of Defense, and the Federal Aviation Administration standards. Many milestones were achieved over the 30 years from 1977 to 2007 and the subsequent 13 Astronaut selections and 4 major expert panel reviews performed by the NASA Flight Medicine Clinic, Aerospace Medicine Board, and Medical Policy Board. These milestones of aerospace medicine standards, evaluations, and clinical care encompassed the disciplines of preventive, occupational, and primary care medicine and will be presented. The screening and retention standards, testing, and specialist evaluations evolved through periodic expert reviews, evidence based medicine, and Astronaut medical care experience. The last decade of the Shuttle Program saw the development of the International Space Station (ISS) with further Space medicine collaboration and knowledge gained from our International Partners (IP) from Russia, Canada, Japan, and the European Space Agencies. The Shuttle Program contribution to the development and implementation of NASA and IP standards and waiver guide documents, longitudinal data collection, and occupational surveillance models will be presented along with lessons learned and recommendations for future vehicles and missions.

Johnston, S.↗

Executive Summary of the American Radium Society Appropriate Use Criteria for Operable Esophageal and Gastroesophageal Junction Adenocarcinoma: Systematic Review and Guidelines

Limited guidance exists regarding the relative effectiveness of treatment options for nonmetastatic, operable patients with adenocarcinoma of the esophagus or gastroesophageal junction (GEJ). In this systematic review, the American Radium Society (ARS) gastrointestinal expert panel convened to develop Appropriate Use Criteria (AUC) evaluating how neoadjuvant and/or adjuvant treatment regimens compared with each other, surgery alone, or definitive chemoradiation in terms of response to therapy, quality of life, and oncologic outcomes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

An expert-driven literature review of “negative” chemicals for developmental neurotoxicity (DNT) in vitro assay evaluation

To date, approximately 200 chemicals have been tested in US Environmental Protection Agency (EPA) or Organization for Economic Co-operation and Development (OECD) developmental neurotoxicity (DNT) guideline studies, leaving thousands of chemicals without traditional animal information on DNT hazard potential. To address this data gap, a battery of in vitro DNT new approach methodologies (NAMs) has been proposed. Evaluation of the performance of this battery will increase the confidence in its use to determine DNT chemical hazards. One approach to evaluate DNT NAM performance is to use a set of chemicals to evaluate sensitivity and specificity. Since a list of chemicals with potential evidence of in vivo DNT has been established, this study aims to develop a curated list of “negative” chemicals for inclusion in a “DNT NAM evaluation set”. A workflow, including a literature search followed by an expert-driven literature review, was used to systematically screen 39 chemicals for lack of DNT effect. Expert panel members evaluated the scientific robustness of relevant studies to inform chemical categorizations. Following review, the panel discussed each chemical and made categorical determinations of “Favorable”, “Not Favorable”, or “Indeterminate” reflecting acceptance, lack of suitability, or uncertainty given specific limitations and considerations, respectively. Further, the panel determined that 10, 22, and 7 chemicals met the criteria for “Favorable”, “Not Favorable”, and “Indeterminate”, for use as negatives in a DNT NAM evaluation set. Ultimately, this approach not only supports DNT NAM performance evaluation but also highlights challenges in identifying large numbers of negative DNT chemicals.

59 BASIC BIOLOGICAL SCIENCES↗

Incorporating adaptation and resilience into an integrated watershed and coral reef management plan

Changing environmental conditions are forcing natural resource managers and communities to adapt their strategies to account for global shifts in precipitation, temperature, sea level and more, all of which are occurring in addition to local human impacts. Adapting to threats from climate change requires a fundamental shift in the practice of natural resource management through the development of forward-looking “climate-smart” goals and strategies. Here we present a proof-of-concept application of a decision-support tool to help design climate-smart management actions for the watershed and coral reef management plan for Guánica Bay watershed in southwest Puerto Rico. We also explore the connection between adaptation planning and coral reef resilience, using a recently developed Puerto Rico-wide reef resilience assessment. In the first phase of the study, we used the publicly available Adaptation Design Tool to draft initial climate-smart versions of twelve proposed management actions. In the second phase, two actions (dirt road management on steep slopes, and coral reef restoration) were further refined through consultations with local experts to make more detailed design adjustments; this included the option to use information from the coral reef resilience assessment to inform design improvements. The first phase resulted in moderately detailed assessments that broadly accounted for anticipated direct and indirect effects of climate change on the planned management actions. The second phase resulted in more site-specific technical assessments and additional important design details. The expert panel charged with discussing climate-smart reef restoration around Guánica used the reef resilience assessment to guide discussion of reef restoration, highlighting the importance of having such information available for adaptation planning. This study demonstrates how climate change impacts can be effectively incorporated into a management plan at the most granular level of planning and how a structured, formalized process can be as valuable as the resulting adaptation information.

Gibbs, David A. (ORCID:0000000173898569)↗

Evaluation of Technologies for Enhancing Grout for Immobilizing Hanford Supplemental Low-Activity Waste (SLAW)

An expert panel consisting of the document authors was assembled by Washington River Protection Solutions, LLC (WRPS) and tasked with (1) identifying technical and regulatory limitations to treating and disposing of grouted low-activity waste (LAW), and (2) with identifying and evaluating a wide range of technical solutions to these limitations. The analysis included technologies to allow inventory management and/or improve retention of iodine, technetium, and nitrate either in the waste packages, or within the Integrated Disposal Facility (IDF), and, technologies to ensure regulated organics are below Resource Conservation and Recovery Act of 1976 (RCRA) Land Disposal Restriction (LDR) levels.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Nuclear Data for Spallation Neutron Radioisotope Production (Final Technical Report)

Over 50 million nuclear medicine procedures are performed annually, leading to a multi-billion dollar market for radioisotope production. The demand for new medical and research isotopes is growing, and radioisotope supply is insufficient. Most radioisotope production today utilizes charged particle or low-energy neutron irradiation of a target. Isotope production with tens to hundred MeV incident energies is a relatively unexplored option. There is a tremendous opportunity associated with a growing number of suitable domestic and international facilities buttressed by hundred million dollar global investments (e.g., the Los Alamos and Brookhaven Isotope Production Facilities, the European Spallation Source in Lund, and the Korean Multi-purpose Accelerator Complex in Gyeongbuk). In part due to a lack of supporting nuclear data that would make modeling radioisotope yields and purities possible, these facilities do not utilize their high-energy neutron fluxes for isotope production. This project attempted to measure neutron reaction excitation functions relevant to the large-scale production of critical radioisotopes, enabling development of cost-efficient isotope production methods, contributing to the improvement of theoretical models, and enhancing the value of national isotope production facilities. Reactions which form 67 Cu, 32 Si, and alpha-emitting isotopes like 225 Ac were chosen for their consistent prioritization by expert panels, representation of diverse reaction mechanisms, and relative lack of supporting nuclear data. Accurate measurement of these data is presently made only using quasi-monoenergetic neutron beams, which are produced by bombarding thin lithium targets with protons at only a few laboratories in the world. Ultimately, the projects efforts were incompletely accomplished due to a combination of multi-year technical issues at the only laboratory in the world which can make the proposed measurements, iThemba Labs in South Africa, and the onset of a global pandemic, which precluded the significant effort and time required to develop an independent measurement capability in the United States.

38 RADIATION CHEMISTRY, RADIOCHEMISTRY, AND NUCLEA↗

Offshore Wind Energy and Communities: Perspectives on Local Impacts [Slides]

In this webinar hosted by the U.S. Department of Energy's WINDExchange initiative, an expert panel discusses the myriad ways that offshore wind may impact communities. Impacted communities can take a variety of forms, from coastal communities hosting ports and cable landings to ocean users such as commercial fishermen, and can experience a range of environmental, economic, cultural, and other impacts related to offshore wind energy. This webinar explores these topics from diverse perspectives and provides an introduction to the local footprints of this emerging industry.

17 WIND ENERGY↗