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NASA NTRS1979

Analysis of population mortality kinetics with application to the longevity followup of the Navy's '1,000 aviators'

A simple physiological model of mortality kinetics is used to assess the intuitive concept that the aging rates of populations are proportional to their mortality rates. It is assumed that the vitality of an individual can be expressed as a simple summation of the weighted functional capacities of its organs and homeostatic systems that are indispensable for survival. It is shown that the mortality kinetics of a population can be derived by a linear transformation of the frequency distribution of vitality, assuming a uniform constant rate of decline of the physiological functions. A simple comparison of two populations is not possible when they have different vitality frequency distributions. Analysis of the data using the model suggests that the differences in decline of survivorship with age between the military pilot population, a medically insured population, and the control population can be accounted for by the effect of physical selection on the vitality frequency distribution of the screened populations.

Economos, A. C.↗

NASA NTRS2006

Construction of a Resting High Fidelity ECG "SuperScore" for Management and Screening of Heart Disease

Resting conventional ECG is notoriously insensitive for detecting coronary artery disease (CAD) and only nominally useful in screening for cardiomyopathy (CM). Similarly, conventional exercise stress test ECG is both time- and labor-consuming and its accuracy in identifying CAD is suboptimal for use in population screening. We retrospectively investigated the accuracy of several advanced resting electrocardiographic (ECG) parameters, both alone and in combination, for detecting CAD and cardiomyopathy (CM).

Schlegel, Todd T.↗

NASA NTRS2024

Herpesviruses in Saliva and Their Clinical Significance

Saliva has been used as a source of biological markers for a wide spectrum of normal and disease states for a long time. It is a non-invasive, easily accessible, and self-collected body fluid that contains a variety of measurable biological substances. While mostly water, saliva also contains ions, carbohydrates, proteins and peptides, exfoliated cells, nucleic acids, and microorganisms. Saliva can reflect tissue levels of some natural substances and a large variety of molecules introduced for therapeutic use, emotional status; hormonal status, immunological status, neurological effects, and nutritional and metabolic status. It can also be used to monitor a variety of drugs including marijuana, cocaine, and alcohol. It is the most cost-effective approach for screening large population in community mass screening programs and for longitudinal sampling of hospitalized individuals aimed at monitoring viral load dynamics and treatment response. During the COVID-19 pandemic, scientific evidence emerged indicating that molecular tests performed on saliva have diagnostic sensitivity and specificity comparable to those observed with nasopharyngeal swabs for SARS-CoV-2 RNA detection. The presence of IgA and IgG antibodies at the mucosal level has been demonstrated to influence the progression of viral infection and the severity of clinical manifestation. As saliva contains both respiratory secretions and immunological components, it has wide applications, ranging from clinical diagnostics to post-vaccine disease burden and immunity surveillance.

Douglass Diak↗

NASA NTRS1975

Automated mass spectrometer/analysis system: A concept

System performs rapid multiple analyses of entire compound classes or individual compounds on small amounts of sample and reagent. Method will allow screening of large populations for metabolic disorders and establishment of effective-but-safe levels of therapeutic drugs in body fluids and tissues.

Boettger, H. G.↗

NASA NTRS1988

Screening For Alcohol-Producing Microbes

Dye reaction rapidly identifies alcohol-producing microbial colonies. Method visually detects alcohol-producing micro-organisms, and distinguishes them from other microbial colonies that do not produce alcohol. Method useful for screening mixed microbial populations in environmental samples.

Schubert, Wayne W.↗

NASA NTRS1998

Prognostic significance of electrical alternans versus signal averaged electrocardiography in predicting the outcome of electrophysiological testing and arrhythmia-free survival

OBJECTIVE: To investigate the accuracy of signal averaged electrocardiography (SAECG) and measurement of microvolt level T wave alternans as predictors of susceptibility to ventricular arrhythmias. DESIGN: Analysis of new data from a previously published prospective investigation. SETTING: Electrophysiology laboratory of a major referral hospital. PATIENTS AND INTERVENTIONS: 43 patients, not on class I or class III antiarrhythmic drug treatment, undergoing invasive electrophysiological testing had SAECG and T wave alternans measurements. The SAECG was considered positive in the presence of one (SAECG-I) or two (SAECG-II) of three standard criteria. T wave alternans was considered positive if the alternans ratio exceeded 3.0. MAIN OUTCOME MEASURES: Inducibility of sustained ventricular tachycardia or fibrillation during electrophysiological testing, and 20 month arrhythmia-free survival. RESULTS: The accuracy of T wave alternans in predicting the outcome of electrophysiological testing was 84% (p < 0.0001). Neither SAECG-I (accuracy 60%; p < 0.29) nor SAECG-II (accuracy 71%; p < 0.10) was a statistically significant predictor of electrophysiological testing. SAECG, T wave alternans, electrophysiological testing, and follow up data were available in 36 patients while not on class I or III antiarrhythmic agents. The accuracy of T wave alternans in predicting the outcome of arrhythmia-free survival was 86% (p < 0.030). Neither SAECG-I (accuracy 65%; p < 0.21) nor SAECG-II (accuracy 71%; p < 0.48) was a statistically significant predictor of arrhythmia-free survival. CONCLUSIONS: T wave alternans was a highly significant predictor of the outcome of electrophysiological testing and arrhythmia-free survival, while SAECG was not a statistically significant predictor. Although these results need to be confirmed in prospective clinical studies, they suggest that T wave alternans may serve as a non-invasive probe for screening high risk populations for malignant ventricular arrhythmias.

Non-NASA Center↗

NASA NTRS2008

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.↗

NASA NTRS2016

Colonoscopy Screening in the US Astronaut Corps

Historically, colonoscopy screenings for astronauts have been conducted to ensure that astronauts are in good health for space missions. This data has been identified as being useful for determining appropriate occupational surveillance targets and requirements. Colonoscopies in the astronaut corps can be used for: (a) Assessing overall colon health, (b) A point of reference for future tests in current and former astronauts, (c) Following-up and tracking rates of colorectal cancer and polyps; and (d) Comparison to military and other terrestrial populations. In 2003, medical screening requirements for the active astronaut corps changed to require less frequent colonoscopies. Polyp removal during a colonoscopy is an intervention that prevents the polyp from potentially developing into cancer and decreases the individual's risk for colon cancer.

Masterova, K.↗

NASA NTRS1993

Results of the second Round Robin on opening-load measurement conducted by ASTM Task Group E24.04.04 on crack closure measurement and analysis

A second experimental Round Robin on the measurement of the crack opening load in fatigue crack growth tests has been completed by the ASTM Task Group E24.04.04 on Crack Closure Measurement and Analysis. Fourteen laboratories participated in the testing of aluminum alloy compact tension specimens. Opening-load measurements were made at three crack lengths during constant Delta K, constant stress ratio tests by most of the participants. Four participants made opening-load measurements during threshold tests. All opening-load measurements were based on the analysis of specimens compliance behavior, where the displacement/strain was measured either at the crack mouth or the mid-height back face location. The Round Robin data were analyzed for opening load using two non-subjective analysis methods: the compliance offset and the correlation coefficient methods. The scatter in the opening load results was significantly reduced when some of the results were excluded from the analysis population based on an accept/reject criterion for raw data quality. The compliance offset and correlation coefficient opening load analysis methods produced similar results for data populations that had been screened to eliminate poor quality data.

Phillips, E. P.↗

NASA NTRS1999

Kennedy Space Center Coronary Heart Disease Risk Screening Program

The number one cause of death in the U.S. is coronary heart disease (CHD). It is probably a major cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial mathematical formula from the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population that required medical evaluation for job certification. Those assessed to be high-risk probabilities will be targeted for intervention. Every year, several thousand KSC employees require medical evaluations for job related certifications. Most medical information for these evaluations is gathered on-site at one of the KSC or Cape Canaveral Air Station (CCAS) medical clinics. The formula used in the Framingham Heart Study allows calculation of a person's probability of acquiring CHD within 10 years. The formula contains the following variables: Age, Diabetes, Smoking, Left Ventricular Hypertrophy, Blood Pressure (Systolic or Diastolic), Cholesterol, and HDL cholesterol. The formula is also gender specific. It was used to calculate the 10-year probabilities of CHD in KSC employees who required medical evaluations for job certifications during a one-year time frame. This KSC population was profiled and CHD risk reduction interventions could be targeted to those at high risk. Population risk could also be periodically reevaluated to determine the effectiveness of intervention. A 10-year CHD risk probability can be calculated for an individual quite easily while gathering routine medical information. An employee population's CHD risk probability can be profiled graphically revealing high risk segments of the population which can be targeted for risk reduction intervention. The small audience of NASA/contractor physicians, nurses and exercise/fitness professionals at the breakout session received the lecture very well. Approximately one third indicated by a show of hands that they would be interested in implementing a similar program at their NASA Center. Questions were asked pertaining to standardization for age, the validity of using the idealized male values also for the female population, and indications of the screening test's sensitivity and specificity.

Tipton, David A.↗

NASA NTRS2001

Screening EEG in Aircrew Selection: Clinical Aerospace Neurology Perspective

As clinical aerospace neurologists we do not favor using screening EEG in pilot selection on unselected and otherwise asymptomatic individuals. The role of EEG in aviation screening should be as an adjunct to diagnosis, and the decision to disqualify a pilot should never be based solely on the EEG. Although a policy of using a screening EEG in an unselected population might detect an individual with a potentially increased relative risk, it would needlessly exclude many applicants who would probably never have a seizure. A diagnostic test performed on an asymptomatic individual without clinical indications, in a population with a low prevalence of disease (seizure) may be of limited or possibly detrimental value. We feel that rather than do EEGs on all candidates, a better approach would be to perform an EEG for a specific indication, such as family history of seizure, single convulsion (seizure) , history of unexplained loss of consciousness or head injury. Routine screening EEGs in unselected aviation applications are not done without clinical indication in the U.S. Air Force, Navy, or NASA. The USAF discontinued routine screening EEGs for selection in 1978, the U.S. Navy discontinued it in 1981 , and NASA discontinued it in 1995. EEG as an aeromedical screening tool in the US Navy dates back to 1939. The US Navy routinely used EEGs to screen all aeromedical personnel from 1961 to 1981. The incidence of epileptiform activity on EEG in asymptomatic flight candidates ranges from 0.11 to 2.5%. In 3 studies of asymptomatic flight candidates with epileptiform activity on EEG followed for 2 to 15 years, 1 of 31 (3.2%), 1 of 30 (3.3%), and 0 of 14 (0%) developed a seizure, for a cumulative risk of an individual with an epileptiform EEG developing a seizure of 2.67% (2 in 75). Of 28,658 student naval aviation personnel screened 31 had spikes and/or slow waves on EEG, and only 1 later developed a seizure. Of the 28,627 who had a normal EEG, 4 later developed seizures, or .0139% (4/28627). After review of the value of the EEG as a screening tool, the US Navy now uses EEG only for certain clinical indications (head injury, unexplained loss of consciousness, family history of epilepsy, and abnormal neurological exam). Currently the US Navy does not use EEG for screening for any flight applicant without a neurologic indication. In the US Navy, an electroencephalographic pattern is determined to be epileptiform by a neurologist.

Clark, Jonathan B.↗

NASA NTRS2007

Measuring Image Navigation and Registration Performance at the 3-Sigma Level Using Platinum Quality Landmarks

Geostationary Operational Environmental Satellite (GOES) Image Navigation and Registration (INR) performance is specified at the 3- level, meaning that 99.7% of a collection of individual measurements must comply with specification thresholds. Landmarks are measured by the Replacement Product Monitor (RPM), part of the operational GOES ground system, to assess INR performance and to close the INR loop. The RPM automatically discriminates between valid and invalid measurements enabling it to run without human supervision. In general, this screening is reliable, but a small population of invalid measurements will be falsely identified as valid. Even a small population of invalid measurements can create problems when assessing performance at the 3-sigma level. This paper describes an additional layer of quality control whereby landmarks of the highest quality ("platinum") are identified by their self-consistency. The platinum screening criteria are not simple statistical outlier tests against sigma values in populations of INR errors. In-orbit INR performance metrics for GOES-12 and GOES-13 are presented using the platinum landmark methodology.

Carr, James L.↗

NASA NTRS2024

A Specialized Ultrasound Protocol for NASA's Renal Stone Surveillance and Clinical Practice

INTRODUCTION Ample evidence exists on the effectiveness of ultrasound in the diagnosis of kidney stones. However, terrestrial practice is mostly concerned with diagnosis of clinically significant urolithiasis. Adapting this non-irradiating, low-cost imaging modality for the asymptomatic astronaut population offers high-sensitivity screening and limits their career radiation dose. METHODS NASA developed a novel ultrasound-based detection and surveillance protocol to identify, categorize, and monitor mineralized renal material (MRM) in astronauts. The term MRM was developed to denote abnormal, presumably calcified, focal material of unknown clinical significance in the kidneys. Sonographic criteria for MRMs include measurable echogenic foci, their detectability in multiple, designated imaging plains, posterior shadowing, and “twinkle” pattern visualized in Color Doppler and/or demonstrated in Spectral Doppler modes. The mere discovery of an MRM does not trigger further imaging or intervention, unless the affected crewmember is mission-assigned, or the MRM meets actionable criteria based on size, location, and sonographic characteristics. If the threshold is met, the crew surgeon is notified, and additional diagnostic imaging and urology consultation are considered. RESULTS In total, 73 individuals have been scanned using our specialized methods, 60 have had more than one study done. As of April 2023, 282 total studies have been performed. So far, over 30 pairs of pre-and postflight studies have been obtained, and the findings are presented elsewhere in this panel. DISCUSSION A surveillance program was initiated nine years ago to screen asymptomatic members of the astronaut corps for renal calcifications, from their initial hiring, through their mission timeframes, and throughout their career. The goal is to reduce the probability that an astronaut will fly with a renal stone that may become symptomatic. This also gives NASA the information it needs to improve screening criteria for future long-duration crewed missions.

H Lyons↗

NASA NTRS2017

Conjunction Assessment Screening Volume Sizing and Event Filtering in Light of Natural Conjunction Event Development Behaviors

Conjunction Assessment screening volumes used in the protection of NASA satellites are constructed as geometric volumes about these satellites, of a size expected to capture a certain percentage of the serious conjunction events by a certain time before closest approach. However, the analyses that established these sizes were grounded on covariance-based projections rather than empirical screening results, did not tailor the volume sizes to ensure operational actionability of those results, and did not consider the adjunct ability to produce data that could provide prevenient assistance for maneuver planning. The present study effort seeks to reconsider these questions based on a six-month dataset of empirical screening results using an extremely large screening volume. The results, pursued here for a highly-populated orbit regime near 700 km altitude, identify theoretical limits of screening volume performance, explore volume configuration to facilitate both maneuver remediation planning as well as basic asset protection, and recommend sizing principles that maximize volume performance while minimizing the capture of "chaff" conjunctions that are unlikely ever to become serious events.

screening volume↗

NASA NTRS1976

Accelerated test techniques for micro-circuits: Evaluation of high temperature (473 k - 573 K) accelerated life test techniques as effective microcircuit screening methods

The application of high temperature accelerated test techniques was shown to be an effective method of microcircuit defect screening. Comprehensive microcircuit evaluations and a series of high temperature (473 K to 573 K) life tests demonstrated that a freak or early failure population of surface contaminated devices could be completely screened in thirty two hours of test at an ambient temperature of 523 K. Equivalent screening at 398 K, as prescribed by current Military and NASA specifications, would have required in excess of 1,500 hours of test. All testing was accomplished with a Texas Instruments' 54L10, low power triple-3 input NAND gate manufactured with a titanium- tungsten (Ti-W), Gold (Au) metallization system. A number of design and/or manufacturing anomalies were also noted with the Ti-W, Au metallization system. Further study of the exact nature and cause(s) of these anomalies is recommended prior to the use of microcircuits with Ti-W, Au metallization in long life/high reliability applications. Photomicrographs of tested circuits are included.

Johnson, G. M.↗

NASA NTRS2017

Protecting the Health of Astronauts: Enhancing Occupational Health Monitoring and Surveillance for Former NASA Astronauts to Understand Long-Term Outcomes of Spaceflight-Related Exposures

The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA's ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of e an Astronaut Occupational Health program to include expanded medical monitoring of former NASA astronauts. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

Rossi, Meredith↗

NASA NTRS1974

Early detection of disease program: Evaluation of the cellular immune response

The early cellular responses of specific components of the leukocyte and epithelial cell populations to foreign challenges of both an infectious and noninfectious character were evaluated. Procedures for screening potential flight crews were developed, documented, and tested on a control population. Methods for preparing suitable populations of lymphocytes, polymorphonuclear leukocytes, macrophages, and epithelial cells were first established and evaluated. Epithelial cells from viral infected individuals were screened with a number of anti-viral antisera. This procedure showed the earliest indication of disease as well as providing a specific diagnosis to the physicians. Both macrophages and polymorphonuclear leukocytes were studied from normal individuals, smokers, and patients with viral infections. Newer techniques enabling better definition of lymphocyte subpopulations were then developed, namely the E and EAC rosette procedures for recognition of T (thymus-derived) and B (bone-marrow-derived) lymphocyte subpopulations. Lymphocyte and lymphocyte subpopulation response to multiple mitogens have been evaluated.

Criswell, B. S.↗

NASA NTRS1993

Opinion polls and the U.S. civil space program

The conclusions that can be drawn from public opinion polls depend a great deal on what usually does not appear on the newspaper page or television screen. Subtle biases can result from the population interviewed, the time of day individuals were called, how a particular question was asked, or how the answer was interpreted. Examples are the 1961 Gallop Poll, the survey done for Rockwell International by the firm of Yankelovich, Skelly and White/Clancy Shulman, and the one done by Jon D. Miller of the International Center for the Advancement of Scientific Literacy. There is more to learn from opinion polls than that a good proportion of adult Americans support the space program. We can learn that social and economic security are not competing goals with space, but interdependent goals. If we want to increase public support for space, we must increase the number of Americans who have the economic freedom to take an interest in something besides getting by, day after day. We can also learn that the majority of those who support the space program can distinguish between the bread and circuses of space travel. They are content to experience extraordinary adventures in the movie theaters; for their tax dollars they want real return in expended scientific knowledge and understanding. Finally, we can learn that we need to increase that return, not just for scientific careers, but for the ordinary people who pay our bills and for their children, our children. Ultimately, the space program is for them, as all investments in the future must be.

Kraemer, Sylvia K.↗